A Bordetella pertussis-antitestek szeroprevalenciája magyarországi felnőttekben

Absztrakt: Bevezetés: A pertussis (szamárköhögés) akut légúti fertőző betegség, amelyet a Bordetella pertussis okoz, és krónikus, súlyos köhögés jellemez. A pertussis védőoltás beadásának optimális rendje nem tisztázott, így országonként eltér. Célkitűzés: A pertussis szeroprevalenciájának becslése magyarországi felnőttek körében. Módszer: Szérum-antipertussistoxin-immunglobulin-G (anti-PT-IgG)-antitest-szintek elemzése enzimhez kötött immunoszorbens vizsgálattal felnőttekben, háziorvosi praxisokban, egy éven át. A szérumminták a gyártó utasításainak megfelelően kerültek osztályozásra, úgymint: erősen valószínűsíthető a fennálló/közelmúltban lezajlott fertőzés (≥1,5 optikaisűrűség [OS]-egység); valószínű a fennálló/közelmúltban lezajlott fertőzés (≥1,0 OS-egység); szeropozitivitás (>0,3 OS-egység); illetve szeronegativitás (≤0,3 OS-egység). Eredmények: A vizsgálatban 1999 felnőtt (60,6% nő; átlagos életkor 47,4 ± 17,7 év) vett részt. Közülük 14,8% volt szeropozitív, 1,1% esetében valószínűsíthető, míg 0,1% esetében erősen valószínűsíthető volt a fennálló/közelmúltban lezajlott fertőzés. Következtetések: A résztvevők 85,2%-a szeronegatív volt, és ily módon fogékony a pertussisfertőzésre. Körülbelül 1% esetében volt valószínűsíthető a fennálló/közelmúltban lezajlott fertőzés, amely potenciálisan átterjedhet fiatal csecsemőkre. A felnőttek immunizálása kulcsjelentőségű a csecsemők közvetett védelme szempontjából. Orv Hetil. 2018; 159(13): 503–510. | Abstract: Introduction: Pertussis (whooping cough) is an acute respiratory tract infection caused by Bordetella pertussis that is characterized by a chronic, severe cough. The optimum immunization schedule for pertussis is unclear, so these vary by countries. Aim: To estimate the seroprevalence of pertussis in adults in Hungary. Method: Serum anti-pertussis toxin immunoglobulin G (anti-PT IgG) antibody levels were analyzed using enzyme-linked immunosorbent assay in adults in general practitioners’ practices during one year. Sera were classified following manufacturer’s instructions as: strongly indicative of current/recent infection (≥1.5 optical density [OD] units); indicative of current/recent infection (≥1.0 OD units); seropositive (>0.3 OD units); or seronegative (≤0.3 OD units). Results: 1999 adults (60.6% female; mean age 47.4 ± 17.7 years) were included. 14.8% were seropositive, 1.1% were indicative of current/recent infection, and 0.1% were strongly indicative of current/recent infection. Conclusions: 85.2% of the subjects were seronegative and therefore susceptible to pertussis infection. Approximately 1% was suspicious of current/recent pertussis infection, potentially transmissible to susceptible young infants. Vaccination of adults is a key way to indirectly protect infants. Orv Hetil. 2018; 159(13): 503–510

Respiratory Syncytial Virus Disease Burden in Community-Dwelling and Long-Term Care Facility Older Adults in Europe and the United States: A Prospective Study

Background. Data on respiratory syncytial virus (RSV) disease burden in adults remain scarce. We assessed the burden of confirmed RSV-acute respiratory infections (cRSV-ARIs) in community-dwelling (CD) adults and those in long-term care facilities (LTCFs).Methods. In this prospective cohort study covering 2 RSV seasons (October 2019-March 2020 and October 2020-June 2021), RSVARIs were identified through active surveillance, in medically stable CD-adults =50 years (Europe) or adults =65 years in LTCFs (Europe and the United States). RSV infection was confirmed by polymerase chain reaction from combined nasal and throat swabs.Results. Of 1981 adults enrolled, 1251 adults in CD and 664 LTCFs (season 1) and 1223 adults in CD and 494 LTCFs (season 2) were included in the analyses. During season 1, overall incidence rates ([IRs] cases/1000 person-years) and attack rates (ARs) for cRSVARIs were 37.25 (95% confidence interval [CI], 22.62-61.35) and 1.84% in adults in CD and 47.85 (CI, 22.58-101.4) and 2.26% in adults in LTCFs. Complications occurred for 17.4% (CD) and 13.3% (LTCFs) of cRSV-ARIs. One cRSV-ARI occurred in season 2 (IR = 2.91 [CI, 0.40-20.97]; AR = 0.20%), without complications. No cRSV-ARIs led to hospitalization or death. Viral pathogens were codetected in =17.4% of cRSV-ARIs.Conclusions. RSV is an important cause of disease burden in adults in CD and LTCFs. Despite the observed low severity of cRSVARI, our results support the need for RSV prevention strategies among adults =50 years old

Seroprevalence of Bordetella pertussis antibodies in adults in Hungary: results of an epidemiological cross-sectional study.

