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Európa
Magyarország
2024. február 8. Megjelentek a Nemzeti Népegészségügyi és Gyógyszerészeti Intézet légúti figyelőszolgálatának ez év 5. hetére vonatkozó adatai, továbbá a szennyvízvizsgálati eredmények. A kórházi ápolást igénylő 291 SARI beteg (súlyos légúti tünetekkel küzdő ember) közül 88-an 2 évesek vagy annál fiatalabbak, 115-en 60 évesek vagy annál idősebbek. Influenza A 74 betegnél, RSV 44, SARS-CoV-2 vírus pedig 59 betegnél van a megbetegedések hátterében. Az RSV-pozitív betegek közül 36-an 2 évesek vagy annál fiatalabbak, a Covid-19 fertőzöttek közül 48-an 60 évesek vagy annál idősebbek. Influenza okozta SARI megbetegedést valamennyi korosztályban azonosítottak. A légúti figyelőszolgálatból származó jelentések és adatok alapvetően az influenzaszerű tünetekkel orvoshoz fordulók számát, valamint az orvosok által beküldött minták elemzésének eredményét összegzik. Az 5. heti 335 minta közül 92 betegnél az influenza A(H1pdm09), 15 betegnél az influenza A(H3), egy betegnél az influenza A(NT), két betegnél az influenza B, tizennyolc betegnél az RSV, négy betegnél a human metapneumovírus, 15 betegnél a SARSCoV-2 vírus kóroki szerepét igazolták. Az influenza pozitivitási arány 32,8 százalék, a SARS-CoV-2 pozitivitási arány 4,5 százalék. A sentinel kórházak által beküldött 29 minta közül kilenc betegnél influenza A(H1pdm09), hat betegnél RSV, egy betegnél SARS-CoV-2 vírust azonosítottak. A hagyományos diagnosztikus célú vizsgálat keretében érkezett 34 légúti minta közül tíz influenza A(H1pdm09), kettő SARS-CoV-2 vírus-pozitív volt. Laboratóriumi vizsgálattal igazolt, influenzavírus által okozott megbetegedéseket Nógrád vármegye kivételével valamennyi területen megállapítottak. 'A 100 000 lakosra jutó orvoshoz fordult' betegek száma a legmagasabb Zala (1 042), Szabolcs-Szatmár-Bereg (932) és Győr-Moson-Sopron (842) vármegyében, legalacsonyabb Heves (158), Komárom-Esztergom (269) és Csongrád-Csanád (274) vármegyében. Az 5. héten a szennyvízben az Influenza A vírus örökítőanyagának sűrűsödése mutatható ki. Amint az NNGYK rendszeresen megjegyzi: az Influenza A vírus a SARS-CoV-2-nél jelentősen alacsonyabb kópiaszámban mutatható ki a szennyvíz mintákban, az eredmények országos összesítésben értelmezhetők. Jelentősen visszaszorulni látszik a koronavírus terjedése. Az 5. héten a szennyvíz SARS-CoV-2 örökítőanyag sűrűsége országosan stagnál. Az országos átlagot tekintve a 2023. év 47. hetét követő mintákban még a JN1 variáns (a BA.2.86 alvariánsa) jelentős növekedése volt megfigyelhető, 2024. első hetében e variáns vált meghatározóvá. Ezzel párhuzamosan a korábban legnagyobb arányban tapasztalt EG.5 ('XBB.1.5-like+F465L') variáns arányának jelentős csökkenését figyelték meg. Emelkedés egyik mintavételi hely esetében sem mutatkozik, enyhe csökkenés az Észak-Pesti Szennyvíztisztító Telep ellátási területén, Egerben, Győrben, Szekszárdon és Szolnokon van. A győri övezet átkerült az alacsony jelenlétet mutató csoportba, növekszik a mérsékelt kategóriába tartozó övezetek száma..Az azonos időszakban vizsgált szennyvízminták variáns-megoszlása egyezést mutat a klinikai mintákban tapasztalt aránnyal. (Forrás: infostart)
