scholarly journals Monoclonal Antibody Treatment, Prophylaxis and Vaccines Combined to Reduce SARS CoV-2 Spread

2021 ◽  
Author(s):  
Mohamed A. Kamal ◽  
Andreas Kuznik ◽  
Luyuan Qi ◽  
Witold Więcek ◽  
Mohamed Hussein ◽  
...  
Keyword(s):  
Public Health ◽  
Diagnostic Testing ◽  
Post Exposure Prophylaxis ◽  
Antibody Treatment ◽  
Viral Shedding ◽  
The Us ◽  
Monoclonal Antibody Treatment ◽  
Exposure Prophylaxis ◽  
Respiratory Coronavirus ◽  
The Impact

Background Antiviral monoclonal antibodies (mAbs) developed for treatment of COVID-19 reduce the magnitude and duration of viral shedding and can thus potentially contribute to reducing transmission of the causative virus, severe acute respiratory coronavirus 2 (SARS-CoV-2). However, use of these mAbs in combination with a vaccine program has not been considered in public health strategic planning. Methods We developed an agent-based model to characterize SARS-CoV-2 transmission in the US population during an aggressive phase of the pandemic (October 2020 to April 2021), and simulated the effects on infections and mortality of combining mAbs as treatment and post-exposure prophylaxis (PEP) with a vaccine program plus non-pharmaceutical interventions. We also interrogated the impact of rapid diagnostic testing, increased mAb supply, and vaccine rollout. Findings Allocation of mAbs as PEP or targeting those ≥65 years provided the greatest incremental benefits relative to vaccine in averting infections and deaths, by up to 17% and 41%, respectively. Rapid testing, facilitating earlier diagnosis and mAb use, amplified these benefits. The model was sensitive to mAb supply; doubling supply further reduced infections and mortality, by up to two-fold, relative to vaccine. mAbs continued to provide incremental benefits even as proportion of the vaccinated population increased. Interpretation Use of anti-viral mAbs as treatment and PEP in combination with a vaccination program would substantially reduce SARS-CoV-2 transmission and pandemic burden. These results may help guide resource allocation and patient management decisions for COVID-19 and can also be used to inform public health policy for current and future pandemic preparedness.

Pattern and Outcome of Dog Bite Injuries among Children-a Study in 200 Cases

2021 ◽  
pp. 1-5
Author(s):  
Md Waliur Rahman ◽  
◽  
Md Habibullah Sarkar ◽  
Samir Kumar Talukder ◽  
Md Joynal Abedin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
Hospital Treatment ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Post Exposure ◽  
Dog Bites ◽  
Exposure Prophylaxis ◽  
Bite Injuries

Introduction: Dog bites in humans are a major public health problem. Globally, millions of people are bitten by dogs but most of the fatal cases occur in children. Dog bites in human are a serious public health problem and have been well documented worldwide. As rabies is not a notifiable disease in Bangladesh and most deaths occur in rural areas where surveillance is poor. Objectives: To determine the pattern of dog bite injuries and associated health problems among children. Methods: The study was an observational retrospective study carried out at the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh. The study reviewed the clinical data of patients managed for dog bite related injuries and rabies over a four and half year period between January 2016 and June 2020. A proforma was designed to extract relevant clinical data from the case records. Information extracted included the age, sex of the victims, site of the bite, time of presentation in the hospital, pre-hospital treatment, hospital treatment including post-exposure prophylaxis and complication. Results: In all, 200 cases of dog bite injuries were managed constituting 0.89% of the total consultations; 5 (2.5%) had rabies. Most of the victims were aged 6-12 years (55.0%) and majority (67.0%) was boys. Eighty two percent of the victims presented within 24hrs of the injury. 92 (46.0%) had WHO grade 3 dog bite injury at presentation and the lower limb was the commonest (56.0%) bite site. Use of herbal preparation was the most common pre-hospital treatment 60%. Although 95.0% received anti-rabies vaccine, only 55.5% of them completed the vaccination schedule. The case fatality rate for dog bite was 5.0%. The 5 that died all presented late, had no post exposure prophylaxis and died within 24 hours of admission. Conclusion: There is need for public enlightenment on dangers associated with dog bites and also for the government to ensure vaccination for cost of post exposure prophylaxis treatment for children free of cost

