Top 5 Contagion® News Articles for the Week of March 12, 2017

This week’s Top 5 articles focused once again on mosquito-borne infections, namely, more information on the threat of the Zika virus in Florida as well as additional complications associated with the infection have come to light. In addition, researchers are remarking on the importance of continuing research and development efforts towards a hepatitis C virus vaccine, despite cure rates that are achievable through direct-acting antivirals. Moreover, news regarding Clorox Healthcare products receiving additional EPA-registered kill claims, and the connection between dental plaque and ventilator-associated pneumonia make up the top two articles for the week.

5: Florida Residents at Increased Risk for Zika Virus Infection Since June 2016

The Zika virus made its way to the shores of the United States last year, hitting hardest in Florida. This week, the Centers for Disease Control and Prevention (CDC) released information revealing just how long Miami-Dade, Broward, and Palm Beach residents have been at risk of contracting the mosquito-borne infection.

According to the official statement from the CDC, residents in Broward and Palm Beach counties have been at increased risk since June 15, 2016 as a result of “local travel to areas of active transmission in Florida and challenges associated with defining the sources of exposure.” Confounding the issue further is the fact that individuals have a risk of contracting the virus through sexual contact, as the virus is known to persist in semen longer than other bodily fluids.

The CDC confirmed the possibility of sexual transmission of the virus in 2016 through more than one form of sexual intercourse. Because of the devastating effects of a Zika virus infection, particularly for unborn fetuses of infected mothers, the CDC stresses the importance of practicing safe sex, or abstaining from sex completely when one or both partners are living in or visiting areas endemic for Zika virus. Individuals should keep in mind that only 20% of those who are infected typically present with symptoms and so proactive measures of protection are important.

Because the virus can also be transmitted via blood transfusion, blood donations from the United States and Puerto Rico are continuously being tested for the virus. Unfortunately, “testing for tissue donors, including semen donors, is not currently available; however, tissue donors are asked travel history questions, and if they have traveled to or live in an area of active Zika virus transmission they would be determined ineligible under current FDA guidance.”

More information on the impact of the Zika virus in Florida counties is available here.

4: Hepatitis C Virus and the Dwindling of Research Funding

Now that modern medicine has found a cure for infection with hepatitis C virus (HCV), many scientists believe that the precious (and scarce) dollars available for research and development (R&D) efforts should be directed at more urgent needs. However, some experts, such as Hugo R. Rosen, MD, FACP, FAASLD, head of gastroenterology and hepatology at the University of Colorado Anschutz Medical Campus in Denver, strongly disagree and instead feel that, “the mission for HCV eradication is far from accomplished.”

In a recent commentary published in the journal, Hepatology, Dr. Rosen called for increased research into HCV identification, particularly because many of those who are infected are not aware that they are infected; these individuals run the risk of disease progression and transmitting the virus to others. The CDC has already taken steps to curb these outcomes by targeting the population at highest risk for infection: the baby boomer generation (those born between 1945 and 1965). To this end, the CDC updated their HCV screening guidelines to include a one-time test for all individuals in the baby boomer population. But, is this enough?

Experts remark on the fact that, “HCV is the world’s most prevalent blood-borne viral infection for which a vaccine does not exist, [and] to eliminate HCV infection on a global scale, vaccine development needs to become a public health priority.” Indeed, major diseases that have been eliminated in the past, such as polio and smallpox, required vaccination. Therefore, treatment alone is not enough to substantiate control of a disease.

It is for these reasons that experts such as Dr. Rosen are discouraging decreased R&D on a vaccine for HCV in favor of more focus on direct-acting antivirals for treatment. A vaccine for the disease would also have a significant impact on populations at high-risk for HCV infection, such as those who inject drugs. Indeed, “illnesses stemming from HCV are the top cause of death among individuals who inject drugs. In this group, the incidence of HCV is 10-fold higher than HIV infection, ranging from 60% to 90%.”

To learn more about the importance of R&D efforts towards an HCV vaccine, visit this page.

3: Zika Linked with Cardiovascular Complications

Last year, health organizations around the world officially linked the Zika virus with neurological complications in the fetuses of infected mothers. Since then, scientists have acknowledged the risks that the Zika virus poses to adults as well, and new complications associated with the infection keep surfacing as more research is completed. A new study out of Venezuela, an area endemic for Zika infection, recently revealed the cases of nine individuals who presented with heart complications soon after becoming infected with the virus.

Eight of the nine patients “developed dangerous heart rhythm disorders” and six of the patients “had evidence of heart failure.” These patients did not have any history of cardiac disease, and so it was concluded that the cardiac irregularities were due to infection with the Zika virus.

