RISK FACTORS FOR ANTIBODY LOSS AFTER HEPATITIS E VIRUS NATURAL INFECTION AND VACCINATION

Hepatitis E virus (HEV) is a vaccine-preventable emerging infectious disease causing 20 million infections in developing countries every year. In South East Asia, HEV causes yearly outbreaks, with the majority of disease seen in adults, surprising for an enterically transmitted pathogen. These outbreaks suggest that antibody persistence after exposure to HEV is not long lasting. We revisited 170 subjects with a documented HEV infection from Bangladesh and China and 97 subjects vaccinated with the HEV239 vaccine during a phase III trial in China to retest their serum for anti-HEV antibodies 6 to 10 years after exposure. Overall, 22.1% (95%CI: 17.3-27.6%) no longer had detectable antibodies at follow-up. Antibody loss was greater among the naturally infected subjects compared to the vaccinated subjects, 24.1% (95%CI: 17.9-31.3%) versus 18.6% (95%CI: 11.4-27.7%), although not statistically significant (p=0.292). Among all the subjects, age at exposure was associated with antibody loss, with younger age increasing the risk of antibody loss (RR: 0.87 per 10 years, 95% CI: 0.76-1.00, p=0.057). Among the subjects from Bangladesh, each 10 year increase in age at infection decreased the risk of antibody loss by 50% across univariate and multivariate Poisson regression models (p<0.05). This age-dependent antibody loss could partially explain cross-sectional sero-prevalence data from South East Asia where children have reportedly low antibody prevalence. In multivariate models, factors that increased the risk of exposure to HEV were generally associated with antibody persistence among the naturally infected subjects. However, this pattern was not found in the vaccinated subjects. This is one of the first studies to compare long term antibody persistence after HEV exposure in both naturally infected and vaccinated individuals, exploring characteristics associated with antibody persistence. The development of a successful, subunit vaccine has increased the need to understand the duration of antibodies and protection after HEV infection and vaccination in order to implement the most cost effective disease control and vaccination strategies

Replication Data for: Mortality Risk Factors among National Football League Players: An Analysis using Player Career and Biometric Data

Long-term adverse health outcomes, particularly those associated with concussions, are of growing concern among elite athletes, especially American football players. These include chronic traumatic encephalopathy, depression, and mortality. Concussions can be difficult to diagnose, and there is mounting evidence that even sub-clinical blows, especially when they occur frequently, can also lead to adverse health outcomes. Certain player attributes such as playing style and position of play, along with on-field events such as number of tackles and sacks are likely to be strong predictors for the risk of developing adverse long-term negative health outcomes from repeated, yet mild, trauma

Predicting attitudes toward mitigation interventions and social distancing behaviors at the onset of the COVID-19 pandemic in the United States

ABSTRACTAim The goal of this research was to assess the influence of adult attachment, personality, and cultural orientation on social distancing and attitudes toward COVID-19 mitigation interventions.Methods Survey data was collected across two samples (NMTurk = 201, Nsnowball = 242) in the US from April 29 to May 11, 2020. Adult attachment was assessed via the Experiences in Close Relationships Scale-Short Form (ECR-S; Wei, M., Russell, D. W., Mallinckrodt, B., & Vogel, D. L. (2007). The experiences in close relationship scale (ECR)-short form: Reliability, validity, and factor structure. Journal of Personality Assessment, 88(2), 187–204), personality was assessed via the Ten Item Personality Inventory (TIPI; Gosling, S. D., Rentfrow, P. J., & Swann, W. B. (2003). A very brief measure of the Big-Five personality domains. Journal of Research in Personality, 37(6), 504–528), cultural orientation was assessed via the Horizontal and Vertical Individualism and Collectivism Scale (Triandis, H. C., & Galfand, M. J. (1998). Converging measurement of horizontal and vertical individualism and collectivism. Journal of Personality and Social Psychology, 74(1), 118–128), and social distancing and attitudes toward mitigation interventions were assessed via self-report measures developed for this assessment.Results In the MTurk sample, agreeableness (β = .19) and conscientiousness (β = .26) predicted positive mitigation intervention attitudes. Agreeableness (β = .24) and vertical collectivism (β = .25) positively predicted social distancing, while attachment anxiety (β = −.32) and vertical individualism (β = −.32) negatively predicted social distancing. In our snowball sample, residing primarily in New York, openness (β = .18) and horizontal collectivism (β = .16) predicted positive intervention attitudes, while horizontal individualism (β = −.20) predicted negative attitudes. Social contact in this sample was low and not associated with predictor variables. In both samples, mitigation attitudes and social distancing were only moderately correlated.Implications Our findings highlight the inherent inconsistency between attitudes and behaviors as well as the potential impact of mandated interventions on both attitudes and behavior

Seroprevalence of hepatitis E virus antibodies in adults and children from upstate New York: A cross-sectional study.

