Category: Infection

MEMPHIS, Tenn. – Shelby County has moved to No. 2 nationally in the number of HIV infections, Shelby County Commissioners were told today during a monthly committee meeting. In response, the Shelby County Health Department presented a resolution that, if passed by the full body, would fund $845,000 for new 13 staff positions. Commissioners voted favorably to advance the resolution, which is federally funded through the state of Tennessee Health Department. Dr. Michelle Taylor, Shelby County Health Department director, said additional staff would help fill in gaps in staffing, to make locations a “one-stop shop.” Their work, including contact tracing, would go toward “curbing the rate of sexually transmitted infections,” she said. Commissioners asked Taylor what success looks like in terms of tracking data. Taylor responded that the department looks at effective models at other health departments and implements those strategies. Health Department employees provide STD health services both in the clinic offices and in one-one one outreach and working with community partners like churches for awareness campaigns, she said. Taylor described the staff as “disease investigators,” getting out into the communities where data reveals problem trends. “We look at numbers – in different zip codes – then we do educational outreach,” Taylor said, adding that workers particularly reach out to help pregnant women who have tested positive for infections. “With new positions we will be able to reach every corner of the county,” eventually, Taylor said. Download the FOX13 Memphis app to receive alerts from breaking news in your neighborhood. CLICK HERE TO DOWNLOAD Trending stories:

A mystery disease which has killed up to 17 people in Uganda has been confirmed as anthrax, health officials said. The outbreak striking Kyotera district has seen infected patients suffer rashes and swollen limbs before dying. As many as 40 are thought to have fallen ill in recent weeks. Africa Centres for Disease Control and Prevention (Africa CDC) earlier this week said anthrax had been ruled out, but local officials have now said tests found the bacterial infection typically infecting cows, sheep, and goats. A number of cattle have also died during the outbreak and victims are thought to have caught the infection by eating contaminated meat. Dr Edward Muwanga, Kyotera’s district health officer, told the Telegraph: “The disease has been confirmed as anthrax. So we now know what we’re dealing with. “People started falling ill in October and we think they contracted the anthrax from eating carcasses of dead cows because 25 cattle have died of the disease in this area.” Local media have put the death toll at up to 17. Dr Muwanga said it was at least 12. He said patients were stricken with blisters, fevers, and a swelling of limbs before dying. Flu-like symptoms, followed by black boils Pontiano Kalebu, the executive director of Uganda Virus Research Institute (UVRI) also said the mysterious disease had been confirmed in laboratory tests in Entebbe as anthrax. “Yes, tests were carried out here and anthrax was confirmed from the samples,” he said. Anthrax is caused by a spore-forming bacterium called Bacillus anthracis that typically affects ruminants such as cows, sheep, and goats. The bacteria produce extremely potent toxins which are responsible for the symptoms, causing a high lethality rate. Cattle and sheep can die quickly, but leave carcasses showing little sign of infection. In humans, symptoms begin with a flu-like illness, followed by respiratory difficulties. Direct contact with anthrax can cause raised boil-like lesions on the skin which develop a black centre. If you inhale anthrax spores, they can cause damage to the lungs, which is often fatal. The outbreak has caused alarm in the district. Ben Karyabwite, 34, a grocery shop owner near Kyotera town said he was worried for himself, his wife and two daughters. He said: “We have been hearing of people dying of a mysterious disease that attacks them and causes rashes on their bodies. “Because we were being told that no cure has been found for this disease, it really terrified me. I had told my wife to minimise all movement … to reduce chances of catching the disease. “Even me, I stopped socialising with friends or attending crowded places.” International and local health bodies are scaling up disease surveillance to spot new infections and outbreaks in Africa. The continent’s poor healthcare systems and its exposure to deadly pathogens that jump from animals to humans, such as Ebola and Marburg viruses, have made it a focus on pandemic prevention. Protect yourself and your family by learning more about Global Health Security

