Author Interviews, CDC, Infections / 20.05.2024
NIH Study Suggests Prion Disease Unlikely to Spread from Deer to Humans
MedicalResearch.com Interview with:
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Dr. Haigh[/caption]
Cathryn Haigh, Ph.D.
Chief Prion Cell Biology Unit
Laboratory of Neurological Infections and Immunity
National Institute of Allergy and Infectious Diseases
Division of Intramural Research, Rocky Mountain Laboratories
National Institutes of Health
Hamilton, MT 59840
MedicalResearch.com: What is the background for this study, ie what are prions/prion-related diseases? Where are prions found?
Response: Prion diseases are infectious neurodegenerative diseases of humans and animals. In humans these diseases often manifest as rapidly progressing dementias but are rarely caused by a known exposure to the infectious agents (prions). More commonly they are sporadic (no known cause) or hereditary.
One form of human disease is believed to have arisen from eating beef contaminated with bovine spongiform encephalopathy (as known as mad cow disease). This has resulted in concerns that chronic wasting disease (CWD), a prion disease affecting deer, elk and moose, might also have the potential to cross the species barrier and cause disease in humans. To date, transmissions of CWD prions to cynomolgus macaques have been negative, a good sign that crossing the species barrier would not be easy, but macaques are not human so we wanted to test whether CWD could infect human brain tissue.
To do this we used a human cerebral organoid model (mini human brain tissues grown from skin cells in a laboratory) and directly exposed the organoids to prions from the brains of animals that had died of CWD.
Dr. Haigh[/caption]
Cathryn Haigh, Ph.D.
Chief Prion Cell Biology Unit
Laboratory of Neurological Infections and Immunity
National Institute of Allergy and Infectious Diseases
Division of Intramural Research, Rocky Mountain Laboratories
National Institutes of Health
Hamilton, MT 59840
MedicalResearch.com: What is the background for this study, ie what are prions/prion-related diseases? Where are prions found?
Response: Prion diseases are infectious neurodegenerative diseases of humans and animals. In humans these diseases often manifest as rapidly progressing dementias but are rarely caused by a known exposure to the infectious agents (prions). More commonly they are sporadic (no known cause) or hereditary.
One form of human disease is believed to have arisen from eating beef contaminated with bovine spongiform encephalopathy (as known as mad cow disease). This has resulted in concerns that chronic wasting disease (CWD), a prion disease affecting deer, elk and moose, might also have the potential to cross the species barrier and cause disease in humans. To date, transmissions of CWD prions to cynomolgus macaques have been negative, a good sign that crossing the species barrier would not be easy, but macaques are not human so we wanted to test whether CWD could infect human brain tissue.
To do this we used a human cerebral organoid model (mini human brain tissues grown from skin cells in a laboratory) and directly exposed the organoids to prions from the brains of animals that had died of CWD.
Dr. Jernigan[/caption]
Dr. John Jernigan, MD MS
Clinical Associate Professor of Medicine
Division of Infectious Diseases
Emory University School of Medicine
Branch Chief
Epidemiology, Research and Innovations Branch
CDC Center for Disease Control
MedicalResearch.com: What is the background for this study?
Response: Staphylococcus aureus commonly causes infections in ICUs. One approach to preventing these infections is using nasal mupirocin plus chlorhexidine gluconate (CHG) bathing for ICU patients. This practice is known to prevent methicillin-resistant Staphylococcus aureus (MRSA) infections and all-cause. bloodstream infections. This practice has been broadly adopted in ICUs in the US, but adoption of mupirocin as a universal topical antibiotic has been slowed by concerns for engendering mupirocin resistance.
This cluster-randomized trial in adult ICUs was conducted to assess whether universal nasal antiseptic povidone-iodine (iodophor), to which minimal S. aureus resistance is expected, was an acceptable alternative to universal nasal mupirocin for reducing S. aureus and MRSA clinical cultures in the setting of daily CHG bathing. Those who received chlorhexidine (CHG) bathing with mupirocin had an 18% reduction in risk of Staphylococcus aureus clinical cultures and a 15% reduction in risk of methicillin-resistant 
Lone Star Tick Nymph-CDC image[/caption]
MedicalResearch.com: What is the background for this study? Would you briefly describe Alpha-gal Syndrome?