2024. február 8. A hajdú-bihari kormányhivatal az influenzaszerű megbetegedések számának növekedése miatt, a betegek és a dolgozók védelméért, járványügyi megelőző intézkedésként teljes körű látogatási tilalmat rendelt el a Debreceni Egyetem klinikai központ nagyerdei, Kenézy Gyula, illetve a berettyóújfalui Gróf Tisza István osztályain. Az intézkedés a központ valamennyi osztályán mától lép életbe. A maszkviselés továbbra is kötelező. (Forrás: magyarhirlap)
2024. február 07. Magyarországon az új omikron variánsok elleni Spikevax (Moderna) monovalens XBB, és egy korábbi Pfizer bivalens (Wu/Om BA1.2) oltóanyag egyaránt elérhető. (Forrás: portfolio)
2024. február 01. Légúti figyelőszolgálati tájékoztató (idei, 4. heti adatok). A légúti figyelőszolgálat keretében kijelölt 24 kórház adatai alapján a negyedik héten 222 beteget vettek fel kórházba súlyos, akut légúti fertőzés (SARI) miatt, közülük 19-en részesültek intenzív/szubintenzív ellátásban. A kórházi ápolást igénylők közül 69-en 2 évesek vagy annál fiatalabbak, 89-en 60 évesek vagy annál idősebbek. 50 betegnél influenza A, 33-nál RSV, 41-nél SARS-CoV-2 vírus van a megbetegedések hátterében. Az RSV-pozitív betegek közül 26-an 2 évesek vagy annál fiatalabbak, a COVID-19 fertőzöttek közül 32-en 60 évesek vagy annál idősebbek. Influenza okozta SARI megbetegedést valamennyi korosztályban megállapítottak. A figyelőszolgálatban résztvevő orvosok jelentései alapján, becslés szerint 2024. január 22 – 28. között az országban 36 900-an fordultak orvoshoz influenzaszerű, 233 400-an akut légúti fertőzés tüneteivel. Akut légúti fertőzésben a betegek több mint 50%-a 0-14 éves gyermek, közel 23%-a 15-34 éves fiatal. Több mint 17%-uk a 35-59 évesek, 9,%-uk a 60 éven felüliek korcsoportjába tartozó. Influenzaszerű megbetegedésben a betegek több mint 38%-a 0-14 éves gyermek, közel 30%-a 15-34 éves fiatal. Közel 28%-uk a 35-59 évesek, 9%-uk a 60 éven felüliek korcsoportjába tartozó. Kiugróan magas a 100 000 azonos korcsoportba tartozó lakosra jutó megbetegedések száma a 3-5 évesek (1 220) körében, ezt követi a 6-9 évesek (960) és a 10-14 évesek (811) érintettsége. Az előző héthez viszonyítva e héten 17 közigazgatási területen nőtt, egy területen csökkent, két területen nem változott az influenzás tünetekkel orvoshoz fordulók gyakorisága. 