In 1897, a massive outbreak of Sekiri, or “red diarrhoea”, in Japan killed more than 20,000 people within six months. Epidemics of dysentery were common in 19th Century Japan and elsewhere, but had been documented since biblical times, with the Ancient Greek physician Hippocrates coining the term dysentery (bowel trouble) to describe the cramping rectal pain and bloody, mucus-containing diarrhoea it provoked. Shigella still causes between 28,000 and 64,000 deaths among children in lower-income countries every year. With a fatality rate of more than 20%, the fear provoked by such outbreaks was palpable. The Japanese bacteriologist Dr Kiyoshi Shiga described dysentery as “the most dreaded disease of children” due to its sudden and severe onset and high risk of death. But the 1897 outbreak marked a turning point in the centuries-old battle against this scourge. Drawing on the latest scientific techniques, Shiga managed to isolate and identify the causative micro-organism from the faeces of affected patients – bacteria we now know as Shigella. Today, antibiotics and improved sanitation have dramatically reduced the frequency of such bacillary (bacterial) dysentery, but Shigella still causes between 28,000 and 64,000 deaths among children in lower-income countries every year. In places where clean water and sanitation are lacking, repeated infections can also lead to stunted growth and impaired brain development, which could have a lasting impact on children’s long-term health and productivity. Scientists have been trying to develop vaccines against Shigella for more than 100 years. But with several candidates now in phase 2 and 3 trials, hope is mounting that an effective vaccine may finally be within reach. What is Shigellosis? Shigella belongs to a large family of bacteria called Enterobacteriaceae and is closely related to Escherichia coli. There are four main types: S. dysenteriae, S. boydii, S. flexneri and S. sonnei, each of which have multiple strains. They are spread through dirty hands, food or water contaminated by human faeces, or contaminated flies landing on food. Fewer than a hundred bacteria are needed to trigger an infection, which makes shigellosis – a variety of dysentery – extremely contagious, and people can continue to spread the bacteria for several weeks after they have recovered. Shigella is a major cause of moderate to severe diarrhoea worldwide, responsible for an estimated 80–165 million cases each year, mostly in low or middle-income countries (LMICs). It is also a major cause of diarrhoea among travellers and military personnel visiting these countries. Symptoms can be mild, but include watery and/or bloody diarrhoea, fever, stomach pain and the urge to pass stool even when the bowels are empty. These typically start one to three days after infection and last for around seven days. Although many people get better with fluids and rest, severe infections are treated with antibiotics, making antimicrobial resistance (AMR) a growing problem. This could make treatment increasingly complex and expensive: a systematic review of travel-associated Shigella infections found that the percentage of drug resistant infections increased from 19% in 1990–1999 to 65% in 2000–2009. A Shigella vaccine would help to counter this problem by reducing countries’ reliance on antibiotics to treat such infections; overuse of antibiotics is a major driver of AMR. We also have growing amounts of evidence linking Shigella to stunting and long-term disability, meaning a vaccine could bring potentially considerable economic and societal benefits in the long-term. Vaccine development The World Health Organization (WHO) has listed Shigella as a priority pathogen for the development of new vaccines, but despite decades of research, there is currently no widely licensed vaccine available. One issue has been the lack of a commercial incentive to develop such vaccines, as shigellosis predominantly affects LMICs that don’t necessarily have the money to fund the necessary research and development, or to commit to purchasing doses in advance. This market failure is a key reason why Gavi, the Vaccine Alliance, was established. Have you read? Another challenge has been that with approximately 50 different strains of Shigella in circulation, a vaccine against just one of them is unlikely to solve the problem, because people can be reinfected with a different strain. The development of multivalent vaccines – ones targeting multiple types and strains of Shigella – is therefore a priority. Researchers have estimated that a vaccine with antigens from S. sonnei, plus three strains of S. flexneri, could cover up to 75% of global strains – and perhaps as many as 93% – due to cross-reactivity between vaccine-generated antibodies and antigens from other related strains of Shigella. Vaccine candidates There are currently nine Shigella vaccine candidates in clinical trials. These include five protein or polysaccharide-based vaccines, which are designed to be injected into muscle, plus four oral vaccines that are based on either live attenuated (weakened) or inactivated (killed) bacteria. Some of these vaccines are designed to prevent other infections, such as enterotoxigenic E. Coli (ETEC) – a major cause of diarrhoeal disease and travellers’ diarrhoea in lower-income countries – as well as shigellosis. Such combination vaccines could be particularly attractive in the context of increasingly crowded and expensive immunisation schedules, as countries seek to weigh competing health priorities. Of particular interest are vaccine candidates being developed by GSK and a Swiss company called LimmaTech Biologics, both of which are currently in Phase 2 trials, and contain antigens from S. sonnei and plus three strains of S. flexneri. They are designed to be given as two or three doses. Otherwise the pipeline of vaccines is still very young, and a vaccine against Shigella is unlikely to be widely available until the early 2030s. However after almost a century of research, an effective vaccine against a leading cause of diarrhoeal deaths in children is within reach. Not only could such vaccines save millions of lives, but they could also help to counter the growing problem of antimicrobial resistance and a major cause of stunting in young children.

