Journal articles on the topic 'Water-borne diseases. eng'

Abstract Unlike urban and semi-urban settlements where the potable water is supplied through a water treatment plant and a distribution network, in rural low-income settings, the provision of the water treatment plant for all villages is not feasible for a developing country like India. The most affordable and reliable way to provide clean drinking water is treatment at the consumer end. This research is aimed to assess occurrence of water-borne diseases based on personal hygiene and quality of drinking water source. Of the households, 4,237 in 15 selected villages were surveyed for personal hygiene using a questionnaire. Water samples were collected from all major water sources in the villages and analyzed for chemical and bacteriological properties. For water and personal hygiene, quality indices were calculated, and a mathematical model was developed using multiple linear regression analysis. The regression concluded that personal hygiene has a more significant effect on the occurrence of water-borne diseases than the quality of water source in the study area. Personal hygiene is one of the health factors neglected by the people specifically in rural India. Therefore, India needs to run campaigns like Swachh Bharat Abhiyaan (Clean India Mission), which mainly aimed to reduce open defecation, to promote personal hygiene and to reduce the prevalence of water-borne diseases.

Many factors influence the world’s atmosphere and climate. Due to human activity, the concentration of "green house" gases is increasing resulting in rise of earth’s surface temperature. As a result of global warming, the eco system is changing, having adverse impact on our lives. Some increased health risk will be due to extreme weather events, while other problems will involve continual climate modification as consequences from ecological disruption or resulting from climate-induced economic disruption, e.g. traumatic, infectious, nutritional, psychological and other health consequences. Population, certain age groups such as elderly, women, children and vulnerable group, is at risk. For instance, there are risks of extreme temperatures and heat-wave, increased allergic disorders, hay fever, asthma due to air pollution, particulate matters and smog. In addition, due to flooding food-borne illnesses, water-borne illnesses, diarrheal diseases, increase in vector-borne diseases transmitted by Mosquitoes and mice e.g. Malaria, Filaria, Dengue fever, etc. There is compromise in food safety due to contaminated food with pesticide and bacteria resulting in food poisoning. Lifestyle and behavior are likely to be affected due to loss of social cohesion, increase in crime, accidents, anxiety, depression, stress, self harm and possible suicide, drug and alcohol misuse. Preventive measures will include assessment of the vulnerability of human health and mitigation measures. The health sector needs to play a key role in disease prevention, health education, disaster preparedness and effective measures to treat early evidence of impact affecting health. DOI: http://dx.doi.org/10.3126/ctbijis.v2i1.10818 Crossing the Border: International Journal of Interdisciplinary Studies Vol.2(1) 2014: 127-134

Anopheles coluzzii is an important vector of malaria in sub-Saharan Africa particularly of the most dangerous malaria parasite. It completes its life cycle in water and a change in physicochemical properties particularly that of salinity of water may affect egg laying and perhaps the development of eggs to maturity. Studies have shown that climate change may alter the transmission of many vector-borne diseases in different parts of the world and global warming will also raise sea levels which will lead to an increase in saline and brackish water body in coastal areas. This study investigated the salinity tolerance level of An. coluzzii. It involved creation of artificial environments of different salinity gradients using rainwater and sea water and the subsequent exposure of the media to An. coluzzii for laying of eggs and development of larvae to adult. Anopheles coluzzii showed ovipositional preference for less saline media as there was significant negative correlation between number of eggs laid and salinity of oviposition media. Effect of salinity was evident in egg development and larval survival, as no egg hatched in >30% sea water, all L3 larvae died in >40% seawater, and the maximum seawater concentration for L4 survival was 30%. An LC50 of 17.51% (95% CI: 9.31–24.56)% and 23.4% (95% CI: 16.76–22.30)% were calculated for L3 and L4 larvae respectively. Adults emerging from fresh and low saline water of 10% seawater had greater energy reserve than those emerging from 20% and 30% seawater. Increasing salinity did not affect wing length of the emerging adult. Despite the increased stress on larval development, some individuals survived and went on to emerge as adults in conditions that seem to be representative of brackish water. This may imply that an increase in brackish water sites caused by rising sea levels might create more suitable breeding sites for this species.

Various pollutants of different sizes are directly (e.g., water-borne diseases) and indirectly (e.g., accumulation via trophic transfer) threatening our water health and safety. To cope with this matter, multifaceted approaches are required for advanced wastewater treatment more efficiently. Wastewater treatment using mixed matrix membranes (MMMs) could provide an excellent alternative since it could play two roles in pollutant removal by covering adsorption and size exclusion of water contaminants simultaneously. This paper provides an overview of the research progresses and trends on the emerging materials used to prepare MMMs for pollutant removal from water in the recent five years. The transition of the research trend was investigated, and the most preferred materials to prepare MMMs were weighed up based on the research trend. Various application examples where each emerging material was used have been introduced along with specific mechanisms underlying how the better performance was realized. Lastly, the perspective section addresses how to further improve the removal efficiency of pollutants in an aqueous phase, where we could find a niche to spot new materials to develop environmentally friendly MMMs, and where we could further apply MMMs.

The ill-provision of water and sanitation services poses the greatest risk to people living with HIV and AIDS in South Africa – a majority of whom reside in slum settlements. People living with HIV and AIDS (PLWHA) die after succumbing to opportunistic infections, especially water-borne diseases (e.g., diarrhoea, cholera). This study was based on 485 individuals with HIV and AIDs drawn from three types of settlements (rural, peri-urban and urban slums) and sampled from three selected provincial districts of Khayelitsha (Western Cape), Ukhahlamba (Eastern Cape) and Groblersdal (Limpopo). The results show PLWHA having higher willingness-to-pay (WTP) for sanitation at ZAR448.40/month compared to water (ZAR428.60). Those living in urban slum settlements show the highest WTP for sanitation (ZAR552.70), followed by the ones in rural areas (ZAR500.24). The results underscore important implications: PLWHA face greater sanitation challenges relative to water; those in slum settlements endure the worst sanitation insecurity compared to counterparts living in other settlement types; higher WTP for sanitation implies that PLWHA will derive greater benefits from improvements in sanitation services relative to water. To conclude, it is imperative for municipal authorities to prioritize the provision of sanitation facilities to PLWHA especially in urban slums as part of the ‘pro-poor service delivery’ campaigns.

The threat of TB continues to occur in the world. In 2018, 10 million people suffered from TB, and 1.5 million people die from this infectious disease. Referring to target 3 of Sustainable Development Goals (SDGs) goals 03 regarding good health and well-being, by 2030, end the epidemic of AIDS, TB, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases. Based on data from the WHO, Indonesia ranks 3rd for TB cases globally. The estimated population suffering from TB is 845,000 cases; only 68 percent of cases were found and treated in 2018. The high number of TB cases in Indonesia could threaten the golden generation's opportunity in the next 2025 demographic bonus, where the number of productive age population is higher than the population non-productive age. This study found that population factors such as population, population density, and the number of poor people had a positive and significant effect on TB cases. In contrast, the GRDP per capita, the number of health workers, and literacy rates negatively affected the TB cases.Furthermore,environmental factors from the availability of proper sanitation and toilet facilities show a negative but insignificant effect on TB cases.

The association that many crops can establish with the arbuscular mycorrhizal fungi (AMF) present in soils can enhance the resistance of the host plants against several pathogens, including Verticillium spp. The increased resistance of mycorrhizal plants is mainly due to the improved nutritional and water status of crops and to enhanced antioxidant metabolism and/or increased production of secondary metabolites in the plant tissues. However, the effectiveness of AMF in protecting their host plants against Verticillium spp. may vary depending on the environmental factors. Some environmental factors, such as the concentration of carbon dioxide in the atmosphere, the availability of soil water and the air and soil temperatures, are predicted to change drastically by the end of the century. The present paper discusses to what extent the climate change may influence the role of AMF in protecting crops against Verticillium-induced wilt, taking into account the current knowledge about the direct and indirect effects that the changing environment can exert on AMF communities in soils and on the symbiosis between crops and AMF, as well as on the development, incidence and impact of diseases caused by soil-borne pathogens.

Increasing antibiotic resistance in bacteria that cause zoonotic infections is a major problem for farmers rearing animals for food as well as for consumers who eat the contaminated meat resulting in food-borne infections. Bacteriophages incorporated in animal feed may help reduce carriage and infections in animals including chickens and pigs. There are, however, unmet challenges in protecting phages from processing stresses e.g., during animal feed pelleting operations and during transit of phages through the acidic gastric environment. Core-shell capsules were produced using a concentric nozzle and commercially available encapsulation equipment to fabricate capsules with phages formulated in an oil-in-water microemulsion in the core. pH-responsive capsules released the encapsulated phage cargo within 10–30 min triggered by changes in local environmental pH typically found in the lower gastrointestinal (GI) tract of animals. Acid stability of phages exposed to pH values as low as pH 1 was demonstrated. Encapsulated phages were able to withstand exposure to 95 °C wet heat thermal stress for up to 120 s, conditions typically encountered during feed pellet extrusion processing. Free phages were inactivated within 15 s under these conditions. The present study demonstrates that encapsulation of bacteriophages in core-shell pH-responsive capsules with water-in-oil emulsified phages in the core significantly improves phage viability upon exposure to processing and environmental stresses that require consideration during production of animal feed and application in animals for biocontrol. The results from this study should help guide future development of phage formulations suitable for use in animal feed for animal biocontrol applications.

The most underdiagnosed water-borne bacterial zoonosis in the world is Leptospirosis which especially impacts tropical and humid regions. According to World Health Organization (WHO), the number of human cases is not known precisely. Available reports showed that worldwide incidences vary from 0.1-1 per 100 000 per year in temperate climates to 10-100 per 100 000 in the humid tropics. Pathogenic bacteria that is spread by the urines of rats is the main reason of water and soil infections. Rice field farmers who are in contact with infected water or soil, contain the most burden of leptospirosis prevalence. In recent years, this zoonotic disease have been occurred in north of Iran endemically. Guilan as the second rice production province (average=750 000 000 Kg, 40% of country production) after Mazandaran, has one of the most rural population (Male=487 679, Female=496 022) and rice workers (47 621 insured workers) among Iran provinces. The main objectives of this study were to analyse yearly spatial distribution and the possible spatial clusters of leptospirosis to better understand epidemiological aspects of them in the province. Survey was performed during the period of 2009–2013 at rural district level throughout the study area. Global clustering methods including the average nearest neighbour distance, Moran’s I and General G indices were utilized to investigate the annual spatial distribution of diseases. At the end, significant spatial clusters have been detected with the objective of informing priority areas for public health planning and resource allocation.