'A 100 000 lakosra jutó orvoshoz fordult betegek száma' Szabolcs-Szatmár-Bereg (693), Győr-Moson-Sopron (667) és Zala (666) vármegyében volt a legmagasabb, Heves (153), Békés (153) és Csongrád-Csanád (203) vármegyében a legalacsonyabb. Laboratóriumi vizsgálattal igazolt, influenzavírus által okozott megbetegedéseket Békés, Nógrád és Tolna vármegye kivételével minden további területen megállapítottak. E héten 298 betegtől érkezett légúti minta a Nemzeti Népegészségügyi és Gyógyszerészeti Központ (NNGYK) Nemzeti Influenza Referencia Laboratóriumába. A sentinel orvosok által beküldött 238 minta közül 54 betegnél az influenza A(H1pdm09), 14 betegnél az influenza A(H3), négy betegnél az influenza B, nyolc betegnél az RSV, három betegnél a human metapneumovírus, 21 betegnél a SARS-CoV-2 vírus kóroki szerepét igazolták. Az influenza pozitivitási arány 30,3%, a SARS-CoV-2 pozitivitási arány 8,8% volt. A sentinel kórházak által beküldött 26 minta közül hat betegnél influenza A(H1pdm09)-et, kilenc betegnél RSV-t, egy betegnél human metapneumovírust, öt betegnél SARS-CoV-2 vírust azonosítottak. Betegségmegállapítás céljából hagyományos vizsgálatra érkezett 34 légúti minta közül nyolc influenza A(H1pdm09), egy RSV és egy SARS-CoV-2 vírus pozitív volt. (A 2023. év 40 – 2024. 03. hete között 3 639 vizsgálati anyagot dolgoztak fel az NNGYK Nemzeti Influenza Referencia Laboratóriumban. 239 betegnél influenza A fertőzést igazoltak - 158 influenza A(H1pdm09-et), 81 influenza A(H3)-at -, tíz betegnél influenza B-t, ötvenhatnál RSV-t, 1 003-nál COVID-19-et. Harminchét megbetegedést rhinovírus okozott, 5 megbetegedést parainfluenza, 2-t adenovírus, 19-et human metapneumovírus). E héten akut légúti megbetegedés halmozódásáról két jelentés érkezett. Egy-egy Hajdú-Bihar és Szabolcs-Szatmár-Bereg vármegyei óvodából jelentettek köhögéssel és lázzal, felsőlégúti tünetekkel járó megbetegedéseket. Az ok-okozat tisztázására mindkét járványban történt légúti mintavételezés. A Hajdú-Bihar vármegyei óvodában az influenza A vírusnak volt kóroki szerepe, a másik óvodából származó légúti minták virológia vizsgálata folyamatban van. A 4. héten a szennyvizekben országos átlagban az Influenza A vírus örökítőanyaga ismét sűrűsödik. A kimutatási határt 12 minta esetében haladta meg a kópiaszám, amely az előző évi influenza szezonra jellemző érték. Országosan a szennyvíz SARS-CoV-2 örökítőanyagának átlagsűrűssége stagnál a vizsgált városok többségénél. Sűrűsödés Salgótarjánban mutatható ki, csökkenés Békéscsabán, Egerben, Kecskeméten és Szegeden észlelhető. A szennyvíz mintákban országos átlagban a JN1 variáns (a BA.2.86 alvariánsa) jelentős növekedése figyelhető meg a 2023. év 47. hetét követő mintákban, a variáns ez év első hetében már meghatározóvá vált. Ezzel párhuzamosan a korábban legnagyobb arányban kimutatott EG.5 ("XBB.1.5-like+F465L') variáns arányának jelentős csökkenését figyelték meg. Az azonos időszakban vizsgált szennyvíz minták variáns megoszlása egyezést mutat a klinikai mintákban tapasztalt aránnyal. Az elsődleges elemzések alapján megállapítható, hogy az influenza szennyvízben mért vírusterhelés emelkedését 2 héttel követi a sürgősségi ellátási igény növekedése, míg a koronavírus (SARS-CoV-2) örökítőanyag vírusterhelés emelkedését 1 héttel követi a mentőszolgálat hívásszámának növekedése.
