Archive for February, 2012

Study of HIV-resistant sex workers could lead to better AIDS vaccine

Tuesday, February 14th, 2012 (last updated)

The discovery of HIV-resistant sex workers in Africa could pave the way for a more effective AIDS vaccine, according to a new study by University of Montreal researchers.

“Studying women who are naturally resistant to the virus enables researchers to identify interesting information in terms of developing vaccinations or … gels that could prevent transmission of HIV,” said lead researcher, Dr. Michel Roger of the University of Montreal Hospital Centre and the university’s Department of Microbiology and Immunology.
“AIDS vaccination research has entirely focused on the blood stream and this approach has been a failure,” Roger said. “Our research shows that the immune response is different at the side of the infection, and that we should turn to the entry points in order to find a means for blocking the virus.”

The year-and-a-half-long study involved 52 commercial sex workers who were uninfected with HIV, 44 sex workers who were HIV-positive and 71 uninfected women not working in prostitution in Benin, all over the age of 18.
The results were published in the scientific journal PLoS ONE in September 2011. This is the first study that compares the blood and immune response to the HIV virus of HIV-resistant women, Roger said.
Surprisingly, Roger noted, researchers found that the group of uninfected sex workers had fewer inflammatory molecules in the vagina than women infected with HIV who were also commercial sex workers, working under similar conditions.
“We have identified prostitutes, who of course, are highly exposed to the virus and some of them, they don’t get infected even though they practise in the same way as others, in the same building, with the same clients. They don’t get infected after four, five, seven years of prostitution,” Roger, who has been investigating HIV-resistance in commercial sex workers in Benin and Zimbabwe for the past 15 years, told Postmedia News.
These results, he said, were even more remarkable given that this group of HIV-resistant women had fewer inflammatory molecules than uninfected women who were not working in prostitution.

Roger explained that the HIV-resistant women were producing fewer “lymphocyte T-cells,” or target cells, in their vaginas that are normally used by the HIV virus to spread throughout the body.
According to the study, the immune response of HIV-resistant women was very different in their blood system than in their vaginal mucous membrane. This new finding suggests that a new vaccine targeting the entry point to the body rather than fighting it once it is already within the body’s system could be more effective.
“This is very important for the future design of a vaccine. This is showing that we need to understand better the mucosal response against HIV in order to design an efficient vaccine,” he said.
This new kind of vaccine could be administered through the nose and would immunize all mucus membranes in the body.

PLoS ONE & The Vancouver Sun

Adult vaccination coverage in the United States (2010)

Monday, February 13th, 2012 (last updated)

Immunizations are recommended throughout life to prevent infectious diseases and their sequelae. Adult coverage, however, remains low for most routinely recommended vaccines and well below Healthy People 2020 targets. In October 2011, the Advisory Committee on Immunization Practices (ACIP) approved the adult immunization schedule for 2012. Apart from influenza vaccination, which is now recommended for all adults, other adult vaccines target different populations based on age, certain medical conditions, behavioral risk factors (e.g., injection drug use), occupation, travel, and other indications. To assess adult (≥ 19 years) vaccination coverage for select vaccines, CDC analyzed data from the 2010 National Health Interview Survey (NHIS).

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MMWR (February 3, 2012)

Flu activity gaining steadily in US and Europe

Friday, February 10th, 2012 (last updated)

Seasonal flu activity in the United States last week passed a key threshold, while many European countries reported similar rises in the spread of the disease, according to flu surveillance reports released today.
The US Centers for Disease Control and Prevention (CDC) said the percentage of respiratory specimens that tested positive for flu jumped from 7.6% to 10.5%, passing a mark (10%) that health officials typically use to gauge when the season has started. It also reported that California became the first state to cite widespread flu transmission this year.
Although the nation’s rise in flu activity seems late this year, the CDC has said that in the past 29 years, specimens testing positive for flu didn’t pass the 10% mark until January or later in 15 of the years.
Nationally, the percentage of doctor visits for flu-like illness was 1.7%, putting it below the baseline. However, regional baselines were exceeded in two parts of the country: Iowa, Kansas, Missouri, and Nebraska; and the northwest, including Alaska, Idaho, Oregon, and Washington.
Deaths from flu and pneumonia were below the epidemic threshold, the CDC said. One more pediatric flu death was reported, raising the season’s total to two. The child’s death occurred during the week that ended Jan 21 and involved an unsubtyped influenza A strain.
Although H3N2 viruses are still dominant, the CDC is seeing regional differences in circulating viruses, including a rising number of 2009 H1N1 detections over the past several weeks, especially in south-central and southwestern states.
Antigenic testing of a small number of influenza B samples shows that fewer than half (45.9%) match the Victoria lineage included in the seasonal flu vaccine. However, the CDC said it is too soon to tell how well circulating strains match the vaccine strains and that most influenza B strains circulating globally match the vaccine strain.
The 2009 H1N1 virus has dominated Mexico’s flu season. The Pan American Health Organization (PAHO) said Mexico has reported 2,815 influenza infections and 58 deaths, with about 90% of the cases and 93% of the deaths due to the 2009 H1N1 virus. States with the most cases are Federal District and Oaxaca.
Meanwhile, the European Centre for Disease Prevention and Control (ECDC) said today that flu activity continued to rise last week with significant variation by country and no clear geographic progression. Belgium, Italy, and Spain reported widespread activity, and 18 countries reported increasing activity.
The ECDC said the H3N2 virus is dominant, with low levels of influenza B and 2009 H1N1 circulating as well. So far no resistance to neuraminidase inhibitors has been reported.