BACKGROUND: Pertussis (whooping cough) is well known to be underreported, particularly among adults, who can act as an infectious reservoir, potentially putting susceptible newborns at risk of serious illness. The purpose of this study was to estimate the seroprevalence of pertussis in adults in Hungary. METHODS: This epidemiological, cross-sectional study was conducted in adults in five general practitioners' practices in Hungary. Serum anti-pertussis toxin immunoglobulin G (anti-PT IgG) antibody levels were analyzed using enzyme-linked immunosorbent assay. Sera were classified following manufacturer's instructions as: strongly indicative of current/recent infection (>/=1.5 optical density [OD] units); indicative of current/recent infection (>/=1.0 OD units); seropositive (>0.3 OD units); or seronegative (/=60 years (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.39-2.80; p = .0002) or 18-29 years (OR, 1.67; 95% CI, 1.13-2.46; p = .0094) vs. 45-59 years; former smoker (OR, 1.46; 95% CI, 1.08-1.97; p = .014) or current smoker (OR, 1.38; 95% CI, 1.01-1.89; p = .045) vs. never smoker; and male (OR, 1.30; 95% CI, 1.01-1.68; p = .041) vs. female. Also, between increased rates of probable current/recent infection and current smoker (OR, 7.50; 95% CI, 2.32-24.31; p = .0008) or former smoker (OR, 4.07; 95% CI, 1.21-13.64; p = .023) vs. never smoker. CONCLUSIONS: Approximately 85% of the adults studied were seronegative and therefore susceptible to pertussis infection. Approximately 1% had anti-PT IgG levels indicative of current/recent pertussis infection, which could potentially be transmitted to susceptible young infants. Vaccination of adults is a key way to indirectly protect infants. TRIAL REGISTRATION: Clinical Trials.gov NCT02014519 . Prospectively registered 12 December 2013

Safety of RTS,S/AS01<sub>E</sub> malaria vaccine up to 1 year after the third dose in Ghana, Kenya, and Malawi (EPI-MAL-003): a phase 4 cohort event monitoring study.

BackgroundRTS,S/AS01E has been successfully administered to over two million children since 2019 through the Malaria Vaccine Implementation Programme (MVIP). In this Article, we report the safety results of a study evaluating RTS,S/AS01E safety and effectiveness in real-world settings.MethodsEPI-MAL-003 is an ongoing phase 4 disease surveillance study with prospective cohort event monitoring and hospital-based surveillance, done in the setting of routine health-care practice in Ghana, Kenya, and Malawi and fully embedded in the MVIP. The study design was dependent on the cluster-randomised vaccine implementation. In active surveillance, we enrolled children younger than 18 months from exposed (where RTS,S/AS01E was offered) and unexposed clusters. The coprimary endpoints were the occurrence of predefined adverse events of special interest and aetiology-confirmed meningitis. We report primary and secondary safety results up to 1 year after the primary vaccine schedule (three doses). The study is registered with ClinicalTrials.gov, NCT03855995.FindingsThe first participant was enrolled on March 21, 2019. The cutoff date for the current analysis was 1 year after the third RTS,S/AS01E dose for each participant. In total, 44 912 children (19 993 in Ghana, 11 990 in Kenya, and 12 929 in Malawi) were included in the analysis set for the cluster-randomised comparison: 22 508 from exposed clusters and 22 404 from unexposed clusters. Incidence rates (expressed per 100 000 person-years) for generalised convulsive seizures and intussusception were similar between vaccinated and unvaccinated children. Aetiology-confirmed meningitis was reported in two children: one case of bacterial meningitis due to Streptococcus pneumoniae in an RTS,S/AS01E-vaccinated child in the exposed clusters, and one case of viral meningitis due to human herpesvirus 6 in an unvaccinated child in the unexposed clusters. Both cases occurred within 12 months after vaccination in children in the cluster-design analysis set, leading to incidence rates of 4·1 (95% CI 0·1-23·0) per 100 000 person-years in RTS,S/AS01E-vaccinated children and 4·0 (0·1-22·6) per 100 000 person-years in unvaccinated children, and a country-adjusted incidence rate ratio (IRR) of 0·96 (95% CI 0·06-15·34; p=0·98). Cerebral malaria cases were reported for four (E-vaccinated children in the exposed clusters and two (E-vaccinated children and unvaccinated children, respectively (IRR 1·43, 95% CI 0·24-8·58, p=0·70). Incidence rates for all-cause mortality were 659·7 (95% CI 561·5-770·3) in vaccinated children versus 724·5 (622·3-838·8) in unvaccinated children, with similar incidence rates for boys and girls.InterpretationWe found no evidence of vaccination being associated with an increased risk of meningitis, cerebral malaria, or mortality among vaccinated children, and no new safety risks were identified.FundingGSK

Role of Cobalt Doping on the Physical Properties of CdO Nanocrystalline Thin Films for Optoelectronic Applications

