Ferret study suggests connection between H5N1 shedding in air and transmissibility

According to a study conducted in primary care settings in Spain, the monoclonal antibody nirsevimab is 76 percent effective overall at preventing respiratory syncytial virus (RSV) respiratory tract infections that require medical attention. The study appears in the Pediatrics journal.

160 infants aged ten months and under who were given the antibody during the 2023–2024 RSV season were examined in this study. Every newborn born after April 1, 2023, was given nirsevimab at birth in hospitals or as part of a catch-up program prior to the start of the RSV season.

RSV-induced lower respiratory tract infection (LRTI) with medical attention was the primary result.

In primary care offices, catch-up lessens workload.

According to the authors, nirsevimab was given to 141 infants (88 percent) in total, of whom 29 (21 percent of the sample) received it in-hospital during the RSV season and 112 (79 percent) received it through the catch-up program. The majority of infants (64 percent) were boys, and 67% were at least three months old.

Forty-four infants (27.5%) in the study had RSV detection. 37 (28.9%) of the catch-up group tested positive for RSV.

Overall efficacy was 75.8 percent (95 percent CI: 40.4 to 92.7) and 80.2 percent (95 percent CI: 44.3 to 95.4) for infants in the catch-up group.

This study shows that nirsevimab is effective in preventing medically attended RSV-LRTI in infants under 10 months of age in a large Spanish primary care network, both for the catch-up group and overall.

In a large primary care network in Spain, the authors concluded that “this study demonstrates the effectiveness of nirsevimab in preventing medically attended RSV-LRTI in infants aged younger than 10 months, both overall and for the catch-up group.”. Additionally, the authors claimed that administering catch-up nirsevimab is an effective way to lessen the burden on primary care during RSV season.

In anticipation of a possible influenza pandemic, the UK Health Security Agency (HSA) today agreed to purchase over 5 million doses of the human H5 avian flu vaccine from CSL Seqirus.

“The vaccine will be based on a current H5 strain and is part of a longer-term plan to ensure access to vaccines for a wider range of pathogens that have pandemic potential,” the HSA said in a statement.

“Early access to vaccines saves lives,” stated Meera Chand, PhD, the HAS’s emerging infection lead. We will be better equipped to handle a greater variety of threats if we supplement the current interventions with H5 vaccines. “,”.

Only if the virus begins to spread among people will the vaccine be used, according to the agency. While a pandemic-specific vaccine is being created and manufactured, the H5 vaccine may be utilized if necessary. In the event that pandemic vaccines are required, the UK government already has an advance purchase agreement in place.

In addition, the US, the EU, and Japan are among the other nations and areas that are hoarding H5 vaccine.

More H5N1 cases have been reported in poultry and dairy herds in the United States.

Additional H5N1 developments include the confirmation of six additional outbreaks in dairy cattle, all in California, by the Animal and Plant Health Inspection Service (APHIS) of the US Department of Agriculture (USDA) today. California now has 481 outbreaks since late August, while the total number of outbreaks nationwide from 15 states now stands at 695.

Additionally, two additional poultry outbreaks were confirmed by APHIS: one had a flock of 80 birds in Bottineau County, North Dakota, and the other had 30 birds in a backyard in Union County, Oregon.

Today’s study in Infection Control and Hospital Epidemiology found that children who were White and had commercial insurance had lower odds than other groups of receiving first-line (FL) antibiotic therapy at pediatric urgent care centers (PUCs).

The REDUCE (Reducing Differences in Urgent Care Encounters—Antibiotic Choice) Collaborative conducted the study, which assessed the use of FL antibiotics that are advised by guidelines for treating acute respiratory infections (ARIs) in children aged 6 to 18 months at US PUCs between April 2022 and April 2023. Viral respiratory infections, sinusitis, pharyngitis, community-acquired pneumonia (CAP), otitis media (ear infection) with effusion (OME), and acute otitis media (AOM) were among the ARIs. Finding out if there are variations in the prescription of antibiotics for ARIs based on insurance, language, and race and ethnicity was the study’s goal.

Minor variations that could have a big impact.

A total of 396,340 ARI encounters at 28 PUCs were included in the analysis. The children in the cohort were 351 percent White, 25 percent Hispanic, 9 percent Black, and 6 percent Asian, with a median age of 51 months. In 20.7% of cases, race and ethnicity were unknown. Children with commercial insurance made up the majority (55.8%).

FL therapy was administered to 351,930 patients (88.8%) out of all encounters (98 percent for viral respiratory infections, 85.4% for AOM, 96.0% for streptococcal pharyngitis, and 83.6% for sinusitis). With FL therapy rates of 49.9 percent and 60.7 percent, respectively, OME and CAP had the lowest rates. Compared to white children, Black children had higher adjusted odds of receiving FL therapy (adjusted odds ratio [aOR] 1.53; 95 percent confidence interval [CI], 1.47 to 1.59), Asian children (aOR 1.46; 95 percent CI, 1.40 to 1.53), and Hispanic children (aOR 1.37; 95 percent CI, 1.33 to 1.41).