Are children at risk from vaccines?

Friday, February 10th, 2012 (last updated)

It was over 200 years ago that Edward Jenner, the pioneer of the smallpox vaccination, was able to protect a man from the dreaded disease smallpox through vaccination.
Since then, through mass immunization efforts, smallpox has been eradicated from the planet.
Vaccinations have eliminated polio from much of the world, and controlled many diseases that once maimed or killed in large numbers.
But in recent years, a growing number of parents have been expressing concern about immunization. Some are refusing to vaccinate their children because of what they have heard or read.
Medical experts across the world say all their research shows that there is no evidence of a link with conditions like autism and Sudden Infant Death Syndrome.
In Australia, the government has decided to take increased action.
Already, there is a penalty for not vaccinating your children – losing out on tax benefits.
Under new rules, some families could lose over $2,000 for each child not fully immunized. Is this the right approach? Are the risks of vaccinations small compared with the health risks associated with the diseases they are intended to prevent?
Joining Inside Story with presenter James Bays to discuss these issues are guests: Brian Deer, an investigative journalist known for inquiries into the drug industry, medicine and social issues for the Sunday Times of London; and Adam Finn, the head of the Academic Unit of Child Health at Bristol Medical School and honorary consultant in paediatric infectious diseases and immunology at Bristol Royal Hospital for Children, and the head of the Bristol Children’s Vaccine Centre

Inside Story (Aljazeera)

Can immunotherapy benefit men with localized prostate cancer?

Wednesday, February 8th, 2012 (last updated)

Dr. Tia Higano, a professor in the division of medical oncology at the University of Washington School of Medicine, describes research that suggests that a prostate cancer “vaccine” therapy (sipuleucel-T, or trade name Provenge) may have promise if used in early stage prostate cancer, either alone or in combination with other late-stage investigational medicines. Dr. Higano goes on to discuss how several agents in development may soon give men with advanced prostate cancer more options than ever before, including treatments that may be more powerful in combination than as single-agent therapies. Dr. Higano also explains how the research questions in the near future will focus on discovering how and when to best use various treatments over the course of therapy.

Patient Power

How do you get 100 percent?

Tuesday, February 7th, 2012 (last updated)

Honduras is a vaccination success story. In spite of significant challenges, the country has proven that vaccination programs can be implemented in what may initially seem to be some of the most challenging places in the world. What makes a success story possible? Everyone is working together to ensure that the children of Honduras have a shot at a healthy life.


The Vaccination Debate: everything you’ve ever wanted to know about protecting yourself and your loved ones

Monday, February 6th, 2012 (last updated)

Did you know that according to the CDC, vaccinating every American child born this year would save 33,000 lives, prevent 14,000,000 infections, and save 10 billion dollars?


The immune system is very complex. Why?

Sunday, February 5th, 2012 (last updated)

Tim Mosmann is the Director of the David H. Smith Center for Vaccine Biology and Immunology at the University of Rochester, where he was appointed in 1998. He received his academic training in virology and immunology at universities in South Africa, Canada and Scotland. Dr. Mossman was one of the original members of a California start-up company, DNAX Research Institute, where he made his most important discoveries regarding specialized subsets of T cells and their contributions to immune responses. This work has since been recognized by several awards, notably the Paul Ehrlich/Ludwig Darmstaedter Prize in 2008.

In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. At a TEDx event, TEDTalks video and live speakers combine to spark deep discussion and connection in a small group. These local, self-organized events are branded TEDx, where x = independently organized TED event. The TED Conference provides general guidance for the TEDx program, but individual TEDx events are self-organized.

