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  #611  
Old 10-08-2019, 07:57 PM
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Mary Pat Campbell
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UNITED STATES
MEASLES

https://www.wsj.com/articles/thousan...te-11570122220

Quote:
Thousands of Schools Fall Below Recommended Measles Vaccination Rate
Even as outbreaks end, pockets of low vaccination leave local communities vulnerable to outbreaks, WSJ examination finds
Spoiler:
Thousands of individual schools in the U.S. don't have high enough immunization levels to meet the threshold considered adequate to protect a population from measles, a Wall Street Journal examination found.

While the majority of schools have relatively high measles-mumps-rubella vaccination rates of 90% or above, many schools have rates in the 70% to 80% range, and some small private schools have rates hovering around 50%.

Federal health authorities expect the U.S. to retain its coveted status as a nation that has eliminated domestic transmission of measles, dodging a bullet after outbreaks in New York state threatened the designation. It came down to the wire for U.S. officials to be able to determine, at the last minute, that the elimination status had likely not been lost because the New York state outbreaks had ended. The federal Centers for Disease Control and Prevention said it would provide further details Friday.

While the U.S. overall had a fairly high and stable MMR immunization rate of 94.3% of kindergartners during the 2017-2018 school year, according to the CDC, these pockets of low vaccination leave local communities vulnerable to outbreaks.

Roughly 95% of a population needs to be vaccinated to prevent the disease from spreading, according to the World Health Organization.

"If you have children clustered together that are unvaccinated, that's why measles outbreaks are happening," said Carla Black, an epidemiologist in the Immunization Services Division at the CDC who tracks kindergarten immunization rates. "The real usefulness of the data is to look at your local coverage."

The Journal obtained data from 48,246 schools in 32 states out of 132,734 total U.S. schools, both public and private. Of the 30,615 schools with MMR-specific data, nearly 30% of schools had an immunization rate less than 95%. For the 31,422 schools with overall immunization data available, roughly 44% of schools fell below the 95% mark, though those numbers don't directly correlate to MMR vaccination status because the students may be missing a different vaccine. The two subsets add to more than the total because some states provided both figures. About 9% of schools withheld data due to privacy issues or inconsistencies in the data.

For the states with MMR-specific school data, 85.3% of schools had an MMR immunization rate of 90% or above. Roughly 1,800 schools, or 6%, fell below an 80% vaccination rate. For states with overall immunization data, 77.8% of schools had an immunization rate of 90% or better, and roughly 2,700 schools were below the 80% vaccination rate.

With over 1,200 confirmed measles cases across 31 states, 2019 has been the worst year for measles in the U.S. in 25 years. Most cases occurred among people who weren't vaccinated, according to the CDC.

"We have to always be worried about another resurgence," said Melissa Stockwell, an associate professor of population and family health and pediatrics at Columbia University's Mailman School of Public Health.

Vaccination is the most effective and easiest way to prevent infectious-disease outbreaks, say physicians and public-health officials. As exemption rates, where parents opt out from having their children vaccinated, have risen in some states, lawmakers have considered or passed new vaccine-related legislation.

To determine the vaccination rates on a more local level, the Journal obtained information from state health departments through health-department websites, requests and legal filings via open-records laws.

Methodology differs among states and sometimes even within schools in the same state. Children who attend home-school are typically not included in immunization levels or subject to the same requirements.

A few states allow schools to self-report data or else conduct a survey of sample schools. Other schools don't send in data when it is required. Data for the current school year aren't available, so any potential change in vaccination rates due to new legislation in states like New York isn't reflected.

Twenty-two states provided MMR-specific rates and 18 states provided overall immunization rates for multiple vaccinations, with eight states providing both sets. Many states also withheld data from schools with a small number of students in order to protect student privacy.

Dr. Black and other experts cautioned that the numbers may not represent the national picture, as not all states were included, and the Journal didn't select a representative sample of schools. Having rates from different years could also skew the data set.

The unknown breakdown of school type may also be important, said Saad Omer, the director of the Yale Institute for Global Health, as private schools tend to have lower vaccination rates than public schools. The size of the school is also a factor in rates, experts say. While the data show the majority of students in the U.S. are vaccinated, Dr. Omer found the pockets of low vaccination rates concerning.


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  #612  
Old 11-04-2019, 11:47 AM
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INFLUENZA
EVERYWHERE

By targeting flu-enabling protein, antibody may protect against wide-ranging strains

Quote:
Summary:
A team of researchers has found an antibody that protects mice against a wide range of potentially lethal influenza viruses, advancing efforts to design of a universal vaccine that could either treat or protect people against all strains of the virus.
They found it in a patient in St. Louis. There's a lot more at the link but here's the main bit:

Quote:
To find out whether the antibodies could be used to treat severe cases of flu, Krammer and colleagues tested them in mice that were given a lethal dose of influenza virus. All three antibodies were effective against many strains, and one antibody, called "1G01," protected against all 12 strains tested, which included all three groups of human flu virus as well as avian and other nonhuman strains.
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  #613  
Old 11-04-2019, 02:17 PM
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MEASLES
Guardian article
I found it interesting in that measles has impacts beyond the temporary infection itself.
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  #614  
Old 11-04-2019, 09:52 PM
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I had read that previously. But I guess the extent of the degredation of the immune system has been hard to measure. They key info is:

The research found that the MMR vaccine itself did not produce immune suppression, meaning that recipients get the benefit of lifelong immunity to measles infection without the damaging effects of natural infection.