Key Takeaways Most people are potentially infectious with COVID-19 for 10 days. People are typically the most infectious the first five days after they are diagnosed. Antibodies to the virus can last for months after infection or vaccination. Emergency room visits for COVID-19 are increasing across the country, suggesting that cases of the virus are also on the rise. If you happen to contract COVID-19, it’s understandable to wonder how long COVID stays in your system, both in terms of infectiousness and protective antibodies. As with every illness, there is a range. But as a rule of thumb, here’s what you should know. How Long Are You Infectious? There is some variability in how long you’re infectious with COVID-19, Thomas Russo, MD, a professor and chief of infectious diseases at the University at Buffalo in New York, told Verywell. “Most people no longer have detectable infectious particles by day 10, but it can vary,” he said. The Centers for Disease Control and Prevention (CDC) has isolation information for people with COVID-19 that notes that patients are most likely infectious during the first five days after they test positive for COVID-19. However, the CDC’s recommendations also suggest that people wear a mask for up to 10 days after testing positive to avoid getting others sick. The CDC also said online that people who have severe COVID-19 may be infectious beyond 10 days and may need to isolate for up to 20 days. “If you’re immunocompromised, you could potentially be infectious for a much longer period of time—20 days vs. 10 days, as well,” Russo said. “Children tend to test positive longer,” William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, told Verywell. How Long Do You Shed COVID-19? Viral shedding is a term used to describe how long a virus is still detected in your body after you get sick, Schaffner explained. When you “shed” a virus, you may be able to infect others. “Over time, the amount of virus you shed diminishes,” Schaffner said. Not all viral shedding will make someone else sick, especially if you shed at low levels. It’s unclear how viral shedding has changed during the pandemic, but there is data on how long it may last now. One study published in 2022 in the journal Emerging Infectious Diseases analyzed samples from patients who were infected with the Omicron variant between November 29 and December 18, 2021. (Subvariants of Omicron are currently circulating in the U.S.) The results showed patients shed the most virus between days two and five after their diagnosis. However, the researchers also noted that people with mild or asymptomatic COVID-19 cases still shed infectious virus six to nine days after they developed symptoms or were diagnosed, even when their symptoms stopped. “There are rare people who continue to shed virus for a more prolonged period of time—a month, for example,” Schaffner said. “But for all practical purposes, 10 days is a good rule.” How Long Do COVID-19 Antibodies Last? Data published in the journal The Lancet in February 2023 offers some insight on the duration of COVID antibodies—proteins made by the immune system in response to an infection or vaccination. For the study, researchers analyzed data from 65 studies from 19 countries and compared the risk of getting COVID-19 again in people who recently had the virus to those who hadn’t been infected. The researchers learned that having the Omicron variant of COVID-19 lowered the risk of being hospitalized and dying from a new infection by almost 89% for 10 months, thanks in part to protective antibodies left behind from infection. That duration of antibodies seems to have gotten stronger over the course of the pandemic. People who were previously infected with a variant other than Omicron were just 74% likely to be protected from getting infected again after a month. That number dropped to 36% after 10 months had passed since the initial infection. In the case of antibodies from vaccination, a study published in The New England Journal of Medicine found that most people receive at least six months of protection after getting the shot. “Measurable levels of antibodies do decrease over time,” Russo said. “The most durable protection is in people who have antibodies from vaccination and infection.” Factors such as age and individual immunity can also influence how long antibodies last in any given person, Schaffner said. “Older, frail people and those who are immunocompromised will have antibodies that wane more