• A multi-model approach to monitor emissions of CO<sub>2</sub> and CO from an urban–industrial complex

      Super, Ingrid; Denier van der Gon, Hugo A. C.; van der Molen, Michiel K.; Sterk, Hendrika A. M.; Hensen, Arjan; Peters, Wouter (2017-11-09)
      Monitoring urban–industrial emissions is often challenging because observations are scarce and regional atmospheric transport models are too coarse to represent the high spatiotemporal variability in the resulting concentrations. In this paper we apply a new combination of an Eulerian model (Weather Research and Forecast, WRF, with chemistry) and a Gaussian plume model (Operational Priority Substances – OPS). The modelled mixing ratios are compared to observed CO2 and CO mole fractions at four sites along a transect from an urban–industrial complex (Rotterdam, the Netherlands) towards rural conditions for October–December 2014. Urban plumes are well-mixed at our semi-urban location, making this location suited for an integrated emission estimate over the whole study area. The signals at our urban measurement site (with average enhancements of 11 ppm CO2 and 40 ppb CO over the baseline) are highly variable due to the presence of distinct source areas dominated by road traffic/residential heating emissions or industrial activities. This causes different emission signatures that are translated into a large variability in observed ΔCO : ΔCO2 ratios, which can be used to identify dominant source types. We find that WRF-Chem is able to represent synoptic variability in CO2 and CO (e.g. the median CO2 mixing ratio is 9.7 ppm, observed, against 8.8 ppm, modelled), but it fails to reproduce the hourly variability of daytime urban plumes at the urban site (R2 up to 0.05). For the urban site, adding a plume model to the model framework is beneficial to adequately represent plume transport especially from stack emissions. The explained variance in hourly, daytime CO2 enhancements from point source emissions increases from 30 % with WRF-Chem to 52 % with WRF-Chem in combination with the most detailed OPS simulation. The simulated variability in ΔCO :  ΔCO2 ratios decreases drastically from 1.5 to 0.6 ppb ppm−1, which agrees better with the observed standard deviation of 0.4 ppb ppm−1. This is partly due to improved wind fields (increase in R2 of 0.10) but also due to improved point source representation (increase in R2 of 0.05) and dilution (increase in R2 of 0.07). Based on our analysis we conclude that a plume model with detailed and accurate dispersion parameters adds substantially to top–down monitoring of greenhouse gas emissions in urban environments with large point source contributions within a  ∼  10 km radius from the observation sites.
    • Aan de slag met opkomende stoffen in de bodem.

      Wintersen, A; Otte, P; Traas, T (2019-02-12)
    • Aangepast preventiebeleid bij patiënten met hyposplenie of asplenie

      Schreuder, I; Kroon, FP; Peters, EJG; Sanders, EAM; Wildenbeest, JG; Lammers, JAJ (2019-05-06)
    • Aanpassing van de BEL-bemonsteringscriteria.

      Euser, S; Brandsema, P; Ruijs, H (2018-09-18)
    • Aantal tbc-patiënten vergelijkbaar met 2017

      Schimmel, H; Slump, E (2018-09-30)
    • Absence of association between 2019-20 influenza vaccination and COVID-19: Results of the European I-MOVE-COVID-19 primary care project, March-August 2020.

      Kissling, Esther; Hooiveld, Mariëtte; Brytting, Mia; Vilcu, Ana-Maria; de Lange, Marit; Martínez-Baz, Iván; Sigerson, Debbie; Enkirch, Theresa; Belhillil, Sylvie; Meijer, Adam; et al. (2021-01-22)
    • Abundance and Antimicrobial Resistance of Three Bacterial Species along a Complete Wastewater Pathway.

      Verburg, Ilse; García-Cobos, Silvia; Hernández Leal, Lucia; Waar, Karola; Friedrich, Alex W; Schmitt, Heike (2019-09-03)
      After consumption, antibiotic residues and exposed bacteria end up via the feces in wastewater, and therefore wastewater is believed to play an important role in the spread of antimicrobial resistance (AMR). We investigated the abundance and AMR profiles of three different species over a complete wastewater pathway during a one-year sampling campaign, as well as including antimicrobial consumption and antimicrobial concentrations analysis. A total of 2886 isolates (997 Escherichia coli, 863 Klebsiella spp., and 1026 Aeromonas spp.) were cultured from the 211 samples collected. The bacterial AMR profiles mirrored the antimicrobial consumption in the respective locations, which were highest in the hospital. However, the contribution of hospital wastewater to AMR found in the wastewater treatment plant (WWTP) was below 10% for all antimicrobials tested. We found high concentrations (7-8 logs CFU/L) of the three bacterial species in all wastewaters, and they survived the wastewater treatment (effluent concentrations were around 5 log CFU/L), showing an increase of E. coli in the receiving river after the WWTP discharge. Although the WWTP had no effect on the proportion of AMR, bacterial species and antimicrobial residues were still measured in the effluent, showing the role of wastewater contamination in the environmental surface water.
    • Acarological Risk of Borrelia burgdorferi Sensu Lato Infections Across Space and Time in The Netherlands.