(Forrás: nnk *)
* 'Nemzeti Népegészségügyi Központ'
Asia
Vietnam
05/02/2024 Sleep researchers from Vietnam have found that even a mild COVID-19 infection may increase symptoms of insomnia. They surveyed more than 1,000 people who had been diagnosed with COVID-19 in the six months before the study. More than 75 per cent of participants reported experiencing insomnia. The participants had not been hospitalised and had no history of insomnia or psychiatric illness. The authors said this was “remarkably higher than previously reported among the general population”. Almost a quarter of those surveyed reported severe insomnia, while half of participants said they woke up more frequently in the night. Around a third said it was harder to fall asleep or they did not sleep as well as they did before having the infection. Of the participants, people with a pre-existing chronic condition and those who had symptoms of depression or anxiety had higher rates of insomnia that were statistically significant. As it was an observational study, the researchers could not determine the direct impact of anxiety and depression on insomnia. The researchers pointed out that there were several limitations to the study, including the online collection of data which could lead to bias. The findings were published in the journal Frontiers in Public Health, today. Previous studies have found that people with lingering symptoms of COVID-19, known as long COVID, have reported moderate to severe sleep problems. Other studies have found that concerns during the COVID-19 pandemic, and not just the disease itself, have contributed to increases in insomnia. Hoang of Phenikaa University, Vietnam was lead author of the study. She said that there are small actions that you can take to improve your sleep, including taking a warm shower before bed, shutting off your phone at least one hour before going to sleep, exercising daily, and avoiding caffeine late in the day. (Source: euronews)
North America
United States
February 1, 2024 Deer are beta-testing chronic wasting disease (CWD), a highly lethal, highly contagious neurodegenerative disease. It is devastating North America’s deer, elk, and other cervids. In the half century since it was discovered in a captive deer colony in Colorado, CWD has worked its way into more than 30 U.S. states and four Canadian provinces, as well as South Korea and several countries in Europe. In some captive herds, the disease has been detected in more than 90 percent of individuals. CWD kills indiscriminately, gnawing away at deer’s brains until the tissue is riddled with holes. “The disease is out of control,” Abdelaziz, a biochemist at the University of Calgary, told. CWD's cause: infectious misfolded proteins called prions. Prion diseases, which include mad cow disease, have long been poorly understood threats. CWD is the most difficult among them to contend with - more transmissible and widespread than any other known, Jorge, a wildlife biologist at the University of Georgia, told. CWD is already a perfect example of how dangerous a prion disease can be - scientists are quite certain that CWD will be impossible to eradicate; even limiting its damage will be a challenge, especially if it spills into other species, which could include us. Unlike standard-issue microbes - viruses, bacteria, parasites, fungi - prions are just improperly folded proteins, devoid of genetic material, unable to build more of themselves from scratch, or cleave themselves in two. To reproduce, they simply find properly formed proteins that share their base composition and convert those to their aberrant shape, through mostly mysterious means. And because prions are slightly malformed versions of molecules that our bodies naturally make, they’re difficult to defend against. The immune system codes them as benign and ignores them, even as disease rapidly unfolds. “This is an entirely new paradigm of infectious disease,” Napper, a biochemist and vaccinologist at the University of Saskatchewan told. “It’s a part of your own body that’s turning against you.” And yet, we’ve managed to keep many prion diseases in check. Kuru, once common in the highlands of Papua New Guinea, was transmitted through local rituals of funerary cannibalism; the disease fizzled out after people stopped those practices. Mad cow disease (more formally known as bovine spongiform encephalopathy) was contained by culling infected animals and eliminating the suspected source, cow feed made with infected tissues. Even scrapie, a highly contagious prion disease of sheep and goats, is limited to livestock, making it feasible to pare down infected populations, or breed them toward genetic resistance. CWD, meanwhile, is a fixture of wild animals, many of them migratory. And whereas most other prion diseases primarily keep quarters in the central nervous system, CWD “gets in pretty much every part of the body,” Jorge told. Deer then pass on the molecules, often through direct contact; they’ll shed prions in their saliva, urine, feces, reproductive fluids, and even antler velvet long before they start to show symptoms. Mathiason, a pathobiologist at Colorado State University, and her colleagues have found that as little as 100 nanograms of saliva can seed an infection. Her studies suggest that deer can also pass prions in utero from doe to growing fawn. Deer also ingest prions from their environment, where the molecules can linger in soil, on trees, and on hunting bait for years or decades. A team led by Pritzkow, a