Response: Alpha-gal syndrome is an emerging and potentially life-threatening allergic condition that is associated with a tick bite. It is also called alpha-gal allergy, red meat allergy, or tick bite meat allergy.
Increasing case studies and anecdotal reports suggested that AGS was a growing concern, but, prior to these studies, information on clinician awareness and the number of people impacted was not available at a national level.
Dr. O'Donnell[/caption]
Julie O’Donnell, PhD MPH
Division of Overdose Prevention
National Center for Injury Prevention and Control
CDC
National Network of Public Health Institutes
New Orleans, Louisiana
MedicalResearch.com: What is the background for this study?
Response: The estimated number of drug overdose deaths in the US surpassed 100,000 over a 12-month period for the first time during May 2020-April 2021, driven by the involvement of synthetic opioids other than methadone (mainly illicitly manufactured fentanyl (IMF)), according to data from the National Vital Statistics System.
The State Unintentional Drug Overdose Reporting System (SUDORS) is a CDC-funded surveillance program that has collected detailed data on unintentional and undetermined intent drug overdose deaths since 2016 from death certificates, medical examiner and coroner reports, and full postmortem toxicology reports. SUDORS data allow for the analysis specifically of deaths involving fentanyl (rather than the larger category of synthetic opioids), and contain information about decedent demographics and other characteristics, as well as circumstances surrounding the overdose that might help inform prevention.
Dr. Budnitz[/caption]
Dr. Daniel S. Budnitz MD MPH CAPT, USPHS
Division of Healthcare Quality Promotion
Director, Centers for Disease Control and Prevention’s Medication Safety Program
Atlanta, Georgia
MedicalResearch.com: What is the background for this study?
Response: Medications are generally safe when used as prescribed or as directed on the label, but there can be risks in taking any medication. Adverse drug events are harms resulting from the use of medication.
The risk of adverse drug events is highest among older adults and very young children. Older adults have higher risks because they typically take more medications and are more likely to have underlying medical conditions. Very young children have higher risks because they often find and ingest medications meant for others.
Previous studies of medication safety have focused on harm from medications when taken for therapeutic reasons. Separate studies have focused on harm from specific types of non-therapeutic use (taking medications for recreational use or self-harm). This study examined the number of emergency department (ED) visits that resulted when people who took medications for any reason – as directed by a clinician or for other reasons, including recreational use or intentional self-harm.
Dr. Jacob[/caption]
Jesse T. Jacob, MD
School of Medicine
Director, Antibiotic Stewardship Program
Emory University, Atlanta, Georgia
MedicalResearch.com: What is the background for this study?
Response: Since coronavirus disease 2019 (COVID-19) was recognized in the United States in January 2020, the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attributed to exposures in the health care workplace has been studied with conflicting results, and the role of job functions (such as nurse) or specific workplace activities, including care for individuals with known and unknown SARS-CoV-2 positivity, increase the risk of SARS-CoV-2 infection.
We assessed more than 24,000 healthcare providers between April and August 2020 across four large academic medical systems (Emory, Johns Hopkins, Rush University Medical Center, and University of Maryland) which collaborate in the CDC’s Prevention Epicenter Program and conduct innovative infection prevention research. Each site conducted voluntary COVID-19 antibody testing on its health care workers, as well as offered a questionnaire/survey on the employees’ occupational activities and possible exposures to individuals with COVID-19 infection both inside and outside the workplace. We also looked at three-digit residential zip-code prefixes to determine COVID-19 prevalence in communities. 
Kathryn M. Edwards, M.D.
Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics
Professor of Pediatrics
Vanderbilt University School of Medicine
Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year. This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age. The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received. The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted. Overall 15, 333 children had their immunization records reviewed.
When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered.
First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage. Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%).
There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates. In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine.