Safety and Immunogenicity of Live Oral Cholera and Typhoid Vaccines Administered Alone or in Combination with Antimalarial Drugs, Oral Polio Vaccine, or Yellow Fever Vaccine

The effects of concomitant administration of antimalarial drugs, oral polio vaccine, or yellow fever vaccine on the immune response elicited by the Vibrio cholerae CVD103-HgR and Salmonella typhi Ty21a live oral vaccines were investigated. Healthy adults were immunized with CVD103- HgR alone or combined with Ty21a. Subjects were randomized to simultaneously receive mefloquine, chloroquine or proguanil, or oral polio or yellow fever vaccine. The vibriocidal antibody seroconversion rate was significantly reduced (P = .008) only in the group that received chloroquine with the CVD103-HgR. The geometric mean vibriocidal antibody titer was significantly decreased in the groups that received chloroquine (P = .001) or mefloquine (P = .02) compared with titers in groups that received CVD103-HgR alone. However, similar immunosuppressive effects were not observed in the groups immunized with Ty21a and CVD103-HgR. Only the concomitant administration of proguanil effected a significant (P = .013) decline in the anti-S. typhi lipopolysaccharide antibody response. These results indicate that chloroquine and proguanil should not be simultaneously administered with the CVD103-HgR and Ty21a vaccine strains, respectivel

Prevention of Birch Pollen-Related Food Allergy by Mucosal Treatment with Multi-Allergen-Chimers in Mice

Among birch pollen allergic patients up to 70% develop allergic reactions to Bet v 1-homologue food allergens such as Api g 1 (celery) or Dau c 1 (carrot), termed as birch pollen-related food allergy. In most cases, specific immunotherapy with birch pollen extracts does not reduce allergic symptoms to the homologue food allergens. We therefore genetically engineered a multi-allergen chimer and tested if mucosal treatment with this construct could represent a novel approach for prevention of birch pollen-related food allergy.BALB/c mice were poly-sensitized with a mixture of Bet v 1, Api g 1 and Dau c 1 followed by a sublingual challenge with carrot, celery and birch pollen extracts. For prevention of allergy sensitization an allergen chimer composed of immunodominant T cell epitopes of Api g 1 and Dau c 1 linked to the whole Bet v 1 allergen, was intranasally applied prior to sensitization.Intranasal pretreatment with the allergen chimer led to significantly decreased antigen-specific IgE-dependent β-hexosaminidase release, but enhanced allergen-specific IgG2a and IgA antibodies. Accordingly, IL-4 levels in spleen cell cultures and IL-5 levels in restimulated spleen and cervical lymph node cell cultures were markedly reduced, while IFN-γ levels were increased. Immunomodulation was associated with increased IL-10, TGF-β and Foxp3 mRNA levels in NALT and Foxp3 in oral mucosal tissues. Treatment with anti-TGF-β, anti-IL10R or anti-CD25 antibodies abrogated the suppression of allergic responses induced by the chimer.Our results indicate that mucosal application of the allergen chimer led to decreased Th2 immune responses against Bet v 1 and its homologue food allergens Api g 1 and Dau c 1 by regulatory and Th1-biased immune responses. These data suggest that mucosal treatment with a multi-allergen vaccine could be a promising treatment strategy to prevent birch pollen-related food allergy

Quark-Gluon Matter

A concise review of the experimental and phenomenological progress in high-energy heavy-ion physics over the past few years is presented. Emphasis is put on measurements at BNL-RHIC and CERN-SPS which provide information on fundamental properties of QCD matter at extreme values of temperature, density and low-x. The new opportunities accessible at the LHC, which may help clarify some of the current open issues, are also outlined.Comment: Minor changes to text. New refs. included. Updated figures with final dat

Bacteraemia among severely malnourished children infected and uninfected with the human immunodeficiency virus-1 in Kampala, Uganda

BACKGROUND: To establish the magnitude of bacteraemia in severely malnourished children, and describe the types of bacteria and antimicrobial sensitivity by HIV status. METHOD: Isolates were recovered from 76 blood specimens. Antibiotic susceptibility tests were performed using commercial antibiotic disks and demographic and clinical findings were recorded. RESULTS: Of the 450 children 63% were male; median age 17.0 months (inter quartile range, IQR 12–24) and 57% had oedema. 151 (36.7 %) of 411 tested HIV-positive; 76 (17.1%) of 445 blood specimens grew bacterial isolates; 58% were Gram negative – S. typhimurium (27.6%) and S. enteriditis (11.8%). Staph. aureus (26.3%) and Strep. pneumoniae (13.2%) were the main Gram positive organisms. There was no difference in the risk of bacteraemia by HIV status, age < 24 months, male sex, or oedema, except for oral thrush (OR 2.3 CI 1.0–5.1) and hypoalbuminaemia (OR 3.5 CI 1.0–12.1). Isolates from severely immuno-suppressed children (CD4% <15%) were more likely to grow Salmonella enteriditis (OR 5.4; CI 1.6 – 17.4). The isolates were susceptible (≥ 80%) to ciprofloxacin, ceftriaxone and gentamicin; with low susceptibility to chlorampenicol, ampicillin (< 50%) and co-trimoxazole (<25%). Suspicion of bacteraemia had 95.9% sensitivity and 99.2% specificity. Among bacteraemic children, mortality was higher (43.5% vs 20.5%) in the HIV-positive; OR 3.0 (95%CI 1.0, 8.6). CONCLUSION: Bacteraemia affects 1 in every 6 severely malnourished children and carries high mortality especially among the HIV-positive. Given the high level of resistance to common antibiotics, there is need for clinical trials to determine the best combinations of antibiotics for management of bacteraemia in severely malnourished children

Effectiveness and economic analysis of the whole cell/recombinant B subunit (WC/rbs) inactivated oral cholera vaccine in the prevention of traveller's diarrhoea

<p>Abstract</p> <p>Background</p> <p>Nowadays there is a debate about the indication of the oral whole-cell/recombinant B-subunit cholera vaccine (WC/rBS) in traveller's diarrhoea. However, a cost-benefit analysis based on real data has not been published.</p> <p>Methods</p> <p>A cost-effectiveness and cost-benefit study of the oral cholera vaccine (WC/rBS), Dukoral^®for the prevention of traveller's diarrhoea (TD) was performed in subjects travelling to cholera risk areas. The effectiveness of WC/rBS vaccine in the prevention of TD was analyzed in 362 travellers attending two International Vaccination Centres in Spain between May and September 2005.</p> <p>Results</p> <p>The overall vaccine efficacy against TD was 42,6%. Direct healthcare-related costs as well as indirect costs (lost vacation days) subsequent to the disease were considered. Preventive vaccination against TD resulted in a mean saving of 79.26 € per traveller.</p> <p>Conclusion</p> <p>According to the cost-benefit analysis performed, the recommendation for WC/rBS vaccination in subjects travelling to zones at risk of TD is beneficial for the traveller, regardless of trip duration and visited continent.</p

Wissenschaftliche Begründung zur COVID-19-Impfempfehlung der STIKO für Personen mit durchgemachter SARS-CoV-2-Infektion und bisher unvollständiger Immunität

Die STIKO geht davon aus, dass erst eine mehrmalige Auseinandersetzung mit dem SARS-CoV-2-Spikeprotein einen soliden Schutz vor einer SARS-CoV-2-Infektion und einer schweren COVID-19-Erkrankung bietet. Dies kann durch eine 3-malige Impfung oder durch eine Kombination von natürlicher Infektion und Impfung (hybride Immunität) erreicht werden. Daher sollen auch Personen mit zurückliegenden SARS-CoV-2-Infektionen geimpft werden. Zwischen den jeweiligen Ereignissen muss jedoch ein zeitlicher Mindestabstand bestehen. Der Beitrag gibt eine Übersicht über die Impfempfehlungen bei unterschiedlichen Impfanamnesen und nach durchgemachten SARS-CoV-2-Infektionen.Peer Reviewe

Beschluss der STIKO zur 19. Aktualisierung der COVID-19-Impfempfehlung

Bisher hat die STIKO empfohlen, dass alle im Ausland mit einem nicht in der EU zugelassenen Impfstoff geimpften Personen eine erneute Impfserie mit einem in der EU zugelassenen Impfstoff erhalten sollen. Ziel der im Epidemiologischen Bulletin 13/2022 veröffentlichten aktualisierten COVID-19-Impfempfehlung ist es, Personen, die eine COVID-19-Impfung mit einem der nicht in der EU zugelassenen Ganzvirusimpfstoffen (CoronaVac, Covilo und Covaxin) oder dem Vektor-basierten Impfstoff Sputnik V erhalten haben, mit einem Impfschutz auszustatten, der vergleichbar mit dem einer Grundimmunisierung plus Auffrischimpfung mit einem mRNA-Impfstoff ist.Peer Reviewe

Empfehlung und wissenschaftliche Begründung der STIKO zur Grundimmunisierung von Personen im Alter von 12 – 17 Jahren mit dem COVID-19-Impfstoff Nuvaxovid von Novavax

Die STIKO erweitert die Empfehlung zur Grundimmunisierung mit dem adjuvantierten, proteinbasierten COVID-19-Impfstoff Nuvaxovid der Firma Novavax von ≥ 18-Jährigen um die Gruppe der Kinder und Jugendlichen im Alter von 12 – 17 Jahren. Das Impfschema sieht für die Grundimmunisierung zwei Impfstoffdosen vor, die im Abstand von mindestens 21 Tagen verabreicht werden.Peer Reviewe

Wissenschaftliche Begründung der STIKO zur Auffrischimpfung von Personen ab 18 Jahren mit dem COVID-19-Impfstoff Nuvaxovid (Novavax)

Die EMA hat der Europäischen Kommission An¬fang September 2022 die Ausweitung der bedingten Zulassung des monovalenten Impfstoffs Nuvaxovid der Firma Novavax zur Auffrischimpfung für Personen ab 18 Jahren empfohlen. Am 06.09.2022 erfolgte die Zulassung durch die Europäische Kommission. Daher empfiehlt nun die STIKO Personen ab 18 Jahren, bei denen produktspezifische medizinische Kontraindikationen gegen die zugelassenen COVID-19-mRNA-Impfstoffe bestehen, alternativ eine Auffrischimpfung mit Nuvaxovid. Die Auffrischimpfung mit Nuvaxovid ist auch möglich bei individuellem Wunsch nach entsprechender Beratung. Für 12 – 17-Jährige ist Nuvaxovid zur Auffrischimp¬fung derzeit nicht zugelassen, kann jedoch in dieser Altersgruppe ebenfalls bei produktspezifischen medizinischen Kontraindikationen für mRNA-Impfstoffe zur Auffrischimpfung eingesetzt werden (off-label-use). Eine Anwendung des Impfstoffs Nuvaxovid während der Schwangerschaft und Stillzeit wird weiterhin nicht empfohlen.Peer Reviewe