biochemist at UTHealth Houston, has found that plants can take up prions from the soil, too. And unlike the multitude of microbes that are easily done in by UV, alcohol, heat, or low humidity, prions are so structurally sound that they can survive nearly any standard environmental assault. In laboratories, scientists must blast their equipment with temperatures of about 275 degrees Fahrenheit (135 degrees Celsius) for 60 to 90 minutes, under extreme pressure, to rid it of prions - or drench their workspaces with bleach or sodium hydroxide, at concentrations high enough to rapidly corrode flesh. Infected deer are also frustratingly difficult to detect. The disease typically takes years to fully manifest, while the prions infiltrate the brain and steadily destroy neural tissue. Deer drool and urinate more, stumble about, and begin to lose weight. Eventually, a predator picks them off, or a cold snap freezes them, or they simply starve; in all cases, though, the disease is fatal. Because of CWD, deer populations in many parts of North America are declining; there is definitely some concern that local populations will disappear. Researchers worry the disease will soon overwhelm caribou in Canada, imperiling the Indigenous communities who rely on them for food. Hunters and farmers, too, are losing vital income. Deer are unlikely to go extinct, but the disease is depriving their habitats of key grazers, and their predators of food. In laboratory experiments, CWD has proved capable of infecting rodents, sheep, goats, cattle, raccoons, ferrets, and primates. But so far, jumps into non-cervid species don’t seem to be happening in the wild - and although people eat an estimated 10,000 CWD-infected cervids each year, no human cases have been documented. Still, lab experiments indicate that human proteins, at least when expressed by mice, could be susceptible to CWD too, Gilch, a molecular biologist at the University of Calgary, told. And the more prions transmit, and the more hosts they find themselves in, the more opportunities they may have to infect creatures in new ways. Prions don’t seem to evolve as quickly as many viruses or bacteria, Gilch told. She and other researchers have detected a multitude of CWD strains bopping around in the wild - each with its own propensity for interspecies spread, with transmission so unchecked, and hosts so numerous. The options to slow CWD's advance are so far limited. Even if sturdier prion resistance is someday found, “it’s probably just a matter of time until prions start to adapt to that as well,” Gilch said. Vaccines, in theory, could help, and in recent years, several research groups - including Napper’s and Abdelaziz’s - have made breakthroughs in overcoming the immune system’s inertia in attacking proteins that look like the body’s own. Some strategies try to target the problematic, invasive prions only; others are going after both the prion and the native, properly folded protein, so that the vaccine can do double duty, waylaying the infectious invader and starving it of reproductive fodder. (So far, lab animals seem to do mostly fine even when they’re bred to lack the native prion protein.) In early trials, both teams’ vaccines have produced promising immune responses in cervids. But neither team yet fully knows how effective their vaccines are at cutting down on shedding, how long that protection might last, or whether these strategies will work across cervid species. One of Napper’s vaccine candidates, for instance, seemed to hasten the progression of disease in elk. Vaccines for wildlife are also tough to deliver, especially the multiple doses likely needed in this case. Napper and other researchers plan to compound their formula with a salty apple - cider slurry that he hopes wild cervids might eat with some regularity. CWD is not, and may never be, the prion disease that most directly affects us. Should any CWD vaccines come to market, though, they will almost certainly be the first prion vaccines that clear the experimental stage. (Source: msn)
Thu February 1, 2024 Covid-19 vaccines provided 54% protection against symptomatic infection among immunocompetent adults who were recently vaccinated compared with those who did not receive an updated vaccine, early data from the US Centers for Disease Control and Prevention (CDC) published today suggests. Vaccine manufacturers updated their formulations to target the Omicron variant XBB.1.5, which was the predominant circulating strain for much of 2023. The new CDC data shows that the latest vaccines are similarly effective against JN.1, which has been causing most Covid-19 infections in the United States since late December. For this analysis, researchers analyzed trends among more than 9,000 adults who were tested for Covid-19 at Walgreens and CVS Pharmacy locations between mid-September and mid-January. “While we don’t have an estimate of vaccine effectiveness specific to immunocompromised people, the fact that the vaccine is working in the general population provides, I think, reassurance for the whole population,” Link-Gelles, lead author of the new study who heads the CDC’s vaccine effectiveness program for Covid and RSV said. Generally, the goal of the US Covid-19 vaccination program is to prevent severe disease. The latest Covid-19 vaccines have only been available since September, after a recommendation from the CDC’s independent vaccine advisory committee and official signoff from the agency and the US Food and Drug Administration. Still, only about 1 in 5 adults and 1 in 9 children have gotten the latest Covid-19 vaccine, which is recommended for everyone ages 6 months and older, the CDC estimates. By comparison, nearly half of adults and children have gotten the flu vaccine this season. And a flu season where the vaccine matches the circulating strain with 50% effectiveness would be considered a really good match, Link-Gelles said. The US doesn’t have a system in place to track Covid-19 cases, but wastewater data suggests that Covid-19 continues to circulate at high levels in the US. During the week ending January 13, there were nearly 31,000 Covid-19 hospitalizations and more than 1,800 deaths, according to CDC data. (Source: cnn)
