Did you read this week’s top infectious disease news coverage from Contagion®?
The top five articles for the week of February 26, 2017 include those in which researchers provide a closer look at how two devastating outbreaks unfolded: the Zika virus epidemic in Brazil and the Ebola outbreak in Africa. In addition, as the 2016-2017 flu season winds down, experts provided additional information on cases that are still lingering and the effects that have been seen from the virus this season. Contagion®’s newest contributor, Thelma King Thiel, RN, BA, discussed the missing link in eliminating viral hepatitis C and B; and finally, coverage of the World Health Organization’s list of the top 12 priority pathogens rounds out the list.
At The First International Conference on Zika Virus last week in Washington, DC, researchers provided attendees with insight into how this devastating virus has impacted so many countries around the world.
One such session was presented by Contagion® Editorial Board member, Pedro Fernando de Costa Vasconcelos, MD, PhD, director of the World Health Organization (WHO) Collaborating Center for Arbovirus and Research, Evandro Chagas Institute. Dr. Vasconcelos presented on the impact of the Zika virus in Brazil during 2015 and 2016. He remarked on the difficulties of first defining the diagnosis of the virus due to its similarities with Dengue and Chikungunya, two arboviruses that were also circulating in Brazil at the time and that cause similar symptoms.
In addition, Dr. Vasconcelos explained that the increase in Zika infections, coupled with the increase in incidence of microcephaly, prompted speculation of the correlation between the two, but further evidence was needed to confirm it. The Ministry of Health (MoH) was finally able to establish the relationship, “through the detection of Zika virus genome in the blood and tissue samples of a baby from the state of Pará.” This finding then prompted an epidemiological alert by the Pan American Health Organization (PAHO) and WHO.
The MoH estimated that the range of cases of Zika virus infection in 2015 was between 500,000 and 1.5 million, with about 200,000 cases in 2016. In addition, the average microcephaly birth rate per 100,000 live births in Brazil was 7.4 in Paraíba, in the northeast region of Brazil; Dr. Vasconcelos reported that this number increased to 436.2 in 2015. A number of other northeastern states saw staggering increases as well.
Continue reading more on the first confirmed case of Zika-related microcephaly and the history of the Zika virus in Brazil here.
Those who were affected by the Ebola virus during the 2014-2015 outbreak faced many difficult decisions aside from fighting off the deadly infection, according to members of Doctors Without Borders/Medecins Sans Frontieres (MSF) who recently conducted a webcast on their experience. Many of those infected with the virus were parents, and therefore they had to struggle with the risks of leaving their children at home while they traveled for care. In addition, those parents who had children that were ill had to leave their children in the care of healthcare workers that they did not know. Almost all individuals who were infected were required to brave the dangers of traveling through areas of ongoing military conflict to areas where care was available.
The representatives discussed the trials those infected lived through, as well as the lessons they learned as healthcare practitioners trying to treat a seriously ill population in the midst of active military conflict. In addition, they discussed the difficulties in effectively delivering education on Ebola virus prevention and treatment to those at risk, in different languages, while trying to maintain cultural traditions and be cognizant of societal norms.
In total, MSF evaluated more than 10,000 individuals for the Ebola virus and treated more than 5,000 who were infected. As a result of their efforts, more than half of these patients survived. Until the end of 2016, the MSF also continued to operate three survivor clinics in each of the most-affected countries, where surviviors gained assistance with lingering symptoms of infection such as vision problems or pain.
Because the threat of the virus continues to this day, MSF has been leading efforts to develop a vaccine and coordinating ongoing clinical trials. They acknowledged that these trials were slow-going at first and therefore, they encouraged the global health community to be better prepared in the future.
To continue reading more on the findings and efforts of the MSF during the Ebola outbreak, click here.
Although the 2016-2017 flu season in the United States has proven to be milder for some, those aged 65 years and older were hit particularly hard by this year’s predominant strain of the virus: H3N2. In fact, the recent FluView report from the Centers for Disease Control and Prevention noted that the flu hospitalization rates for this age group is currently at 155.2 per 100,000 individuals, higher than any other age group.
