Top 5 Contagion&reg News Articles for the Week of April 30, 2017

The Top 5 articles this past week provide information on hepatitis B virus infections in pregnant women and how the infections impact their offspring. In addition, new information on the deadly Candida auris fungus was recently revealed at the 2017 Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) Conference and included in one of the top articles for the week. New guidelines to prevent influenza pandemics and a focus on the dangers of flawed infection control research studies are also presented. And, finally, our top article highlights a newly discovered compound that has been found to stop the replication of the Zika virus in human cells.

#5: Two-Thirds of Pregnant Women with High Viral Loads of Hepatitis B Go Untreated

When left untreated, hepatitis B virus (HBV) infection in pregnant women can cause chronic HBV infections in their offspring at birth. Despite this information, recent research has shown that many pregnant women who are infected with HBV go untreated during their pregnancy.

According to research presented by lieutenant Ruth Link-Gelles, PhD, MPH, at the recent 2017 Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) Conference, if administered correctly, post-exposure prophylaxis “is effective in about 95% of perinatal HBV infections,” but, “many women who should be receiving treatment to protect their infants are not tested for viral load and, as a result, are not treated for the infection during pregnancy.”

After looking at demographic, clinical, and maternal antiviral treatment information from the medical charts of HBV-infected pregnant women in Michigan and New York City, the team found that the women who were both treated and non-treated were of similar age and most were of Asian or Pacific Islander descent. The researchers noted that the study had limitations, such as the fact that 98% of the data included in the analysis was from New York City and 63% of the data “had to be dropped due to exclusion criteria.”

#4: More Information on Candida auris Revealed at 2017 CDC EIS Conference

New information continues to come to light about Candida auris, a strain of fungus that appears to have developed immunity to “most, if not all, antifungal drugs.” The fungus has remained largely controlled in the United States; however, it has been “associated with hospital-related outbreaks and high mortality in several countries.”

Contagion^® spoke with Sharon Tsay, MD, an Epidemic Intelligence Service (EIS) officer in the Mycotic Diseases Branch of the Centers for Disease Control and Prevention (CDC) at the recent EIS conference. Dr. Tsay stated that, “lots of people have C. auris on their skin and have no symptoms at all; [however, infection with the particularly virulent fungus] really affects the sickest of the sick, [such as] people in nursing homes, infants, and individuals with other medical conditions.”

Indeed, Paige Armstrong, MD, revealed during a media briefing that alarming outbreaks of antifungal-resistant-C. auris in Columbia occurred in two separate neonatal intensive care units. The resistant strain of Candida is “particularly disturbing because it mirrors the behavior associated with emerging antibiotic-resistant bacteria.” According to Dr. Armstrong, “This is an emerging fungus acting like a superbug.”

#3: New CDC Guidelines Aim to Prevent Future Influenza Pandemics

Using what they learned from the 2009 influenza pandemic, the Centers for Disease Control and Prevention (CDC) recently released new guidelines on pandemic prevention.

The 2009 influenza pandemic was caused by the novel A H1N1 strain of the influenza virus. A total of 288 pediatric deaths resulting from the infection made the 2009 pandemic “the deadliest flu season of the past decade.” The new guidelines focus on “the importance of nonpharmaceutical interventions that people and communities can take to help control the spread of respiratory viral infections.” In addition, the guidelines provide recommendations for state and local health officials for prepandemic planning, such as voluntary home isolation, increased focus on hand hygiene, and the use of face masks.

The new guidelines also stress the fact that individuals who are infected with the influenza virus are infectious 1 day prior to the onset of symptoms, and they “continue to be infectious for 5 to 7 days after becoming ill.” In addition, those patients who are immunocompromised or infants can shed the virus for up to 21 days.

#2: The Hazards of Flawed Infection Control Studies—for Providers and Patients

This week, Contagion® contributor, Saskia v. Popescu, MPH, MA, CIC, continued her discussion of the issues surrounding flawed infection control studies. Popescu brought attention to the fact that although many of industry-sponsored and hospital-run infection control studies are small in size, because the industry is desperate for new methods to fight healthcare-associated infections, they pack a large punch in terms of impact. This can become particularly troublesome as indeed some of these studies are wrought with flaws and bias.

In addition to drawing attention to the damage that these flawed and biased studies can do, Popescu sheds light on the fact that the infection control industry’s need for new methods seems to be “falling on deaf ears.” Sad news for an industry that has been “fighting an up-hill battle for decades.” With the increase in antibiotic resistance and the growing threat of emerging infectious diseases, new products and methods to treat these infections are sorely needed. Some manufacturers have worked to provide new products that can fight these pathogens and infection prevention programs have changed their methods; however, many are still trying to catch up and “are lagging behind… desperately trying to make an existing product fit new threats.” As infection control programs struggle to fight the problems of today, legitimate research programs are necessary to test new products capable of truly handling these new threats

#1: New Compound May Block Zika Virus Replication as Puerto Rico Faces Heat on Misreporting Cases

Scientists from the Vaccine and Gene Therapy Institute at Oregon Health and Science University have found a molecule that blocks the replication of the Zika virus within human cells. The molecule, AV-C, not only “controlled the replication of an arbovirus in human fibroblast cells after 6 hours of initial infection,” but it also, “establishes a cellular state antagonistic to replication.” According to the authors, AV-C may be used to improve the efficacy of vaccines against arboviruses, such as Dengue.

Interestingly, although AV-C “was able to block Zika virus replication even after 16 hours of initial infection with the virus, it did not affect replication of Chikungunya virus, after just 2 hours of initial infection.”

On the heel of this new discovery, major media outlets have been reporting a discovery of a different kind. It is widely known that the Zika virus was widespread throughout Puerto Rico for most of 2016; however, major news outlets are reporting that they have evidence that the devastation may in fact be much worse than previously reported. According to, STAT, they have obtained a document which “details a ‘feud’ between health officials in Puerto Rico and the Centers for Disease Control and Prevention (CDC) regarding Zika surveillance in pregnant women on the island.” The news outlet goes on to detail that the outbreak has been diminished for more than 6 months and that monies provided to the Puerto Rico Department of Health (DOH) spurned non-responsiveness between the DOH and the CDC.

As the weather warms in much of the Northern Hemisphere, mosquito-season is underway and so much effort is being made to control populations of Aedes aegypti, the mosquito that transmits the Zika virus.