In the current work, the authors aim to present an insight on the role of cobalt (Co) doping for the structural, morphological, and linear and nonlinear optical (NLO) properties of CdO thin films. The films were prepared using the spray pyrolysis (SP) technique, and the weight % of Co (x) was varied from 0–10. The structural properties of the films were confirmed by the powder X-ray diffraction (P-XRD) studies and are polycrystalline with a cubic structure and a lattice parameter of 0.4658 nm. As Co content in CdO films increases, cluster grain size and porosity decrease significantly, as seen in surface topographic and nanostructural analysis. Through the Burstein–Moss shift, the optical band gap “Eg” in Co: CdO film decreases from 2.52 to 2.05 eV with the increase in Co-doping. To study the NLO parameters, open aperture (OA) and closed aperture (CA) Z-scan measurements were performed using the diode-pumped solid-state continuous wave laser excitation (532 nm), and with the increased Co-content, the NLO parameters—nonlinear absorption coefficient (β∼10−3 cm/W), nonlinear refractive index n2 ∼10−8 cm2/W), and the 3rd-order NLO susceptibility χ3∼10−7 to 10−6 e.s.u.) values were determined and found to be enhanced. The maximum NLO parameters achieved in the present study with increasing Co concentration on CdO nanostructures prepared by the SP method are found to be the highest among the reported values and suggest that processed films are a capable material for optoelectronic sensor applications

Incidence and mortality of pertussis disease in infants <12 months of age following introduction of pertussis maternal universal mass vaccination in Bogotá, Colombia

Background Maternal immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine confers protection to young infants. We aimed to describe trends in pertussis incidence and associated mortality in children aged <12 months before and after introduction of maternal Tdap immunization in Bogotá, Colombia. Methods Data on pertussis-related cases/deaths in infants aged <12 months were collected from SIVIGILA for the period 2005–2016, and compared incidence for the pre-vaccine introduction (2005–2012) and post-maternal Tdap vaccination (2014–2016) periods in infants aged <12 months and in three distinct age-strata; ≤6 weeks, 7–<28 weeks, and 28–52 weeks. Mortality comparisons were performed in all infants <12 months. Results From 2005 to 2016, 2315 laboratory or clinically-confirmed pertussis cases were reported in infants <12 months of age (278 cases in young infants aged ≤6 weeks); 55 pertussis deaths were reported in children aged <12 months. No pertussis deaths were reported in the 2014–2016 period. Since maternal Tdap introduction in 2013, a consistent decline in pertussis incidence and mortality was observed. In the time-series analysis, incidence declined from 209.4/100,000 persons (2005–2012) to 49.1/100,000 persons (2014–2016) in all children <12 months; a 87.5% (95%CI: 77.2-93.2%) reduction. For these same period’s incidence in young infants ≤6 weeks declined from 196.7 to 89.6/100,000 person-years (an 54.4% [95% CI: 35.4–67.9%] reduction). Greater incidence reductions were observed in older infants; 73.4% (95% CI: 68.4–77.6%) in those aged 7–<28 weeks, and 100% in those aged 28–52 weeks. A 100% reduction in Pertussis mortality in infants <12 months was observed. Since Tdap introduction, maternal vaccine coverage rose from <60% in 2013–2015 to 80% in 2016. Conclusions Implementation of maternal immunization in Bogotá may have contributed to the reduction in pertussis incidence and mortality among infants <12 months of age (ClinicalTrials.gov: NCT02569879)

Pneumonia hospitalizations of children aged <2 years in Poland before (2013–2016) and after (2017–2018) universal mass vaccination with 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine

As infection with Streptococcus pneumoniae is an important cause of pneumonia in children, the World Health Organization recommends childhood pneumococcal conjugate vaccines (PCVs). In January 2017, PCV universal mass vaccination (UMV) was introduced in Poland for children aged <2 years. The objective of this study was to estimate and describe the trends in the incidences of various types of pneumonia hospitalizations in Poland before (2013–2016) and after (2017–2018) introduction of the UMV program. The study was conducted at the regional hospitals of Opole and Bialystok and included all hospitalized children aged <2 years with a primary or secondary diagnosis of pneumonia in their electronic medical records. Pneumonia diagnoses were identified based on International Classification of Diseases 10th revision (ICD-10) codes for bacterial, viral, and other/unknown-cause pneumonias. The effect of the implementation of PCV UMV was modeled via an inferential multivariate model. Among 4,168 children included in the study, 64.3% were admitted before PCV UMV. The number of radiograph-confirmed likely bacterial pneumonia cases varied between 55 and 176 cases per 100,000 person-years, and no trend was observed over time. However, inferential modeling showed statistically significant decreasing trends in the incidence rates of bacterial-coded pneumonia (28.48%), viral-coded pneumonia (35.36%), all-cause pneumonia (24.60%), and radiograph-confirmed likely non-bacterial pneumonia (24.98%) among children eligible for UMV. This might be the first indication of the impact of the PCV UMV program in Poland