      Takken, Willem; van Vliet, Arnold J H; Verhulst, Niels O; Jacobs, Frans H H; Gassner, Fedor; Hartemink, Nienke; Mulder, Sara; Sprong, Hein (2017)
      A longitudinal investigation on tick populations and their Borrelia infections in the Netherlands was undertaken between 2006 and 2011 with the aim to assess spatial and temporal patterns of the acarological risk in forested sites across the country and to assess variations in Borrelia genospecies diversity. Ticks were collected monthly in 11 sites and nymphs were examined for Borrelia infections. Tick populations expressed strong seasonal variations, with consistent and significant differences in mean tick densities between sites. Borrelia infections were present in all study sites, with a site-specific mean prevalence per month ranging from 7% to 26%. Prevalence was location-dependent and was not associated with tick densities. Mean Borrelia prevalence was lowest in January (4%), gradually increasing to reach a maximum (24%) in August. Borrelia afzelii represented 70% of all infections, with Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia valaisiana represented with 4%, 8%, and 10%, respectively. The density of infected nymphs and the proportional distribution of the four Borrelia genospecies, were significantly different between sites. The results show a consistent and significant spatial and temporal difference in acarological risk across the Netherlands.
    • Accelerating Action in Global Health Security: Global Biosecurity Dialogue as a Model for Advancing the Global Health Security Agenda.

      Brizee, Sabrina; Budeski, Katherine; James, Wilmot; Nalabandian, Michelle; Bleijs, Diederik A; Becker, Scott J; Wallace-Sankarsingh, Sacha; Ahumibe, Anthony; Agogo, Emmanuel; Ihekweazu, Chikwe; et al.
    • The Acceptability of Pre-Exposure Prophylaxis: Beliefs of Health-Care Professionals Working in Sexually Transmitted Infections Clinics and HIV Treatment Centers.

      Bil, Janneke P; Hoornenborg, Elske; Prins, Maria; Hogewoning, Arjan; Dias Goncalves Lima, Fernando; de Vries, Henry J C; Davidovich, Udi (2018)
      Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV infections, but is not yet implemented in the Netherlands. As the attitudes of health-care professionals toward PrEP can influence future PrEP implementation, we studied PrEP knowledge and beliefs and their association with PrEP acceptability among professionals in clinics for sexually transmitted infection (STI professionals) and HIV treatment centers (HIV specialists). In addition, we examined preferred regimens, attitudes toward providing PrEP to key populations and to reimbursement of PrEP costs.
    • Accessibility of standardized information of a national colorectal cancer screening program for low health literate screening invitees: A mixed method study.

      Fransen, Mirjam P; Dekker, Evelien; Timmermans, Daniëlle R M; Uiters, Ellen; Essink-Bot, Marie-Louise (2017-02)
      To explore the accessibility of standardized printed information materials of the national Dutch colorectal cancer screening program among low health literate screening invitees and to assess the effect of the information on their knowledge about colorectal cancer and the screening program.
    • Accounting for ingrowth of radioactive progeny in dose assessments: generic weighting factors for dose coefficients.

      van Dillen, Teun; van Dijk, Arjan; Kloosterman, Astrid; Russo, Federica; Mommaert, Chantal (2019-08-27)
    • Accounting for long-term manifestations of Cryptosporidium spp infection in burden of disease and cost-of-illness estimations, the Netherlands (2013-2017).

      Monge, Susana; Pijnacker, Roan; van Pelt, Wilfrid; Franz, Eelco; Kortbeek, Laetitia M; Mangen, Marie-Josée J (2019-01-01)
      Burden of disease (BoD) estimations are increasingly used to prioritize public health interventions. Previous Cryptosporidium BoD models accounted only for acute episodes, while there is increasing evidence of long-term manifestations. Our objective was to update Cryptosporidium BoD and cost-of-illness (COI) models and to estimate BoD and COI for the Netherlands in years 2013-2017. We performed a scoping literature review and drew an outcome tree including long-term manifestations for which sufficient evidence was found, such as recurrent diarrhea and joint pain. We chose the Disability-Adjusted Life Year (DALY) metric to synthesize years of life lost due mortality (YLLs) and years lived with disability due to non-fatal outcomes (YLDs). For the costs, we adopted a societal perspective accounting for direct healthcare costs, patient costs and productivity losses. Uncertainty was managed using Latin Hypercube sampling (30,000 iterations). In the Netherlands in 2017, we estimated 50,000 Cryptosporidium cases (95% uncertainty interval (UI): 15,000-102,000), 7,000 GP visits, 300 hospitalizations and 3 deaths, resulting in 137 DALYs (95%UI: 54-255) and €19.2 million COI (95%UI: €7.2 million- €36.2 million). Estimates were highest for 2016 (218 DALYs and €31.1 million in COI), and lowest in 2013 (100 DALYs and €13.8 million in COI). Most of the BoD was attributable to YLD (≈80% of DALYs). The most important cost was productivity losses (≈90% of total COI). Long-term manifestations, including recurring diarrhea and joint pain, accounted for 9% of the total DALYs and 7% of the total COI. Current evidence supports the inclusion of long-term manifestations in Cryptosporidium models, which contribute close to 10% of the total DALYs and costs. This may be an underestimation, as we were conservative in our assumptions. Cryptosporidium should be considered a priority organism with respect to public health surveillance, even in industrialized countries with high hygiene standards.
    • Accurate Serology for SARS-CoV-2 and common Human Coronaviruses using a Multiplex Approach.