In developing areas around the globe it is extremely hard for health related institutions and governments to implement prevention and treatment policies, to improve public health, due to poor economical resources and infrastructures; low awareness; inadequate personnel; high prevalence of parasites and pathogens with extreme infection burdens, as well as sociopolitical factors. Central government programs essential for the improvement of the general public health are limited in developing countries. These include mass vaccination programs, which are cornerstones of primary health-care [1]; programs to reduce waterborne and water-associated vector-borne diseases [2]; routine surveillance activities [3,4]; regulation of pesticide usage (e.g. developing countries use only 20% of the world's agrochemicals, yet they suffer 99% of deaths from pesticide poisoning [5]); programs to reduce malnutrition [6]; programs to educate the public (e.g. use of condoms to reduce sexually transmitted diseases); and funding of medical care. However, the high disease rate itself possesses a very significant economic burden on developing countries. This burden exacerbates the incapacity of the governments to address the critical need for better health care. For example, malaria alone costs sub-Saharan Africa US$100 billion in lost annual gross domestic product (GDP) [1]. The combination of high infection rates together with poor public health care has become a vicious cycle that needs to broken. While in developed countries prevention and treatment modalities have significantly improved public health, the standard of living and life expectancy [1,7-9], this is not the case in developing countries, where the improvement of health care is multifaceted and extremely complicated. Assistance from world organizations together with the developed and affluent countries is essential. However, it has to be taken into consideration that solutions that have been successful in developed countries may not be appropriate for those that are developing. For example, vaccines that may confer protection against HIV-1 in Europe and USA, may fail to do so in Africa and other developing countries due to the significantly different pre-existing immune background of the population [10-12]. Another problem is the extremely high illiteracy and poverty rate that prevails in many rural areas in these countries. Thus, simple, cost affordable, wide spectrum, immediate and applicable means, which accommodate the particular constraints of developing countries, must be developed and applied in order to specifically and rapidly address key issues of public health in these volatile regions. The current Hot Topic issue presents several cost-affordable and sustainable means that may help fight the high infections rates in developing countries. Doucoure and Farcy propose novel membrane systems that can be applied in small rural communities and remote areas in developing countries aimed at reducing water-borne diseases and pollutants. Borkow and Gabbay suggest the use of biocidal textiles in hospitals in order to reduce the high rates of nosocomial infections. Togo and his colleagues from a hospital in Bamako - Mali make a robust attempt to identify the causes of nosocomial infections in a developing country and recommend measures aimed at reducing these infections in hospital settings. Ole Skovmand discusses the use of insecticidal bednets for the fight against malaria in developing countries. Finally, Bentwich and colleagues present the hypothesis that the relatively straightforward treatment of helminthic parasites may have very wide ramifications in improving the treatment and prognosis of other diseases, and in enhancing the capacity to achieve effective immunization.

SUMMARYMembers of the genusCryptosporidium, which cause the gastrointestinal disease cryptosporidiosis, still represent a significant cause of water-borne disease worldwide. While intensive efforts have been invested in the development of techniques for parasite culture,in vitrogrowth has been hampered by a number of factors including low levels of infectivity as well as delayed life-cycle development and poor synchronicity. In this study we examined factors affecting the timing of contact between excysted sporozoites and target host cells and the subsequent impact of this upon the establishment of infection. We demonstrate that excystation rate impacts upon establishment of infection and that in our standard assay format the majority of sporozoites are not close enough to the cell monolayer when they are released from the oocyst to successfully establish infection. However, this can be easily overcome by centrifugation of oocysts onto the cell monolayer, resulting in approximately 4-fold increases in sporozoite attachment and subsequent infection. We further demonstrate that excystation procedures can be tailored to control excystation rate to match the assay end purpose and that excystation rate can influence data interpretation. Finally, the addition of both a centrifugation and washing step post-sporozoite attachment may be appropriate when considering the design ofin vitroculture experiments for developmental analysis and stage-specific gene expression as this appears to increase the synchronicity of early developmental stages.

ABSTRACTViruses excreted by humans affect the commercial and recreational use of coastal water. Shellfish produced in contaminated waters have been linked to many episodes and outbreaks of viral gastroenteritis, as well as other food-borne diseases worldwide. The risk can be reduced by appropriate treatment following harvesting and by depuration. The kinetics of inactivation of murine norovirus 1 and human adenovirus 2 in natural and artificial seawater by free available chlorine was studied by quantifying genomic copies (GC) using quantitative PCR and infectious viral particles (PFU). Human JC polyomavirus Mad4 kinetics were evaluated by quantitative PCR. DNase or RNase were used to eliminate free genomes and assess potential viral infectivity when molecular detection was performed. At 30 min of assay, human adenovirus 2 showed 2.6- and 2.7-log10GC reductions and a 2.3- and 2.4-log10PFU reductions in natural and artificial seawater, respectively, and infectious viral particles were still observed at the end of the assay. When DNase was used prior to the nucleic acid extraction the kinetic of inactivation obtained by quantitative PCR was statistically equivalent to the one observed by infectivity assays. For murine norovirus 1, 2.5, and 3.5-log10GC reductions were observed in natural and artificial seawater, respectively, while no viruses remained infectious after 30 min of contact with chlorine. Regarding JC polyomavirus Mad4, 1.5- and 1.1-log10GC reductions were observed after 30 min of contact time. No infectivity assays were conducted for this virus. The results obtained provide data that might be applicable to seawater used in shellfish depuration.

Malaria is one of the most cited vector-borne infectious diseases by climate change expert panels. Malaria vectors often need water sheets or wetlands to complete the disease life cycle. The current context of population mobility and global change requires detailed monitoring and surveillance of malaria in all countries. This study analysed the spatiotemporal distribution of death and illness cases caused by autochthonous and imported malaria in Spain during the 20th and 21st centuries using multidisciplinary sources, Geographic Information System (GIS) and geovisualisation. The results obtained reveal that, in the 20th and 21st centuries, malaria has not had a homogeneous spatial distribution. Between 1916 and 1930, 77% of deaths from autochthonous malaria were concentrated in only 20% of Spanish provinces; in 1932, 88% of patients treated in anti-malarial dispensaries were concentrated in these same provinces. These last data reveal the huge potential that anti-malarial dispensaries could have as a tool to reconstruct historical epidemiology. Spanish autochthonous malaria has presented epidemic upsurge episodes, especially those of 1917–1922 and 1939–1944, influenced by armed conflict, population movement and damaged health and hygiene conditions. Although meteorological variables have not played a key role in these epidemic episodes, they contributed by providing suitable conditions for their intensification. After the eradication of autochthonous malaria in 1961, imported malaria cases began to be detected in 1973, reaching more than 700 cases per year at the end of the second decade of the 21st century. Therefore, consistent and detailed historical studies are necessary to better understand the drivers that have led to the decline and elimination of malaria in Europe and other temperate countries.

The Community-Based Drinking Water Provision Program (Pamsimas) is a government program that collaborates with regions and is supported by the World Bank in terms of increasing access to drinking water, sanitation, and improving health, especially in solving diarrhea and water-borne and environmental diseases. This program requires a large budget so it is a shame if it does not have a positive impact on society. So it isnecessary to study the impact of different programs for the community and information on the effectiveness of the program so that apart from being useful, the community can jointly contribute to the sustainability of the program. The method used is the binomial test related to differences in the level of clean water availability before and after the Pamsimas program. The ratio of effectiveness to see the relationship between output and the expected end result. The greater the output contribution to the achievement of the final result, it can be said that the organization, program or activity is effective. The results showed that there were differences in the availability of clean water facilities in Sudimara Village, Cilongok District, Banyumas Regency, Central Java before and after the Pamsimas program. Meanwhile, based on 6 indicators of success, it shows the level of effectiveness, only the fifth criterion is in the effective criteria and the other 5 indicators are in the very effective criteria. The conclusion of the Pamsimas program has been optimal and successful in providing clean water and this program is also said to be very effective in its implementation in Sudimara Village, Cilongok District, Banyumas Regency, Central Java. Abstrak Program Penyediaan Air Minum Berbasis Masyarakat (Pamsimas) adalah program pemerintah yang bekerjasama dengan daerah didukung Bank Dunia untuk peningkatan akses layanan air minum, sanitasi, dan peningkatan kesehatan terutama dalam penyelesaian penyakit diare dan penyakit yang ditularkan melalui air dan lingkungan. Program ini membutuhkan anggaran yang besar sehingga disayangkan jika tidak membawa dampak yang positif pada masyarakat. Sehingga perlu adanya kajian mengenai dampak perbedaan program bagi masyarakat dan informasi mengenai efektifitas keberadaan program agar selain bermanfaat, masyarakat diminta bersama-sama berkontribusi demi keberlanjutan program.. Metode yang digunakan yakni uji Beda terkait perbedaan tingkat ketersediaan air bersih sebelum dan sesudah adanya program pamsima. Rasio Efektivitas untuk melihat hubungan diantara output dan hasil akhir yang diharapkan. Semakin besar kontribusi output pada pencapaian hasil akhir, dapat dikatakan bahwa organisasi, program, atau kegiatan tersebut efektif. Hasil penelitian memperlihatkan terdapat perbedaan ketersediaan sarana air bersih di Desa Sudimara sebelum dan setelah adanya program Pamsimas. Sedangkan berdasarkan 6 indikator keberhasilan memperlihatkan tingkat efektivitasnya sangat efektif dan efektif. Simpulan program pamsimas sudah optimal dan berhasil dalam penyediaan air bersih di Desa Sudimara. Program ini juga sudah dapat dikatakan efektif dalam pelaksanaan. Kata Kunci : Uji Binomial, Rasio Efektivitas, Pamsimas

