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The article discusses several published infectious diseases studies. It includes a study on the antibody invasion properties of the BQ and XBB subvariants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and two studies that provide information about the mechanisms of HIV silencing, prolonged survival of provirus carrying CD4 cells, and the escape of the cells from immune surveillance.
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Using aerosol-based tracers to estimate risk of infectious aerosol transmission aids in the design of buildings with adequate protection against aerosol transmissible pathogens, such as SARS-CoV-2 and influenza. We propose a method for scaling a SARS-CoV-2 bulk aerosol quantitative microbial risk assessment (QMRA) model for impulse emissions, coughing or sneezing, with aerosolized synthetic DNA tracer concentration measurements. With point-of-emission ratios describing relationships between tracer and respiratory aerosol emission characteristics (i.e., volume and RNA or DNA concentrations) and accounting for aerosolized pathogen loss of infectivity over time, we scale the inhaled pathogen dose and risk of infection with time-integrated tracer concentrations measured with a filter sampler. This tracer-scaled QMRA model is evaluated through scenario testing, comparing the impact of ventilation, occupancy, masking, and layering interventions on infection risk. We apply the tracer-scaled QMRA model to measurement data from an ambulatory care room to estimate the risk reduction resulting from HEPA air cleaner operation. Using DNA tracer measurements to scale a bulk aerosol QMRA model is a relatively simple method of estimating risk in buildings and can be applied to understand the impact of risk mitigation efforts.
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COVID-19 , SARS-CoV-2 , Humanos , Aerosoles y Gotitas Respiratorias , Medición de Riesgo/métodos , ADNRESUMEN
The article discusses two published infectious diseases studies. It includes a study which examined the clinical presentation and outcome of invasive Trichoderma spp. infections reported in the literature and from Fungiscope, a global registry of invasive fungal infections, and another study which reviewed a range of autoantibodies targeting cytokines that are associated with a variety of infectious diseases.
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Subjects were judged to be at risk, either because of a likely inadequate response to vaccination or increased risk of exposure due to location (e.g., nursing home) or circumstance. The reduced activity against BA.1 had led the U.S. Food and Drug Administration, in February 2022, to recommend a doubling of the doses of the components to 600 mg each, with the purpose of overcoming modest reductions in activity. [...]in the clinical trial results discussed here, there were only a total of 198 patients with immunocompromise, with symptomatic infection occurring in 1/125 and 2/93 tixagevimab-cilgavimab and placebo recipients, respectively. [...]we really do not know the degree of benefit that may be achieved in these patients, just as we do not know for certain its efficacy in an Omicron world.
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Rituals are an integral part of human life but a wide range of rituals (both religious and non-religious), from self-flagellation to blood brotherhood to ritual sprinkling of holy water, have been associated with transmission of infections. These infections include angiostrongyliasis, anthrax, brucellosis, cholera, COVID-19, cutaneous larva migrans, Ebola, hepatitis viruses, herpes simplex virus, HIV, human T-cell leukemia virus (HTLV), kuru, Mycobacterium bovis, Naegleria fowleri meningoencephalitis, orf, rift valley fever, and sporotrichosis. Education and community engagement are important cornerstones in mitigating infectious risks associated with rituals.
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Within that interval, beginning Dec. 29, 1,226 reports of post-vaccination myocarditis were reported to the Vaccine Adverse Event Reporting System (VAERS). All recorded elevated cardiac troponin levels, and all had late enhancement of MRI images with gadolinium enhancement, a characteristic finding in myocarditis.1 All patients recovered rapidly without apparent sequelae. Montgomery et al described 23 cases of myocarditis identified within the U.S. Military Health System that occurred over a period during which more than 2.8 million mRNA vaccine doses had been administered.2 All were male and their median age was 25 years (range, 20-51 years).
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The Centers for Disease Control and Prevention (CDC) has updated their 2015 guidelines for the treatment of sexually transmitted infections, and some of the changes are reviewed here. Empiric treatment of PID required coverage against Chlamydia trachomatis, Neisseria gonorrhoeae, and other likely pathogens, including anaerobes, with the last consideration leading to a recommendation to add metronidazole to all regimens. [...]the currently recommended regimen is single-dose ceftriaxone (1,000 mg IM) together with doxycycline (100 mg orally twice daily for 14 days) and metronidazole (500 mg orally twice daily for 14 days). The number of reported cases of sexually transmitted disease reached a new high for the sixth consecutive year in 2019 and, despite the appearance of COVID-19, the CDC reported a few months ago that “preliminary data suggest that many of these concerning trends continued in 2020, when much of the country experienced major disruptions to sexually transmitted disease testing and treatment services due to the COVID-19 pandemic.”