than a young person who is fit as a fiddle,” he said. “But this is not a black and white phenomenon.” What This Means For You Doctors say that most people with COVID-19 will no longer infect others after 10 days have passed since their diagnosis or start of symptoms. Many people are also protected from being reinfected with COVID-19 for six months. However, factors such as your individual immune system, your age, your health status, and the variant you were infected with, can all play a role. The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. COVID data tracker. Centers for Disease Control and Prevention. Isolation and precautions for people with COVID-19. Centers for Disease Control and Prevention. Ending isolation and precautions for people with COVID-19: interim guidance. Takahashi K, Ishikane M, Ujiie M, et al. Duration of infectious virus shedding by SARS-CoV-2 Omicron variant-infected vaccinees. Emerg Infect Dis. 2022;28(5):998-1001. doi:10.3201/eid2805.220197 COVID-19 Forecasting Team. Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis. Lancet. 2023;401(10379):833-842. doi:10.1016/S0140-6736(22)02465-5 Doria-Rose N, Suthar MS, Makowski M, et al. Antibody persistence through 6 months after

By George HerdBBC News Jones family Nesta Jones died more than a month after being admitted to hospital A hospital consultant was “duty bound” to rely on the conclusion of specialists that a patient’s knee was not infected, an inquest has heard. Nesta Jones, 77, died in Ysbyty Gwynedd in Bangor, Gwynedd, after developing pneumonia shortly after the infection was confirmed. Consultant Mahdi Jibani told the hearing in Caernarfon he suspected infection. But several orthopaedic doctors all said she did not have septic arthritis. Mrs Jones, a retired teacher from Valley, Anglesey, had a knee replacement in 2015, due to rheumatoid arthritis. Her family told the hearing they believe multiple opportunities were missed to diagnose the source of the infection. Mrs Jones was taken to Ysbyty Gwynedd in Bangor by ambulance on 31 March 2017 after being found seriously ill at home by her family GP. Mr Jibani told the inquest he had been in charge of her care when she was first admitted to the hospital’s Hebog ward. He told the coroner that tests showed she had a bacterial infection caused by the staphylococcus aureus bug, and he initially suspected the knee as the prime candidate for the location. He put Mrs Jones on antibiotics to treat it, and referred her case to the orthopaedic team. “Multiple other doctors suspected septic arthritis, but none of these are experts in that field,” Mr Jibani said. ‘Acute kidney injury’ “But others who are, including orthopaedic surgeons, gave us the opinion that it was not septic arthritis, and I am duty bound to respect that opinion.” Mrs Jones finally underwent a procedure on 3 May to draw fluid from her knee, which had a prosthetic replacement joint. Surgeons discovered pus in the knee, and consultant Mr Jibani told the inquest that it confirmed the presence of septic arthritis. Following the procedure to examine the knee, Mrs Jones developed pneumonia and her condition rapidly deteriorated. She died in May 2017, a month after being admitted to hospital Questioned by the legal team for the Betsi Cadwaladr University Health Board, Mr Jibani described Mrs Jones as a patient with complex health conditions, including heart disease and an acute kidney injury. “Looking back, it was never on the cards that she would recover,” he told the hearing. The inquest is continuing. BBC in other languages Copyright 2023 BBC. All rights reserved. The BBC is not responsible for the content of external sites. Read about our approach to external linking. Beta Terms By using the Beta Site, you agree that such use is at your own risk and you know that the Beta Site may include known or unknown bugs or errors, that we have no obligation to make this Beta Site available with or without charge for any period of time, nor to make it available at all, and that nothing in these Beta Terms or your use of the Beta Site creates any employment relationship between you and us. The Beta Site is provided on an “as is” and “as available” basis and we make no warranty to you of any kind, express or implied. In case of conflict between these Beta Terms and the BBC Terms of Use these Beta Terms shall prevail. Innovation

By John Ely Senior Health Reporter For Mailonline Published: 11:00 EST, 29 November 2023 | Updated: 11:05 EST, 29 November 2023