In light of the increasing global demographics, disease emergence and intensified encroachment on natural habitats, meeting the needs of the community and safeguarding their health is becoming a significant challenge. Engaging communities in one health activities is one way to ensure that they are involved in the planning, implementation and management of activities and interventions right from the beginning. The One Health Central and Eastern Africa (OHCEA) network of veterinary, environmental and public health institutions have been developing regional collaboration sites (One Health Demonstration Sites) for capacity building, outreach, and applied research in One Health where students, faculty, communities and government representatives work together to address joint complex health problems in long-term research, training and outreach at the human-animal -environment interface.In Tanzania, Kilosa district located close to Mikumi national park was identified as a perfect site. Villages surround the national park and are in close interaction with wild animals. Environmental issues such as flooding have happened in this area, there are internally displaced communities, and farmers live in conflict with pastoralists, wildlife authorities and the government.Faculty and students from Sokoine University and Tufts University performed a baseline survey of this area with key stakeholders in mind, and a focus on the different one health activities and interventions possible and the roles and responsibilities of the community in the demo site. Existing field based programs and attachments were reviewed, a situational analysis was conducted to allow for the engagement of local and national stakeholders in order to assure that activities are aligned with priorities and existing activities. Specific human health, animal health, and ecosystem challenges and impacts were identified, e.g. local human, livestock and wildlife diseases, habitat fragmentation, edge effect, biodiversity loss, around which training modules and/or curriculum could be developed for prospective trainees in public health, veterinary medicine, nursing and environmental health consistent with One Health themes and competencies. Focus group discussions were held with the community. Various community leaders as well as district level government and civil society officials exchanged ideas on how to implement the one health demonstration site.The Kilosa region was found to be strategically positioned in terms of cultural resources and vulnerable populations as well as endemic or threatened wildlife species. Rabies, Rift Valley Fever and milk borne (Bovine Tuberculosis and Brucellosis) as well as water borne zoonoses were identified by community members as priority diseases that would be intervened effectively using one health approach. There was ongoing conflict among pastoralists, farmers, the national parks administration that presented opportunities for research and novel intervention systems. Community support and existing infrastructure for ongoing activities including influx of trainees and research staff was considered adequate. Potential opportunities for the demonstration site to contribute to the local economy by virtue of employment, improved subsistence resources, conservation and sustainability, biodiversity protection, improved recreation or appreciation by tourists were present as well as future opportunities for community-based participatory research and training. The presence of ongoing stakeholder conflict presents opportunities for investigation and intervention by community members, the government and the universities working together using a one health approach. The survey provided prospects for engaging the community from the initial planning and execution stages of the demonstration site.

Targeted sanctions—often referred to as “smart sanctions”—began in large measure as a response to the UN Security Council sanctions imposed on Iraq in 1990 and 1991, after its invasion of Kuwait. By 1991 it was clear that the sanctions on Iraq, initially welcomed by antiwar activists as a peaceful alternative to military action, were different from any sanctions seen before. Combined with the destruction from the bombing campaign of the Gulf War, they were devastating to the Iraq economy and infrastructure, resulting in widespread malnutrition, epidemics of water-borne diseases, and the collapse of every system necessary to ensure human well-being in a modern society. As the sanctions seemed to have no end in sight, there was considerable “sanctions fatigue” within the United Nations, as well as a growing body of literature that questioned whether sanctions were effective at obtaining compliance by the target state, even when there was considerable impact on its economy.In the wake of these concerns, there were efforts in many venues to design sanctions that would not have the humanitarian impact of broad trade sanctions, and that would also be more effective by putting direct pressure on individual national policy-makers. These targeted sanctions included arms embargoes, financial sanctions on the assets of individuals and companies, travel restrictions on the leaders of a sanctioned state, and trade sanctions on particular goods. Many viewed targeted sanctions as an especially promising tool for foreign policy and international governance, and many still see targeted sanctions as a natural and obvious solution to a broad array of difficult situations. But there are considerable difficulties with each type of targeted sanction, with regard to implementation, humanitarian impact, and, in some cases, due process rights. Some of these difficulties may be resolved as these measures continue to be refined. Others are rooted in fundamental conflicts between competing interests or intractable logistical challenges.

Spinach is rich in minerals, vitamins, phytochemicals and bioactive compounds with health-beneficial effects; however, this plant also tends to accumulate oxalates and nitrates in their leaves. Apart from genotype, nutrition is the pre-harvest factor that mostly affects quality attributes at harvest. Particularly, the application of compost extracts (CE) may induce resistance against soil-borne diseases and favour secondary metabolism, increasing antioxidant capacity. The objective of this study was to evaluate the effects of different types of fertilization with or without the addition of CE, on harvest quality and shelf life of minimally processed spinach (Spinacia oleracea, var. Shrike RZ) stored during 12 days at 4 °C. A compost extract (CE) was prepared by mixing a compost from agri-food wastes (vine pruning, leek waste and olive mill waste) with deionized water. CE foliar applications were done from days 28 and 56 after sowing. The treatments applied were: Control; Control + CE; NPK (inorganic NPK fertilizer 15-15-15); NPK + CE; DMPP (ENTEC Nitrofoska® plus the nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP)) and DMPP + CE. After harvest, spinach leaves were minimally processed and packaged to generate a passive modified atmosphere. Nitrate content in the control treatment was reduced by the addition of CE, although in the rest of the treatments, CE addition did not produce any effect. For nitrite contents, the lowest value was obtained for the Control + CE. Moreover, the oxalate content was the lowest for the control treatment with a decreasing trend throughout the storage. The treatment Control + CE also showed the highest initial total phenolic contents, with very similar values at the end of shelf life to those observed at harvest for all the treatments. The highest differences in color as regards the initial values were detected for DMPP. Microbial loads increased for all the treatments without differences between them. The atmosphere reached at the end of the cold storage was the same for all the cases, with CO2 and O2 around 10 kPa for each one of them. After 12 days at 4 °C, all the treatments were above the limit of usability, with the spinach leaves acceptable for consumption. The results found in this study indicate that the addition of CE might be convenient for obtaining spinach rich in bioactive compounds and with low concentrations of antinutritional factors, without affecting the microbial load of the final product.

Objective: To study the effectiveness of an integrated intervention of health worker training, a low-cost ecological mosquito ovitrap, and community engagement on Aedes spp. mosquito control over 10 months in 2015 in an urban remote community in Guatemala at risk of dengue, chikungunya and Zika virus transmission. Methods: We implemented a three-component integrated intervention consisting of: web-based training of local health personnel in vector control, cluster-randomized assignment of an ecological modified ovitrap (ovillantas: ovi=egg, llanta=tire) or standard ovitraps to capture Aedes spp. mosquito eggs (no efforts have been taken to determine the exact Aedes species at this moment), and community engagement to promote participation of community members and health personnel in the understanding and maintenance of ovitraps for mosquito control. The intervention was implemented in local collaboration with Guatemala’s Ministry of Health’s Vector Control Programme, and in international collaboration with the National Institute of Public Health in Mexico. Findings: Eighty percent of the 25 local health personnel enrolled in the training programme received accreditation of their improved knowledge of vector control. When ovillantas were used in a cluster of ovitraps (several in proximity), significantly more eggs were trapped by ecological ovillantas than standard ovitraps over the 10 month (42 week) study period (t=5.2577; p<0.05). Repetitive filtering and recycling of the attractant solution (or water) kept the ovillanta clean, free from algae growth. Among both community members and health workers, the levels of knowledge, interest, and participation in community mosquito control and trapping increased. Recommendations for enhancing and sustaining community mosquito control were identified. Conclusion: Our three-component integrated intervention proved beneficial to this remote community at risk of mosquito-borne diseases such as dengue, chikungunya, and Zika. The combination of training of health workers, cluster use of low-cost ecological ovillanta to destroy the second generation of mosquitoes, and community engagement ensured the project met local needs and fostered collaboration and participation of the community, which can help improve sustainability. The ovillanta intervention and methodology may be modified to target other species such as Culex, should it be established that such mosquitoes carry Zika virus in addition to Aedes.

Objective: To study the effectiveness of an integrated intervention of health worker training, a low-cost ecological mosquito ovitrap, and community engagement on Aedes spp. mosquito control over 10 months in 2015 in an urban remote community in Guatemala at risk of dengue, chikungunya and Zika virus transmission. Methods: We implemented a three-component integrated intervention consisting of: web-based training of local health personnel in vector control, cluster-randomized assignment of an ecological modified ovitrap (ovillantas: ovi=egg, llanta=tire) or standard ovitraps to capture Aedes spp. mosquito eggs (no efforts have been taken to determine the exact Aedes species at this moment), and community engagement to promote participation of community members and health personnel in the understanding and maintenance of ovitraps for mosquito control. The intervention was implemented in local collaboration with Guatemala’s Ministry of Health’s Vector Control Programme, and in international collaboration with the National Institute of Public Health in Mexico. Findings: Eighty percent of the 25 local health personnel enrolled in the training programme received accreditation of their improved knowledge of vector control. When ovillantas were used in a cluster of ovitraps (several in proximity), significantly more eggs were trapped by ecological ovillantas than standard ovitraps over the 10 month (42 week) study period (t=5.2577; p<0.05). Repetitive filtering and recycling of the attractant solution (or water) kept the ovillanta clean, free from algae growth. Among both community members and health workers, the levels of knowledge, interest, and participation in community mosquito control and trapping increased. Recommendations for enhancing and sustaining community mosquito control were identified. Conclusion: Our three-component integrated intervention proved beneficial to this remote community at risk of mosquito-borne diseases such as dengue, chikungunya, and Zika. The combination of training of health workers, cluster use of low-cost ecological ovillanta to destroy the second generation of mosquitoes, and community engagement ensured the project met local needs and fostered collaboration and participation of the community, which can help improve sustainability. The ovillanta intervention and methodology may be modified to target other species such as Culex, should it be established that such mosquitoes carry Zika virus in addition to Aedes.

Persistent organic pollutants (POPs) are organic (carbon-based) compounds that include synthesized substances (pesticides and polychlorinated biphenyls [PCBs]) and other by-product substances generated as a result of human and natural activity (dioxins and furans). Extensive scientific studies have shown that POPs are some of the most dangerous pollutants released into the environment by humans. Great efforts have been made since the early 1960s to enhance chemical management and safety issues. Various conventions have been adopted for this purpose: the Stockholm Convention (SC) is one of the well-known meetings in this context. The SC on POPs (May 2001) focuses on reducing and eliminating releases of 12 POPs coined the ‘Dirty Dozen’ by the United Nations Environment Program (UNEP). Persistence of such chemicals in soils, air, and water, together with natural processes such as evaporation to the atmosphere and washout by rain and flood, give rise to their ubiquitous distribution in the environment and eventual penetration into food chains and bio-accumulation in humans. Public concern about contamination by POPs increased recently because several of these compounds are identified as hormone disruptors, which can alter normal function of endocrine and reproductive systems in humans and wildlife. African countries are using pesticides, such as dichlorodiphenyltrichloroethane (DDT), lindane, toxaphene, endrin, dieldrin, heptachlor, since more than 50 years for combating agricultural pests and controlling disease vectors, especially malaria. The way in which pesticides are used in Africa caused serious environmental and health problems much more than elsewhere. These problems are represented by accumulation of organochlorine pesticide (OCP) residues in different environmental samples and hosting of at least 50,000 tons of obsolete pesticides, as well as tens of thousands of tons of contaminated soil. Within the framework of the Africa Stockpiles Program (ASP), huge quantities of pesticidal POPs have been completely or partially destroyed in a number of African countries (e.g. Egypt, Namibia, Niger, Senegal, Seychelles, South Africa, Sudan, Tanzania, Uganda, Zambia). At regional level (i.e. African Countries), a strategic plan for monitoring and getting rid of POPs in the continent should be set up and implemented through coordination between all governments. Among issues of top priorities are to find alternative non-combustion technologies for disposing obsolete pesticides, and to use alternative control measures for mosquitoes’ management and other vector-borne diseases.

Edgeworthia papyrifera, Oriental paperbush, is a deciduous flowering shrub becoming increasingly popular because of its clove-like perfumed flowers appearing in late winter-early spring. During August of 2009 in a commercial nursery close to Maggiore Lake (Verbano-Cusio-Ossola Province) in northwest Italy, 2-year-old plants of E. papyrifera showed extensive chlorosis and root rot. Twigs wilted and died, dropping leaves in some cases. Most frequently, wilted leaves persisted on stems. At the soil level, dark brown-to-black water-soaked lesions formed and coalesced, girdling the stem. All of the crown and root system was affected. Infected plants died within 14 days of the appearance of symptoms. Disease was widespread and severe, affecting 90 of the 100 plants present. After disinfestation for 1 min in a solution containing 1% NaOCl, rotting root and collar pieces of E. papyrifera consistently produced a Phytophthora-like organism when plated on a medium selective for oomycetes (3). The pathogen was identified morphologically as Phytophthora nicotianae (= P. parasitica) (2). On V8 agar, coenocytic hyphae, 4 to 8 μm in diameter, formed fluffy, aerial colonies and spherical, intercalary chlamydospores, 21.0 to 36.5 (average 26.7) μm in diameter. Colonies grew well at 35°C and stopped growing at 40°C. Sporangia were produced by growing a pure hyphal-tip culture in a diluted, sterilized soil-extract. Sporangia were borne singly, laterally attached to the sporangiophore, were noncaducous, spherical to ovoid, papillate, and measured 28.6 to 55.2 × 22.4 to 45.1 (average 42.4 × 34.6) μm, length/breadth ratio (1.1:1)-1.2:1-(1.3:1). Papillae measured 3.1 to 7.6 (average 4.6) μm. The internal transcribed spacer (ITS) region of rDNA of a single isolate was amplified with primers ITS4/ITS6 and sequenced. BLAST analysis (1) of the 839-bp segment showed 99% homology with the sequence of P. nicotianae (No. AJ854296). The sequence has been assigned the GenBank No. GU353341. Pathogenicity of isolates Edg.1 and Edg.2 obtained, respectively, from the root and collar of an infected plant was confirmed by inoculating 1-year-old plants of E. papyrifera. Both strains were grown for 15 days on a mixture of 70:30 wheat/hemp kernels, and 4 g/liter of the inoculum was mixed into a substrate containing sphagnum peat moss/pumice/pine bark/clay (50:20:20:10 vol/vol). One plant per 3-liter pot was transplanted into the substrate and constituted the experimental unit. Five plants were used for each test strain and noninoculated control treatment; the trial was repeated once. All plants were kept in a greenhouse at 25 to 28°C. Plants inoculated with Edg.1 and Edg.2 developed chlorosis and root rot 18 and 14 days after the inoculation, respectively, and wilt rapidly followed. Control plants remained symptomless. P. nicotianae was consistently reisolated from inoculated plants. To our knowledge, this is the first report of P. nicotianae on E. papyrifera in Italy as well as worldwide. The current economic importance of the disease is minor due to the limited number of farms that grow this crop in Italy, although spread could increase as the popularity of plantings expand. References: (1) S. F. Altschul et al. Nucleic Acids Res. 25:3389, 1997 (2) D. C. Erwin and O. K. Ribeiro. Phytophthora Diseases Worldwide. The American Phtytopathological Society, St Paul, MN, 1996. (3) H. Masago et al. Phytopathology 67:425, 1977.

Fusarium rot is considered a minor disease of citrus fruits. Several Fusarium species have been associated with fruit decay, most commonly F. lateritium Nees, F. moniliforme J. Sheld., F. oxysporum Schltdl., and F. solani (Mart.) Sacc. (2,3). In the winters of 2007, 2009, 2010, and 2011, lemon [Citrus limon (L.) Burm. f.] fruit with white mycelium covering the peduncle were submitted to the Phytopathology Lab at the Estación Experimental Agroindustrial Obispo Colombres. All fruit samples from Tucumán, Argentina, were stored in boxes kept in packinghouse for more than 1 month. In 2007 only, light to dark brown flavedo around the peduncle was observed in less than 1% of the sample fruit received. No internal breakdown was visible. No change in rind color was observed in the samples received in remaining years. Abundant Fusarium sp. conidia were observed on the mycelium. Colonies with white to violet fluffy aerial mycelium developed on potato dextrose agar (PDA) and produced abundant ovoid or oblong microconidia (1.9 to 3.6 × 4.8 to 10.8 μm), usually unicellular, borne in false heads on short monophialides, and loculated slightly falcate macroconidia were mostly three to five septate (2.4 to 4.8 × 19.2 to 31.2 μm). Unbranched and branched-monophialidic conidiophores were observed. Simple or paired chlamydospores developed on synthetic nutrient agar (1 g KH2PO4, 1 g KNO3, 0.5 g MgSO4.7H2O, 0.5 g KCl, 0.2 g sucrose, and 20 g agar/liter distilled water). On the basis of morphological and cultural criteria, 22 isolates were identified as F. oxysporum (4) designated as D1 to D22. Morfological identification was confirmed by PCR (1) using genomic DNA extracted from the mycelium of pure culture, and an amplified product of 70 bp, specific for the species F. oxysporum, was obtained. The internal transcribed spacer (ITS) region of rDNA was amplified using the primers ITS4/ITS5 and secuenced. BLAST analysis of the 600 bp segment showed a 100% indentity with F. oxysporum, strains CCF 4362 and 1166 (GenBank Accession Nos. HE974454 and FR731133, respectively). Pathogenicity tests were conducted twice by inoculating 10 surface-disinfected wounded lemon fruit. A rind disc (5 mm in diameter and 1 mm deep) near the stem end was removed and a 5-mm-diameter agar disc of D2 isolate (grown at 25°C for 5 days on PDA) was attached to the wound replacing the rind disc. The inoculation site was covered with moistened cotton wool and the fruit were wrapped in plastic bags to prevent the inoculum from drying out. Ten control fruit were inoculated with uncultured PDA plugs (5 mm in diameter). All fruit were maintained in a growth chamber at 25°C under humid conditions. After 5 to 6 days, all inoculated fruit showed white aerial mycelium, initially on the inoculation site and then on the peduncle, similar to that observed on naturally infected fruit. After 20 days, two fruit developed stem end dry rot and showed peduncle fall but no internal breakdown was visible. Control fruit developed any symptom as described above. F. oxysporum was consistently reisolated from infected tissues, completing Koch's postulates. To our knowledge, this is the first report of Fusarium rot caused by F. oxysporum on lemon in Tucumán, Argentina. References: (1) V. Edel et al. Mycol. Res. 104:518, 2000. (2) H. S. Fawcett. Citrus Diseases and Their Control, 1936. (3) A. Z. Joffe and M. Schiffmann-Nadel. Fruits 27:117, 1972. (4) P. E. Nelson et al. Fusarium species: An Illustrated Manual for Identification, 1983.

Powdery mildew of mango is an important disease in Mexico's northern Sinaloa state. Identification of the causal fungal agent has been hindered by the absence of information regarding its teleomorph, as well as a detailed morphometric analysis of the anamorph and molecular characterization. The first symptoms of the disease appear in mango inflorescences of early February, and it subsequently affects young fruits. The disease progresses during March and early April, causing significant fruit abortion and a scabby appearance in a high percentage of fruits that remain attached to the trees. We observed the disease on inflorescences but not in leaves during our sampling period. Powdery mildew specimens were collected during 2011 and 2012 and included Kent and Keith varieties from commercial orchards, and creole materials from backyards of private residences in the Ahome and Fuerte Counties of northern Sinaloa, Mexico. Symptomatic inflorescences were analyzed morphologically. Conidiophores and conidia were prepared by touching the whitish lesions with clear adhesive tape, which was then placed over microscope slides with a drop of distilled water and observed under a compound microscope. The anamorph structures of the pathogen were measured. The mycelium was septate and ramified on the surface of the host, forming a dense coat of branching hyphae. The mycelium had a diameter of 2.5 to 8.7 μm; conidiophores (Pseudoidium type) emerged from the superficial mycelium, were unbranched, and consisted of 1 to 3 cells with conidia forming singly from the apex. The length of the conidiophores varied from 30.0 to 77.5 μm; the foot cell of the conidiophores was straight, 10.0 to 47.5 μm long and with a diameter of 5.0 to 15.5 μm across its midpoint. Conidia without fibrosin bodies were borne singly, and were ellipsoid/ovoid, 22.5 to 46.2 μm long and 15.0 to 27.5 μm wide. Eighty percent of the germ tubes were forked (lobed); the rest were simple, emerged from the end, and were occasionally on the side of the conidia. Germ tubes ranged from 2.0 to 7.2 μm at the midpoint. The surface of the conidia appeared smooth under the scanning electron microscope, and elliptical conidia appeared constricted at their ends; this, however, was not observed in the ovoid conidia. In both cases, the terminal end of the conidia was smooth. The teleomorph was not found. Molecular and phylogenetic analysis of the ITS rDNA (2) region showed that samples are closely related to specimens of Pseudoidium anacardii (1) (teleomorph: Erysiphe quercicola [4]) collected from mango trees in diverse countries. Measurements of somatic and asexual structures are in agreement with descriptions of P. anachardii (formerly known as Oidium mangiferae) from India (3). The nucleotide sequences derived from this research were deposited in GenBank (Accession Nos. JX893951 to JX893957). To our knowledge, this is the first report of P. anacardii associated to mango inflorescences in Sinaloa, Mexico. Due to the economic importance of powdery mildew of mango trees in Sinaloa, future research directions should focus on finding the teleomorph of the fungus to support its identity. References: (1) U. Braun and R. T. A. Cook CBS Biodiversity Series No. 11, 2012. (2) S. Limkaisang et al. Mycoscience 47:327, 2006. (3) O. Prakash and K. C. Srivastava. Mango diseases and their management. A World Review Today and Tomorrow Publishers. New Delhi, India, 1987. (4) S. Takamatsu et al. Mycol. Res. 111:809, 2007.

