Day: July 3, 2024

Cases of tuberculosis (TB) — an illness that kills more people than any other infectious disease — rose in the U.S. during 2022, per the Centers for Disease Control and Prevention (CDC). And some doctors are concerned that limitations of testing at the border could be partly to blame for the surge. In 2021, the disease infected nearly 11 million people and caused 1.6 million deaths worldwide, according to the World Health Organization (WHO). Tuberculosis is a highly contagious disease caused by a bacterial infection. It primarily affects the lungs, but can also affect the brain, kidneys and spine. Required testing may have limitations: CDC The CDC states that all refugees ages two and older must be tested for tuberculosis before entering the U.S. TEXAS CITY REPORTS SYPHILIS OUTBREAK AMID ‘LIMITED SUPPLY’ OF PENICILLIN DRUG “By law, refugees diagnosed with an inadmissible condition are not permitted to depart for the United States until the condition has been treated,” the agency states on its website. Some doctors are concerned that limitations of testing at the border could be partly to blame for the rise in tuberculosis cases. (iStock) The CDC uses its Electronic Disease Notification (EDN) system to notify federal, state and local health departments of any immigrants and refugees who are found to have medical conditions that require follow-up. There are limitations to that process, however. “By design, the EDN system only collects information for the approximately 10% of immigrants who have an overseas medical classification,” explained Neha Sood, health communication specialist for the CDC in Atlanta, Georgia, in a statement to Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor. “Human error likely caused some losses, resulting in possible underestimates of immigrants with medical classifications.” “Thus, DHS [Department of Homeland Security] data were used to approximate the immigrant denominators.” There is also some degree of human error that comes into play, Sood added. “Because data transfer for immigrants during the study period primarily relied on staff at ports of entry to correctly review, retain and route paper forms for each immigrant with a medical classification, human error likely caused some losses, resulting in possible underestimates of immigrants with medical classifications,” she said. DENGUE FEVER CASES COULD REACH NEAR-RECORD HIGHS THIS YEAR: WHAT TO KNOW ABOUT THE TROPICAL INFECTIOUS DISEASE While health departments are “encouraged and provided incentives” to share the results of immigrants’ testing with the CDC, Sood said there is always the chance of “underreporting.” She added, “The proportion of immigrants, refugees and eligible others who completed a post-arrival examination might be higher than indicated in this report.” Although the CDC has “comprehensive surveillance systems” to track communicable diseases within the U.S., the agency does not track diseases by immigration status, Sood explained. Tuberculosis is a highly contagious disease that primarily affects the lungs, but can also affect the brain, kidneys and spine. (Spencer Platt/Getty Images) Linda Yancey, M.D., a specialist in infectious disease who is affiliated with Memorial Hermann Health System in Houston, Texas, said she regularly sees people who have screened positive for the disease and need treatment to prevent developing symptomatic illness. “Tuberculosis is quite common in Texas, especially in the big cities,” she told Fox News Digital. “Houston is an international port of entry, so we get people from TB-endemic areas coming here frequently.” Most of the imported tuberculosis cases seen at Memorial Hermann are among people coming from Africa and the Indian subcontinent, Yancey said. “People can be exposed to TB years before they become contagious.” <!–> “This is why immigrants coming into the U.S. are screened at the time of entry,” she said. “People can be exposed to TB years before they become contagious,” she went on. “By doing early screening, we are able to treat people long before they develop severe pneumonia.” WHY ANTIBIOTICS MAY NOT HELP PATIENTS SURVIVE THEIR VIRAL INFECTIONS: NEW RESEARCH Immigrants who have positive screenings are given three to four months of pills to protect their TB from developing into an illness, Yancey said. In a 2022 study by the University of Texas, researchers analyzed patterns in tuberculosis patients who had been diagnosed when crossing into the U.S. from the Mexican state of Tamaulipas, which serves as a “migration waypoint.” A diagnosis of tuberculosis can be made via a skin test or a blood test. (iStock) The study, which was published in the Journal of Immigrant and Minority Health, found that an average of 30% of immigrants screened positive for tuberculosis over an eight-year period. Immigrants with tuberculosis may be less likely to get successful treatment due to various factors, the study authors also wrote in a discussion of their findings. The barriers to treatment that were cited included mobile living conditions, economic constraints, fear of deportation and the policy of the host country to provide free TB therapies. Drug-resistant tuberculosis poses treatment challenge Another concern is the type of TB that potentially could be coming into the U.S. James Hodges, M.D., an internist in Waco, Texas, is concerned that immigrants are bringing in a drug-resistant strain of the disease. “Immigrants who are positive for tuberculosis are more likely to have a drug-resistant type.” –> “I have found that immigrants who are positive for TB are more likely to have a drug-resistant type,” he told Siegel. “This is likely due to the over-the-counter meds and antibiotics that are available in Mexico and other central and South American countries — these patients have incompletely treated coughs on their own,” Hodges continued. “This is becoming more common with the last two years of an open border,” Dr. Hodges of Waco, Texas, said of drug-resistant tuberculosis cases entering the United States of America. (iStock) “This is becoming more common with the last two years of an open border.” Tuberculosis treatments need to be “specialized, complex regimens,” Dr. Siegel explained. “Here in the U.S., we use INH, Rifampin, PZA, Ethambutol and others. If you use an over-the-counter antibiotic that only partially

