Vaccination Of Close Contacts Research Articles

Human monkeypox infection threat: A comprehensive overview.

In addition to the COVID-19 waves, the globe is recently facing global monkeypox (MPX) outbreak. As the daily confirmed cases of MPX infection across epidemic and nonepidemic countries are increasing, taking measures to control global pandemic remains crucial. Therefore, this review aimed to provide fundamental knowledge for the prevention and control of future outbreaks of this emerging epidemic. The review was conducted using PubMed and Google Scholar databases; the search terms used were "monkeypox," "MPX tropism," "replication signaling of MPX," "biology and pathogenicity of MPX," "diagnosis of MPX," "treatment of MPX," "prevention of MPX," etc. The update epidemic data were collected from the websites of the World Health Organization (WHO), United States Centers for Disease Control and Prevention (CDC), and Africa Center for Disease Control and Prevention (ADCC). High-quality research results published in authoritative journals were summarized and preferred cited. Excluding all duplicates, non-English published references, and irrelevant literature, totally 1,436 articles were assessed for eligibility. It is still difficult to diagnose the patient as MPX simply based on clinical manifestations; therefore, under this situation, employing polymerase chain reaction (PCR) technology to provide confirmed evidence for the diagnosis of MPX seems to be the preferred and indispensable strategy. The treatment approach for MPX infection is mainly symptomatic and supportive; anti-smallpox virus drugs including tecovirimat, cidofovir, and brincidofovir can be employed in severe cases. Timely identification and isolation of confirmed cases, cutting off dissemination routes, and vaccination of close contacts are effective measures to control MPX. Also, smallpox vaccines (JYNNEOS, LC16m8, and ACAM2000) can be under consideration due to their immunological cross-protection among Orthopoxvirus. Nevertheless, given the low quality and scarcity of relevant evidence of current antiviral drugs and vaccines, deeply seeking for the MAPK/ERK, PAK-1, PI3K/Akt signaling, and other pathways involved in MPX invasion may provide potential targets for the treatment, prevention, and control of the epidemic. In response to the current MPX epidemic, the development of vaccines and antiviral drugs against MPX, as well as the rapid and precise diagnostic methods are still urgently needed. Sound monitoring and detection systems should be established to limit the rapid spread of MPX worldwide.

Planning for Mpox on a College Campus: A Model-Based Decision-Support Tool.

In spring and summer 2022, an outbreak of mpox occurred worldwide, largely confined to men who have sex with men (MSM). There was concern that mpox could break swiftly into congregate settings and populations with high levels of regular frequent physical contact, like university campus communities. To estimate the likelihood of an mpox outbreak and the potential effect of mitigation measures in a residential college setting. A stochastic dynamic SEIR (susceptible, exposed but not infectious, infectious, or recovered) model of mpox transmission in a study population was developed, composed of: a high-risk group representative of the population of MSM with a basic reproductive number (R 0) of 2.4 and a low-risk group with an R 0 of 0.8. Base input assumptions included an incubation time of 7.6 days and time to recovery of 21 days. U.S. residential college campus. Hypothetical cohort of 6500 students. Isolation, quarantine, and vaccination of close contacts. Proportion of 1000 simulations producing sustained transmission; mean cases given sustained transmission; maximum students isolated, quarantined, and vaccinated. All projections are estimated over a planning horizon of 100 days. Without mitigation measures, the model estimated an 83% likelihood of sustained transmission, leading to an average of 183 cases. With detection and isolation of 20%, 50%, and 80% of cases, the average infections would fall to 117, 37, and 8, respectively. Reactive vaccination of contacts of detected cases (assuming 50% detection and isolation) reduced mean cases from 37 to 17, assuming 20 vaccinated contacts per detected case. Preemptive vaccination of 50% of the high-risk population before outbreak reduced cases from 37 to 14, assuming 50% detection and isolation. A model is a stylized portrayal of behavior and transmission on a university campus. Based on our current understanding of mpox epidemiology among MSM in the United States, this model-based analysis suggests that future outbreaks of mpox on college campuses may be controlled with timely detection and isolation of symptomatic cases. National Institutes of Health National Institute on Drug Abuse and National Institute of Allergy and Infectious Diseases.

Characteristics of and prevention/control measures against the worldwide outbreak of human monkeypox 2022

Human monkeypox (hMPX) is a smallpox-like disease caused by the monkeypox virus (MPXV) that belongs to the genus of Orthopoxvirus, in the family of Poxviridae. The natural hosts of MPXV are species of rodents, which are found in habitats in Central and Western Africa. Sporadic cases of patients with hMPX have been identified in central Africa since the discovery of the first cases in the early 1970s in the Democratic Republic of the Congo (DRC) and Western African countries. Since May 2022 (and up to the end of October 2022), more than 75,000 patients with hMPX have been reported, mainly in European and American countries. In the current outbreak, MPXV is transmitted from human to human, through close sexual contact, especially among men who have sex with men (MSM). Safe and effective third-generation smallpox vaccines, namely, LC16m8 and modified vaccinia virus Ankara (MVA), are effective in protecting vaccinees from hMPX. It is highly possible that immediate vaccination of close contacts with MVA or LC16m8, before disease onset, may be effective in reducing the severity of hMPX if infected. A proper vaccination program would reduce the scale of the current hMPX outbreak. Furthermore, hMPX in endemic areas should be prevented through mass vaccination programs with third-generation vaccines for those living in these regions. Notably, the current hMPX outbreak is mainly associated with community-specific MSM circumstances. Special consideration should be given to patients with hMPX, who must be protected from societal discrimination.