      van Tol, Sophie; Mögling, Ramona; Li, Wentao; Godeke, Gert-Jan; Swart, Arno; Bergmans, Barbara; Brandenburg, Afke; Kremer, Kristin; Murk, Jean-Luc; van Beek, Josine; et al. (2020-08-20)
    • Acellular Pertussis Vaccines Induce Anti-pertactin Bactericidal Antibodies Which Drives the Emergence of Pertactin-Negative Strains.

      Lesne, Elodie; Cavell, Breeze E; Freire-Martin, Irene; Persaud, Ruby; Alexander, Frances; Taylor, Stephen; Matheson, Mary; van Els, Cécile A C M; Gorringe, Andrew (2020-01-01)
      Despite high vaccination coverage, Bordetella pertussis the causative agent of whooping cough is still a health concern worldwide. A resurgence of pertussis cases has been reported, particularly in countries using acellular vaccines with waning immunity and pathogen adaptation thought to be responsible. A better understanding of protective immune responses is needed for the development of improved vaccines. In our study, B. pertussis strain B1917 variants presenting a single gene deletion were generated to analyze the role of vaccine components or candidate vaccine antigens as targets for bactericidal antibodies generated after acellular vaccination or natural infection. Our results show that acellular vaccination generates bactericidal antibodies that are only directed against pertactin. Serum bactericidal assay performed with convalescent samples show that disease induces bactericidal antibodies against Prn but against other antigen(s) as well. Four candidate vaccine antigens (CyaA, Vag8, BrkA, and TcfA) have been studied but were not targets for complement-mediated bactericidal antibodies after natural infection. We confirm that Vag8 and BrkA are involved in complement resistance and would be targeted by blocking antibodies. Our study suggests that the emergence and the widespread circulation of Prn-deficient strains is driven by acellular vaccination and the generation of bactericidal antibodies targeting Prn.
    • Achieving successful community engagement: a rapid realist review

      De Weger, E.; Van Vooren, N.; Luijkx, K. G.; Baan, C. A.; Drewes, H. W. (2018-04-13)
    • Acquisition of C1 inhibitor by Bordetella pertussis virulence associated gene 8 results in C2 and C4 consumption away from the bacterial surface.

      Hovingh, Elise S; van den Broek, Bryan; Kuipers, Betsy; Pinelli, Elena; Rooijakkers, Suzan H M; Jongerius, Ilse (2017-07)
      Whooping cough, or pertussis, is a contagious disease of the respiratory tract that is re-emerging worldwide despite high vaccination coverage. The causative agent of this disease is the Gram-negative Bordetella pertussis. Knowledge on complement evasion strategies of this pathogen is limited. However, this is of great importance for future vaccine development as it has become apparent that a novel pertussis vaccine is needed. Here, we unravel the effect of Virulence associated gene 8 (Vag8) of B. pertussis on the human complement system at the molecular level. We show that both recombinant and endogenously secreted Vag8 inhibit complement deposition on the bacterial surface at the level of C4b. We reveal that Vag8 binding to human C1-inhibitor (C1-inh) interferes with the binding of C1-inh to C1s, C1r and MASP-2, resulting in the release of active proteases that subsequently cleave C2 and C4 away from the bacterial surface. We demonstrate that the depletion of these complement components in the bacterial surrounding and subsequent decreased deposition on B. pertussis leads to less complement-mediated bacterial killing. Vag8 is the first protein described that specifically prevents C1s, C1r and MASP-2 binding to C1-inh and thereby mediates complement consumption away from the bacterial surface. Unravelling the mechanism of this unique complement evasion strategy of B. pertussis is one of the first steps towards understanding the interactions between the first line of defense complement and B. pertussis.
    • Acquisition of multidrug-resistant Enterobacterales during international travel: a systematic review of clinical and microbiological characteristics and meta-analyses of risk factors.

      Voor In 't Holt, Anne F; Mourik, Kees; Beishuizen, Berend; van der Schoor, Adriënne S; Verbon, Annelies; Vos, Margreet C; Severin, Juliëtte A (2020-05-20)