TEDx Talks

Advocates say flu vaccine should be mandatory for health

Friday, February 3rd, 2012 (last updated)

Despite more than 20 years of recommendations that health workers get flu shots, the most recent data from the Centers for Disease Control and Prevention show more than a third don’t comply.
The voluntary approach to reducing the risk that workers will transmit flu to patients has fallen short.
So consumer and business groups met in Washington Thursday to show their support for a recommendation from the National Business Group on Health that hospitals require all health care workers to be vaccinated annually against the flu.
“We believe that patients have the right to assume that health care personnel, themselves, will take all reasonable measures to reduce and avoid transmission of preventable diseases including the flu,” said Helen Darling, president and CEO of the NBGH. “I think we, as people, assume that after all, they’re our caretakers and we look to them for care and treatment.”

The NBGH is a nonprofit representing more than 300 large employers, including 68 of the Fortune 100. Its statement urged hospitals to “require annual flu vaccination of all employees as a condition of employment unless employees can demonstrate medical contraindications (with physician documentation) or religious objections.”
If that is the case, the NHBG says those employees “should not engage in direct patient care if they have flu-like symptoms.”
But flu vaccinations have been a point of contention among health care workers and labor groups for years. New York health workers pushed back against mandatory vaccination during the pandemic in 2009.
Even within the government, there are conflicting views. In a letter to the National Vaccine Program Office last month, Jordan Barab, deputy assistant secretary for the Department of Labor’s Occupational Safety and Health Administration, said his organization supports the goal of the HHS’ Healthy People 2020 initiative to get 90 percent of health care personnel vaccinated. But “we are troubled that some have tried to convert the goal into a mandate,” he wrote. (The Department of Labor letter was first reported on by Inside Health Policy)
At the media briefing, Darling said a mandate is an effective means to ensure health care providers are safe from the influenza infection. “We know that mandates work.”
Among other groups supporting the proposal there were Consumer Reports and the American Hospital Association. Dr. Don Wright, deputy assistant secretary for health care quality at the Department of Health and Human Services, said at the briefing that the agency will be publishing data by next year on hospitals that have vaccinated employees as part of their efforts to reduce hospital-acquired infections.
Hospitals that report their employee vaccination data will receive a bonus payment, Wright said, and already well over 95 percent of hospitals are doing that. Wright said in an interview later that HHS is not “endorsing any one method [of boosting vaccination rates] over another. Our goal is to get the rate of vaccinations up, so the jury is still out on the best way to do that.”
HHS’ plan for reducing the number of hospital-acquired infections suggests “that we need a 70 percent rate of immunizations for health care workers by the end of 2015. That really splits the difference from the Healthy People 2010 goal, which was 60 percent, and the Healthy People 2020 goal which is 90 percent,” Wright said.

NPR’s Health Blog

New vaccine recommendations for boys and diabetics

Thursday, February 2nd, 2012 (last updated)

Federal health experts are now recommending that all boys be routinely vaccinated against human papillomavirus, or HPV.
The vaccine already has been recommended for girls and young women since 2006 largely to prevent cervical cancer. But health authorities never expressly encouraged the vaccine for young boys, saying only that they “could” receive it to protect against genital warts and certain cancers and to help prevent the spread of HPV.
In releasing a new immunization schedule on Thursday — published in The Annals of Internal Medicine — the Centers for Disease Control and Prevention used much stronger language, explicitly recommending HPV vaccination for boys 11 to 12 years old and catch-up vaccination for those 13 to 21.
The move came about because health authorities were swayed by new data in the past two years showing that the vaccine is “very effective” in preventing genital warts in men and women and some cancers, said Eileen Dunne, a C.D.C. scientist. HPV infection can increase the risk of several cancers, including cervical, anal and oropharyngeal cancers affecting the back of the tongue and the throat.
The new recommendation comes on the heels of a report last week showing that roughly 1 in 15 Americans are infected with oral HPV and that the disease is especially common among men. HPV is typically found in the genital area, affecting up to 80 percent of men and women at some point in their lives, but can be transmitted to the mouth area by intimate contact, including oral sex.
In addition to the change in HPV vaccinations in the new schedule, health officials recommended that people with Type 1 or 2 diabetes be vaccinated against hepatitis B. The hepatitis vaccine has been recommended for a number of years for people at risk of “blood exposure,” like health care workers, injection drug users and people with end-stage renal disease, who have to undergo dialysis, said Carolyn Bridges, associate director for adult immunizations at the National Center for Immunization and Respiratory Diseases at the C.D.C.
She said that diabetics have twice the risk of getting hepatitis B as others, and that health officials had recorded hepatitis outbreaks at nursing homes among people who shared devices that test blood sugar levels.

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The New York Times & Annals of Internal Medicine