Impact of a nurse-led enhanced monitoring, management and contact tracing intervention for chronic hepatitis B in England, 2015-2017.

Around 200,000 people live with chronic hepatitis B in England. Despite national guidance on identification and management of cases and their close contacts, testing rates of close contacts is as low as 43% in high prevalence areas of London. Our study aimed to determine whether a nurse-led enhanced management and contact tracing of chronically infected individuals improved testing uptake, vaccination and onward referral of close contacts. The study was conducted across Greater Manchester and East of England regions between October 2015 and July 2017. All HBV chronically infected individuals registered with a GP and their close contacts were eligible for recruitment. The proportion of contacts who were tested, vaccinated and referred where appropriate were compared before and after the nurse-led intervention. Baseline and outcome information was collected using questionnaires. The intervention improved case referral rates by an additional 14% (from 86% (88/102 cases) to 99.7%; 648/650 cases). The proportion of contacts tested increased from 34% to 72%-94% with 18 new cases of HBV diagnosed. Amongst close contacts tested, vaccination rates of at least three doses increased from 77% (43/56) to 93% (452/491) during the study. Our study has shown that nurse-led enhanced management greatly improves identification, testing and vaccination of close contacts. The identification of new acute and chronic cases is likely to make the intervention cost effective and local health commissioners should consider providing a nurse-led service as part of hepatitis B care pathways.

2746. Effectiveness of Influenza Vaccine for Prevention of Influenza-associated Hospitalizations Among Immunocompromised Adults—2017–2018

BackgroundImmunocompromised (IC) individuals are at higher risk for severe complications of influenza. Little literature describes vaccine effectiveness (VE) in this population. We evaluated VE for prevention of influenza-associated hospitalization among IC adults.MethodsWe analyzed data from adults hospitalized with acute respiratory illness (ARI) during the 2017–2018 FLU season at 9 hospitals participating in the US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) study. Details of disease severity, underlying health status, and vaccination status were obtained through enrollment interviews and medical records. Prior year clinical encounter diagnoses and enrollment interviews were used to define IC groups. IC groups were mutually exclusive. VE was evaluated with a test-negative case–control design using multivariate logistic regression with PCR-confirmed influenza as the outcome and vaccination status as the exposure, adjusting for age, race, and other factors, and stratifying by immunocompromising conditions.ResultsOf 3524 adults hospitalized with ARI, 1210 (34%) had an immunocompromising condition. Chronic steroid (n = 397), chemo/radiation therapy (n = 242), hematologic condition (n = 175), and organ transplant (n = 144) were most common. HIV (n = 45) and stem cell transplant (SCT) (n = 28) were least common. IC patients were more likely to be vaccinated than non-IC (60% vs. 55%, P = 0.002). Overall, vaccination reduced risk of influenza hospitalization by 36% (95% CI: 24,46). Among IC adults, VE was 9% (95% CI: −25,34). VE was 32% (95% CI: 5,51) for chemo/radiation therapy, 29% (95% CI: 6,47) for chronic steroids, 29% (95% CI: -6,52) for hematologic conditions, −1% (95% CI: −50,32) for organ transplant, −48% (95% CI: −190,25) for HIV, and −154% (95% CI = −458,−15) for SCT (Figure 1).ConclusionVaccination reduced risk of influenza hospitalization among adults with the most prevalent immunocompromising conditions in our cohort; however, it had little to no effect in other groups, such as in HIV and organ and stem cell transplant recipients. Results support using other preventative strategies in addition to vaccinating adults with immunocompromising conditions, such as vaccination of close contacts. Disclosures All authors: No reported disclosures.

