January 16, 2023
Mpox disproportionately affects Black and Hispanic women compared to White women.
The CDC analyzed case reports between May and November 2022 to determine the prevalence of mpox (formerly known as monkeypox) among cisgender women over the age of 15 and pregnant people. Researchers found that among 769 cases of women infected with mpox, three percent were pregnant. Furthermore, among the 717 participants with information on race and ethnicity, nearly half were Black, one-fourth were Hispanic, and one-fourth were White. Hispanic women make up 19 percent of the US women population, so they are over-represented in the group studied. While mpox infections among women in the surveillance period constituted less than 3 percent of total mpox cases in the US, the disproportionate burden of the disease among Black and Hispanic women outlines common disparities and emphasizes the need for equitable access to diagnosis and treatment. [CDC]
Researchers are using mRNA technology to develop cancer vaccines.
On January 6, 2023, the UK government announced its partnership with BioNTech, the developer of the first mRNA vaccine against COVID-19, to enroll subjects in trials for new mRNA vaccines against cancer. Despite prior attempts, scientists have been mostly unsuccessful in identifying tumor-specific antigens that can be targeted by a vaccine. Another challenge is that cancer cells have evolved to evade the human immune system, making it difficult to ensure that a cancer vaccine will successfully eliminate tumors. Current promising projects involve increasing inflammation in tumors in order to attract immune cells that can detect and destroy tumor cells or targeting the enzyme telomerase which permits cancer cells to multiply. Overall public acceptance of the COVID-19 mRNA vaccine has motivated pharmaceutical companies to scale up mRNA vaccine efforts against cancer. [BMJ]
A third study of vaccine hesitancy showed that willingness to accept COVID vaccination has increased since 2021.
In the summer of 2022, scientists conducted the third study of COVID-19 vaccine hesitancy in 23 populous countries heavily impacted by the burden of COVID-19, including the United States, the United Kingdom, Brazil, China, India, Italy, and South Africa, among others. Data collected from 23,000 respondents showed that willingness to accept vaccination against COVID-19 rose to over 75 percent, a 5 percent increase from the number recorded in June 2021. However, general vaccine hesitancy rose among respondents from eight countries, including the United Kingdom and South Africa. Booster hesitancy was reported by around 12 percent of vaccinated respondents, many of whom were younger individuals in South Korea and some European countries and older individuals in Ecuador. [Nature Medicine]
Global access to RSV prophylaxis for SCID patients must be expanded.
Shortly after birth, a male newborn diagnosed with severe combined immunodeficiency (SCID) developed respiratory symptoms and tested positive for the respiratory syncytial virus (RSV), eventually requiring pediatric ICU admission and invasive ventilation. He subsequently experienced similar episodes of respiratory deterioration and passed away at the age of six months due to uncontrolled RSV pneumonia. Physicians in the patient’s treatment team note that prophylactic RSV treatment immediately after SCID diagnosis could have prevented the contraction of RSV. Access to monoclonal antibodies for RSV prevention should be expanded for SCID patients worldwide. [Journal of Clinical Immunology]
Regional distribution and maternal age affect measles vaccine uptake in Ethiopia.
In 2019, Ethiopia introduced the measles-containing second-dose vaccine (MCV2) to reduce the high incidence of measles in the country. A recent study assessed the spatial variations and the individual and contextual factors influencing MCV2 uptake among children aged 24 to 35 months in Ethiopia. Based on maternal reports and vaccination data, the proportion of MCV2 uptake in this age group was less than one-tenth (95% CI: 7.96%, 12.11%). Maternal age, birth order, and immunization status against other common diseases were significantly associated with MCV2 uptake; for example, children of older mothers were less likely to receive MCV2 compared to children of younger mothers. Regional analysis revealed that children living in Benishangul-Gumuz were the least likely to have received MCV2 compared to other areas included in the study, possibly due to sociocultural norms and access to health facilities. [PLOS One]
Impoverished groups might not drive antimicrobial misuse, but they bear the greatest AMR burden.
Researchers conducted a mixed-methods study investigating the relationship between multidimensional poverty and antimicrobial misuse in Kenya, Tanzania, and Uganda. Antibiotic non-adherence and self-medication were more common among individuals who were not deprived than those living in deprivation. Less deprived individuals, particularly those employed, may feel the effects of financial and time constraints in accessing healthcare more acutely than more deprived people. The researchers emphasize that more deprived subgroups may not necessarily be drivers of antimicrobial misuse despite facing the largest burden of antimicrobial resistance (AMR). [The Lancet Global Health]
Understanding the manifestations of AMR is essential in combatting it.
After antimicrobial resistance emerged in the 1930s, a large body of work showed that bacteria could evolve to become resistant through genetics and transmit this feature to their descendants. However, a recent article highlights the importance of distinguishing genetic from phenotypic AMR. In the context of genetic AMR, resistant bacteria differ genotypically from susceptible bacteria. However, in the context of phenotypic AMR, which results from endogenous resistance mechanisms, often triggered by stress or environmental factors, resistant and susceptible bacteria could be genotypically identical. [Current Opinion in Microbiology]
The mechanism of resistance in S. aureus mediated by BlaR1 receptor has been uncovered.
Researchers aimed to define the structure of the Staphylococcus aureus BlaR1 receptor, which mediates broad-spectrum antibiotic resistance in many methicillin-resistant S. aureus (MRSA) strains. Through advanced microscopy techniques, it was demonstrated that in the presence of extracellular beta-lactams, the active state of BlaR1 is stabilized and results in the cleavage of beta-lactamase, which derepresses resistance-encoding genes. Protein homologs of BlaR1, such as that in M. tuberculosis, may use similar derepression mechanisms to confer resistance, emphasizing the importance of these findings. [Nature]
COVID-19 delayed children’s first RSV exposure, leading to more severe outcomes among older children with RSV.
Researchers assessed the age-related risk of respiratory syncytial virus (RSV) infection hospital admissions and need for mechanical ventilation in Denmark in the summer and fall of 2021 compared to four pre-COVID RSV seasons. The number of RSV-associated hospitalizations and the number of children with RSV requiring mechanical ventilation doubled in the 2021-2022 RSV season compared to the four pre-COVID seasons. The increase in the risk of admission for RSV was most significant for children aged 24 to 59 months compared to younger groups. Researchers note that the complications leading to necessary mechanical ventilation did not differ pre- and post-pandemic. However, COVID-19 prevention measures may have led to delays in children’s first RSV infection, placing older children (more than two years of age) at a greater risk of requiring hospital admission and intubation associated with RSV. [The Lancet Child & Adolescent Health]
COVID-19 conflicts and mental health challenges reduced the quality of life among Afghan migrants and refugees in Iran.
A cross-sectional study of 300 Afghan refugees and migrants in Iran conducted between February and May 2022 aimed to reveal the effects of various social determinants of health on the participants’ quality of life during the COVID-19 pandemic. The results showed that socioeconomic status (SES) had the most positive relationship with quality of life, whereas the number of COVID-19 conflicts (such as post-traumatic symptoms) had the most negative relationship. Depression, Anxiety, and Stress Scale (DASS) scores also had negative associations with quality of life: the higher the DASS score, the lower the reported quality of life. The number of family members was positively linked to the quality of life, indicating the importance of time spent with family and family cohesion for quality of life during public health crises. [BMC Psychiatry]
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