Author Interviews, HIV, Infections, JNCI, Lymphoma / 08.08.2013 Interview with: Satish Gopal, MD, MPH Program in Global Oncology, Lineberger Comprehensive Cancer Center UNC Project-Malawi, Tidziwe Center, Private Bag A-104, Lilongwe, What is the primary message our physician readers should take away from the piece?”Answer: Lymphoma is one of the leading causes of HIV-associated death in the modern ART era. In our analyses of a large multicenter US cohort, survival for HIV-associated lymphoma patients receiving routine care has not clearly improved since the modern ART era began, and remains significantly worse than SEER outcomes for the same lymphoma subtypes in the general population. This was somewhat surprising in an era of normalizing life expectancy for HIV-infected patients on ART, and quite different from the outstanding results achieved for this population in recent clinical trials conducted by AMC and NCI. (more…)
Author Interviews, HPV, Infections, Race/Ethnic Diversity / 02.08.2013 interview with: Matthew B. Schabath, Ph.DAssistant Member, Department of Cancer Epidemiology H. Lee Moffitt Cancer Center, 12902 Magnolia Drive MRC-CANCONT, Tampa, What are the main findings of the study? Dr. Schabath: In this study we found that Asian/Pacific Islander men had the lowest incidence of human papillomavirus (HPV) infection and that they exhibited a lower probability of acquiring new HPV infections. Furthermore, men of multiple and mixed race had the second lowest incidence of HPV infection and however, while they had a lower probability of acquiring HPV, they also had a lower probability of clearing an HPV infection once acquired. (more…)
CDC, Infections / 01.08.2013

CDC Highlights from 7/31/2013 From

Epidemiologic Investigation

  • As of July 30, 2013 (5pm EDT), CDC has been notified of 378 cases of Cyclospora infection from the following 16 health departments: Iowa, Texas, Nebraska, Florida, Wisconsin, Illinois, New York City, Georgia, Missouri, Arkansas, Connecticut, Kansas, Minnesota, New Jersey, New York, and Ohio.
  • Most of the illness onset dates have ranged from mid-June through early July.
  • At least 21 persons reportedly have been hospitalized in three states.
  • Nebraska and Iowa have performed investigations within their states and have shared the results of those investigations with CDC. Based on their analysis, Cyclospora infections in their states are linked to a salad mix. CDC will continue to work with federal, state, and local partners in the investigation to determine whether this conclusion applies to the increase in cases of cyclosporiasis in other states.
  • It is not yet clear whether the cases from all of the states are part of the same outbreak. (more…)
Author Interviews, Hospital Acquired, Johns Hopkins / 31.07.2013 Interview with:Bruce Y. Lee, MD MBA Associate Professor of International Health Director of Operations Research International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health 855 N. Wolfe Street Suite 600 Baltimore, MD 21205Bruce Y. Lee, MD MBA Associate Professor of International Health Director of Operations Research International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health 855 N. Wolfe Street Suite 600 Baltimore, MD What are the main findings of the study?Dr. Lee: Vancomycin resistant enterococci (VRE) is every hospital’s problem. A VRE outbreak in one hospital, even if the hospital is relatively small or distant, can readily spread to other hospitals in a region because patients leaving one hospital often will go to other hospitals either directly or after an intervening stay at home. These patients can then carry VRE with them to other hospitals. Therefore, as long a single hospital has a problem with VRE or any other healthcare associated infection, all other hospitals are at risk. Conquering VRE then requires cooperation among hospitals. (more…)
Author Interviews, Diabetes, Infections, JAMA, Respiratory / 15.07.2013

Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Interview with: Andreas Beyerlein, PhDInstitute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, What are the main findings of the study?Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity. (more…)
Author Interviews, Infections, Lyme, NEJM / 02.07.2013 Interview with: Sam R. Telford III, ScD Department of Infectious Disease and Global Health, Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MABorrelia miyamotoi Infection Presenting as Human Granulocytic Anaplasmosis: A Case What are the main findings of the study?Answer: The study presents two additional cases of BMD (Borrelia miyamotoi disease) that add to our knowledge of the spectrum of illness of this recently recognized zoonosis. Our report of the North American index case in NEJM in January 2013 described a case-patient who was elderly and immunocompromised and it was not clear whether that case was just very unusual. With our Annals report, we describe cases in immune-intact individuals and suggest that cases of BMD may have been under our noses all along, just presumptively diagnosed as HGA and successfully treated with doxycycline with no followup (e.g., lab confirmation of diagnosis of HGA Human Granulocytic Anaplasmosis). Hence, individuals presenting with fever, headache, myalgia, and show leukopenia and elevated LFTs may have either HGA or BMD and confirmatory testing should be done accordingly. It should be noted that all tick borne diseases are clinical diagnoses and treatment of an acute case should not depend on "lab tests". Both these infections are effectively managed by oral doxycycline, hence those with these signs and symptoms might be empirically treated with doxycyline, which would be important in areas where RMSF and tularemia (which also produce leukopenia and elevated LFTs) co-occur with deer tick -transmitted infections such as Lyme disease; waiting for "lab tests" to confirm RMSF or tularemia might lead to a negative outcome. RMSF and tularemia are the most dangerous of the tick American tick borne diseases, although I would certainly place the very rare deer tick virus and Powassan virus in the same category. (more…)
Author Interviews, Infections, Lyme / 27.06.2013 Interview with: Xin Li, Ph.D. Assistant Professor Department of Veterinary Biosciences The Ohio State University 344 Veterinary Medicine Academic Building Columbus, OH What are the main findings of the study?Dr. Xin Li :Antibody responses to borrelial antigens that are primarily expressed during the tick phase the spirochetes’ life cycle are common in American patients with Lyme arthritis, a late-stage manifestation of Lyme borreliosis, but are rare in American patients with early-stage infection or European patients with early- or late-stage infection. (more…)
HIV, Infections, JAMA, Race/Ethnic Diversity / 21.06.2013 Interview with Dr. H. Irene Hall, PhD Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC 1600 Clifton Road, MS E-47, Atlanta, GA What are the main findings of the study?Dr. Hall: Our research finds that, across all populations, far too few Americans with HIV receive the care they need to stay healthy and reduce risk of transmission. According to our research, gaps in care are the largest among African Americans and young people. Moving forward, improving care for all HIV-infected people will be critical to achieving the goal of an AIDS-free generation in America.More specifically, some of the key findings of the study include:
  • Overall, only a quarter of all Americans with HIV have a suppressed viral load – meaning the level of HIV in their bodies is low enough to stay healthy and dramatically reduce the chance of transmitting to others.
  • By race/ethnicity, African-Americans and Hispanics or Latinos are less likely to be aware of their infection compared to whites.
  • By age, younger Americans are less likely to be in ongoing care and have a suppressed viral load; HIV care and viral suppression generally improved with age. For example:
  • Fifteen percent of those aged 25-34 were virally suppressed, compared to 36 percent of those aged 55-64.
  • In terms of ongoing care, 28 percent of those 25-34 years old were retained in care, compared to 46 percent of those aged 55-64. (more…)
Author Interviews, BMJ, Hospital Acquired, Infections, Outcomes & Safety / 19.06.2013

