September 19, 2022
Cardiac involvement as a potential complication associated with Monkeypox.
A recent case study describes a 31-year-old male with monkeypox who developed acute myocarditis days after the eruption of skin lesions. Within a week of treatment, the patient made a complete clinical recovery. As the related smallpox virus has previously been associated with myocarditis, tropism for injury to cardiac tissue in monkeypox may also be likely. A better understanding of the relationship between myocarditis and monkeypox may further support recognition of other associated monkeypox complications and improve future patient outcomes. [JACC: Case Reports]
Neutralizing antibody levels confers longer-lasting COVID-19 protection in children.
To further investigate how the immune response of children is affected by the SARS-CoV-2 virus, researchers in Singapore analyzed antibody levels from infected individuals aged 0 to 16 years between February 2020 and September 2021. They found that neutralizing antibodies persisted for 9 to 13 months following infection, with peak levels being reached more rapidly in children under five. Overall, the findings suggested that the risk of COVID-19 reinfection may be lower among young children. [JAMA Pediatrics]
Climate tipping points may provide applicable thresholds for at-risk ecosystems.
As a warming climate continues to stress the natural processes of multiple ecosystems, a recent study warns against self-sustaining drivers of climate change, known as ‘climate tipping points’, that can potentially lead to irreversible changes for the planet. Using mixed methodologies, researchers created 16 regional forecasts and identified six areas with tipping points below 2°C warming, four with tipping points between 2 and 4°C, and six with tipping points greater than 4°C. These results raise concerns over the current Paris Agreement to keep warming under 1.5°C and recommend that more robust modeling analyses are urgently needed to outpace the effects of climate change. [Science]
Better tools are needed to combat malaria in Mozambique.
Between 2015 and 2020, malaria incidence in Mozambique increased by 60%, with no improvement since 2011 for children under five. Despite increased anti-malaria efforts, residual malaria transmission persists due in part to insecticide resistance and behavioral changes of mosquitoes. Seasonal chemoprevention with stronger combination antimalarials (sulfadoxine-pyrimethamine and amodiaquine) will soon be tested in children of ages 3 to 59 months in Mozambique; however, sulfadoxine-resistant mosquitoes remain a concern. Increased diagnostic capabilities, universal bed-net coverage, and immediate access to improved antimalarial therapies in high-burden areas of central and northern Mozambique may help drive malaria down, especially in areas with limited resources and extreme poverty. [Science]
A One Health approach may help reduce future catastrophes in Texas.
The last 15 years have seen extensive morbidity, mortality, and economic loss in Texas due to multiple disasters ranging from massive floods to large-scale power disruption. To mitigate further losses, an interdisciplinary network of professionals is working to train next-generation scientists using a One Health approach that may help combat the complexities of future catastrophes. Among these initiatives are training in biopreparedness, recognition of recurrent pathogens, development of improved therapeutics and vaccines, and implementation of novel surveillance methods for emerging pathogens, all of which aim to provide multi-disciplinary solutions for complex disasters. [One Health]
Excess deaths in 2020 and 2021 demonstrate the importance of reducing income and access inequities.
Researchers calculated within-country Gini coefficients, a commonly used measure of income inequality, as well as inequality in access to effective antenatal care (ANC) in sub-Saharan Africa, and compared these two metrics against excess deaths between 2020 and 2021. Greater inequality in income and access to effective ANC were both correlated with a greater excess death count during the first two years of the pandemic. However, income inequality is a better predictor of excess deaths than access inequality. Countries should focus on and invest in resolving health inequities while preparing for future pandemics. [BMJ Global]
Urine samples from pregnant women could allow for more accessible AMR surveillance in rural West Africa.
An assessment of whether Escherichia coli isolates among pregnant women could be used as a proxy for clinical AMR surveillance in rural Burkina Faso was done by analyzing 5,934 urine samples collected from healthy, pregnant women during routine antenatal care (ANC) visits between October 2016 and September 2018. Bacterial growth was detected in 28.9% of all samples with E. coli accounting for 76.7% of isolated pathogens. Resistance to ampicillin, cotrimoxazole, and ciprofloxacin was significantly lower among the isolates from pregnant women compared to those from clinical patients diagnosed with fever in the same rural area. Surveying urine samples from ANC visits may serve as a better indicator and more affordable measure of community-level AMR than clinical surveillance. [Antimicrobial Resistance & Infection Control]
An antimicrobial stewardship program in Japan decreased antibiotic use and incidence of hospital-acquired candidemia.
A retrospective study conducted between April 2017 and September 2020 at a tertiary care hospital in Tokyo, Japan, showed that an antimicrobial stewardship program implemented in April 2018 resulted in reduced antibiotic use and a lower incidence of hospital-acquired candidemia. Patients treated with three antipseudomonal antibiotics, carbapenem, tazobactam/piperacillin, and cefepime, were included in the study. The median monthly days of therapy (DOT) of carbapenem declined from 28.4 to 10.0 per 1,000 patient days following the intervention period. The median monthly DOT for all three antipseudomonal agents dropped from 69.4 to 56.3 per 1,000 patient days. The median incidence of hospital-acquired candidemia fell from 0.17 to 0.08 per 1,000 patient days. [Scientific Reports]
Surveillance for type 3 vaccine-derived poliovirus is needed to achieve polio eradication.
In March 2022, type 3 vaccine-derived poliovirus (VDPV3) was detected in stool specimens collected from a one-year-old infant hospitalized in Chongqing, China, with newly diagnosed primary immunodeficiency disorder (PID). VDPVs are thought to emerge in unvaccinated and immunodeficient populations due to mutations in the widely used oral poliovirus vaccine (OPV). Children with PID are vulnerable to developing iVDPVs in response to receiving the OPV, hindering global polio eradication efforts. Surveillance among patients with PID has increased the detection of iVDPVs in non-paralyzed patients, signaling the need for expanded iVDPV surveillance systems. [CDC Morbidity and Mortality Weekly Report (MMWR)]
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