Because heart complications are known to occur in those infected with severe forms of other mosquito-borne infections, such as malaria, the researchers were not surprised that individuals infected with the Zika virus were experiencing these issues. What did come as a surprise for the researchers, though, was the severity of the complications.

Additional new studies on the Zika virus are providing evidence for the presence of the virus in various tissues in the body and looking at specific points in time to see where the virus was identified in tissues. By studying rhesus macaque monkeys, researchers were able to detect presence of the virus “in the nervous system, reproductive and urinary tracts, lymph nodes, muscles and joints.”

This information can be used in the future to “identify and target reservoirs where the virus hides,” stated Daniel Streblow, PhD, associate professor of Molecular Microbiology and Immunology at the Gene Therapy Institute at Oregon Health & Science University in a press release on the study.

The Zika virus continues to circulate in many parts of the world and is poised for a come-back in the United States as the warmer seasons approach. With the absence of a vaccine against the virus, infection prevention is still the best way individuals can protect themselves from being infected. However, while personal protection measures may reduce landing and biting rates for mosquitoes, no data currently exists that show personal protection translates to less disease.

Read more about the latest Zika complications here.

2: Clorox Healthcare Products Receive Additional EPA-Registered Kill Claims for Bacterial and Viral Pathogens

In the battle against healthcare-associated infections, infection prevention measures are of the utmost importance. To this end, Clorox Healthcare recently announced that their Bleach Germicidal Wipes are now EPA-registered to kill 58 microorganisms in three minutes or less, and Clorox Healthcare Bleach Germicidal Cleaners are EPA-registered to kill 50 microorganisms in three minutes or less. Furthermore, the wipes and cleaners effectively eliminated the bacterial spores within a three-part soil load, as per interim guidance set by the EPA in 2014.

Each year, millions of individuals become infected with Clostridium difficile, which can cause severe diarrhea, and is deemed an “urgent threat” by the CDC. According to the CDC, C. diff infects approximately 250,000 individuals annually; in addition, a total of 14,000 of these individuals will die from infection each year.

C. diff infections are mainly associated with antibiotic use, and occur in patients either during their hospital stay or after their release. Infection can be transmitted within the patients’ environment; however, and because C. diff spores are notoriously resilient against many common infection measures, using cleaners specifically formulated to kill these bacteria can decrease that risk.

In a press release touting the additional EPA-registered kill claims for the products, Director of Marketing at Clorox Healthcare, Lynda Lurie, said, “At Clorox Healthcare, we are dedicated to safeguarding patient environments and continuously strive to ensure our surface disinfectants meet the needs of the ever-changing healthcare environment. We made these changes proactively so that healthcare professionals can be prepared for whatever comes through their doors, wherever care is delivered.”

Learn more about the new Clorox Healthcare products here.

1: Dental Plaque May Provide a Pathway to Pneumonia in Ventilated Patients

Ventilator-associated pneumonia (VAP) is the most common infection acquired by critical-care hospital patients on ventilators. In fact, the infection develops in 9% to 24% of patients who are on a ventilator for more than 48 hours. Perhaps most startling is that 13% of patients who acquire VAP will die from the infection.

As such, healthcare practitioners are always looking for new ways to prevent the development of this infection. One way to do this is to identify the possible contributing factors of VAP. To this end, researchers have identified a new culprit: dental plaque.

In a recent study, researchers obtained samples from biofilms in endotracheal tubes, non-directed bronchial lavages, and dental plaque for 12 ventilated adult patients. Oral hygiene for each patient was assessed at the beginning of the study, and basic dental care was administered while the patient was ventilated through the use of a mechanical toothbrush.

After analyzing the samples using metataxonomics, the researchers found the presence of microbes in all of the samples—in endotracheal tubes and non-directed bronchial lavages as well as in dental plaque. Perhaps more importantly, the patients’ dental plaque were found to be harboring bacteria not normally residing in healthy mouths but which are known to cause respiratory infections.

Although the researchers were unsure of how the bacteria are able to migrate downward into the respiratory tract, they theorized that organisms colonizing in dental plaque are directly aspirated into the lungs from the mouth. In addition, microbes may also be growing inside of the endotracheal tube and are then breathed in by the patient.

The study stresses the importance of good oral hygiene among patients who are ventilated, particularly those who are ventilated for a long period of time. In addition, a recent statement from the Infectious Disease Society of America asserted that good oral hygiene through regular visits to the dentist may, in fact, decrease the risk of pneumonia, since dental cleanings rid the mouth of bacteria before they can invade the lungs.

More on the association between dental plaque and VAP is available here.