Systematic Review and Meta-Analysis on the Association Between Outpatient Statins Use and Infectious Disease-Related Mortality

Background: To update and refine systematic literature review on the association between outpatient statins use and mortality in patients with infectious disease. Materials and Methods: We searched articles published before September 31, 2012, on the association between statins and infectious disease-related mortality through electronic databases. Eligible articles were analyzed in Review Manager 5.1. We conducted stratification analysis by study design, infection types, clinical outcomes and study locations. Results: The pooled odds ratio (OR) for death (statins use vs. no use) across the 41 included studies was 0.71 (95% confidence interval: 0.64, 0.78). The corresponding pooled ORs were 0.58 (0.38, 0.90), 0.66 (0.57, 0.75), 0.71 (0.57, 0.89) and 0.83 (0.67, 1.04) for the case-control study, retrospective cohort studies, prospective cohort studies and RCTs; 0.40 (0.20, 0.78), 0.61 (0.41, 0.90), 0.69 (0.62, 0.78) and 0.86 (0.68, 1.09) for bacteremia, sepsis, pneumonia and other infections; 0.62 (0.534, 0.72), 0.68 (0.53, 0.89), 0.71 (0.61, 0.83) and 0.86 (0.70, 1.07) for 30-day, 90-day, in-hospital and long-term (>1 year) mortality, respectively. Conclusions: Outpatient statins use is associated with a lower risk of death in patients with infectious disease in observational studies, but in a less extent in clinical trials. This association also varies considerably by infection types and clinical outcomes

Passive immunotherapy for influenza A H5N1 virus infection with equine hyperimmune globulin F(ab')(2 )in mice

BACKGROUND: Avian influenza virus H5N1 has demonstrated considerable pandemic potential. Currently, no effective vaccines for H5N1 infection are available, so passive immunotherapy may be an alternative strategy. To investigate the possible therapeutic effect of antibody against highly pathogenic H5N1 virus on a mammal host, we prepared specific equine anti-H5N1 IgGs from horses vaccinated with inactivated H5N1 virus, and then obtained the F(ab')(2 )fragments by pepsin digestion of IgGs. METHODS: The horses were vaccinated with inactivated H5N1 vaccine to prepare anti-H5N1 IgGs. The F(ab')(2 )fragments were purified from anti-H5N1 hyperimmune sera by a protocol for 'enhanced pepsin digestion'. The protective effect of the F(ab')(2 )fragments against H5N1 virus infection was determined in cultured MDCK cells by cytopathic effect (CPE) assay and in a BALB/c mouse model by survival rate assay. RESULTS: By the protocol for 'enhanced pepsin digestion', total 16 g F(ab')(2 )fragments were finally obtained from one liter equine antisera with the purity of over 90%. The H5N1-specific F(ab')(2 )fragments had a HI titer of 1:1024, and the neutralization titre of F(ab')(2 )reached 1: 2048. The in vivo assay showed that 100 μg of the F(ab')(2 )fragments could protect BALB/c mice infected with a lethal dose of influenza H5N1 virus. CONCLUSION: The availability of highly purified H5N1-specific F(ab')(2 )fragments may be promising for treatment of influenza H5N1 infection. Our work has provided experimental support for the application of the therapeutic equine immunoglobulin in future large primate or human trials

The Pearl River Declaration: a timely call for enhancing health security through fostering a regional One Health collaboration in the Asia-Pacific

The Second International Symposium on One Health Research (ISOHR) was held in Guangzhou city, China on 23–24 November 2019. A transdisciplinary collaborative approach, One Health (OH), was the central theme of the symposium which brought together more than 260 experts, scholars and emerging researchers from human health, veterinary health, food safety, environmental health and related disciplines and sectors. More than 50 organizations including World Health Organization, Centers for Disease Control (USA), and Queensland Government (Australia) participated in the symposium. Scholars, experts and emerging researchers, policy-makers and practitioners in their respective fields delivered over 50 presentations at the symposium, highlighting the collective vulnerability to some of the emerging health challenges the region was combating. These included emerging infectious diseases, antimicrobial resistance, climate change, food safety and the growing burden of non-communicable diseases. The Pearl River Declaration , emanated from the symposium, called for establishing a One Health Cooperation Network in the Southeast Asia–Pacific region with a vision to strengthen regional health security through sharing each other’s knowledge and experience, and making investments in workforce development, scientific innovations such as vaccine research and development, sharing epidemic intelligence, risk identification, risk communication and appropriate response measures against emerging health threats

Spatiotemporal patterns and climatic drivers of severe dengue in Thailand.