Soil-borne fungal diseases have become an important problem in grapevine nurseries of the Aegean region (western Turkey) in recent years. Reduced vigor, black vascular streaking in basal ends, blackish-sunken necrotic root lesions, and young vine death were observed in 15 grapevine nurseries of Manisa city in May 2011 and 2012. To determine the causal agents, symptomatic young grapevine (Vitis vinifera cv. Sultana 7) plants (grafted on 1103 Paulsen) were collected from nurseries (8 to 10 plants from each). Symptomatic basal end tissues were surface disinfested with 95% ethanol and flame sterilized. The internal tissues were plated onto potato dextrose agar amended with tetracycline (0.01%). Campylocarpon-like fungi were isolated (with 37.9% isolation frequency) from only one nursery (corresponding to 6.7% of all surveyed nurseries). Fungal colonies were incubated for 21 days in the dark to induce sporulation. Fungal colonies produced cottony aerial mycelium and turned chocolate-brown to dark brown on PDA. Abundant macroconidia were observed at branched conidiophores on long and cylindrical phialides. Microconidia were not observed. Macroconidia were generally 2 to 4 septate, cylindrical and slightly curved, with the following dimensions: 2 septate: 33.5 to 40.7 × 6.1 to 7.6 μm (mean: 35.9 × 6.8 μm), 3 septate: 36.2 to 43.4 × 6.6 to 8.3 μm (mean: 37.3 × 7.6 μm), and 4 septate: 48.9 to 53.5 × 7.6 to 8.3 μm (mean: 50.7 × 8.0 μm). Fifty macroconidia were measured. Morphologically, the isolates resembled the published description of Campylocarpon fasciculare Schroers, Halleen & Crous (2,4). For molecular identification, fungal DNA was extracted from mycelium and ribosomal DNA fragments (ITS1, 5.8S ITS2 rDNA), β-tubulin, and histone H3 genes, amplified with ITS 4-5, Bt 2a-2b, and H3 1a-1b primers (3,5), and sequenced. Sequences were compared with those deposited in GenBank. The isolate (MBAi45CL) showed 99% similarity with Campylocarpon fasciculare isolates AY677303 (ITS), AY377225 (β-tubulin), and JF735502 (histone H3). The DNA sequences were deposited into GenBank under accessions KJ573392, KJ573393, and KJ573394 for ITS, β-tubulin, and Histone H3 genes, respectively. To fulfill Koch's postulates, pathogenicity tests were conducted under greenhouse conditions on own-rooted grapevines (Vitis vinifera) cv. Sultana 7. Plants were removed from the rooting bench and the roots were slightly trimmed and submerged in a 107 ml–1 conidial suspension of the isolate for 60 min (5). After inoculation, the rooted cuttings were planted in 1-liter bags containing a mixture of soil, peat, and sand (2:1:1, v/v/v), and maintained in the greenhouse (24°C. 16/8-h day/night, 75% RH). Ten plants were inoculated with the isolate and five plants were submerged in sterile distilled water (control). After 4 months, young vines were examined for vascular discoloration, reduced root biomass, blackish lesions, and recovery of fungal isolates. The experiment was repeated twice. Blackish-brown discoloration of xylem vessels and necrosis in the basal ends was visible in the inoculated plants but not in the control plants. The pathogen was successfully re-isolated from 69.1% of the inoculated plants. This report is important for the new studies aiming at black foot disease control in Turkey viticulture. References: (1) A. Cabral et al. Phytopathol. Mediterr. 51:340, 2012. (2) P. Chaverri et al. Stud. Mycol. 68:67, 2011. (3) N. L. Glass and G. C. Donaldson. Appl. Environ. Microbiol. 61:1323, 1995. (4) F. Halleen et al. Stud. Mycol. 50:431, 2004. (5) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

Abstract: Viruses cause various diseases in humans through vector-borne (e.g., Zika and dengue fever), airborne (e.g., measles) and water-borne (e.g., hepatitis) transmission, as well as direct physical contact (e.g., AIDS and herpes). Recently, the new coronavirus (SARS-CoV-2) pandemic has triggered the greatest global health crisis in a century. However, not all viruses in nature are human enemies. A vast body of literature indicates that viral infection is vital for ecosystem functioning by affecting nutrient cycling, controlling species growth and enhancing biodiversity. Here we provide a perspective on the ecological role of viruses in nature, with special focus on Brazilian aquatic ecosystems.

Abstract Globally, ~1 billion people, mostly residing in Africa and South Asia (e.g. India), still lack access to clean drinking water and sanitation. Resulting, unsafe disposal of fecal waste from open-defecation to nearby drinking water sources severely endanger public health. Until recently, India had a huge open-defecating population, leading declining public health from water-borne diseases like diarrhoea by ingesting polluted water, mostly sourced to groundwater. However, in recent past, sanitation development to achieve Sustainable Development Goals (SDGs) has been encouraged throughout India, but their effect to groundwater quality and human health conditions are yet-unquantified. Here, for the first time, using long term, high-spatial resolution measurements (>1.7 million) across India and analyses, we quantified that over the years, groundwater fecal coliform concentration (2002–2017, −2.56 ± 0.06%/year) and acute diarrheal cases (1990–2016, −3.05 ± 0.01%/year) have significantly reduced, potentially influenced by sanitation development (1990–2017, 2.63 ± 0.01%/year). Enhanced alleviation of groundwater quality and human health have been observed since 2014, with initiation of acceletated constructions of sanitation infrastructures through Clean India (Swachh Bharat) Mission. However, the goal of completely faecal-pollution free, clean drinking water is yet to be achieved. We also evaluated the suitability of using satellite-derived night-time light (NLan, 1992–2013, 4.26 ± 0.05%/year) as potential predictor for such economic development. We observed that in more than 80% of the study region, night-time light demonstrated to be a strong predictor for observed changes in groundwater quality, sanitation development and water-borne disease cases. While sanitation and economic development can improve public health, poor education level and improper human practices can strongly influence on water-borne diseases loads and thus health in parts of India.

It is estimated that one million deaths per year are caused by mosquito-borne diseases worldwide. While preventing such diseases is possible and, of course, more manageable than attended to treat patients. Prevention of these diseases is based on improving the environment (e.g., decreased stagnant water) and controlling mosquitoes in immature and adult forms. Resistances among mosquitoes, environmental pollution, and adverse effects on non-target species, such as humans, are some of the major disadvantages of using chemical insecticides. Essential oils (EO)s with a wide range of activities on mosquitoes, including ovicide effect, larvicide effect, pupicide effect, adulticide effects, and repellent effect, are proper alternatives for synthetic ones. However, their practical usage is questioned due to their volatility and lower efficiency than synthetic samples. In recent years, researchers have attended to overcome these challenges by formulating EOs into nanoformulations. In this study, existing reports on exploiting EO-based nanoformulations in mosquito control have been categorized as larvicides, repellents, and adulticides. Moreover, by discussing the reported results, the appropriate nanoformulations for each purpose have been suggested; polymeric nanoparticles are more suitable for larvicides, lipid nanocarriers are more suitable for repellents nanoemulsions are more suitable for adulticide.

AbstractArthropod vectors carry vector-borne pathogens that cause infectious disease in vertebrate hosts, and arthropod-associated microbiota, which consists of non-pathogenic microorganisms. Vector-borne pathogens and the microbiota can both influence the fitness of their arthropod vectors, and hence the epidemiology of vector-borne diseases. The bacterium Borrelia afzelii, which causes Lyme borreliosis in Europe, is transmitted among vertebrate reservoir hosts by Ixodes ricinus ticks, which also harbour a diverse microbiota of non-pathogenic bacteria. The purpose of this controlled study was to test whether B. afzelii and the tick-associated microbiota influence the fitness of I. ricinus. Eggs obtained from field-collected adult female ticks were surface sterilized (with bleach and ethanol), which reduced the abundance of the bacterial microbiota in the hatched I. ricinus larvae by 28-fold compared to larvae that hatched from control eggs washed with water. The dysbiosed and control larvae were subsequently fed on B. afzelii-infected or uninfected control mice, and the engorged larvae were left to moult into nymphs under laboratory conditions. I. ricinus larvae that fed on B. afzelii-infected mice had a significantly faster larva-to-nymph moulting time compared to larvae that fed on uninfected control mice, but the effect was small (2.4% reduction) and unlikely to be biologically significant. We found no evidence that B. afzelii infection or reduction of the larval microbiota influenced the four other life history traits of the immature I. ricinus ticks, which included engorged larval weight, unfed nymphal weight, larva-to-nymph moulting success, and immature tick survival. A retrospective power analysis found that our sampling effort had sufficient power (> 80%) to detect small effects (differences of 5% to 10%) of our treatments. Under the environmental conditions of this study, we conclude that B. afzelii and the egg surface microbiota had no meaningful effects on tick fitness and hence on the R0 of Lyme borreliosis.

Pesticides are a hidden threat to humans, animals, insects, as well as to all ecosystems. They control pests and play an important role in crop productivity and prevent vector borne-diseases in humans, but they also extremely pollute our surroundings. These toxic substances are found in soil, water, air, plants, food and feed. Their residues enter plants and animal products and accumulate in humans and animals by the food chain. They endanger our lives and put down our health, as well as demolish beneficial organisms in the environment. This paper expresses a piece of information that has been obtained from reviewing academic papers, books and other sources. People take these toxic chemicals from water, air, and agricultural products, as well as their surroundings. They are stored in humans and animals’ tissues or excreted by different routes, but their adverse effects have no end. Brain, kidneys, skin, gastrointestinal, liver, lungs, spleen and every organ of humans are suppressed by them. They cause various diseases, cancers, mutations, as well as lead to death. These chemicals destroy honeybees’ colonies and decrease pollinator’s populations. Additionally, birds, wildlife and soil organisms are extremely suppressed by the heavy application of pesticides. They damage human beings, animals, pollinators, honeybees, and soil microorganisms. Increasing the application of pesticides decreases the population of pollinators, honeybees, and other beneficial organisms, as well as impacts human health. If these living organisms are diminished, our lives are threatened by food shortage, a collapsed economy, and increased food and feed demand, therefore new crises including famine and diseases put down our prosperity. All pesticides should be used cautiously and need to develop a new type of pesticides that do not harm seriously our environment.

