August 20, 2018
Alcohol products for hand washing may be losing effectiveness. In a recent study, researchers testing Enterooccus faecium samples from 139 hospitals between 1997 and 2015 discovered a ten-fold increase in alcohol tolerance after 2010. Using mouse models, alcohol-tolerant E. faecium samples were shown to resist standard alcohol surface disinfectant, resulting in greater gut colonization. The resulting change is not clinically relevant as yet, and alcohol-based disinfectants remain an important component of infection prevention and control in hospital settings. However, this increase in tolerance suggests that there is a long-term potential for resistance emerging to alcohol-based hand rubs and there may be a need for new approaches to hand hygiene in the coming decades. [Inside Science, Science Translational Medicine]
Triage for the world’s emerging infectious diseases: World Health Organization’s new methodology. At the request of the 2015 United Nations General Assembly, the World Health Organization (WHO) has recently launched a new Research and Development (R&D) Blueprint for preventing epidemics. Their three-step process aims to create a list of ten priority diseases to focus research efforts. As a result of targeted R&D, the WHO hopes to strengthen emergency response systems and improve public health preparedness against outbreaks of epidemic potential. [Centers for Disease Control and Prevention]
Philosophical reasoning for increase in measles outbreaks. A recent study shows that in 12 of the 18 states allowing nonmedical vaccine exemptions, such exemptions have increased overall since 2009. Researchers found that among states where nonmedical exemptions are legal, increases in exemption rates were associated with decreased measles, mumps, and rubella vaccine coverage of kindergarteners. Conversely, states that banned nonmedical exemptions saw an increase in vaccine coverage. While rates of nonmedical exemptions have plateaued among half of states with exemptions in recent years, six states continue to report increasing rates of nonmedical exemptions. Researchers worry that, should these exemptions continue to increase, large low- and middle-income countries may follow suit, risking a much larger and more severe outbreak. [New York Times (Opinion), PLoS Medicine]
Study shows that prices for drugs do not align with value in the United States. A recent study published in Health Affairs estimated the cost-effectiveness of cardiovascular drugs to understand whether drug pricing was consistent with the drug’s effectiveness. The study found a wide range of cost-effectiveness values among the most common cardiovascular drugs suggesting that drug prices are not consistently related to health gains or that relationships between price and value are confounded by extraneous factors, such as price discounts. Researchers hope that this information leads to fairer drug pricing in the United States. [Health Affairs, EurekAlert]
Foreign tick raising concerns across the East coast of the United States. The Asian longhorned tick (Haemaphysalis longicornis), a tick originally found in East Asia, has been found in seven states, including the densely populated suburbs of New York. While the ticks found in the United States have yet to carry any human diseases (affecting only livestock, domestic pets, and wild animals), this species is known to carry a virus with a mortality rate of 15 percent among infected humans in Asia. [New York Times, The Independent]
China to launch emergency inspections on farms after swine fever outbreak. In response to the first ever outbreak of African swine fever in East Asia, the Bureau of Animal Health and Production in Liaoning province, where the first case was reported, announced the launching of emergency inspections of all pig farms, markets, slaughterhouses, and treatment sites in the province. Fear that the outbreak may spread has fueled growing concerns throughout China – which has the world’s largest pig herd – and has also prompted neighboring country Japan to suspend all imports of heat-treated Chinese pork. [Reuters, BRICS Journal]
Obesity playing a major role in influenza transmission and duration of shedding. Prior research has demonstrated that obesity increases the risk of complications and death from influenza. In a new study of viral shedding, researchers found that obese individuals symptomatically infected with influenza A virus had 42% longer shedding periods than non-obese individuals. However, this association was only significant in adults, which researchers hypothesize may be linked to chronic inflammation. A separate study found that obese subjects demonstrated increased aerosol-based shedding. Combined, these findings suggest that obesity may be an important factor in influenza transmission. [EurekAlert, EurekAlert, The Journal of Infectious Diseases]
Minimizing Zika-related birth defects: Maternal dengue immunity through CD8+ T cells. In a recent study investigating the role of prior dengue-immunity on Zika-related congenital birth defects, researchers found a stronger CD8+ T cell response in dengue-immune pregnant mice, compared to non-immune mice. Because CD8+ T cells are responsible for launching the immune response in patients with both Zika and dengue virus (two closely related flaviviruses), researchers believe these cells may play an important role in mediating the protective effects of prior dengue-immunity on Zika-related birth defects. This finding could lead to more effective flavivirus vaccines and introduce new vaccine designs, which boost CD8+ T cell responses. [EurekAlert, Nature]
Antimicrobial consumption and impact of antimicrobial stewardship programs in long-term care facilities. A review of antibiotic consumption in long-term care facilities and the need for and impact of antimicrobial stewardship programs has found extensive variation in the use of antibiotics in this setting, both within and across countries. Inappropriate use was especially high among elderly patients with asymptomatic bacteriuria and influenza-like symptoms. However, high-quality randomized controlled trials as well as quasi-experimental studies have shown that antimicrobial stewardship programs that include educational interventions targeting nurses and physicians are an effective means of reducing inappropriate prescribing and unnecessary antibiotic therapy. [Clinical Microbiology and Infection]
Realities of antibiotic use in low income countries. CDDEP researchers’ March 2018 article on the global increase in antibiotic consumption sparked an abundance of responses, most recently from researchers in France. In a letter to the editor in PNAS, it was noted that there are potential positive outcomes to the accessibility and prevalence of antibiotics in low income countries and suggest that the decrease in deaths from respiratory infections over the last two decades is one of the positive outcomes. In their response, CDDEP researchers noted that there was little correlation between respiratory deaths and increasing use of antibiotics and that it remains important to improve policies to reduce the unnecessary use of antibiotics, particularly broad-spectrum drugs. [PNAS]
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