New findings to be presented at AACC 2023 Annual Scientific Meeting ANAHEIM, Calif., July 25, 2023 /PRNewswire/ — Today, at the 2023 AACC Annual Scientific Meeting & Clinical Lab Expo, scientists will present new data about rates of co-infections with SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) in the United States, providing one of the first snapshots of the interplay among these common but potentially deadly viruses. Their work could lead to better diagnosis and patient management for all three illnesses. The research, which garnered results from more than 26,000 respiratory tests of U.S. adults and children in late 2022, found co-infections in more than 1% of positive samples. Co-infections were especially widespread among those under the age of 21. The findings could have implications for how clinicians approach respiratory disease testing during future epidemics and seasonal outbreaks. “With changing behaviors as the COVID pandemic began to recede, we felt it was important to investigate the resurgence of other respiratory viruses and potential incidents of co-infection, especially with the additional circulation of SARS-CoV-2,” said lead scientist George Pratt, PhD, at Quest Diagnostics in Marlborough, Massachusetts. Household respiratory viruses such as RSV pose major burdens on public health systems. Co-infections tend to occur when there are multiple outbreaks of respiratory diseases, such as in winter during flu season. Patients with multiple infections have a higher risk of severe disease and treatment complications, making it critical to understand how common co-infections are in the general population. Co-infections can be especially problematic during an epidemic. For example, in late 2022, there was a spike in cases of RSV in the United States, which coincided with the ongoing spread of COVID-19 and the appearance of seasonal influenza. But researchers have lacked the data to define rates of co-infections during this outbreak of RSV, which until recently had no vaccine. Now, Pratt and colleagues present one of the first wide-ranging studies of co-infection rates in the U.S. during the COVID-19 pandemic. In a retrospective study, they analyzed 26,657 respiratory tests from a clinical laboratory, gathered during a 107-day period in autumn of 2022. These tests included 9,800 samples from pediatric patients under the age of 21. The scientists tested the samples for RSV, SARS-CoV-2, and influenza A/B with the Roche cobas® and Cepheid Xpert® platforms. “The most novel part of our research is the large sample size of results we had available as a part of co-testing in the Northeast,” Pratt said. “Being able to look at over 26,000 test results was a great asset for our study.” Overall, the tests revealed that co-infections with two or more of the viruses occurred in 1.33% of positive results and in .55% of the studied samples. The positivity rates varied by the viruses involved, ranging from .38% in adults for both SARS-CoV-2 and RSV to 2.28% in adults for both influenza A and SARS-CoV-2. However, co-infection rates in the pediatric group were higher than in the adult population for all three viruses. Pratt noted that his team was surprised by the very high 6% co-infection rate of SARS-CoV-2 and influenza A in those under 21, which he said matched what was previously observed by the Centers for Disease Control and Prevention in hospitalized pediatric patients. “As we experience more flu-seasons and future epidemics of respiratory viruses, we’ll be able to acquire more co-infection rate data,” Pratt said. “Our current work would make a useful data point to help evaluate whether future co-infection rates are shrinking or growing,” he added. About the 2023 AACC Annual Scientific Meeting & Clinical Lab ExpoThe 2023 AACC Annual Scientific Meeting offers 5 days packed with opportunities to learn about exciting science from July 23-27 in Anaheim, California. Plenary sessions will explore microbiome-directed therapies for undernutrition, big data for practicing precision medicine, healthcare equity, cardiovascular disease in women, and promising sickle cell disease treatments. At the Clinical Lab Expo, more than 900 exhibitors will fill the show floor of the Anaheim Convention Center in Anaheim, California, with displays of the latest diagnostic technology, including but not limited to COVID-19 testing, artificial intelligence, point-of-care, and automation. About the Association for Diagnostics & Laboratory Medicine (ADLM) Dedicated to achieving better health through laboratory medicine, ADLM (formerly AACC) brings together more than 70,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, ADLM has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.myadlm.org. CONTACT: Bill MaloneAACCDirector, Communications & News Publications(p) 202.835.8756[email protected] Molly PolenAACCSenior Director, Communications & PR(p) 202.420.7612(c) 703.598.0472[email protected] SOURCE ADLM