Water is a mandatory need for all human beings. Without water, life is not possible. The increasing population of the world has an inverse relationship with the availability of clean water. It is used for different purposes e.g., drinking, washing, cooking, agriculture, industries, etc. It is one of the precious natural resources. Unfortunately, excessive use and wastage lead to serious circumstances for other consumers. The major causes of the wastage are overflow in overhead tanks, damaged pipelines, open and faulty water taps and valves, and unnecessary consumption. Dry running of the water pumps is another important issue concerning water pumps. When the water from the main pipeline is not reaching them or the flow rate of water is too low, the water pump will consume more electric supply, which shorten their working span. On the other hand, inappropriate voltage is also damaging the water pump motor. The drinking water with an average quality of purity is responsible for a healthy nation. The water with inadequate levels of pH and turbidity can invite water-borne diseases. After considering all the problems, a need for proper solutions is highly recommended. In this regard, we found an adequate solution in the form of an autonomous system called Smart Water Tank. Our intention is not limited to overcome the wastage of the water only but also to control the unnecessary use of resources-electricity and water pump, the monitoring of drinkable water quality concerning pH and turbidity level. This flexible, portable, and economical automated system will be responsible for automatically switching ON/OFF the water pump motor, monitoring the water flow rate, electricity magnitude, and its temperature-needed for the water pump motor, during and before it takes starts for filling. All the updates for the different parameters will be displayed by the LCD and LEDs installed on the system-locally as well as on the smartphone app connected with Smart Water Tank System via server.

Abstract Background This study aimed at determining urogenital schistosomiasis (UGS) prevalence, intensity, knowledge and risk factors in school-aged children (SAC) in the new endemic focus of Tiko, Cameroon. Methods A cross-sectional study including 389 SAC of both sexes aged 5–15 years was carried out between April and June 2018. A structured questionnaire was used to collect demographic data, clinical and predisposing factors. Urine sample collected was used to detect Schistosoma haematobium eggs by filtration technique and microhaematuria by Heme dipstick COMBI 11. Logistic regression model was used to determine risk factors of UGS. Results The overall prevalence of UGS was 37.0% (CI 32.4–41.9) and 32.6% (CI 28.2–37.5) were positive by egg excretion while 24.4% (CI 20.4–28.9) by haematuria. S. haematobium egg excretion and haematuria were significantly higher in males (P = 0.016; P = 0.049) and children 12–15 years old (P = 0.009; P = 0.002), respectively. The mean number of eggs per 10 mL of urine was 77.6 (10.2) and ranged from 2 to 400. The proportion of light intensity of infection was higher (67.7%, CI 59.2–75.2) with no significant differences by sex, age and residence. However, the older children were more heavily infected when compared to the younger children, who had more of light infection. Overall, the mean knowledge score 1.42 (CI 1.32–1.51) on a scale of 6, was poor and the proportion of good knowledge of the disease (23.14%, CI 19.2–27.6) was low. Stream water contact (AOR = 4.94; P = 0.001) was the only significant risk factor identified. Conclusion Urogenital schistosomiasis is of public health concern among SAC in Tiko, Cameroon. Most participants have poor knowledge about the disease, hence education on vector-borne diseases and the avoidance of stream water contact should be implemented.

Abstract Background Vector-borne diseases are a major cause of disease burden in Guayaquil, Ecuador, especially arboviruses spread by Aedes aegypti mosquitoes. Understanding which household characteristics and risk factors lead to higher Ae. aegypti densities and consequent disease risk can help inform and optimize vector control programs. Methods Cross-sectional entomological surveys were conducted in Guayaquil between 2013 and 2016, covering household demographics, municipal services, potential breeding containers, presence of Ae. aegypti larvae and pupae, and history of using mosquito control methods. A zero-truncated negative binomial regression model was fitted to data for estimating the household pupal index. An additional model assessed the factors of the most productive breeding sites across all of the households. Results Of surveyed households, 610 satisfied inclusion criteria. The final household-level model found that collection of large solid items (e.g., furniture and tires) and rainfall the week of and 2 weeks before collection were negatively correlated with average pupae per container, while bed canopy use, unemployment, container water volume, and the interaction between large solid collection and rainfall 2 weeks before the sampling event were positively correlated. Selection of these variables across other top candidate models with ∆AICc < 1 was robust, with the strongest effects from large solid collection and bed canopy use. The final container-level model explaining the characteristics of breeding sites found that contaminated water is positively correlated with Ae. aegypti pupae counts while breeding sites composed of car parts, furniture, sewerage parts, vases, were all negatively correlated. Conclusions Having access to municipal services like bulky item pickup was effective at reducing mosquito proliferation in households. Association of bed canopy use with higher mosquito densities is unexpected, and may be a consequence of large local mosquito populations or due to limited use or effectiveness of other vector control methods. The impact of rainfall on mosquito density is multifaceted, as it may both create new habitat and “wash out” existing habitat. Providing services and social/technical interventions focused on monitoring and eliminating productive breeding sites is important for reducing aquatic-stage mosquito densities in households at risk for Ae. aegypti-transmitted diseases. Graphical Abstract

ObjectiveDescribe short-term health effects of the Hurricane using the syndromic surveillance system based on emergency departments, general practitioners and dispensaries in Saint-Martin and Saint-Barthélemy islands from September 11, 2017 to October 29, 2017.IntroductionIn Saint-Martin (31 949 inhabitants) and Saint-Barthélemy (9 625 inhabitants) islands in the French West Indies, the surveillance system is based on several data sources: (1) a syndromic surveillance system based on two emergency departments (ED) of Saint-Barthélemy (HL de Bruyn) and Saint-Martin (CH Fleming) and on mortality (SurSaUD® network [1])); (2) a network of sentinel general practitioners (GP’s) based on the voluntary participation of 10 GPs in Saint-Martin and 5 in Saint-Barthélemy; (3) the notifiable diseases surveillance system (31 notifiable diseases to individual case-specific form); (4) the regional surveillance systems of leptospirosis and arboviruses based on the biological cases reported by physicians and laboratories of two islands.On September 6, 2017, Hurricane Irma struck Saint-Martin and Saint-Barthélemy islands. Both islands were massively destroyed. This storm led to major material damages, such as power outages, disturbance of drinking water systems, road closures, destruction of medical structures and evacuation or relocation of residents.In this context, the usual monitoring system did not work and life conditions were difficult. The regional unit of French National Public Health Agency set up an epidemiological surveillance by sending epidemiologists in the field in order to collect data directly from ED physicians, GP’s and in dispensaries. Those data allowed to describe short-term health effects and to detect potential disease outbreaks in the aftermath of Hurricane Irma. This paper presents results of the specific syndromic surveillance.MethodsBefore Irma, ED data were collected daily directly from patients’ computerized medical files that were filled in during medical consultations at ED. Among the collected variables, the diagnosis was categorized according to the 10th revision of the International Classification of Diseases (ICD-10). This surveillance system was completed by aggregated data of Emergency Medical Services (EMS), also including medical diagnosis coded using the ICD10.Because of the sudden disruption in hospital departments due to hurricane, electronic transmission was stopped. To replace it, ED data collection turned temporary into paper-forms and several epidemiologists were sent in Saint-Martin and Saint-Barthélemy to collect data directly from the ED physicians. This system remained until the end of October when connections and data transmission were restored.Because of destruction of medical structures, dispensaries were opened in different strategic areas of the island, 3 in Saint-Martin and none in Saint-Barthélemy. General practitioners have progressively reopened their practice (8 GP’s in Saint-Martin and 5 in Saint-Barthélemy) and patient's data were collected and integrated into the surveillance system.Based on a literature review and former experience, the main pathologies identified for the health risk assessment were: (1) somatic pathologies directly or indirectly related to the hurricane (trauma, wounds, cuts, burns, secondary infection); (2) infectious diseases related to the lack of hygiene partly due to damaged water and electricity networks and unavailable health care structures (gastroenteritis, food infections, respiratory diseases, skin infections, tetanus and other pathologies that may occur in the longer term linked to the incubation period especially leptospirosis and hepatitis A); (3) chronic pathologies by discontinuity of care (renal insufficiency, diabetic, cardio-respiratory decompensation, etc.); (4) pathologies related to animal bites and mosquito bites (vector-borne diseases); (5) psychological and / or psychiatry disorders.Then in the French West Indies, from September 11 to October 29,2017, data were routinely analyzed to detect and follow-up various expected or unusual variations of one or more pathology of the above list.ResultsThe following week after Irma (2017-37), the weekly number of ED visits compared to the mean activity observed in normal situation has increased: 1225 ED visits vs. 313 in 2017-35 in Saint-Martin and 227 ED visits vs. 94 ED visits in 2017-35 in Saint-Barthélemy. ED activity has gradually decreased to finally return to a based-activity as observed before the hurricane at the end of October.From September 11 to October 29, 25% of recorded emergency consultations in Saint-Martin island were trauma, wounds, burns and cuts. As in Saint-Martin, 42% of emergency visits in Saint-Barthélemy were pathologies directly or indirectly related to the passage of Irma (trauma, wounds, etc). Others major causes of ED visits were for treatment renewal (diabetes, renal insufficiency, etc.) and gyneco-obstetric activity because general practitioners had stopped their activity.In dispensaries and general practitioners, the most common pathology was gastroenteritis (11% in Saint-Martin) over the entire period of surveillance. At the beginning of the surveillance, skin infections were the most frequently found (20%) in Saint-Martin and psychological disorders (3%) in Saint-Bartélemy, while at the end respiratory infections were the most frequent (6%) in both islands.No increase in visits for chronic diseases, food-borne diseases, acute respiratory or diarrhea illness were detected. No autochthonous confirmed cases of cholera, leptospirosis, vector-bone disease, hepatitis A or typhoid fever had been reported, due to the destruction of the laboratory.ConclusionsSyndromic surveillance in the French West Indies allowed the epidemiologists to assess rapidly the health impact of hurricane in Saint-Martin and Saint-Barthélemy.The well-established relations between French National Public Health Agency and local professionals of both affected islands allowed to temporary switch from an electronic into a paper-based data transmission without any interruption of data analysis.Although several cluster suspicions have been investigated (especially of gastroenteritis, scabies, etc), no massive outbreak was detected. Then even with a degraded system, syndromic surveillance allowed to reinsure authority of the absence of major health impact due to Irma.References1-Caserio- Schönemann C, Bousquet V, Fouillet A, Henry V. Le système de surveillance syndromique SurSaUD ®. Bull Epidemiol Hebd 2014 ;3-4 :38-44.