Globalization
February 3, 2024 COVID vaccines don’t add any protection for vaccinated with history of infection. Vaccinated people who took one of the shots actually saw a slight decrease in protection against infection, researchers in Japan found. They compared people who had received at least two doses of the original Pfizer and Moderna vaccines to people who received a bivalent shot on top of at least two doses of the originals. “We did not find sufficient evidence of the effectiveness of bivalent vaccines among previously infected older adults,” the researchers, with the Department of Health Care Administration and Management at Kyushu University and other institutions, said. The paper was published following peer review in BMC Infectious Diseases on 29 January 2024. Funding came from the Japan Agency for Medical Research and Development and the Japan Society for the Promotion of Science. “I would interpret the study to mean that in those without previous infection a booster vaccination is more important and valuable [than] in those with previous infection where the impact may be smaller or non-existent,” Dr. Klausner, clinical professor of medicine, population and public health sciences at the University of Southern California’s Keck School of Medicine, told. In vaccinated people without prior infection, the study estimated a bivalent booster added 18.6 percent protection against infection. Limitations of the paper included not examining the long-term protection from the bivalent vaccines. Authors declared no conflicts of interest. The bivalent vaccines were available in the United States, Japan, and some other countries from the fall of 2022 to the fall of 2023. They were introduced, without clinical trial data, because the original vaccines stopped performing as well against emerging variants of the virus that causes COVID-19. The shots were widely recommended in the United States. Japan used two versions of the bivalent shots, one targeting the BA.1 subvariant and another based on the BA.4/Ba.5 sublineages. The United States only used the version that targeted the latter. The bivalent vaccines have since been replaced by new monovalent shots that target the XBB.1.5 virus subvariant, although that strain has since been displaced in many places. In Japan, the new shots are available to the population but authorities are only recommending them to the elderly and people with underlying health problems. In the United States, officials recommend the new shots for virtually every person aged 6 months or older, regardless of whether they’ve been infected before. Just 22 percent of adults and 11 percent of children have received one of the new shots, according to the U.S. Centers for Disease Control and Prevention (CDC). “We do need nuance in our vaccine recommendations - vaccination has less benefit in younger people, those generally healthy, and in those recovered from infection,” said Dr. Klausner, who was not involved in the research. “Vaccine efforts should be targeted to those most at risk of complications and severe disease like the elderly, those with chronic medical conditions or immunocompromise or in either of those groups without prior infection.” Several other new papers have focused on the bivalent vaccines, the publication mentioned: In a study published in the January 2024 issue of the "Journal of Korean Medical Science" the researchers said that “The BA.1-based bivalent vaccine was effective only in individuals without prior SARS-CoV-2 infection”. The funding came from the Korea University College of Medicine, and no disclosures were listed. The study’s limitations included a lack of stratification by vaccine manufacturer. In volume 29 Issue 3 / 18/Jan/2024 of journal "Eurosurveillance," European researchers' study estimated that bivalent vaccines provided strong protection against severe illness initially but that the shielding dropped to near-zero over time. They examined records of adults aged 60 or older who experienced severe acute respiratory infection between February and August 2023. The researchers estimated that vaccine effectiveness started at 80 percent against the infection but dropped to 0 percent beyond 269 days. The researchers did not adjust for prior infection, a fact they listed as one of the limitations of the paper. Funding came from the European Centre for Disease Prevention and Control. Declared conflicts included sponsorship from Pfizer for one author and payments from Pfizer for another. (Source: ntd *): http://tinyurl.com/6t7hjarb
* New Tang Dynasty Television (New York City)
Note: The Japanese study's conclusion: "Bivalent vaccines are effective against COVID-19 infections among older adults without a history of infection." See it: http://tinyurl.com/bdf5zan6
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