Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management:A GRADE assessment and international consensus approach

This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against &gt;15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.</p

Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management:A GRADE assessment and international consensus approach

This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against &gt;15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.</p

Phytoplankton species enumeration, abundance and biomass estimation

In this data, from the first to the last sheet of the attached excel spreadsheet, we show the process used to estimate calculate (ind/L), biovolume (um^3/L) and biomass (ug/L) to obtain the final data used for "Phytoplankton and bacterioplankton community assembly in the Jiulong River (southeastern China)" project. Ten images of which four were captured by a smart phone (Vivo x5 pro) and six were captured by a microscope-attached camera (Moticam2306) during species enumeration are also attached

Type I allergic reaction to rituximab upon first lifetime exposure: a case report

Abstract Background While drug reactions to rituximab have been commonly reported in the literature, a type I allergic reaction to rituximab after first lifetime exposure has never been reported. Case presentation We describe a case of a 58-year-old female patient who received rituximab for the first time for treatment of rheumatoid arthritis. She developed symptoms immediately after infusion, however presented 11 days after drug exposure with cyclical anaphylaxis-like reaction requiring multiple doses of epinephrine. On second exposure, she experienced immediate anaphylaxis 30 min into infusion. Conclusion Our case illustrates the importance of heightened awareness by physicians that type I IgE-mediated reactions after first exposure to monoclonal antibodies such as rituximab are possible, and if unrecognized, could be potentially life-threatening. </jats:sec

Potential For Transmission Of Schistosomiasis In Kayonza District

Introduction: Schistosomiasis, also known as bilharzia or snail fever, is a tropical parasitic disease caused by a trematode platyhelminthes called Schistosoma sp. Schistosoma species are transmitted by cercariae penetrating the skin when a person is bathing, washing clothes, fishing or engaged in agricultural activities; involving contact with fresh water that has fecal or urinary contamination, and contains the parasites’ snail host. The present study aimed to survey freshwater snails in Kayonza District (Rwanda) especially Lake Muhazi and surrounding water bodies, stream and swamps to assess the potential for transmission of two species of Schistosoma: S. mansoni and S. haematobium . Methods: Six sites were selected to assess the potential for transmission of schistosomiasis. The intermediate hosts of schistosomes, namely the snails Biomphalaria , Bulinus sp. and Lymnaea sp., were collected and brought to the laboratory and investigated to see if trematode cercaria responsible for the disease were present. Results: Snails dissected were not only infected with trematode cercaria but also with annelids and flatworms (Platyhelminths). Cercaria found therein were of two types: furcocercous, probably responsible for schistosomiasis; and gymnocephalous cercaria for fasciolasis: an infection of cattle, goats and sheep. Conclusion: Biomphalaria sp were the major hosts for schistosome cercaria, and most snails collected of this species were infected. Moreover, they were found in large number from all sites. Lymnaea sp, hosts snails for Fasciola cercaria , were also found in a considerable number compared to the low number of Bulinus sp in the region. District and national authorities may wish to further investigate this infestation and identify potential interventions to disrupt the disease transmission.Introduction: La schistosomiase également connue sous le nom de bilharziose est une maladie parasitaire tropicale causée par des plathelminthes trématodes appelés schistosomes. Les Schistosomes sont transmises par des cercaires pénétrant la peau quand une personne se baigne, lave des vêtements, pêche ou pendant des activités agricoles en contact avec l’eau douce contaminée par des matières fécales ou urinaires, et contenant les mollusques hôtes intermédiaires des parasites. La présente étude visait à examiner les mollusques d’eau douce dans le district de Kayonza (Rwanda) particulièrement le lac Muhazi et les eaux environnantes: les ruisseaux et les marais; pour évaluer le potentiel de la transmission de deux espèces de schistosome: Schistosoma mansoni et Schistosoma haematobium . Méthodes: Six endroits ont été choisis pour évaluer le potentiel pour la transmission de la schistosomiase. Des mollusques hôtes intermédiaires des schistosomes, à savoir les espèces de Biomphalaria , Bulinus sp. et Lymnaea sp. ont été collectés, amenés au laboratoire et étudiés pour voir si les cercaires de trématodes responsables de la maladie étaient présentes. Résultats: Des mollusques disséqués ont été atteints par les cercaires de trématodes mais également par des annélides et des vers plats (Plathelminthes). Les Cercaires trouvées là-dedans étaient de deux types: furcocercaires, probablement responsable de la schistosomiase et cercaires gymnocéphales probablement responsables du fasciolose: une infection du bétail, des chèvres et des moutons. Conclusion: Les espèces Biomphalaria étaient les principaux hôtes des cercaires des schistosomes, les plus infectés parmi les espèces des mollusques collectés. Ces espèces de Biomphalaria ont été trouvées en grand nombre dans tous les sites. Les espèces de Lymnaea, mollusques hôtes intermédiaires pour les cercaires de Fasciola cercaria , ont été également trouvés en nombre considérable comparé à un nombre peu élevé des espèces Bulinus dans la région. Les autorités de district et ainsi que nationales devraient étudier davantage cette infestation et identifier les interventions potentielles pour interrompre sa transmission

Drug allergy

Abstract Drug allergy encompasses a spectrum of immunologically-mediated hypersensitivity reactions (HSRs) with varying mechanisms and clinical presentations. This type of adverse drug reaction (ADR) not only affects patient quality of life, but may also lead to delayed treatment, unnecessary investigations, and increased morbidity and mortality. Given the spectrum of symptoms associated with the condition, diagnosis can be challenging. Therefore, referral to an allergist experienced in the diagnosis and management of drug allergy is recommended if a drug-induced allergic reaction is suspected. Diagnosis relies on a careful history and physical examination and, in some instances, skin testing or in vitro testing and drug challenges. The most effective strategy for the management of allergist-confirmed drug allergy is avoidance or discontinuation of the offending drug. When available, alternative medications with unrelated chemical structures should be substituted. Cross-reactivity among drugs should also be taken into consideration when choosing alternative agents. Additional therapy for drug HSRs may include topical corticosteroids, oral antihistamines and, in severe cases, systemic corticosteroids and other immunomodulators. In the event of anaphylaxis, the treatment of choice is intramuscular epinephrine. If a patient with a history of anaphylaxis requires a specific drug and there is no acceptable alternative, desensitization to that drug may be considered. This article provides a background on drug allergy and strategies for the diagnosis and management of some of the most common drug-induced allergic reactions