Risk of lymphoid malignancies increased after Puumala virus infection in Finland, 2009-2019: A retrospective register-based cohort study

Objectives: The Puumala virus (PUUV) is a hantavirus that causes hemorrhagic fever with renal syndrome. Studies showing an increased risk of lymphoid malignancies after hantavirus infection, together with the observation that PUUV infects B cells, motivated us to study the risk of lymphoid malignancies after PUUV infection. Methods: We linked data from the Finnish Cancer Registry and National Infectious Diseases Register for 2009-2019. We used a time-dependent Cox regression model to evaluate the hazard of the lymphoid malignancies grouped according to the HAEMACARE classification. Results: We identified 68 cases of lymphoid malignancies after PUUV infection among 16,075 PUUV-infected individuals during 61,114,826 person-years of observation. A total of 10 cases occurred within 3-<12 months and 38 within 1-<5 years after PUUV infection, and the risk of lymphoid malignancies increased with hazard ratios (HRs) of 2.0 (95% confidence interval [CI], 1.1-3.7) and 1.6 (95% CI, 1.2-2.3), respectively. The group of mature B cell neoplasms showed an increased risk 3-<12 months and 1-<5 years after PUUV infection, HR 2.2 (95% CI, 1.2-4.3) and HR 1.8 (95% CI, 1.3-2.5), respectively. Conclusion: PUUV infection is associated with lymphoid malignancies in the Finnish population, supporting the earlier studies. Further research is required to understand the pathophysiological mechanisms behind this association

6 kuukauden 4 vuoden ikäisten lasten rokottaminen COVID-19-tautia vastaan Suomessa

Suomessa COVID-19-pandemia alkoi maaliskuussa 2020. Epidemian kuva on ajan kuluessa muuttunut vallitsevan virusvariantin vaihtuessa ja väestön rokotusten edetessä. Aikuisten koronarokotukset aloitettiin Suomessa vuodenvaihteessa 2020-2021. Kesällä 2021 lääkeviranomainen hyväksyi myyntiluvan laajennuksen 12 15-vuotiaiden koronarokotteille. Tämän ikäryhmän rokotukset aloitettiin Suomessa loppukesästä 2021. Myyntilupa laajeni syksyllä 2021 5-11-vuotiaisiin lapsiin, joiden rokotukset alkoivat Suomessa loppuvuodesta 2021. Lokakuussa 2022 Euroopan lääkevirasto EMA suositteli mRNA-koronarokotteiden myyntiluvan laajentamista 6 kuukauden 4 vuoden ikäisille lapsille. Tässä työpaperissa esitetään SARS-CoV-2-koronaviruksen aiheuttama tautitaakka 6 kuukauden 4 vuoden ikäisillä lapsilla, aiempien COVID-19-infektioiden merkitys suojalle uutta tautia vastaan, 6kk-4-vuotiaiden koronarokotusten tehokkuus ja turvallisuus nykyisen tutkimustiedon perusteella sekä arvio rokotusten toteutettavuudesta. Lopussa esitetään yhteenveto johtopäätöksistä ja pohdinta tämän ikäryhmän lasten rokotusten aloittamisesta Suomessa. Työpaperin on tehnyt Kansallisen rokotusasiantuntijaryhmän lasten koronarokottamisen alatyöryhmä

Clinical characteristics and evaluation of the incidence of cryptococcosis in Finland 2004-2018

Background Cryptococcosis is one of the major causes of mortality among HIV patients worldwide. Though most often associated with late stage HIV infection/AIDS, a significant number of cases occur in other immunocompromised patients such as solid organ transplant recipients and patients with hematological malignancies. Immunocompromised patients are a heterogeneous group and their number increases constantly. Since little is known about the incidence and the clinical features of cryptococcosis in Northern Europe, our aim was to investigate the clinical characteristics of cryptococcosis patients in Finland. Methods We retrospectively reviewed the laboratory confirmed cryptococcosis cases in Finland during 2004-2018. Only those who were treated for cryptococcosis were included in the study. Initial laboratory findings and medical records were also collected. Results A total of 22 patients with cryptococcosis were included in our study. The annual incidence of cryptococcosis was 0.03 cases per 100,000 population. Ten patients were HIV-positive and 12 out of 22 were HIV-negative. Hematological malignancy was the most common underlying condition among HIV-negative patients. Conclusions To our knowledge, this is the first study of the clinical presentation and incidence of cryptococcosis in Finland. We demonstrate that invasive cryptococcal infection occurs not only in HIV/AIDS patients or otherwise immunocompromised patients but also in immunocompetent individuals. Even though cryptococcosis is extremely rare in Finland, its recognition is important since the prognosis depends on rapid diagnostics and early antifungal therapy.Peer reviewe

Clinical characteristics and evaluation of the incidence of cryptococcosis in Finland 2004-2018

