How nasopharyngeal pneumococcal carriage evolved during and after a PCV13-to-PCV10 vaccination programme switch in Belgium, 2016 to 2018

Background: The current carriage study was set up to reinforce surveillance during/after the PCV13-to-PCVC10 switch in Belgium. Aim: This observational study monitored carriage of Streptococcus pneumoniae (Sp) serotypes, particularly those no longer covered (3, 6A, 19A), as well as Haemophilus influenzae (Hi), because PCV10 contains the non-typeable Hi protein D. Methods: A total of 2,615 nasopharyngeal swabs from children (6-30 months old) attending day care were collected in three periods over 2016-2018. Children's demographic and clinical characteristics and vaccination status were obtained through a questionnaire. Sp and Hi were identified by culture and PCR. Pneumococcal strains were tested for antimicrobial (non-)susceptibility by disc diffusion and serotyped by Quellung-reaction (Quellung-reaction and PCR for serotypes 3, 6A, 19A). Results: The carriage prevalence of Sp (> 75%) remained stable over the successive periods but that of Hi increased (87.4%, 664 Hi-carriers/760 in 2016 vs 93.9%, 895/953 in 2017-2018). The proportion of non-PCV13 vaccine serotypes decreased (94.6%, 438 isolates/463 in 2016 vs 89.7%, 599/668 in 2017-2018) while that of PCV13-non-PCV10 vaccine serotypes (3 + 6A + 19A) increased (0.9%, 4 isolates/463 in 2016 vs 7.8%, 52/668 in 2017-2018), with serotype 19A most frequently identified (87.9%, 58/66 isolates). Non-susceptibility of pneumococci against any of the tested antibiotics was stable over the study period (> 44%). Conclusions: During and after the PCV13-to-PCV10 vaccine switch, the proportion of non-PCV13 serotypes decreased, mainly due to a serotype 19A carriage prevalence increase. These results complement invasive pneumococcal disease surveillance data, providing further basis for pneumococcal vaccination programme policy making

Low Penetrance, Broad Resistance, and Favorable Outcome of Interleukin 12 Receptor β1 Deficiency: Medical and Immunological Implications

The clinical phenotype of interleukin 12 receptor β1 chain (IL-12Rβ1) deficiency and the function of human IL-12 in host defense remain largely unknown, due to the small number of patients reported. We now report 41 patients with complete IL-12Rβ1 deficiency from 17 countries. The only opportunistic infections observed, in 34 patients, were of childhood onset and caused by weakly virulent Salmonella or Mycobacteria (Bacille Calmette-Guérin -BCG- and environmental Mycobacteria). Three patients had clinical tuberculosis, one of whom also had salmonellosis. Unlike salmonellosis, mycobacterial infections did not recur. BCG inoculation and BCG disease were both effective against subsequent environmental mycobacteriosis, but not against salmonellosis. Excluding the probands, seven of the 12 affected siblings have remained free of case-definition opportunistic infection. Finally, only five deaths occurred in childhood, and the remaining 36 patients are alive and well. Thus, a diagnosis of IL-12Rβ1 deficiency should be considered in children with opportunistic mycobacteriosis or salmonellosis; healthy siblings of probands and selected cases of tuberculosis should also be investigated. The overall prognosis is good due to broad resistance to infection and the low penetrance and favorable outcome of infections. Unexpectedly, human IL-12 is redundant in protective immunity against most microorganisms other than Mycobacteria and Salmonella. Moreover, IL-12 is redundant for primary immunity to Mycobacteria and Salmonella in many individuals and for secondary immunity to Mycobacteria but not to Salmonella in most

Many Labs 5:Testing pre-data collection peer review as an intervention to increase replicability