Such a great immunization!
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  #615  
Old 11-14-2019, 06:50 AM
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Mary Pat Campbell
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EBOLA
VACCINE
https://www.forbes.com/sites/brucele...wAKSrvLGmHIZ1A
Quote:
The Ebola Vaccine Is Now Officially Here With Approval In Europe
Spoiler:
It’s official. We now have a real Ebola vaccine. Not a kind-of-almost-sort-of-there vaccine. Not an experimental-use vaccine. Not a vaccine just for macaques. No, this is a vaccine that the European Commission has just approved for use in humans, the first of its kind.


According to today’s announcement, the European Commission has granted Merck Sharp and Dohme B.V. marketing authorization in Europe for their Ebola vaccine, named Ervebo. The approval came not too long after the European Medicines Agency (EMA) had recommended approval in mid-October.

This is big. Actually, it’s big times big plus big. Having a vaccine to protect against the Ebola virus is a game changer. The Ebola virus, in technical terms, really sucks. It is a nasty virus that can cause a severe and deadly hemorrhagic fever. Fever means fever as in body temperature rising. And hemorrhagic means bleeding as in blood leaking out of blood vessels inside your body, in your skin, and potentially in your eyes, nose, ears, mouth, and rectum.


Foreign Minister Heiko Maas in the Congo
05 September 2019, Congo, Goma: Signposts on the[+]
DPA/PICTURE ALLIANCE VIA GETTY IMAGES
How can the virus wreak such havoc? The virus is a sneaker sucker. It first targets cells that serve as your immune system’s first line of defense. This is a bit like the Ocean’s 11 crew taking out the surveillance system first when trying to rob Terry Benedict’s casino. As a result, your immune system cannot even recognize that something is amiss. Eventually, macrophages, which are your body’s cookie monster-like protectors, gobble up the viruses. This then triggers your macrophages to do the wrong thing. Your macrophages release proteins that initiate a cascade of events that cause the formation of small blood clots, inflammation, and leaks in your blood vessels throughout your body. This leads to the unhappy combination of you losing blood and blood flow to your organs being blocked, which starves your organs of oxygen. This process is what ends up killing up to 90% of those infected by the virus, according to the World Health Organization (WHO) Africa Region Office.


If this sounds horrible, it is. Ebola infections can be costly too. As our PHICOR team’s study published in the Journal of Pathogens and Global Health showed, the cost of each case can range from several hundred dollars (if you fully recover) to close to $20K if you don’t survive.

Ebola virus under microscope
Here is the Ebola virus under a microscope.[+]
GETTY
That’s why you never want to get infected by the Ebola virus. You can catch the virus from contacting the body fluids of an infected person, fruit bat, or non-human primate such as an ape or monkey. As the Centers for Disease Control and Prevention (CDC) explains, until now, the only thing that you could do to prevent an Ebola infection was to avoid the virus. That may be relatively easy in the U.S. where the Ebola virus so far has been exceedingly rare. However, that ain’t so easy in the middle of an outbreak such as the one that rocked West Africa from 2014 to 2016.

The Ebola vaccine works by exposing you to a form of the virus that can’t cause an infection. This then prompts your immune system to in effect say, “hmm, what is this? Oh, this doesn’t look good. We should get prepared for when this virus returns.” Think of Terry Benedict being shown the Ocean’s 11 crew and their plans before they even attempt the heist and how that would help the casino shore up defenses.


Health officials have been using the vaccine on an experimental basis to try to control Ebola outbreaks that have been going on in the Democratic Republic of the Congo (DRC). As described in this PBS Newshour segment, the war-torn DRC hasn’t been the easiest place to test the vaccine:


Nevertheless, researchers managed to test the efficacy of the vaccine in the country. As the WHO reported in April, this vaccine had an estimated protective efficacy of 97.5% in field studies there. That would mean if a hundred people vaccinated were exposed to the virus, less than three would end up getting infected. That’s a remarkably high efficacy. After all, nothing in life is 100%. However, keep in mind that the efficacy of a vaccine also depends on how many people around you are vaccinated as we’ve seen with the measles vaccine as I have explained for Forbes previously.

Ebola and the Ebola vaccine didn’t always get the attention that it’s getting today. In fact, as chronicled in the scientific journal CMAJ, the history of the Ebola vaccine reads sort of like an ugly duckling, She’s All That movie story line. It wasn’t until the year 2001 that the Public Health Agency of Canada’s National Microbiology Laboratory began in earnest attempts to develop an Ebola vaccine. Back then Ebola researchers struggled to secure funding because Ebola wasn’t exactly a household name and working on the virus wasn’t considered cool or sexy by the public and thus policy makers.


