Top Infectious Disease News of the Week—March 10, 2019

#5: Anti-Vaccine Movement Gains Steam and Fuels Measles Outbreaks: Public Health Watch

Seen any vaccine-related memes online lately?

If you’re on social media, chances are you’ve encountered some content on measles-mumps-rubella (MMR) prophylaxis in the midst of the usual assortment of cat videos. In fact, several platforms, including YouTube and Facebook, have taken steps to limit the spread of anti-vaccine messages. There have even been suggestions that Russian bots and trolls have been behind some of this content, using the vaccine debate to sow the seeds of discord in public discourse on the subject.

Whatever the source of anti-vaccine messaging, and the scope of its spread, it’s having a significant effect. According to the US Centers for Disease Control and Prevention (CDC), since the start of the year, there have been 228 cases of measles in 12 states: California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington. The CDC attributes the ongoing outbreak to increases in the number of travelers who get measles while abroad and the further spread of measles in US communities “with pockets of unvaccinated people.”

Read about the anti-vaccine movement.

#4: Only 2 of 5 PrEP Users Persist on Treatment Over 2-Year Period

Persistence on pre-exposure prophylaxis (PrEP) medication for HIV prevention drops off significantly in both the first and second years of treatment, according to a recent study, suggesting that interventions are needed to increase persistence on PrEP treatment.

The study, published in the Journal of the International AIDS Society, examined pharmacy fill records of 7148 patients who initiated PrEP in 2015. It found that persistence was 56% in the first year, 63% in the second year, and 41% from initiation through the second year.

"What was surprising to me was that the drop-off in persistence in year 2 was also relatively high," study author Aaron Siegler, PhD, associate professor at the Rollins School of Public Health at Emory University, told Contagion^®.

Read about the persistence of PrEP failures.

#3: Tuberculosis Raises Mortality Risk in HIV Infected, Even After Successful TB Treatment

A study supported by the National Institute of Allergy and Infectious Diseases (NIAID) has found that people in Latin America with HIV who were diagnosed with tuberculosis (TB) at an initial clinic visit were twice as likely to die within 10 years than those with HIV who did not have tuberculosis.

The new findings shed light on the serious global health threat of HIV and TB coinfection. According to the World Health Organization (WHO), in 2017 an estimated 920,000 people living with HIV worldwide developed TB—the leading cause of death among people with HIV—and about 300,000 people died from HIV-associated TB. In an poster presented at the Annual Conference on Retroviruses and Opportunistic Infections (CROI 2019) in Seattle, investigators say that that the risk of mortality in those who have been coinfected with HIV and TB increases even after successful TB clearance.

Read about tuberculosis mortality.

#2: Top Takeaways from CROI 2019

From the London Patient to the DISCOVER trial and everything in between, HIV experts provide their biggest takeaways from CROI 2019, in the second part of our highlight reel.

Check out part 1 and part 2 of our highlight reel.

#1: Are We Taking a Step Back in Staph?

Staphylococcus aureus is one of those bacteria that’re becoming all too common so, despite the seriousness of these infections, they don’t seem to cause as much of a stir when we hear about cases or outbreaks. But the facts remain: Staph infections are easily spread, increasingly common, and the methicillin-resistant Staphylococcus aureus (MRSA) strains are only becoming more widespread in the community. But attention tends to focus on the newer resistant infections, like those with the MCR-1 genes, which are surely an issue in the struggle against antimicrobial resistance, but lack the commonality of staph infections. Now, a new report from the US Centers for Disease Control and Prevention (CDC) has revealed some unsettling findings about this somewhat forgotten bug.

Staph infections can either be methicillin-resistant or methicillin-sensitive (MSSA) but, overall, staph is the leading cause of infections in US hospitals. Infection preventionists have been zeroing in on MRSA for decades in the health care industry, working tirelessly to stop the spread. Unfortunately, according to the CDC, progress in curbing MRSA has slowed, and findings indicate that MSSA rates are also not declining. One theory is that the opioid crisis may be connected, as 9% of all serious staph infections in 2016 occurred in patients who used injection drugs, a statistic that represented an increase from 4% in 2011. Consider this—right now, nearly 1 in 10 staph infections that occur are in people who use intravenous drugs.

The CDC also reports that in 2017, there were more than 119,000 bloodstream infections caused by staph, leading to the deaths of 20,000 people. Patients who have surgery or inpatient hospitalizations, have implanted medical devices, or who come into contact with others who have staph are at an increased risk for infection.

Read about taking a step back in staph.