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Monoclonal antibody administration also was associated with an 85.8% relative risk reduction of having a high nasopharyngeal viral load, defined as >104 ribonucleic acid (RNA) copies/mL, and the duration of having a high viral load was almost one week shorter. COMMENTARY Administration of the combination of casirivimab and imdevimab to at-risk outpatients with symptomatic COVID-19 has been demonstrated previously to result in an approximately 70% reduction in the incidence of hospitalization or death, rapidly reduce the viral load, and shorten the duration of symptoms.1 That study, which clearly demonstrated therapeutic benefit, resulted in the issuance of an Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration (FDA).2,3 Of note is that this remains the only unequivocally effective therapeutic for use in symptomatic outpatients. In a study evaluating the therapeutic efficacy of REGEN-COV in hospitalized patients with COVID-19, benefit was limited to those seronegative at enrollment.4 As a consequence, it was stated by the investigators that “therapeutic use of REGEN-COV in the hospital setting may be best restricted to seronegative patients.”
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From December 2020, when the Food and Drug Administration (FDA) issued Emergency Use Authorization for the use of Moderna and Pfizer-BioNTech mRNA COVID-19 vaccines, through June 11, 2021, approximately 296 million doses were administered in the United States, including 52 million doses given to individuals 12-29 years of age. A further review of 323 patients who met Centers for Disease Control and Prevention (CDC) definitions for myocarditis, pericarditis, or myopericarditis was performed. Montgomery et al described 23 cases of myocarditis identified within the U.S. Military Health System that occurred over a period during which more than 2.8 million mRNA vaccine doses had been administered.2 All were male and their median age was 25 years (range, 20-51 years).
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Johnson and colleagues have provided a focused update of the 2017 Infectious Diseases Society of America — Society for Healthcare Epidemiology of America clinical practice guidelines for Clostridioides difficile infection (CDI). [...]the panel points out that since 2017 there have been two Food and Drug Administration (FDA) alerts about the treatment modality: two related to transmission of antibiotic-resistant Escherichia coli and one raising issues regarding COVID-19. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).
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The immune response to natural SARS-CoV-2 infection in immunnosuppressed patients also is of interest, and some studies have found that antibody and cellular immune responses were similar to those of a non-immunosuppressed control group. In a study by the same group responsible for the paper reviewed here, SARS-CoV-2 infection resulted in the development of antibody to the viral spike protein in 78% after a median of 98 days.1 Favà et al found that solid organ transplant recipients had serologic and cellular immune responses similar to those of a control population, although with a delay in some.2 These results seem consistent with a number of reports that, despite their immunosuppressive therapy, the outcome of COVID-19 in solid organ transplant recipients is similar to that of patients not receiving such therapy. [...]immunosuppressive agents (dexamethasone, baricitinib, and perhaps tocilizumab) have been demonstrated to provide clinical benefit in selected patients with COVID-19.
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[...]the not insignificant incidence of non-severe adverse reactions (possibly related to the presence of an adjuvant) after receipt of Shingrix raised concern about whether, outside the cloak of a clinical trial, many patients might not return for a second dose. [...]although the effectiveness of the vaccine was high in these studies, including when compared to Zostavax, effectiveness was lower than in the two clinical trials leading to the approval. Martins and colleagues reported that the introduction of a publicly funded herpes zoster immunization program in 2019 was associated with significant reductions in medically attended visits, emergency department visits, and hospitalization related to zoster — and this was with the use of the less effective live virus vaccine.2
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There were several exclusion criteria, including severe respiratory disease, primary hypogammaglobulinemia, lymphoproliferative disorders, cancer with treatment in the previous six months, immunosuppressive therapy, solid organ transplant, chronic liver or lung disease, and receipt of anticoagulants. The results also may be considered possibly surprising based on prior published experience. [...]in a supplementary appendix, the authors listed five previous randomized, controlled trials that enrolled between 81 and 333 patients and that failed to demonstrate benefit from administration of convalescent plasma in the treatment of patients with COVID-19. Of note is the emergency use authorizations for these monoclonals allow for infusion to patients with symptom durations as long as 10 days. [...]convalescent plasma with high IgG antibody titers should be considered for administration to patients who match the entry/exclusion criteria in the Libster et al study.
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The patients, whose mean age was 46 years (range, 0.3-73.8 years), had been seen at 31 transplant centers in 13 countries in Asia, Australia, and South America. Because they received their grafts from unrelated adult donors, cord blood, or haplo-identical family donors, 57% were considered high risk. [...]a mortality rate as high as 8% has been seen in outbreaks in elderly residents of long-term care facilities.1 The mortality rate in patients with lower respiratory infection reported by Piñana and colleagues was 16.7%. In an adjusted comparison with cases of lower respiratory tract infection in a similar patient population, mortality was similar to that observed with infections due to respiratory syncytial virus, influenza, and parainfluenza virus — each of which is recognized as a significant cause of morbidity and mortality in immunocompromised patients.