Despite these hurdles, the researchers at the Canadian laboratory persisted and by 2005 managed to develop a vaccine had perfect efficacy in protecting macaques, based on a study published in Nature Medicine. This was good news, for macaques. While these results were promising, much more work was necessary to proving that a vaccine could work in humans and be appropriately safe. Although the Canadian government had patented the vaccine, at the time, the future of the vaccine remained uncertain. It wasn’t as if pharmaceutical companies were lining up to further develop the vaccine.

Everything changed in 2014 when the West Africa Ebola outbreak made international news. Suddenly, people in other continents began wondering and worrying about this deadly disease that could cause “bleeding eyeballs.” There were concerns about Ebola spreading to the U.S. and Europe. People who previously had never heard of Ebola were clamoring, “do something, do something!” Seemingly overnight, the previous wallflower Ebola vaccine had become the prom king or queen or at least someone invited to the prom. Merck then entered the picture to subsequently take the Canadian vaccine to the finish line and approval.

Having a major regulatory body like the European Commission approve the vaccine is a major step towards other regulatory bodies around the world following suit. The U.S. Food and Drug Administration (FDA) is currently reviewing Merck’s application for approval. So stay tuned for news from the FDA by the first quarter of 2020 about possible approval in the United States.

The Ebola vaccine approval is a major public health success. As history has shown, the advent of a vaccine can dramatically dampen the spread of an infectious disease, in many cases taking it from a clear and present danger to something that people don’t have to worry about on a regular basis. Just look at what happened to measles after the measles vaccine was introduced. Actually, just look at what happened to measles at least until 2000, before some people thought that it would be good idea to tell people to stop getting vaccinated.


Ervebo won’t be a blockbuster money maker for Merck. Vaccines typically are far from the most profitable products for pharmaceutical companies, and the Ebola virus is far from common in higher income countries. Thus, the global health community will need to find ways to support and fund use of this vaccine. Alas, the Ebola vaccine will continue to face this and other obstacles after approval such as finding ways to get people vaccinated. Nevertheless, this approval news is still a big times big to the biggeth power step forward.


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  #616  
Old 11-14-2019, 02:31 PM
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SUPERBUGS

https://www.wsj.com/articles/superbu...ys-11573668001

Quote:
Superbugs Toll Worse Than Thought, CDC Says
Antibiotic-resistant bacteria and fungi have spread beyond hospitals, complicating medical care, new CDC report says

Spoiler:
Drug-resistant bacteria and fungi, along with heavy use of antibiotics, fuel nearly 3.1 million infections with 48,700 deaths a year in the U.S., according to a new federal report that warns the toll from so-called superbugs is greater than previously known.

The findings from the Centers for Disease Control and Prevention, based on data from millions of patient electronic health records and other sources, update a 2013 report in which the agency sounded an alarm about the dangers of these bugs, some of which are resistant to many or most antibiotics.

Antibiotic-resistant bacteria and fungi, once confined mostly in hospitals, are spreading aggressively now in other health-care facilities and communities, the CDC warned. Doctors regularly struggle to find antibiotics that can effectively treat patients, and to operate on or provide cancer care to patients at risk of infection.

"Our nation must stop referring to a coming post-antibiotic era -- it's already here," CDC director Robert Redfield said in an introductory letter to the report released Wednesday.

The report identified 18 bacteria and fungi of concern, and new bugs are emerging rapidly, the CDC said. It included a "watch list" of pathogens identified elsewhere in the world, such as a drug-resistant form of Bordetella pertussis, bacteria that cause whooping cough.

"The problem of antibiotic resistance is worse than we previously thought," said Michael Craig, the CDC's senior adviser for antibiotic resistance. Someone in the U.S. develops an antibiotic-resistant infection every 11 seconds, and someone dies every 15 minutes, he said in an interview.

The new estimates include 223,900 cases, including 12,800 deaths a year from Clostridioides difficile bacteria. Those bacteria aren't drug-resistant, but infections with them are fueled by use of antibiotics.

There is some good news, Mr. Craig said. The number of annual deaths from drug-resistant bacteria and fungi has declined 18% since 2013, excluding the deaths from C. difficile. That improvement is due largely to steps hospitals have taken to prevent the spread of drug-resistant bugs, he said. Now, 84% of U.S. hospitals have a program in place to use antibiotics more judiciously, following CDC guidelines, according to the report.

Still, Mr. Craig said, more-dangerous bugs are spreading outside hospitals. They include drug-resistant gonorrhea and urinary-tract infections caused by bacteria with enzymes, called extended-spectrum beta-lactamases, or ESBLs, that break down and destroy many common antibiotics including penicillin. Urinary-tract infections caused by those bacteria can be life-threatening, Mr. Craig said.

New pathogens are also making their way to the U.S. Candida auris, a drug-resistant pathogen first identified in Asia in 2009, has quickly spread around the world, causing life-threatening infections, the report noted, listing it as one of five "urgent threats."


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