White spot syndrome virus (WSSV) belongs to a new virus family, Nimaviridae, genus Whispovirus and contains a large circular double-stranded DNA genome of 292,967 bp. WSSV virions are ellipsoid to bacilliform, enveloped particles with a distinctive tail-like appendage at one end. They can be found throughout the body of infected shrimp. The virions contain one nucleocapsid with a typical striated appearance and 5 major and at least 13 minor proteins. WSSV, which was first discovered in Southeast Asia around 1992, is currently the most serious viral pathogen of shrimp worldwide. It causes up to 100% mortality within 7 to 10 days in commercial shrimp farms, resulting in large economic losses amounting to billions of US dollars across different countries to the shrimp farming industry. In a natural situation, shrimp become infected through both oral and water-borne routes, and the gills are thought to be a major point of viral entry. Considering the global economic and sociological importance of shrimp farming and its continued high growth, the development of novel control measures becomes necessary against the outbreak of WSSV. A number of strategies have been used to control WSSV, each with some limitations. Conventional control strategies such as improvement of environmental conditions, stocking of pathogen-free post-larvae, and augmentation of disease resistance by oral immune-stimulants or probiotics are currently employed to control WSSV infection. Use of recombinant viral proteins as vaccines that induce a specific immune response and protection has been demonstrated to control WSSV. Other studies have shown successful vaccination of shrimp with DNA vaccines that have prolonged effects. The RNA interference (RNAi) mediated silencing of targeted viral mRNAs holds tremendous potential for controlling shrimp diseases. The silencing of viruses using RNAi has been experimentally demonstrated for WSSV in shrimp by injecting or feeding synthetic siRNA, long double-stranded RNA (dsRNA), and short/long-hairpin RNA (shRNA/lhRNA) prepared by in vitro transcription or expressed in bacteria. In addition to targeting viral proteins, protection of WSSV has also been achieved by dsRNA targeted against shrimp PmRab7, a protein important for viral entry into the host cells. Antisense constructs offered strong protection in WSSV challenged shrimp, P. monodon, with a corresponding decrease in viral load. Antisense constructs expressing VP24 and VP28 offered the best protection with a consistent reduction in WSSV copy number in both cell culture and in experimental shrimp. The advantage of using antisense constructs is their lack of toxicity and immunogenicity and their high specificity towards the desired target. The usage of edible pellet feed coated with dsRNA against WSSV has shown promising results. Overall, the present investigation clearly demonstrates that it is possible to induce strong protection in shrimp against WSSV infection using host promoter-driven antisense constructs in controlled laboratory-scale experiments. However, it is important to develop a simple and efficient delivery system for extending this study to the field level.

Every year on 24 March, World Tuberculosis Day is commemorated annually, for raising the public awareness regarding devastating consequences of tuberculosison health and economic aspects of life. This helps to launch efforts to end the globalepidemic of tuberculosis. On the date of 24th March in 1882, Dr. Robert Koch announced about the discovery of bacterium that causes tuberculosis.1 It was held on 24th March 1982 first time by The World Health Organization at the 100th anniversary of Dr. Koch’s discovery. The target 3.3 of SDG calls for, by 2030, ending the epidemics of tuberculosis, malaria, AIDS, combat other communicable and water-borne diseases. A large number of people 1.7 billion, roughly 23% of the world's population suffered from tuberculosis. In the world, each year 1.5 million people died due to TB, proving it a leading infectious killer disease. Thirty countries having the high burden of TB, accounted for 87% of new TB cases during 2019.2 Among these, two thirds of the total cases were in India, Indonesia, China, Bangladesh, Philippines, Pakistan, Nigeria, and South Africa. An estimated 510,000 new TB cases are emerging each year in Pakistan. Among these about, 15 000 are developing drug resistant TB cases. Pakistan is bearing 61% of the TB burden in the EMRO. Tuberculosis is preventable and curable disease. The causative agent of tuberculosis, Mycobacterium tuberculosis, most often affect the lungs. The vaccine for tuberculosis (TB) disease is called BCG (Bacille Calmette-Guérin). In 1921, first patient was vaccinated with BCG vaccine, 13 years were spent in the making the vaccine. In countries where TB is common, BCG vaccine is given to infants and small children. It does not always protect people from getting TB. BCG vaccine is included in national Expanded Program on Immunization (EPI) in Pakistan and given at birth. To make TB free Pakistan through universal access to quality TB care, National TB Control Program (NTP) is striving for achieving Zero TB death by reducing 50% prevalence of TB in general population by 2025. The mode of transmission of TB from person to person is through the air. The TB germs are propelled into the air,when people with lung TB cough, sneeze or spit carelessly due to lack of awareness that they are participating in the spread of disease and weakening the efforts. These germs are when inhaled by other people, resulting in lung infection, which is called primary TB. From primary TB infection, majority of people recover withoutany further evidence of the disease. For years the infection may stay inactive (latent). People with TB infection are not contagious, do not have any symptoms, and do not put their friends, co-workers and family at risk. Many people who have latent TB infection never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria become active, multiply, and cause TB disease. There is good news for people with TB disease! It can almost always be treated and cured with medicine. But the medicine must be taken as directed by Physician. The relapse rate differs by a country's incidence and control: 0–27% of TB relapses occur within 2 years after treatment completion and most relapses occur within 5 years; however, some relapses occur 15 years after treatment. A person who has genital tuberculosis can infect others through sexual contact. The most common means of spreading genital TB can be through blood or lymph. Hence, sexual contact can spread genital tuberculosis. Genital tuberculosis can spread to any other body organ, once it enters the body. Consuming a diet high in nutritious foods and beverages is a smart way to support and protect lung health. Coffee, dark leafy greens, fatty fish, peppers, tomatoes, olive oil, oysters, blueberries, and pumpkin are just some examples of foods and drinks that have been shown to benefit lung function. Milk can be used by TB patient. It is also a great source of protein, providing strength necessary to perform day-to-day activities. Directly observed treatment, short-course (DOTS, also known as TB-DOTS) is the name given to the tuberculosis (TB) control strategy recommended by the World Health Organization. According to WHO, "The most cost-effective way to stop the spread of TB in communities with a high incidence is by curing it. The usual treatment is: two antibiotics (isoniazid and rifampicin) for 6 months, two additional antibiotics (pyrazinamide and ethambutol) for the first 2 months of the 6-month treatment period. Groups with high rates of TB transmission are homeless persons, injection drug users, and persons with HIV infection are more susceptible for TB and persons who have immigrated from areas of the world with high rates of TB. The disease is prevalent mainly in the underprivileged sections of the society. The lack of knowledge in the masses and the communities is a factor that contributes largely to the spread of the disease. The theme of World TB Day 2020 was “It's TIME to end TB” and in 2021 it is,” Am I stopping TB” highlighting the importance of awareness. It is the time to fuel the awareness program with full energy, resources and ways. In such a scenario, there is always a need for new and innovative ideas to create mass awareness about tuberculosis. The more focus of this awareness campaign should be very much targeted towards people living in an area where there are a lot of people are with TB, or have been homeless or live in poorly ventilated or overcrowded housing and sufferers of a weakened immune system.

