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Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

215

 The 2014-15 influenza season was distinguished by an A(H3N2) epidemic of antigenically-drifted virus and vaccine containing identical components to 2013-14. We report 2014-15 vaccine effectiveness (VE) estimates from Canada and explore contributing agent-host factors.

Concepts: Immune system, Infectious disease, Virus, Vaccine, Vaccination, Influenza, Avian influenza, Influenza vaccine

208

We investigated the evolution and epidemiology of a novel livestock-associated methicillin-resistant Staphylococcus aureus strain, which colonizes and infects urban-dwelling Danes even without a Danish animal reservoir. Genetic evidence suggests both poultry and human adaptation, with poultry meat implicated as a probable source.

Concepts: Bacteria, Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus, Meat, Livestock, Adaptation, Charles Darwin, Poultry

176

Acute otitis media (AOM) is a leading cause of visits to physicians and of antibiotic prescriptions for young children. We systematically reviewed studies on all-cause AOM episodes and physician visits in which impact was attributed to pneumococcal conjugate vaccines, either as efficacy or effectiveness. Of 18 relevant publications found, most used the 7-valent pneumococcal conjugate vaccine (7vCRM). The efficacy of 7vCRM against all-cause AOM episodes or visits was 0%-9% in randomized trials and 17%-23% in nonrandomized trials. In observational database studies, physician visits for AOM were already declining in the 3-5 years before 7vCRM introduction (mean change, -15%; range, +14% to -24%) and continued to decline afterward (mean, -19%; range, +7% to -48%). This vaccine provides some protection against OM, but other factors have also contributed to the recent decline in OM incidence. Future effectiveness studies should thus use better-controlled methods to estimate the true impact of vaccination on AOM.

Concepts: Medicine, Streptococcus pneumoniae, Vaccine, Vaccination, Randomized controlled trial, Vaccination schedule, Pneumococcal conjugate vaccine, Otitis media

102

Prophylactic HPV-vaccination programs constitute major public-health initiatives worldwide. We assessed the global effect of 4vHPV vaccination on HPV infection and disease. PubMed and Embase were systematically searched for peer-reviewed articles from January-2007 through February-2016 to identify observational studies reporting the impact or effectiveness of 4vHPV vaccination on infection, anogenital warts, and cervical cancer or precancerous lesions. Over the last decade, the impact of HPV-vaccination in real-world settings has become increasingly evident, especially among girls vaccinated before HPV exposure in countries with high vaccine uptake. Maximal reductions of ∼90% for HPV 6/11/16/18 infection, ∼90% for genital warts, ∼60% for low-grade cytological cervical abnormalities, and ∼90% for high-grade histologically-proven cervical abnormalities have been reported. The full public-health potential of HPV vaccination is not yet realized. HPV-related disease remains a significant source of morbidity and mortality in developing and developed nations, underscoring the need for HPV-vaccination programs with high population coverage.

Concepts: Immune system, Human papillomavirus, Cervical cancer, Papillomavirus, HPV vaccine, Gardasil, Anal cancer, Genital wart

89

We randomized 115 children to trivalent inactivated influenza vaccine (TIV) or placebo. Over the following 9 months, TIV recipients had an increased risk of virologically-confirmed non-influenza infections (relative risk: 4.40; 95% confidence interval: 1.31-14.8). Being protected against influenza, TIV recipients may lack temporary non-specific immunity that protected against other respiratory viruses.

Concepts: Immune system, Virus, Vaccination, Innate immune system, Influenza, Avian influenza, English-language films, Influenza vaccine

68

 More than 300 million travelers visit regions with poor hygiene annually. A significant percentage of them become colonized by resistant intestinal bacteria such as extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) and may transmit the strains to others and to medical care settings when they return home. Despite the threats to global healthcare caused by an upsurge in antimicrobial resistance, no effort has been centered on prevention of colonization while traveling.

Concepts: Health care, Medicine, Public health, Health, Bacteria, Microbiology, Antibiotic resistance, Escherichia coli

50

Sushi is a traditional Japanese cuisine enjoyed worldwide. However, using raw fish to make sushi may pose risk of certain parasitic infections, such as anisakidosis, which is most reported in Japan. This risk of infection can be eliminated by freezing fish; however, Japanese people are hesitant to freeze fish because it is believed that freezing ruins sushi’s taste.

Concepts: Immune system, Japan, Sensory analysis, Sushi, Japanese people, Japanese cuisine, Sashimi, Discrimination testing

38

Influenza vaccination aims to prevent infection by influenza virus and reduce associated morbidity and mortality; however, vaccine effectiveness (VE) can be modest, especially for subtype A(H3N2). Low VE has been attributed to mismatches between the vaccine and circulating influenza strains and to the vaccine’s elicitation of protective immunity in only a subset of the population. The low H3N2 VE in the 2012-2013 season was attributed to egg-adaptive mutations that created antigenic mismatch between the actual vaccine strain (IVR-165) and both the intended vaccine strain (A/Victoria/361/2011) and the predominant circulating strains (clades 3C.2 and 3C.3).

Concepts: Immune system, Virus, Vaccine, Vaccination, Immunology, Influenza, Avian influenza, Influenza vaccine

36

We report on an Ebola virus disease (EVD) survivor who showed Ebola virus (EBOV) in seminal fluid 531 days after onset of disease. The persisting virus was sexually transmitted in February 2016, about 470 days after onset of symptoms, and caused a new cluster of EVD in Guinea and Liberia.

Concepts: AIDS, Biological warfare, Ebola, Viral hemorrhagic fever, Incubation period, Crab-eating Macaque

36

Background. Measles was eliminated in the United States through high vaccination coverage and a public health system able to rapidly respond to measles. Measles may occur among vaccinated individuals, but secondary transmission from such individuals has not been documented. Methods. Suspected cases and contacts exposed during a measles outbreak in New York City in 2011 were investigated. Medical histories and immunization records were obtained. Cases were confirmed by detection of measles-specific IgM and/or RNA. Tests for measles IgG, IgG avidity, measurement of measles neutralizing antibody titers, and genotyping were performed to characterize the cases. Results. The index case had two doses of measles-containing vaccine. Of 88 contacts, four secondary cases were confirmed that had either two doses of measles-containing vaccine or a past positive measles IgG antibody. All cases had laboratory confirmation of measles infection, clinical symptoms consistent with measles, and high avidity IgG antibody characteristic of a secondary immune response. Neutralizing antibody titers of secondary cases reached >80,000 mIU/mL 3-4 days post-rash onset while that of the index was <500 mIU/mL 9 days post-rash onset. No additional cases occurred among 231 contacts of secondary cases. Conclusions. This is the first report of measles transmission from a twice vaccinated individual. The clinical presentation and laboratory data of the index were typical of measles in a naïve individual. Secondary cases had robust anamnestic antibody responses. No tertiary cases occurred despite numerous contacts. This outbreak underscores the need for thorough epidemiologic and laboratory investigation of suspected measles cases regardless of vaccination status.

Concepts: Immune system, Antibody, Public health, Epidemiology, Vaccine, Vaccination, Immunology, Immunity