Hepatitis E virus (HEV) is a major cause of viral hepatitis around the world, especially in developing countries. Recently, HEV has also been recognized as important cause of hepatitis in Europe and Japan, however, there is a paucity of clinical data from the United States. The overall seroprevalence of HEV antibodies is around 10% in the United States, but considerable variation is seen based on geographic location, year, and assay used. In this study, 63 adults and 417 children from New York State were tested for anti-HEV IgG antibodies using the commercially available Wantai IgG assay. The overall seroprevalence of HEV antibodies among adult participants was 9.52% (95% CI: 3.58-19.59%). Positive adults tended to be older than HEV negative adults, all positive adults were female. Only 3 (0.7%, 95% CI:: 0.15-2.09%) of the children were positive, all positive children were male. These results are consistent with global and United States trends in HEV seroprevalence

An exploratory case control study of risk factors for hepatitis E in rural Bangladesh.

Hepatitis E virus (HEV) is the major cause of epidemic and sporadic hepatitis globally. Outbreaks are associated with fecal contamination of drinking water, yet the environmental reservoir of HEV between epidemics remains unclear. In contrast to neighboring countries, where epidemics and sporadic disease co-occur, HEV-endemic communities in rural Bangladesh seldom report outbreaks; sporadic hepatitis E is reported from urban and rural areas of the country. Besides typical enteric risk factors, other routes for HEV infection and disease are unclear. We conducted monthly household surveillance of a southern Bangladeshi community of 23,500 people to find incident cases of acute hepatitis E over a 22 month period. An algorithm was used to capture 279 candidate cases, of which 46 were confirmed acute HEV infections. An exploratory case-control study was conducted to identify putative risk factors for disease. Nearly 70% of cases were over 15 years old. Female gender seemed protective (OR:0.34) against hepatitis E in this conservative setting, as was the use of sanitary latrines (OR:0.28). Socioeconomic status or animal exposures were not significant predictors of disease, although outdoor employment and recent urban travel were. Unexpectedly, recent contact with a "jaundiced" patient and a history of injection exposure in the 3 months prior to disease (OR:15.50) were significant. Susceptible individuals from "endemic" communities share similar enteric exposure risks to those commonly associated with tourists from non-endemic countries. This study also raises the novel possibility of parenteral and person-to-person transmission of HEV in non-epidemic, sporadic disease settings

Correction: A 10+10+30 radio campaign is associated with increased infant vaccination and decreased morbidity in Jimma Zone, Ethiopia: A prospective, quasi-experimental trial.

[This corrects the article DOI: 10.1371/journal.pgph.0001002.]

Correlation between AFRIMS and commercial anti-HEV IgM Assay.

*<p>AFRIMS in-house anti-HEV IgM Immunoassay as described in Myint 2006.</p>**<p>Anti-HEV IgM Enzyme Immunoassay 1056, Medical Biological Service (MBS), Milano, Italy.</p

A 10+10+30 radio campaign is associated with increased infant vaccination and decreased morbidity in Jimma Zone, Ethiopia: A prospective, quasi-experimental trial.

Mass media interventions have the potential to reach large audiences and influence health behaviours and outcomes. To date, no study has evaluated the effect of a radio-only campaign on infant vaccination coverage, timeliness, and related morbidity in a low-income country. We implemented the "10+10+30" radio campaign involving broadcasting a weekly 10-minute radio drama series on vaccination, followed by a 10-minute discussion by community health workers, and then a 30-minute listener phone-in segment in Jimma Zone, Ethiopia for three months. To assess the impact of 10+10+30, which was aired on a community radio station, we recruited mothers of infants up to 5 weeks old in intervention district clusters that were inside the radio station's reception range (n = 328 dyads) and control district clusters that were outside of the range (n = 332 dyads). Intention-to-treat and per-protocol analyses, adjusted for pre-intervention differences between the districts, were conducted to examine the co-primary outcome of Penta-3 vaccination coverage and timeliness as well as those of other vaccines and outcomes related to infant morbidity. Both intention-to-treat and per-protocol analyses revealed higher vaccine coverage (p<0.001) and more timely vaccine administration (p<0.001) in the intervention district relative to the control district, with infants in the intervention district being 39% more likely to receive a Penta 3 vaccination (adjusted RR: 1.39, p<0.001). In addition, adjusted regression analyses of maternal retrospective reports over a two-week period revealed 80% less infant diarrhoea (RR: 0.20, p<0.001), 40% less fever (RR: 0.60, p<0.001) and 58% less cough (RR: 0.42, p<0.001) in the intervention district relative to the control district. This study provides compelling initial evidence that a radio drama integrated with discussion and phone-in components may improve infant vaccination coverage and timeliness, and may reduce infant morbidity. Randomized controlled trials are needed to confirm and extend these findings with other samples