OBJECTIVES: The burden of dengue fever in Thailand is considerable, yet there are few large-scale studies exploring the drivers of transmission. This study aimed to investigate the spatiotemporal patterns and climatic drivers of severe dengue in Thailand. METHODS: Geographic Information System (GIS) techniques and spatial cluster analysis were used to visualize the spatial distribution and detect high-risk clusters of severe dengue in 76 provinces of Thailand from January 1999 to December 2014. The seasonal patterns of severe dengue cases in different provinces were identified. A two-stage modelling approach combining a generalized linear model with a distributed lag non-linear model was used to quantify the effects of monthly mean temperature and relative humidity on the occurrence of severe dengue cases in 51 provinces of Thailand. RESULTS: Significant severe dengue clustering was detected, especially during epidemic years, and the location of these clusters showed substantial inter-annual variation. Severe dengue cases in Northern and Northeastern Thailand peaked in June to August and this pattern was stable across the study period, whereas the seasonality of severe dengue cases in other regions (especially Central Thailand) was less predictable. The risk of the occurrence of severe dengue cases increased with an increase in mean temperature in Northeastern Thailand, Central Thailand, and Southern Thailand, with peaks occurring between 24 °C to 30 °C in Northeastern Thailand and 27 °C to 29 °C in Southern Thailand West Coast, respectively. Relative humidity significantly affected the occurrence of severe dengue cases in Northeastern and Central Thailand, with optimal ranges observed for each region. CONCLUSIONS: Our findings substantiate the potential for developing climate-based dengue early warning systems for Thailand, and have implications for informing pre-emptive vector control

From concept to action: a united, holistic and One Health approach to respond to the climate change crisis

It is unequivocal that human influence has warmed the planet, which is seriously affecting the planetary health including human health. Adapting climate change should not only be a slogan, but requires a united, holistic action and a paradigm shift from crisis response to an ambitious and integrated approach immediately. Recognizing the urgent needs to tackle the risk connection between climate change and One Health, the four key messages and recommendations that with the intent to guide further research and to promote international cooperation to achieve a more climate-resilient world are provided

A brief historical overview of emerging infectious disease response in China and the need for a One Health approach in future responses

In 1952, under the guidance of Chairman Mao, China's central government established an epidemic prevention system that focused on the principle of “putting prevention first” [1]. This approach greatly strengthened public health infrastructure and capacity in China. Chinese society has changed dramatically over the last 60 years, characterized by rapid economic and population growth. Intensification of animal production to accommodate population growth and increasing personal wealth have driven what appears to be a seemingly unceasing series of emerging infectious disease (EID) events [2]. The emergence of pandemic strains of influenza from high risk areas of China seems an almost seasonal occurrence and, in the wake of this and a number of other globally important public health emergencies, China is moving from a passive approach to EID surveillance and response to a more proactive one. This change has not occurred spontaneously; it is a process that has occurred through a number of distinct stages. China, however, appears to be in a transitional period again

One health insights to prevent the next HxNy viral outbreak: learning from the epidemiology of H7N9

Background: With an increased incidence of viral zoonoses, there is an impetus to strengthen collaborations between public health, agricultural and environmental departments. This interdisciplinary cooperation, also known as the 'One Health' approach, has received significant support from various stakeholders. However, current efforts and policies still fall short of those needed for an effective One Health approach towards disease control and prevention. The avian-origin H7N9 influenza A virus outbreak in China serves as an ideal case study to emphasise this point. Discussion: Here, we present the features and epidemiology of human infections with H7N9 influenza virus. At the early stages of the H7N9 epidemic, there was limited virus surveillance and limited prevention measures implemented in live poultry markets. As a result, zoonotic infections with H7N9 influenza viruses continued to enlarge in both numbers and geographic distribution. It was only after the number of human infections with H7N9 influenza virus spiked in the 5th wave of the epidemic that inter-departmental alliances were formed. This resulted in the rapid control of the number of human infections. We therefore further discuss the barriers that prevented the implementation of an effective One Health approach in China and what this means for other emerging, zoonotic viral diseases. Summary: Effective implementation of evidence-based disease management approaches in China will result in substantial health and economic gains. The continual threat of avian influenza, as well as other emerging zoonotic viral infections, emphasizes the need to remove the barriers that prevent the effective implementation of One Health policies in disease management