Public health impacts of culture independent diagnostic testing in Australia

2017 ◽  
Vol 38 (4) ◽  
pp. 162
Author(s):  
Fiona J May
Keyword(s):  
Public Health ◽  
Health Management ◽  
Diagnostic Testing ◽  
Primary Source ◽  
Outbreak Detection ◽  
Surveillance Systems ◽  
Advantages And Disadvantages ◽  
Testing Protocol ◽  
Culture Independent ◽  
The Impact

Culture independent diagnostic tests (CIDT) for detection of pathogens in clinical specimens have become widely adopted in Australian pathology laboratories. Pathology laboratories are the primary source of notification of pathogens to state and territory surveillance systems. Monitoring and analysis of surveillance data is integral to guiding public health actions to reduce the incidence of disease and respond to outbreaks. As with any change in testing protocol, the advantages and disadvantages of the change from culture based testing to culture independent testing need to be weighed up and the impact on surveillance and outbreak detection assessed. This article discusses the effect of this change in testing on surveillance and public health management of pathogens in Australia, with specific focus on gastrointestinal pathogens.

scholarly journals United States Ending the Human Immunodeficiency Virus (HIV) Epidemic plan: evaluation of the role of industry funding in published pre-exposure prophylaxis (PrEP) literature

2021 ◽  
Author(s):  
Somya Gupta ◽  
Reuben Granich
Keyword(s):  
Industry Funding ◽  
Potential Conflict ◽  
Immunodeficiency Virus ◽  
The Us ◽  
Frequent Testing ◽  
Potential Impact ◽  
Corporate Support ◽  
Exposure Prophylaxis ◽  
The Impact

Pre-exposure prophylaxis (PrEP) is integral to the US End of AIDS strategy. However, low adherence, high costs, frequent testing and monitoring side effects make delivery of PrEP complicated. Gilead has sponsored PrEP-related research efforts and access as part of its marketing efforts. We review potential conflict of interests (COI) in the scientific literature for the US PrEP related articles to understand the impact of Gilead’s corporate sponsorship.We identified 93 US PrEP articles published in the top 10 medical journals and top 10 HIV/AIDS journals in 2018. There were 289 first three and senior authors in these articles, of which, 34 (11%) declared a Gilead COI and 28 (10%) had undeclared Gilead COI. Only 10 authors accounted for 50% of the articles, with 70% of them having potential COI including receiving grants, fees and study drugs. The 93 articles were associated with 51 leading institutions (institution of three or more authors or participating institutions in a trial). Authors from 12 (24%) institutions declared an institutional Gilead COI and 22 (45%) institutions had undeclared Gilead support. Overall, of the 93 included articles, 30 (32%) had declared Gilead COI. Combining declared and undeclared COIs for authors and institutions provided an overall 83 (89%) articles with a potential Gilead COI. Of the 93 articles, 60 (71%) had favorable conclusions in 60 (71%). Declared Gilead support was significantly associated with favorable article conclusions (p<.05) but combined declared/undeclared author and/or institutional Gilead support was not associated with favorable conclusion. Nearly 90% of US PrEP articles had Gilead support and authors failed to report individual or institutional COI in 70% of articles. Direct corporate support is important for scientific research. However, Gilead’s marketing push for PrEP, undeclared COI, and potential influence of Gilead supported authors are of concern given the potential impact on the scientific discourse and the US HIV control strategy.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
The Us ◽  
The Impact ◽  
Individualized Decision

Abstract The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs) to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is in great need to assist in guiding the individualized decision making for adjustment of interventions in the US and around the world. However, the impact of these approaches remain uncertain. Based on the reported cases, the effective reproduction number of COVID-19 epidemic for 50 states in the US was estimated. The measurement on the effectiveness of eight different NPIs was conducted by assessing risk ratios (RRs) between and NPIs through a generalized linear model (GLM). Different NPIs were found to have led to different levels of reduction in. Stay-at-home contributed approximately 51% (95% CI 46%-57%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-13%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 6% (2%-11%). This retrospective assessment of NPIs on has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals The Epidemiological and Economic Impact of a Cell-Based Quadrivalent Influenza Vaccine in Adults in the US: A Dynamic Modeling Approach