Background: Cryptococcosis is one of the major causes of mortality among HIV patients worldwide. Though most often associated with late stage HIV infection/AIDS, a significant number of cases occur in other immunocompromised patients such as solid organ transplant recipients and patients with hematological malignancies. Immunocompromised patients are a heterogeneous group and their number increases constantly. Since little is known about the incidence and the clinical features of cryptococcosis in Northern Europe, our aim was to investigate the clinical characteristics of cryptococcosis patients in Finland.Methods: We retrospectively reviewed the laboratory confirmed cryptococcosis cases in Finland during 2004-2018. Only those who were treated for cryptococcosis were included in the study. Initial laboratory findings and medical records were also collected.Results: A total of 22 patients with cryptococcosis were included in our study. The annual incidence of cryptococcosis was 0.03 cases per 100,000 population. Ten patients were HIV-positive and 12 out of 22 were HIV-negative. Hematological malignancy was the most common underlying condition among HIV-negative patients.Conclusions: To our knowledge, this is the first study of the clinical presentation and incidence of cryptococcosis in Finland. We demonstrate that invasive cryptococcal infection occurs not only in HIV/AIDS patients or otherwise immunocompromised patients but also in immunocompetent individuals. Even though cryptococcosis is extremely rare in Finland, its recognition is important since the prognosis depends on rapid diagnostics and early antifungal therapy.</p

Koronavirusinfektiot (COVID-19) terveyden- ja sosiaalihuollon työntekijöillä Suomessa 1.2.2020-30.6.2021 : Rekisteripohjainen kohorttitutkimus

Terveyden- ja sosiaalihuollon ammattilaiset voivat hoito- ja hoivatyössään altistua koronavirustartunnalle. THL toteutti rekisteripohjaisen tutkimuksen terveyden- ja sosiaalihuollon työntekijöiden COVID-19-infektioiden ilmaantuvuuden määrittämiseksi eri ammattiryhmissä ja arvioi näiden infektioiden riskitekijöitä. Tutkimus osoitti, että COVID-19-infektioiden ilmaantuvuus oli suurinta lähihoitajien ja sairaanhoitajien ammattiryhmissä. COVID-19-infektion riskitekijöitä olivat miessukupuoli, muu syntymämaa kuin Suomi tai vieras äidinkieli sekä asuminen Helsingin ja Uudenmaan sairaanhoitopiirin alueella

Lasten ja nuorten osallisuus, terveysturvallisuus ja koronarajoitukset

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Pre-Diagnostic Saliva Microbiota of School-Aged Children Who Developed Type 1 Diabetes or Inflammatory Bowel Diseases

Funding Information: The project has received financial support from the Päivikki and Sakari Sohlberg Foundation, the Swedish Cultural Foundation in Finland, and the Folkhälsan Research Foundation governed by HV. K.-L.K. received grants from the Pediatric Research Foundation and Helsinki University Hospital Research Fund. There are no other specific grants from any public, commercial, or non-profit sectors relevant to this article to disclose. The funding sources had no role in the design and conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. Publisher Copyright: © 2023 by the authors.Altered commensal microbiota composition has been associated with pediatric type 1 diabetes mellitus (T1D) and inflammatory bowel diseases (IBD), but the causal relationship is still unclear. To search for potential pre-diagnostic biomarkers for pediatric T1D or IBD, we compared microbiota in saliva samples in a nested case-control design comprising children developing T1D (nchildren = 52) or IBD (nchildren = 21) and controls with a similar age, sex, and residential area (nchildren = 79). The pre-diagnostic saliva microbiota alpha- and beta-diversity of children who would develop T1D (nsamples = 27) or IBD (nsamples = 14) minimally varied from that of controls. The relative abundances of Abiotrophia were higher, while those of Veillonella, Actinomyces, Megasphaera, Butyrivibrio, and Candidatus ancillula were lower in children who would develop T1D. Within 2 years before diagnosis, the metabolic PWY-5677 pathway (converting succinate into butyrate) was lower in pre-T1D samples than in controls (q = 0.034). No significant pre-IBD differences were found. In conclusion, saliva microbiota diversity or composition were not successful predictors for pediatric T1D nor IBD. Intriguingly, the succinate fermentation pathway was predicted to be lowered before the onset of T1D. Thus, investigating functional pathways might provide a better approach in searching for biomarkers for autoimmune disease in the future.Peer reviewe

Pre-Diagnostic Saliva Microbiota of School-Aged Children Who Developed Type 1 Diabetes or Inflammatory Bowel Diseases

Altered commensal microbiota composition has been associated with pediatric type 1 diabetes mellitus (T1D) and inflammatory bowel diseases (IBD), but the causal relationship is still unclear. To search for potential pre-diagnostic biomarkers for pediatric T1D or IBD, we compared microbiota in saliva samples in a nested case-control design comprising children developing T1D (nchildren = 52) or IBD (nchildren = 21) and controls with a similar age, sex, and residential area (nchildren = 79). The pre-diagnostic saliva microbiota alpha- and beta-diversity of children who would develop T1D (nsamples = 27) or IBD (nsamples = 14) minimally varied from that of controls. The relative abundances of Abiotrophia were higher, while those of Veillonella, Actinomyces, Megasphaera, Butyrivibrio, and Candidatus ancillula were lower in children who would develop T1D. Within 2 years before diagnosis, the metabolic PWY-5677 pathway (converting succinate into butyrate) was lower in pre-T1D samples than in controls (q = 0.034). No significant pre-IBD differences were found. In conclusion, saliva microbiota diversity or composition were not successful predictors for pediatric T1D nor IBD. Intriguingly, the succinate fermentation pathway was predicted to be lowered before the onset of T1D. Thus, investigating functional pathways might provide a better approach in searching for biomarkers for autoimmune disease in the future