Marin L. Schweizer Ph.D. Assistant Professor University of Iowa Carver College of Medicine, Iowa City, IA, Interview with: Marin L. Schweizer Ph.D.Assistant Professor University of Iowa Carver College of Medicine Iowa City, IA, What are the main findings of the study?Dr. Schweizer: A clinical bundle that includes nasally screening cardiac and orthopedic surgery patients for S. aureus (both methicillin-resistant S. aureus and methicillin-susceptible S. aureus), decolonizing carriers, and changing antibiotic prophylaxis for MRSA carriers, can significantly reduce the number of gram-positive surgical site infections, S. aureus surgical site infections and MRSA surgical site infections. (more…)
Author Interviews, C. difficile, Infections, Nutrition, Probiotics / 07.06.2013 eInterview with: Dr. Reena Pattani MD Department of Medicine St. Michael’s Hospital 30 Bond Street, Toronto ON M5B What are the main findings of the study?Dr. Pattani:We performed a meta-analysis of 16 studies that assessed the effectiveness of probiotics administered concurrently with antibiotics compared to the use of antibiotics alone. The use of probiotics among patients in these trials reduced the risk of antibiotic-associated diarrhea by almost 40% and decreased the rate of Clostridium difficile infection by 63%. On subgroup analysis, the reduction remained statistically significant for the subgroups of good quality trials, trials in which a primarily Lactobacillus-based regimen was used, and those studies which had a follow-up period of less than 4 weeks. (more…)
Author Interviews, Infections, Lancet, Vaccine Studies / 31.05.2013 eInterview with: Fengcai Zhu Deputy Director of the Jiangsu Provincial Center for Disease Prevention and Control, Jiangsu provincial center for disease prevention and control

Fengcai Zhu

Deputy Director of the Jiangsu Provincial Center for Disease Prevention and Control, Jiangsu provincial center for disease prevention and control Editor's Note: HFMD = Hand Foot and Mouth Disease Hand Foot and Mouth Disease What are the main findings of the study?Answer: From this trial, the inactivated alum-adjuvant EV71 vaccine showed a good protection for both the EV71-associated HFMD and EV71-associated disease. The vaccine gave 90% protection against clinical EV71-associated HFMD and 80.4% against EV71-associated disease (including neurological complications) for at least 12 months. The safety profile and immunogenicity of this vaccine is proved to be clinical acceptable. We also proposed a titre (1:32) of neutralization antibody as surrogate of protection against EV71-associated disease.


Author Interviews, HIV / 27.04.2013 eInterview with Dr. Sara Gianella Weibel, M.D. Center For Aids Research (CFAR) University of California San Diego La Jolla CA, 92093-0679 Email: What are the main findings of the study? Answer: In this study we evaluated a large number of seminal samples from HIV-infected sexually active gay men treated with antiretroviral therapy (ART) using an extensive battery of tests for viral and bacterial co-infections. Around 10% of enrolled subjects presented detectable levels of HIV RNA in semen despite being on suppressive ART. (more…)
Author Interviews, Infections, PLoS / 11.03.2013 Author Interview: Dr.Donald K. Milton, MD, Dr.P.Hdr_donalk_k_miltonDr. Donald K. Milton, MD, Dr.P.HProfessor and DirectorMaryland Institute for Applied Environmental Health University of Maryland What are the main findings of the study?Dr. Milton: We found that total viral copies detected by molecular methods were 8.8 times more numerous in fine (≤5 µm) than in coarse (>5 µm) aerosol particles and that the fine particles from cases with the highest total number of viral RNA copies contained infectious virus.Surgical masks reduced the overall number of RNA copies by 3.4 fold. (more…)