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1095
Author(s):  
Van Hung Nguyen ◽  
Yvonne Hilsky ◽  
Joaquin Mould-Quevedo
Keyword(s):  
Public Health ◽  
Influenza Vaccine ◽  
Economic Impact ◽  
Influenza Vaccines ◽  
Sensitivity Analyses ◽  
Life Years ◽  
The Us ◽  
A Cell ◽  
The Impact ◽  
Quadrivalent Influenza Vaccine

Mutations of the H3N2 vaccine strain during the egg-based vaccine manufacturing process partly explain the suboptimal effectiveness of traditional seasonal influenza vaccines. Cell-based influenza vaccines improve antigenic match and vaccine effectiveness by avoiding such egg-adaptation. This study evaluated the public health and economic impact of a cell-based quadrivalent influenza vaccine (QIVc) in adults (18–64 years) compared to the standard egg-based quadrivalent influenza vaccine (QIVe) in the US. The impact of QIVc over QIVe in public health and cost outcomes was estimated using a dynamic age-structured SEIR transmission model, which accounted for four circulating influenza strains [A/H1N1pdm9, A/H3N2, B(Victoria), and B(Yamagata)] and was calibrated on the 2013–2018 influenza seasons. The robustness of the results was assessed in univariate and probabilistic sensitivity analyses. Switching from QIVe to QIVc in 18- to 64-year-olds may prevent 5.7 million symptomatic cases, 1.8 million outpatient visits, 50,000 hospitalizations, and 5453 deaths annually. The switch could save 128,000 Quality-Adjusted Life Years (QALYs) and US $ 845 M in direct costs, resulting in cost-savings in a three-year time horizon analysis. Probabilistic sensitivity analyses confirmed the robustness of the cost-saving result. The analysis shows that QIVc is expected to prevent hospitalizations and deaths, and result in substantial savings in healthcare costs.

scholarly journals Is there sufficient scientific evidence to rule out the use of hydroxychloroquine for postexposure prophylaxis of COVID-19?

2020 ◽  
Author(s):  
Llorenç Quintó ◽  
Jose Miguel Morales-Asencio ◽  
Raquel González ◽  
Clara Menéndez
Keyword(s):  
Public Health ◽  
Effect Size ◽  
Statistical Power ◽  
Scientific Evidence ◽  
Post Exposure Prophylaxis ◽  
Postexposure Prophylaxis ◽  
Post Hoc Analysis ◽  
Exposure Prophylaxis ◽  
Post Hoc ◽  
Rule Out

Since the beginning of the COVID-19 pandemic, the use of hydroxychloroquine (HCQ) has been surrounded by a lot of controversy, both scientific and non-scientific. This has continued with the publication of two trials of HCQ for post-exposure prophylaxis of the infection, which concluded that HCQ is not efficacious to prevent SARS-CoV-2 infection, and their results are influencing public health decisions.We have carried out a comprehensive post-hoc analysis of the statistical power of the two trials, which shows that their power to detect an effect of HCQ in preventing COVID-19 is low, not only for their observed effect size, but also for other clinically important levels of efficacy, and therefore both studies are inconclusive.

HIV seroconversions among male non-occupational post-exposure prophylaxis service users: a data linkage study

Sexual Health ◽  
2011 ◽  
Vol 8 (2) ◽  
pp. 179 ◽  
Author(s):  
Anna B. Pierce ◽  
Keflemariam Yohannes ◽  
Rebecca Guy ◽  
Kerrie M. Watson ◽  
Jude Armishaw ◽  
...  
Keyword(s):  
Risk Behaviour ◽  
Linkage Study ◽  
Incidence Rates ◽  
Post Exposure Prophylaxis ◽  
Hiv Incidence ◽  
Hiv Surveillance ◽  
Post Exposure ◽  
Hiv Seroconversion ◽  
Exposure Prophylaxis ◽  
The Impact

Background: Despite widespread prescription of non-occupational post-exposure prophylaxis (NPEP) in Victoria, little is known about subsequent HIV acquisition among NPEP users. We linked the Victorian NPEP Service (VNPEPS) database and the Victorian HIV Surveillance Registry to determine the number, incidence rate and predictive factors of HIV seroconversions among users of the VNPEPS. Methods: Records from male patients that received NPEP in the VNPEPS database (n = 1420) between January 2001 and February 2008 were linked with all entries in the Victorian HIV Surveillance Registry up to May 2008. Results: Sixty-one men who presented to the VNPEPS were identified as HIV seropositive; 16 of these were diagnosed at initial presentation for NPEP. The incidence of HIV seroconversion in males who were HIV seronegative at first presentation for NPEP was 1.27 (95% confidence interval 0.95–1.70) per 100 person-years. There was no association between HIV seroconversion and number of NPEP presentations or age. The median age of seroconversion was 34.6 years. Conclusion: The incidence of HIV infection among men presenting to the VNPEPS is slightly lower than the HIV incidence in NPEP users in a recent Australian cohort study of men who have sex with men, but higher than HIV incidence in general gay male populations. Frequency of NPEP use was not associated with risk of HIV seroconversion. Examination of risk behaviour before and after NPEP use in this population is required to further assess the impact of NPEP availability and use on HIV incidence rates and risk behaviour in Australia.

scholarly journals Passive surveillance of United Kingdom bats for lyssaviruses (2005–2015)

2017 ◽  
Vol 145 (12) ◽  
pp. 2445-2457 ◽  
Author(s):  
E. L. WISE ◽  
D. A. MARSTON ◽  
A. C. BANYARD ◽  
H. GOHARRIZ ◽  
D. SELDEN ◽  
...  
Keyword(s):  
Public Health ◽  
Phylogenetic Analysis ◽  
United Kingdom ◽  
Natural Population ◽  
Single Species ◽  
Post Exposure Prophylaxis ◽  
Passive Surveillance ◽  
Myotis Daubentonii ◽  
Geographical Clustering ◽  
Exposure Prophylaxis

SUMMARYPassive surveillance for lyssaviruses in UK bats has been ongoing since 1987 and has identified 13 cases of EBLV-2 from a single species;Myotis daubentonii. No other lyssavirus species has been detected. Between 2005 and 2015, 10 656 bats were submitted, representing 18 species, creating a spatially and temporally uneven sample of British bat fauna. Uniquely, three UK cases originate from a roost at Stokesay Castle in Shropshire, England, where daily checks for grounded and dead bats are undertaken and bat carcasses have been submitted for testing since 2007. Twenty per cent of Daubenton's bats submitted from Stokesay Castle since surveillance began, have tested positive for EBLV-2. Phylogenetic analysis reveals geographical clustering of UK viruses. Isolates from Stokesay Castle are more closely related to one another than to viruses from other regions. Daubenton's bats from Stokesay Castle represent a unique opportunity to study a natural population that appears to maintain EBLV-2 infection and may represent endemic infection at this site. Although the risk to public health from EBLV-2 is low, consequences of infection are severe and effective communication on the need for prompt post-exposure prophylaxis for anyone that has been bitten by a bat is essential.

scholarly journals Reducing Public Health Risk During Disasters: Identifying Social Vulnerabilities

2015 ◽  
Vol 12 (4) ◽  
pp. 809-822 ◽  
Author(s):  
Amy Wolkin ◽  
Jennifer Rees Patterson ◽  
Shelly Harris ◽  
Elena Soler ◽  
Sherry Burrer ◽  
...  
Keyword(s):  
Public Health ◽  
At Risk ◽  
Social Vulnerability ◽  
Emergency Managers ◽  
The Social ◽  
The Us ◽  
At Risk Populations ◽  
Negative Impacts ◽  
Social Vulnerabilities ◽  
The Impact

Abstract All regions of the US experience disasters which result in a number of negative public health consequences. Some populations have higher levels of social vulnerability and, thus, are more likely to experience negative impacts of disasters including emotional distress, loss of property, illness, and death. To mitigate the impact of disasters on at-risk populations, emergency managers must be aware of the social vulnerabilities within their community. This paper describes a qualitative study which aimed to understand how emergency managers identify social vulnerabilities, also referred to as at-risk populations, in their populations and barriers and facilitators to current approaches. Findings suggest that although public health tools have been developed to aid emergency managers in identifying at-risk populations, they are not being used consistently. Emergency managers requested more information on the availability of tools as well as guidance on how to increase ability to identify at-risk populations.

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