997. Protection of Unvaccinated Individuals by Influenza Vaccine Coverage of Household Contacts

BackgroundThe evidence that influenza vaccination programs provide some protection to unvaccinated members of a community (i.e., indirect effects) is lacking. We sought to determine the indirect effects of influenza vaccine in prospective cohort study of households with children.MethodsWe used longitudinal data over six influenza seasons from the Household Influenza Vaccine Evaluation (HIVE) study. We categorized households each season based on the proportion of members who received a seasonal influenza vaccination: unvaccinated (0%), low coverage (1–50%), moderate coverage (50–99%), and fully vaccinated (100%). We used mixed-effect Poisson regression models adjusted for age group and sex with random effects to account for household clustering and repeated measures. We estimated the association between the proportion of vaccinated household members and the incidence of influenza virus infection in the entire cohort. We then estimated the indirect effects of influenza vaccination by comparing unvaccinated members of households with low levels of vaccination to unvaccinated members of households with higher levels of vaccination.ResultsDuring 7,286 person-seasons of follow-up, we detected 578 cases (8 per 100/season) of influenza virus infection. The seasonal incidence rate was highest in completely unvaccinated households (10 per 100/seasons) and lower at all other levels of vaccine coverage (Figure 1). Individuals in fully vaccinated households had a 29% lower seasonal incidence rate of influenza infection compare to those in unvaccinated households (IRR 0.72, 95% CI 0.56–0.93). The estimated indirect VE comparing unvaccinated individuals in completely unvaccinated households to those in households with moderate vaccine coverage was 40 % (95% CI −4 to 65).ConclusionWe demonstrate that vaccination of close contacts can reduce incidence of influenza in unvaccinated members of a community. Despite insufficient evidence, guidance from public health authorities currently suggests that vaccination protects close contacts. Our findings quantifying the protective effects of seasonal influenza vaccination of household contacts in unvaccinated individuals can provide clearer evidence for global vaccine recommendations. Disclosures All authors: No reported disclosures.

Influenza vaccination in older people with diabetes and their household contacts

BackgroundPeople with diabetes are at a higher risk of influenza infections and severe complications. The vaccination of close contacts could offer indirect protection to people with diabetes; this is known as “herd immunity.” The aim of this study is to investigate the vaccination rates of people with diabetes and their household contacts in Hong Kong. Research design and methodsFace-to-face interviews with 158 patients diagnosed with Type 2 diabetes and aged ⩾65years were conducted in clinics. Telephone interviews were then conducted with 281 adult household contacts. ResultsSeasonal influenza vaccination rates were 54.5% and 27.4%, in people with diabetes and their contacts, respectively. The vaccination status of patients was not significantly associated with the vaccination of their household contacts (p=0.073). Among household contacts, children or the elderly, the partners or couples of patients, and those with more hours of daily contact, or with chronic conditions, were associated with higher vaccination rates. However, only age remained significant after adjusting for confounding factors in logistic regression models. ConclusionsThe low vaccination rates of people with diabetes and their close contacts highlight the need to promote vaccination in susceptible populations and to educate the public about herd immunity.

Reasons for adult immunization -- prevention of most frequent respiratory infections

The adult vaccination is utilized insufficiently as a preventive method currently, even the incidence and mortality of vaccine-preventable infections is very high in the elderly and patients with immunocompromised conditions. They should be protected due to many reasons: the rate of these individuals are getting higher in the population, the effectiveness of antibiotic therapy is limited and becoming more significant due to antibiotic resistance, the quality of life in survivors of severe infections is deteriorated, resulting huge burden to the individual and society as well. The impaired functions of immune system with the advancing age cause higher morbidity and mortality especially in respiratory infections, it is representing in the incidence and high lethality of community acquired pneumonia in older adults. Beyond the old polysaccharide vaccine (PPV23) the inclusion of new conjugate vaccine (PCV13) means a significant improvement in the prevention of pneumococcal infections, providing a possibility to prevent not just pneumococcal infections with bacteraemia caused by serotypes presented in the vaccine, but non-bacteraemic pneumonias as well. The necessity of flu vaccines cannot be stressed enough even the vaccines is not so effective in elderly than in younger adults: annual immunization against influenza administering together with pneumococcal vaccination decrease significantly the number, severity and complications in older adults as well. Further improvement in protection of immunocompromised patients is the establishment of cocoon immunity with the vaccination of close contacts.

Neonatal pertussis, cocooning and maternal immunization

The rising incidence of whooping cough, a highly contagious infection caused by Bordetella pertussis, is particularly significant for young infants who have the highest risk for morbidity and mortality. The pertussis resurgence has led to a shift in primary prevention relying on childhood vaccination to a cocooning strategy, that is, vaccination of close contacts of newborn infants (new mothers, fathers, grandparents, siblings, caretakers, etc.), thereby reducing pertussis exposure. Immunization of women during pregnancy rather than during the immediate postpartum period (the initial cocooning recommendation) appears to be a better approach by directly providing protection through transplacental transfer of maternal vaccine-induced antibodies. This article describes neonatal pertussis, cocooning as a means of reducing neonatal exposure to pertussis and maternal immunization as a means of protecting young infants against pertussis infection.

Management of secondary immune deficiencies

Management of secondary immune deficiencies

Should we be doing more to prevent Group C meningococcal infection in school age children? How can we decide?

Meningococcal Group C infections are potentially preventable by vaccination in most cases. Population immunization has not been adopted because the disease is rare and the vaccine effective for only about three years. However, the recent rise in cases in school age children has prompted an assessment of the cost-effectiveness of alternative strategies for management of a case of Group C infection. Chemoprophylaxis and vaccination of close contacts is the most cost-effective strategy but will prevent relatively few cases. Population vaccination prevents considerably more cases, but at a much higher total and marginal cost. An intermediate strategy of giving antibiotics to and vaccinating the school population following a single case, in addition to contact tracing, has intermediate cost-effectiveness. Policy decisions will take into account other important factors but the approach we have taken makes explicit key assumptions so that wider debate including profession and public can be developed.