Top 5 Contagion® News Articles for the Week of April 2, 2017

This past week’s Top 5 articles focused on the importance of infection prevention in long-term care facilities, such as nursing homes, and the differences in infrastructure at these facilities that may make infection prevention measures challenging. The Zika virus was also a focus of discussion again as new data from the Centers for Disease Control and Prevention (CDC) revealed that up to 40 new cases of the virus are reported in pregnant women in the United States each week, among other statistics. In addition, Zika vaccine trials are continuing to move forward as warmer weather heats up the United States and Florida prepares for more Zika cases. In other vaccine news, this past week the US Food and Drug Administration presented a webinar on the latest in methods to assess the safety and effectiveness of vaccines, focusing specifically on updates to vaccine adjuvants. Finally, an article highlighting recent research which found that MRI scans can detect HIV in the brain of infected individuals was our number one article this past week.

#5: Assessing Infection Prevention Programs in Nursing Homes

In a session at the recent Society for Healthcare Epidemiology of America (SHEA) Spring 2017 Conference, Nimalie Stone, MD, MS, Team Lead, LTC, Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention, discussed the current infrastructure for infection prevention programs in nursing homes in the United States and highlighted the key components that are needed to perform “good healthcare epidemiology and infection prevention.”

According to Dr. Stone, some of the driving aspects of infrastructure include a team of dedicated full-time registered nurses certified in infection prevention and control (IPC), a dedicated physician lead with experience in healthcare epidemiology, a dedicated IPC support committee, dedicated and properly equipped office space, integrated electronic healthcare records, and IT support.

Dr. Stone then went on to examine several studies that analyzed nursing home infrastructure. The first was conducted in British Columbia, Canada in 2012, while the second was conducted in the United States in 2016. The second study found a “statistically significant” difference in regards to IPC certification across close to 1,000 nursing homes in the country. Dr. Stone concluded that major infrastructure gaps exist in IPC programs across nursing homes in the United States, and even went on to highlight some areas that need improvement.

To illustrate an effective strategy to improve infrastructure in long-term care settings, Dr. Stone pulled “hot off the press” data from the Centers for Disease Control and Prevention.

To read more about the CDC data and some measures that can be taken to improve infrastructure programs in nursing homes, read the full article here.

#4: New CDC Data: Up to 40 New Cases of Zika in Pregnant Women Reported Weekly

According to the Centers for Disease Control and Prevention (CDC), if pregnant women or women who plan to become pregnant are diagnosed with Zika, the infant or fetus is 30 times more likely have birth defects associated with the virus, including microcephaly, hearing and vision loss, and other developmental issues.

These findings were published in the CDC’s recent Vital Signs report, and followed up with a CDC telebriefing. The report pulled data from the Zika Pregnancy Registry on 1,000 completed pregnancies to women with suspected Zika virus infection, and 250 women with confirmed Zika infection.

“Although Zika may seem like last year’s problem or an issue for Brazil or Latin America, our data indicate this is not the time to be complacent,” CDC acting director Anne Schuchat, MD, said on a telebriefing held on the same day as the report’s release. “We’re still seeing about 30 to 40 new [Zika] cases in pregnant women in the United States each week. The majority of these cases involve travel to Zika-affected areas. While there is much left to learn about Zika, we do know this devastating outbreak is far from over and the consequences are devastating.”

According to the CDC, more than 1,600 women in all 50 US states are suspected to have been infected with the mosquito-borne virus. Nonetheless, due to the challenging process of diagnosing Zika (only 20% of infected individuals are symptomatic), this number may represent only a fraction of actual cases.

To read more about the CDC’s findings regarding Zika infection in US pregnant women and rates of complications associated with the virus, continue reading the full article here.

#3: A Look into the Paradigm Shift in Vaccine Production

The US Food and Drug Administration recently held a webinar presenting an update on new ways of assessing the safety and effectiveness of vaccine adjuvants. Adjuvants are used to “improve immunogenicity of recombinant vaccines and to increase the breadth of protection;” however, some adjuvants “have been associated with reactogenicity which results in adverse reactions such as fever in a small proportion of vaccinated individuals.” As a result, the technology used to create vaccines has shifted from using whole virus particles, to using subunit antigens, which is said to decrease the potency of vaccines and increase the safety.

The vaccine type that is most in need of “approaches to improve the immunogenicity” are pandemic influenza vaccines. Because the “response rate against rate against inactivated influenza vaccines targeting pandemic viral strains is very low, … new strategies have included developing vaccines using novel vaccine adjuvants.” One such promising adjuvant has been the use of an old-in-water adjuvant, which performed well in studies compared with the traditional aluminum adjuvant. Additional data was shared from studies “involving toll-like receptor (TLR) ligands, which play a key role in innate immunity because they detect conserved pathogen-associated molecular patterns on various microbes, including viruses, leading to innate immune activation.”

To learn more about other methods discussed to make vaccines safer and more effective, click here.

#2: Zika Vaccine Trials Move Forward as Florida Health Agencies Assert They Are Prepared for a Potential Outbreak

On March 30, 2017, the first major Zika virus “town hall” was broadcasted nationally via the University of Florida (UFL)’s website, a meeting of public health experts from the Florida Department of Health, UFL, and the University of Miami; the “town hall” was held in Gainesville, Florida.

The goal of the meeting to foster a “2-way conversation between researchers and community” to discuss Zika virus and its impact on public health. Members of the public who were in attendance and those who participated online as part of the “Our Community, Our Health” initiative, shared their upmost concerns, pertaining particularly to: “virus transmission, the potential environmental consequences of large-scale insecticide/larvicide spraying programs, and the implications of Zika for women who are pregnant or planning to become pregnant.”

The panelists stressed to the public that residents living in the United States have many advantages over those in other parts of the world due to the stronger “infrastructure in place to prevent the virus’ spread,” which includes preventive measures such as air conditioning and window screens. However, one panelist stressed the importance of using mosquito repellant and getting rid of any areas of standing water found in or around the home.

Preventive measures are even more imperative as the world waits for a much needed, safe and effective vaccine to become available. However, the National Institute of Allergy and Infectious Disease (NIAID) announced on March 31, 2017, that an experimental DNA vaccine designed to protect against Zika-causing disease, VRC705, is being used in a multi-site Phase II/IIb clinical trial.

To read more, click here.

#1: MRI Scans Can Help Identify HIV Persistence in the Brain After Treatment

Researchers around the world are constantly searching for better ways to understand HIV with the hope that they can find a way to control it and help cure all of those infected. Over 36.7 million individuals around the world are living with HIV, a staggering number. Currently, some of the methods that are being used to learn more about the virus can be particularly invasive for patients, but new research coming from University College London (UCL) may change this.

A new study published in the journal Clinical Infectious Diseases, shows that UCL have found a way to use MRI scans to detect HRI persistence in the brain, despite “effective drug treatment.”

These findings are particularly important because in the past, AIDS was known to result in several cognitive problems, such as dementia. With the assistance of antiretroviral therapies, the prevalence of the most severe forms of HIV-associated dementia has decreased but related neurocognitive disorders remain common to this day.

“Up to half of HIV patients still report cognitive problems,” said senior author Ravindra K. Gupta, professor of infection and immunity at UCL. He continued, “We see evidence that HIV has spread to the brain in around 10-15% of these patients, but in most cases the symptoms are down to other causes.”

In order to confirm if those with HIV, are in fact, experiencing related cognitive problems, a lumbar puncture has to be performed, “which involves inserting a needle into the back to draw out the spinal fluid and test it for HIV,” said Dr. Gupta; this procedure is “quite invasive” and “requires patients to stay in the hospital for several hours.”

However, things may be looking up.

UCL researchers conducted a single-center retrospective study, in which they examined 147 patients living with HIV and examined them for cognitive issues between 2011 and 2015.

To see the study’s results and the implications of their findings, click here.