The season continues to wind down, though, with the number of individuals who saw their healthcare provider for flu-like symptoms this past week down .4% from the previous week (4.8% vs 5.2%). The virus continues to be active in 44 states. In some of these states, such as in Massachusetts—where the flu seemed to hit its peak early in the season—the virus led to fewer hospitalizations than were seen during the 2014-2015 flu season. However, those over the age of 65 saw more severe illness and hospitalizations this year.
Conversely, flu activity still remains high in Maryland, prompting several hospitals in Baltimore to put restrictions in place on visitors in an effort to contain the spread of the virus to patients from those who may be infected. A total of 52% of all influenza-related hospitalizations in Maryland are patients who are 65 years of age and older.
This year's influenza vaccine has been found to be 48% effective at preventing illness; however, a recent study published in the British Medical Journal has suggested that vitamin D supplementation can work to complement that effectiveness. The researchers noted, “a 12% reduction in the proportion of participants experiencing at least one acute respiratory tract infection among those taking vitamin D.”
To read more about the latest on the 2016-2017 flu season and the effects of vitamin D supplementation, click here.
Contagion®’s newest online contributor, Thelma King Thiel, RN, BA, is the former CEO of both the American Liver Foundation and the Hepatitis Foundation International. She is the current organizer of the Liver Health Initiative. According to Ms. Thiel, the enormous gaps in education about liver health in the United States has led to “an enormous national pool of uninformed individuals” regarding liver health.
Ms. Thiel writes that the United States has seen a 150% increase in the incidence of hepatitis C (HCV), and 40% of liver cancer cases are being attributed to the virus. Because HCV can largely be prevented by foregoing many risky behaviors, this is evidence that a lack of education on these behaviors and their effects is largely lacking in the United States. Ms. Theil states that most individuals are unaware of how the liver is ultimately responsible for “the maintenance of multiple body functions that support their health and life itself.” Therefore, liver-damaging behaviors are having a profound impact on their health.
Most of us are aware that drug and alchohol use and misuse contribute to liver disease, but illnesses such as obesity, fatty liver, atherosclerosis, high cholesterol, and early onset diabetes also expose individuals to hepatitis infection. Studies, such as the Study to Reduce Intravenous Exposure (STRIVE) research project, have proven that “education is the key to prevention.” Additional studies have shown that, “once informed of a few vitally important liver functions they could relate to in their daily lives, individuals were motivated to avoid liver damaging activities and to adopt healthier food and lifestyle behaviors.”
These education efforts need to span across demographics in order to be effective. Education on the liver needs to be provided in schools, as well as government agencies and the military, in order to empower everyone to actively take an interest in their own liver health.
Click here to read more about how education is the missing link in eliminating HCV and hepatitis B.
In an effort to encourage increased research and development (R&D) for new antibiotics to treat antibiotic-resistant bacteria, the World Health Organization (WHO) released a list of priority pathogens this week that urgently need treatments against them.
The Division of Infectious Diseases at the University of Tübingen, Germany developed the list with WHO through the use of a multi-criteria decision analysis technique. The pathogens that are included are those that were considered to be: the most-deadly; required the longest hospital stays; were most frequently resistant to existing antibiotics when people in communities acquired them; were spread easily between animals, from animals to humans, or humans to humans; their level of preventability; and whether or not antibiotics to treat them were already in the R&D pipeline.
Gram-negative bacteria resistant to multiple antibiotics are notably highlighted on the list. Among their alarming features is their ability to “pass along the genetic material that allows other bacteria to become drug-resistant as well.” Those bacteria “that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters,” are also ranked high on this list.
According to Marie-Paule Kieny, MD, WHO's Assistant Director-General for Health Systems and Innovation, "Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time." According to WHO, “the list is intended to spur governments to put in place policies that incentivize basic science and advanced R&D by both publicly funded agencies and the private sector investing in new antibiotic discovery.” In addition, the list, “will provide guidance to new R&D initiatives such as the WHO/Drugs for Neglected Diseases initiative (DNDi) Global Antibiotic R&D Partnership that is engaging in not-for-profit development of new antibiotics.”
The full list of priority pathogens is available here.