Top Infectious Disease News of the Week—September 23, 2018

#5: The Immigration Debate and HIV/AIDS: Public Health Watch

“Build the wall!”

“Reunite the families!”

Regardless of where you stand on the immigration debate, it’s likely you hope that the issue doesn’t seep into other aspects of American life and impact the well-being of our most vulnerable. Unfortunately, it seems it has.

According to a report in the Washington Post, the federal government has spent approximately $500 million to shelter and care for the children in its custody at the border. It has been well documented that Immigration and Customs Enforcement (ICE) officials for several months beginning last spring detained parents and their children separately after they were arrested for attempting to enter the country illegally. Although that policy was discontinued, the Post reports that some 200 children remain in federal custody.

Read more about the immigration debate and HIV/AIDS.

#4: HIV Impacts Neurocognition in Resource-Limited Settings

Despite big advances in the field of HIV treatment, including streamlined drug regimens that help infected individuals achieve normal or near-normal lifespans, living with HIV often means dealing with neurocognitive impairment of some kind. This is particularly problematic in resource-limited settings such as parts of Africa, Asia, and Latin America. Unfortunately, the vast majority of the world’s HIV-positive people live in resource-limited settings, with two-thirds of them in sub-Saharan Africa alone.

From 2006 to 2010, a team led by investigators in the University of North Carolina’s department of neurology conducted a trial known as the AIDS Clinical Trials Group 5199 International Neurological Study (INS). This study separated 860 HIV-positive participants with CD4+ cell counts below 300 into 3 arms, each of which received a different antiretroviral (ART) treatment. The subjects, who came from 7 countries, were followed for a median of 168 weeks and assessed on a variety of neurocognitive measures. There was a demonstrable improvement in their symptoms once they began on ART, with no difference between the types of ART offered.

Read more about how HIV impacts neurocognition in resource-limited settings.

#3: Rebel Conflict Escalates Concern Over DRC Ebola Outbreak

The World Health Organization (WHO) is voicing concern over a number of variables that could lead to more challenging circumstances in the Ebola outbreak that is ongoing in the Democratic Republic of the Congo (DRC).

During the month of September, the number of new cases associated with the outbreak decreased significantly, compared with August. As of September 23, 2018, just 19 new cases have been confirmed since September 1, 2018.

However, due to widespread violence in the city of Beni, all of the efforts made by WHO to contain the outbreak have been suspended for the time being, and officials are concerned about the repercussions.

Read more about the ongoing Ebola outbreak in the DRC.

#2: High Rates of Adverse Events Linked with 2009 H1N1 Pandemic Vaccine

Nearly 10 years ago, in 2009, the influenza A (H1N1)pdm09 virus spread throughout the world, marking the most recent influenza pandemic since 1968.

The virus was first detected in the United States, where, according to an estimate by the US Centers for Disease Control and Prevention, it ultimately led to 60.8 million cases of influenza and 12,469 deaths.

After the first cases were detected in April 2009, health officials around the world began initiating pandemic responses and rolling out new vaccinations, designed especially for pandemic response.

One such vaccination administered across Europe—Pandemrix—has now been implicated in a new report by Peter Doshi, associate editor of The BMJ, who suggests that the vaccine had serious safety issues that led to an influx of adverse events and that these safety concerns were not communicated to the public.

Read more about adverse events linked with the 2009 H1N1 pandemic vaccine.

#1: Airplanes and Airports—A Hub for Travel and Germs

Most people have a general sense that air travel tends to involve exposure to germs. Whether it’s through the thousands of people we will come into contact with, the sick person next to us on the plane or the dirty surfaces, many of us get a sense of unease knowing there is a real chance we may arrive at our destination with a microscopic companion.

The recent quarantine of several flights, including the flight from Dubai which landed at John F. Kennedy International Airport with 100 sick passengers, was another reminder that air travel is not without the risks. The majority of sick passengers on that flight were found to be experiencing influenza and other common respiratory illnesses. One of the reasons for the heightened response to the illnesses was the flight’s origin—Dubai—which likely saw increased travelers following the recent Hajj pilgrimage to Mecca, in Saudi Arabia. Any large gathering can increase the risk of disease transmission, but, the risk is amplified during the pilgrimage because Saudi Arabia has continued to experience outbreaks of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) since it was first identified there in 2012. One can, therefore, understand the heightened concern over a large group of passengers returning from the country all falling ill. The simple truth is that when traveling, there are some things you can control and some you cannot.

The good news is that you can try to at least reduce the risk of infection through your seating practices and trying to avoid sick people. On a transcontinental flight, investigators have found that if a person is sitting within 1 row of a sick person, they are more likely to catch their illness. Meaning that if you are seated in the same row, or directly in front of or behind, an ill person (in the aisle seat), the odds are not in your favor. If you can move outside that area or pick a window seat should you be in that 3-row zone, you can decrease the odds of getting sick.

Although in-flight movements were found to have little effect on increasing disease transmission, to have the best chance of avoiding illness an individual should stay in a window seat for the duration of the flight. Those concerned about more threatening, but less likely illnesses, such as pneumonic plague or severe acute respiratory syndrome (SARS), can breathe a little easier (pun intended). According to Nereyda Sevilla, PhD, a civilian aerospace physiologist for the Medical Research and Acquisitions Division in the Office of the Air Force Surgeon General, “I’ve found the airplane is not what’s going to get you infected with disease. You’re more likely to get sick from waiting in the boarding area next to someone with a cold.”

Read more about infectious diseases and airplanes.