The odds of receiving FL therapy were also higher for children with self-pay (aOR 1.18; 95 percent CI, 1.1 to 1.27) and Medicaid/Medicare (aOR 1.21; 95 percent CI, 1.18 to 1.24) than for children with commercial insurance.

The authors of the study stated that “even though the differences reported in our study are relatively small, they are persistent across centers and diagnoses and have the potential to be clinically significant.”. Developing strategies for equitable antibiotic stewardship will be aided by an understanding of the underlying causes of the variations in antibiotic prescribing practices. “.

Researchers published their findings in Open Forum Infectious Diseases yesterday, citing a population-wide cohort study conducted in Ontario that revealed over 15% of residents colonized with an antimicrobial-resistant (AMR) pathogen later contracted the same infection.

A team headed by researchers from the University of Toronto examined the risk of infection among a cohort of Ontario residents who had a positive surveillance test for a resistant pathogen between January 1, 2017, and December 31, 2021, using population-level health administrative data. Vancomycin-resistant Enterococcus (VRE), carbapenemase-producing Enterobacterales (CPE), extended-spectrum beta-lactamase-producing Enterobacterales (ESBL), and methicillin-resistant Staphylococcus aureus (MRSA) were among the particular organisms of interest. The impact of colonization detection in a healthcare setting, age, and sex on the risk of infection later on was also investigated by the researchers.

In a median of 57 days, 15.6% of the 69,998 individuals who had a positive surveillance test during the study period went on to get a sterile or non-sterile site infection. The infection rates were different for each organism: 18–3% for MRSA within a median of 57 days, 2–8% for VRE within a median of 37 days, 21–5% for ESBL within a median of 71 days, and 20–3% for CPE within a median of 10 days. Within 90 days, over half of all infections happened.

While there were differences in the relationship between infection risk and age and sex, a positive surveillance test found in a hospital setting was consistently linked to a higher risk of infection following colonization for all resistant organisms when compared to the community.

greater risk than what was previously discovered.

According to the study’s authors, the observed rate of infection following colonization is greater than what has been discovered in earlier research, which was constrained by small sample sizes, single-care settings, and a sole focus on high-risk individuals or environments.

They stated that “the overall risk of infection from colonization with an AMR pathogen is probably higher than what has been previously reported for most organisms, highlighting the importance of detecting colonization from both an infection control and empiric antibiotic selection perspective,” although the risk of infection varies based on the particular pathogen.

They propose using the same cohort in future research to look at clinical predictors of colonization to infection progression.

A study published yesterday in JAMA Network Open found that Swedish adults who had bacterial meningitis as children had lower educational attainment, used 13.5 more days of sick leave and disability pension, and earned 4.0 percent less in annual income than their peers.

Merck & Co. is the study’s sponsor and its investigator. in New Jersey and Umea University in Sweden assessed the results of 2,534 adults with childhood meningitis who were followed up with for a year and were listed in a national disease registry between January 1987 and December 2019. They contrasted their results with those of 22,806 matched peers who were not diagnosed.

“Permanent neurological disabilities can result from a childhood diagnosis of bacterial meningitis,” the authors stated.

“Long-lasting costs” to society and patients.

Participants with childhood meningitis earned, on average, $1,295 less annually (95 percent CI: -$2587 to −$4) at age 28 and older, which is a 4.0 percent (95 percent CI: 0 to 8.0 percent) decrease from controls. Additionally, they lost 13.5 (95 percent CI, 8.6 to 18.5) more workdays.

These results imply that adults with childhood bacterial meningitis have a decreased capacity for work, which has long-term consequences for both the patient and society as a whole.

Individuals diagnosed with meningitis earlier had lower incomes and more missed workdays than those diagnosed later, and they had a lower chance of graduating from high school by age 30 than controls (adjusted odds ratio, 0.68 [95 percent CI, 0.56 to 0.81]).

“With long-lasting costs for the individual patient and society at large, these findings suggest that work ability is reduced in adults diagnosed with bacterial meningitis in childhood,” the researchers wrote.

The researchers did not look into long-term outcomes among newborns or very young infants, who typically have worse neurologic and neurodevelopmental outcomes than older children, according to a commentary on the study by Malte Tetens, MD, and Niels Obel, MD, DMSc, both of the University of Copenhagen in Denmark.

They wrote, “Further research should focus on this subgroup’s long-term socioeconomic functioning, as it is likely to differ significantly from that of children with meningitis in general.”.