Replication studies in psychological science sometimes fail to reproduce prior findings. If these studies use methods that are unfaithful to the original study or ineffective in eliciting the phenomenon of interest, then a failure to replicate may be a failure of the protocol rather than a challenge to the original finding. Formal pre-data-collection peer review by experts may address shortcomings and increase replicability rates. We selected 10 replication studies from the Reproducibility Project: Psychology (RP:P; Open Science Collaboration, 2015) for which the original authors had expressed concerns about the replication designs before data collection; only one of these studies had yielded a statistically significant effect (p < .05). Commenters suggested that lack of adherence to expert review and low-powered tests were the reasons that most of these RP:P studies failed to replicate the original effects. We revised the replication protocols and received formal peer review prior to conducting new replication studies. We administered the RP:P and revised protocols in multiple laboratories (median number of laboratories per original study = 6.5, range = 3?9; median total sample = 1,279.5, range = 276?3,512) for high-powered tests of each original finding with both protocols. Overall, following the preregistered analysis plan, we found that the revised protocols produced effect sizes similar to those of the RP:P protocols (?r = .002 or .014, depending on analytic approach). The median effect size for the revised protocols (r = .05) was similar to that of the RP:P protocols (r = .04) and the original RP:P replications (r = .11), and smaller than that of the original studies (r = .37). Analysis of the cumulative evidence across the original studies and the corresponding three replication attempts provided very precise estimates of the 10 tested effects and indicated that their effect sizes (median r = .07, range = .00?.15) were 78% smaller, on average, than the original effect sizes (median r = .37, range = .19?.50)

La prévention du virus respiratoire syncitial chez l'enfant : rôle du médecin généraliste

Le virus respiratoire syncitial (VRS) est bien connu du monde médical comme agent étiologique principal des infections respiratoires inférieures (IVRI) de l’enfant de moins de deux ans. Il entraîne à chaque saison une saturation des services de pédiatrie mais également une surcharge en médecine de première ligne. Le très jeune âge constitue le principal facteur de risque d’hospitalisation. L’arrivée sur le marché de deux outils préventifs visant à protéger les nourrissons via une immunisation passive à savoir un anticorps monoclonal à longue demi-vie (Beyfortus®) et un vaccin à administrer durant la grossesse (Abrysvo®) va considérablement bouleverser l’expression de cette maladie. À ce jour, les deux produits peuvent être recommandés mais dans des stratégies spécifiques qui ne les combinent pas. Le présent article a pour but d’aider le médecin généraliste à conseiller les parents pour l’une ou l’autre des stratégies

Vaccination contre le rotavirus : pour qui, pourquoi ?

[Anti-rotavirus vaccination: For which, why?]Rotavirus disease kills approximately half a million children annually and accounts for one third of hospitalisations for gastro-enteritis. The rotavirus vaccine is the hopeful way to control the disease burden. The main objectives of all new vaccines are safety and efficacy. Two manufacturers have accepted the challenge to develop a new live oral rotavirus vaccine. Efficacy and safety of these new vaccines is based on large-scale trials. Both vaccines demonstrate an impressive efficacy profile with a particularly great reduction in hospitalisations for gastro-enteritis. They demonstrate also a reassuring safety profile. With the introduction of rotavirus vaccine, we should expect to see a substantial reduction in direct and indirect costs due to rotavirus infection as well as an effect on mortality in developing countries

Stratégie de vaccination contre le Covid-19 en Belgique

Dans cet avis scientifique, qui propose des lignes directrices aux responsables des politiques en matière de santé publique, le Conseil supérieur de la santé de Belgique émet des recommandations sur les groupes à risque dans le cadre de la vaccination contre le Covid-19 pour la population belge. Cet avis vise à proposer aux décideurs politiques des recommandations précises sur les groupes à risque, les groupes prioritaires ainsi qu'une estimation du nombre de vaccins nécessaires si un vaccin contre le Covid-19 voyait le jour

Preventie van RSV-infectie bij kinderen : rol van de huisarts

RSV (respiratoir syncytieel virus) is de belangrijkste verwekker van ondersteluchtweginfecties bij kinderen jonger dan twee jaar. Elk seizoen resulteren dergelijke infecties in een verzadiging van de diensten voor kindergeneeskunde en een overbelasting van de eerstelijnszorg. De zeer jonge leeftijd is de belangrijkste risicofactor voor ziekenhuisopname. We beschikken nu over twee geneesmiddelen om zuigelingen te beschermen: passieve immunisatie met een langwerkende monoklonale antistof (Beyfortus®) en een vaccin dat tijdens de zwangerschap wordt toegediend (Abrysvo®). Die zullen de expressie van de ziekte grondig veranderen. Er bestaan specifieke strategieën voor beide geneesmiddelen apart, maar niet voor een combinatie van beide. Dit artikel geeft de informatie die huisartsen nodig hebben om de ouders informatie ter zake te geven