Top 5 Infectious Disease News of the Week—May 27, 2018

#5: NCDC Team Diligently Working to Control Nipah Virus Situation in India

A newly emerging zoonosis capable of causing severe disease in animals and humans alike has been plaguing India. The disease in question? Nipah virus.

Although news of an outbreak has been shouted across headlines for the past couple of weeks, the most recent update released by the World Health Organization (WHO) stresses that after reviewing the cases of all patients who have died, the central high-level team led by the National Centre for Disease Control (NCDC) has concluded that the disease is “not a major outbreak and is only a local occurrence.”

For the most recent case counts associated with the Nipah virus outbreak in India, be sure to check out the Contagion^® Outbreak Monitor.

Read more about Nipah virus in India.

#4: Administration Errors Involving Shingrix Vaccine

By all accounts, shingles is a painful disease. Originating from the same virus that causes chickenpox, shingles results in a blistering rash on one side of the body. A mild case may clear up within a few weeks and cause no complications, while a more severe case can result in lasting postherpetic neuralgia or pain where the rash was.

Zoster vaccine live (ZVL)—or Zostavax—a vaccine to prevent shingles, was introduced more than a decade ago and was approved by the Advisory Committee on Immunization Practices (ACIP) for use in adults aged 60 and older. Last year, a more effective vaccine, recombinant zoster vaccine (RZV)—also known as Shingrix—became available. ACIP now recommends this vaccine for all adults aged 50 and older who are at risk of shingles (basically, anyone who ever had chickenpox) and are not immunocompromised. Shingrix differs from Zostavax in that it’s an intramuscular injection rather than a subcutaneous one, and it’s given in 2 doses anywhere from 2 to 6 months apart. Both vaccines must be stored frozen before being given.

Read more about administration errors involving Shingrix.

#3: HIV Infection Intensified by Stimulant Use

Investigators on a new study found that the use of stimulants in conjunction with antiretroviral therapy (ART) in patients with HIV can have a profoundly negative impact on disease progression.

After study the epigenetic samples of 55 HIV-positive men who were on ART, but who also used methamphetamines, the investigators found a differential expression of 32 genes and perturbation of 168 pathways in patients who had recently used the drugs. Some of those genes are associated with the HIV immune reservoir, immune activation, and inflammation, according to study co-author Adam Carrico, PhD, associate professor of Public Health Sciences and Psychology at the University of Miami Miller School of Medicine.

Read more about HIV and stimulant use.

#2: FDA Grants Market Clearance to Rapid Sepsis Test

The US Food and Drug Administration (FDA) has provided marketing clearance for a device capable of detecting specific sepsis-causing bacterial pathogens directly from a whole blood specimen in around 5 hours.

T2 Biosystems’ T2Bacteria Panel has been approved for the direct detection of bacterial species in the whole blood specimens of patients with possible bloodstream infections. Its processing speed significantly improves on the market’s previous standard of 3-day blood culture tests.

In fact, all other available FDA-approved diagnostic tests that detect bacteria in blood need a positive blood culture sample previous to the identification of bacterial species; this can delay results by up to 5 days. This delay can place patients at risk of sepsis in a compromising position: researchers estimate every hour of increased speed to targeted therapy decreases patient mortality by nearly 8%.

Read more about the rapid sepsis test.

#1: Study on Infection Prevention Programs Find Urgent Need for Increased Staffing

How many infection preventionists should hospitals employ? Hospitals spend a lot of time looking at nursing ratios for patients and ensuring enough staff are on the units, but what about the infection prevention program? There have been only a handful of studies to truly address the staffing of infection prevention and control programs (IPC) within health care facilities and as the duties become more diverse, such analyses are critical to reinforcing support.

The 2014 Ebola cluster in Dallas, Texas, underscored the importance of infection prevention practices and preparedness in health care, which adds another layer of complexities to health care programs. Infection preventionists (IPs) who make up the backbone of these teams are responsible for a range of duties that include surveillance and investigation of health care-associated infections, environment of care rounding, national reporting for quality metrics, isolation rounding, communicable disease reporting, and more. As the threat of emerging infectious diseases and hospital preparedness has become a hot topic, this has also been added to the list of IP duties.

A previous study from 2002, found that infection control staffing was recommended as 1 full-time employee (FTE) IP for every 250 acute care beds; however, the authors recommended that should be changed to 0.8 to 1.0 IP for every 100 occupied acute care beds. Although this was a welcome update, it has become increasingly obvious to infection control program staff and their IPs, that the scope of practice is expanding.

Now, a new study sought to address this through a comprehensive quantitative needs assessment regarding the number of IPs needed to build an effective infection prevention program.

For the study, the research team evaluated a large, nonprofit health care system that included 34 hospitals, and nearly 600 physician clinic and other outpatient services, which is divided across 9 regions. To truly understand the needs of each hospital, the investigators spent an entire day, on-site in each region to meet with key stakeholders (including those outside the infection prevention team, such as the chief nursing officer and chief medical officer), among other actions. They then compiled all data collected via survey and addressed the IPC duties at the locations that required an IP to be physically present (ie, performing isolation rounding, environment of care rounding, etc.) and its frequency.

Read more about the need for increased staffing in infection prevention programs.