Introduction: Conceptualizing DisabilityThe two most prominent models for understanding disability are the medical model and the social model (“Disability”). The medical model locates disability in the person and emphasises the possibility of a cure, reinforcing the idea that disability is the fault of the disabled person, their body, their genes, and/or their upbringing. The social model, formulated as a response to the medical model, presents disability as a failure of the surrounding environment to accommodate differently abled bodies and minds. Closely linked to identity politics, the social model argues that disability is not a defect to be fixed but a source of human experience and identity, and that to disregard the needs of people with disability is to discriminate against them by being “ableist.”Both models have limitations. On the one hand, simply being a person with disability or having any other minority identity/-ies does not by itself lead to exclusion and discrimination (Nocella 18); an element of social valuation must be present that goes beyond a mere numbers game. On the other hand, merely focusing on the social aspect neglects “the realities of sickness, suffering, and pain” that many people with disability experience (Mollow 196) and that cannot be substantially alleviated by any degree of social change. The body is irreducible to discourse and representation (Siebers 749). Disability exists only at the confluence of differently abled minds and bodies and unaccommodating social and physical environs. How a body “fits” (my word) its environment is the focus of the “ecosomatic paradigm” (Cella 574-75); one example is how the drastically different environment of Cormac McCarthy’s The Road (2006) reorients the coordinates of ability and impairment (Cella 582–84). I want to examine a novel that, conversely, features a change not in environment but in body.Alien LegsTim Farnsworth, the protagonist of Joshua Ferris’s second novel, The Unnamed (2010), is a high-powered New York lawyer who develops a condition that causes him to walk spontaneously without control over direction or duration. Tim suffers four periods of “walking,” during which his body could without warning stand up and walk at any time up to the point of exhaustion; each period grows increasingly longer with more frequent walks, until the fourth one ends in Tim’s death. As his wife, Jane, understands it, these forced excursions are “a hijacking of some obscure order of the body, the frightened soul inside the runaway train of mindless matter” (24). The direction is not random, for his legs follow roads and traffic lights. When Tim is exhausted, his legs abruptly stop, ceding control back to his conscious will, whence Tim usually calls Jane and then sleeps like a baby wherever he stops. She picks him up at all hours of the day and night.Contemporary critics note shades of Beckett in both the premise and title of the novel (“Young”; Adams), connections confirmed by Ferris (“Involuntary”); Ron Charles mentions the Poe story “The Man of the Crowd” (1845), but it seems only the compulsion to walk is similar. Ferris says he “was interested in writing about disease” (“Involuntary”), and disability is at the core of the novel; Tim more than once thinks bitterly to himself that the smug person without disability in front of him will one day fall ill and die, alluding to the universality of disability. His condition is detrimental to his work and life, and Stuart Murray explores how this reveals the ableist assumptions behind the idea of “productivity” in a post-industrial economy. In one humorous episode, Tim arrives unexpectedly (but volitionally) at a courtroom and has just finished requesting permission to join the proceedings when his legs take him out of the courtroom again; he barely has time to shout over his shoulder, “on second thought, Your Honor” (Ferris Unnamed 103). However, Murray does not discuss what is unique about Tim’s disability: it revolves around walking, the paradigmatic act of ability in popular culture, as connoted in the phrase “to stand up and walk.” This makes it difficult to understand Tim’s predicament solely in terms of either the medical or social model. He is able-bodied—in fact, we might say he is “over-able”—leading one doctor to label his condition “benign idiopathic perambulation” (41; my emphasis); yet the lack of agency in his walking precludes it from becoming a “pedestrian speech act” (de Certeau 98), walking that imbues space with semiotic value. It is difficult to imagine what changes society could make to neutralize Tim’s disability.The novel explores both avenues. At first, Tim adheres to the medical model protocol of seeking a diagnosis to facilitate treatment. He goes to every and any (pseudo)expert in search of “the One Guy” who can diagnose and, possibly, cure him (53), but none can; a paper in The New England Journal of Medicine documents psychiatrists and neurologists, finding nothing, kicking the can between them, “from the mind to body back to the mind” (101). Tim is driven to seek a diagnosis because, under the medical model, a diagnosis facilitates understanding, by others and by oneself. As the Farnsworths experience many times, it is surpassingly difficult to explain to others that one has a disease with no diagnosis or even name. Without a name, the disease may as well not exist, and even their daughter, Becka, doubts Tim at first. Only Jane is able to empathize with him based on her own experience of menopause, incomprehensible to men, gesturing towards the influence of sex on medical hermeneutics (Mollow 188–92). As the last hope of a diagnosis comes up empty, Tim shifts his mentality, attempting to understand his condition through an idiosyncratic idiom: experiencing “brain fog”, feeling “mentally unsticky”, and having “jangly” nerves, “hyperslogged” muscles, a “floaty” left side, and “bunched up” breathing—these, to him, are “the most precise descriptions” of his physical and mental state (126). “Name” something, “revealing nature’s mystery”, and one can “triumph over it”, he thinks at one point (212). But he is never able to eschew the drive toward understanding via naming, and his “deep metaphysical ache” (Burn 45) takes the form of a lament at misfortune, a genre traceable to the Book of Job.Short of crafting a life for Tim in which his family, friends, and work are meaningfully present yet detached enough in scheduling and physical space to accommodate his needs, the social model is insufficient to make sense of, let alone neutralize, his disability. Nonetheless, there are certain aspects of his experience that can be improved with social adjustments. Tim often ends his walks by sleeping wherever he stops, and he would benefit from sensitivity training for police officers and other authority figures; out of all the authority figures who he encounters, only one shows consideration for his safety, comfort, and mental well-being prior to addressing the illegality of his behaviour. And making the general public more aware of “modes of not knowing, unknowing, and failing to know”, in the words of Jack Halberstam (qtd. in McRuer and Johnson 152), would alleviate the plight not just of Tim but of all sufferers of undiagnosed diseases and people with (rare forms of) disability.After Tim leaves home and starts walking cross-country, he has to learn to deal with his disability without any support system. The solution he hits upon illustrates the ecosomatic paradigm: he buys camping gear and treats his walking as an endless hike. Neither “curing” his body nor asking accommodation of society, Tim’s tools mediate a fit between body and environs, and it more or less works. For Tim the involuntary nomad, “everywhere was a wilderness” (Ferris Unnamed 247).The Otherness of the BodyProblems arise when Tim tries to fight his legs. After despairing of a diagnosis, he internalises the struggle against the “somatic noncompliance” of his body (Mollow 197) and refers to it as “the other” (207). One through-line of the novel is a (failed) attempt to overcome cartesian duality (Reiffenrath). Tim divides his experiences along cartesian lines and actively tries to enhance while short-circuiting the body. He recites case law and tries to take up birdwatching to maintain his mind, but his body constantly stymies him, drawing his attention to its own needs. He keeps himself ill-clothed and -fed and spurns needed medical attention, only to find—on the brink of death—that his body has brought him to a hospital, and that he stops walking until he is cured and discharged. Tim’s early impression that his body has “a mind of its own” (44), a situation comparable to the Strange Case of Dr Jekyll and Mr Hyde (1886; Ludwigs 123–24), is borne out when it starts to silently speak to him, monosyllabically at first (“Food!” (207)), then progressing to simple sentences (“Leg is hurting” (213)) and sarcasm (“Deficiency of copper causes anemia, just so you know” (216)) before arriving at full-blown taunting:The other was the interrogator and he the muttering subject […].Q: Are you aware that you can be made to forget words, if certain neurons are suppressed from firing?A: Certain what?Q: And that by suppressing the firing of others, you can be made to forget what words mean entirely? Like the word Jane, for instance.A: Which?Q: And do you know that if I do this—[inaudible]A: Oof!Q: —you will flatline? And if I do this—[inaudible]A: Aaa, aaa…Q: —you will cease flatlining? (223–24; emphases and interpolations in original except for bracketed ellipsis)His Jobean lament turns literal, with his mind on God’s side and his body, “the other”, on the Devil’s in a battle for his eternal soul (Burn 46). Ironically, this “God talk” (Ferris Unnamed 248) finally gets Tim diagnosed with schizophrenia, and he receives medication that silences his body, if not stilling his legs. But when he is not medicated, his body can dominate his mind with multiple-page monologues.Not long after Tim’s mind and body reach a truce thanks to the camping gear and medication, Tim receives word on the west coast that Jane, in New York, has terminal cancer; he resolves to fight his end-of-walk “narcoleptic episodes” (12) to return to her—on foot. His body is not pleased, and it slowly falls apart as Tim fights it eastward cross-country. By the time he is hospitalized “ten miles as the crow flies from his final destination”, his ailments include “conjunctivitis”, “leg cramps”, “myositis”, “kidney failure”, “chafing and blisters”, “shingles”, “back pain”, “bug bites, ticks, fleas and lice”, “sun blisters”, “heatstroke and dehydration”, “rhabdomyolysis”, “excess [blood] potassium”, “splintering [leg] bones”, “burning tongue”, “[ballooning] heels”, “osteal complications”, “acute respiratory distress syndrome”, “excess fluid [in] his peritoneal cavity”, “brain swelling”, and a coma (278–80)—not including the fingers and toes lost to frostbite during an earlier period of walking. Nevertheless, he recovers and reunites with Jane, maintaining a holding pattern by returning to Jane’s hospital bedside after each walk.Jane recovers; the urgency having dissipated, Tim goes back on the road, confident that “he had proven long ago that there was no circumstance under which he could not walk if he put his mind to it” (303). A victory for mind over body? Not quite. The ending, Tim’s death scene, planned by Ferris from the beginning (Ferris “Tracking”), manages to grant victory to both mind and body without uniting them: his mind keeps working after physical death, but its last thought is of a “delicious […] cup of water” (310). Mind and body are two, but indivisible.Cartesian duality has relevance for other significant characters. The chain-smoking Detective Roy, assigned the case Tim is defending, later appears with oxygen tank in tow due to emphysema, yet he cannot quit smoking. What might have been a mere shortcut for characterization here carries physical consequences: the oxygen tank limits Roy’s movement and, one supposes, his investigative ability. After Jane recovers, Tim visits Frank Novovian, the security guard at his old law firm, and finds he has “gone fat [...] His retiring slouch behind the security post said there was no going back”; recognising Tim, Frank “lifted an inch off [his] chair, righting his jellied form, which immediately settled back into place” (297; my emphases). Frank’s physical state reflects the state of his career: settled. The mind-body antagonism is even more stark among Tim’s lawyer colleagues. Lev Wittig cannot become sexually aroused unless there is a “rare and extremely venomous snak[e]” in the room with no lights (145)—in direct contrast to his being a corporate tax specialist and the “dullest person you will ever meet” (141). And Mike Kronish famously once billed a twenty-seven-hour workday by crossing multiple time zones, but his apparent victory of mind over matter is undercut by his other notable achievement, being such a workaholic that his grown kids call him “Uncle Daddy” (148).Jane offers a more vexed case. While serving as Tim’s primary caretaker, she dreads the prospect of sacrificing the rest of her life for him. The pressures of the consciously maintaining her wedding vows directly affects her body. Besides succumbing to and recovering from alcoholism, she is twice tempted by the sexuality of other men; the second time, Tim calls her at the moment of truth to tell her the walking has returned, but instead of offering to pick him up, she says to him, “Come home” (195). As she later admits, asking him to do the impossible is a form of abandonment, and though causality is merely implied, Tim decides a day later not to return. Cartesian duality is similarly blurred in Jane’s fight against cancer. Prior to developing cancer, it is the pretence for Tim’s frequent office absences; she develops cancer; she fights it into remission not by relying on the clinical trial she undergoes, but because Tim’s impossible return inspires her; its remission removes the sense of urgency keeping Tim around, and he leaves; and he later learns that she dies from its recurrence. In multiple senses, Jane’s physical challenges are inextricable from her marriage commitment. Tim’s peripatetic condition affects both of them in homologous ways, gesturing towards the importance of disability studies for understanding the experience both of people with disability and of their caretakers.Becka copes with cartesian duality in the form of her obesity, and the way she does so sets an example for Tim. She gains weight during adolescence, around the time Tim starts walking uncontrollably, and despite her efforts she never loses weight. At first moody and depressed, she later channels her emotions into music, eventually going on tour. After one of her concerts, she tells Tim she has accepted her body, calling it “my one go-around,” freeing her from having to “hate yourself till the bitter end” (262) to instead enjoy her life and music. The idea of acceptance stays with Tim; whereas in previous episodes of walking he ignored the outside world—another example of reconceptualizing walking in the mode of disability—he pays attention to his surroundings on his journey back to New York, which is filled with descriptions of various geographical, meteorological, biological, and sociological phenomena, all while his body slowly breaks down. By the time he leaves home forever, he has acquired the habit of constant observation and the ability to enjoy things moment by moment. “Beauty, surprisingly, was everywhere” (279), he thinks. Invoking the figure of the flâneur, which Ferris had in mind when writing the novel (Ferris “Involuntary”), Peter Ferry argues that “becoming a 21st century incarnation of the flâneur gives Tim a greater sense of selfhood, a belief in the significance of his own existence within the increasingly chaotic and disorientating urban environment” (59). I concur, with two caveats: the chaotic and disorienting environment is not merely urban; and, contrary to Ferry’s claim that this regained selfhood is in contrast to “disintegrating” “conventional understandings of masculinity” (57), it instead incorporates Tim’s new identity as a person with disability.Conclusion: The Experience of DisabilityMore than specific insights into living with disability, the most important contribution of The Unnamed to disability studies is its exploration of the pure experience of disability. Ferris says, “I wanted to strip down this character to the very barest essentials and see what happens when sickness can’t go away and it can’t be answered by all [sic] of the medical technology that the country has at its disposal” (“Tracking”); by making Tim a wealthy lawyer with a caring family—removing common complicating socioeconomic factors of disability—and giving him an unprecedented impairment—removing all medical support and social services—Ferris depicts disability per se, illuminating the importance of disability studies for all people with(out) disability. After undergoing variegated experiences of pure disability, Tim “maintained a sound mind until the end. He was vigilant about periodic checkups and disciplined with his medication. He took care of himself as best he could, eating well however possible, sleeping when his body required it, […] and he persevered in this manner of living until his death” (Ferris Unnamed 306). 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