Sign up for our free Health Check email to receive exclusive analysis on the week in health Get our free Health Check email Newborn babies could be at a higher risk of a deadly bacterial infection carried by their mothers than previously thought. Group B Strep or GBS is a common bacteria found in the vagina and rectum which is usually harmless. However, it can be passed on from mothers to their newborn babies leading to complications such as meningitis and sepsis. NHS England says that GBS rarely causes problems and 1 in 1,750 babies fall ill after contracting the infection. However, researchers at the University of Cambridge have found that the likelihood of newborn babies falling ill could be far greater. Researchers have developed a new PCR test to check for the bacteria They claim one in 200 newborns are admitted to neonatal units with sepsis caused by GBS. Pregnant women are not routinely screened for GBS in the UK and only usually discover they are carriers if they have other complications or risk factors. The team reanalysed data from its previous study which found GBS in the placenta of about 5% of women prior to labour. The cohort included 436 babies born full-term, with the team confirming their findings in a second group of 925 pregnancies. Jane Plumb, co-founded charity Group B Strep Support with her husband Robert after losing their middle child to the infection in 1996. She said: “This important study highlights the extent of the devastating impact group B Strep has on newborn babies, and how important it is to measure accurately the number of these infections. “This research suggests that the number of preventable infections may be ten times higher than previously thought, each one having a significant impact on babies and their families. “Inadequate data collected on group B Strep is why we recently urged the Government to make group B Strep a notifiable disease, ensuring cases would have to be reported. “Without understanding the true number of infections, we may not implement appropriate prevention strategies and are unable to measure their true effectiveness.” The bacteria is usually harmless but can lead to infection in some cases Dr Francesca Gaccioli, of the department of obstetrics and gynaecology at the University of Cambridge, said the team’s findings – published in Nature Microbiology – “profoundly changes the risk/benefit balance of universal screening”. The research team has developed a new polymerase chain reaction (PCR) test which looks for the presence of the bacteria. Professor Gordon Smith, head of obstetrics and gynaecology at the University of Cambridge, said: “Using this new test, we now realise that the clinically-detected cases of GBS may represent the tip of the iceberg of complications arising from this infection. “We hope that the ultra-sensitive test developed by our team might lead to viable point-of-care testing to inform immediate neonatal care.” The study was funded by the Medical Research Council and supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre.

Patients having surgery at Valley Regional Hospital (VRH) will get a sense of warmth and comfort through specialized warming systems being used to enhance patient safety and care. The initiative stemmed from Nova Scotia Health’s participation in the National Surgical Quality Improvement Program (NSQIP), which collects information on patients 30 days after their surgeries and uses the data on surgical outcomes to highlight areas for improvement and best practices to share and spread. Regulating patient’s body temperatures before, during and after their surgeries, was flagged by NSQIP and Perioperative (surgical) Services teams as being one of many key factors in overall efforts to prevent surgical site infections. During surgery, a patient’s body temperature can decrease below normal levels. This is called hypothermia and not only can patients experience discomfort from shivering, but it also places them at a higher risk for surgical site infections, blood loss and other negative outcomes. A steady core body temperature between 36°C to 38°C is considered normal, or normothermia in medical terms. Normothermia is proven to reduce surgical site infections, the need for pain medication and can also help reduce stress and anxiety. Since December, Valley Regional Hospital has been using special warming systems to help maintain and monitor patients’ temperatures and offer them a sense of comfort before, during, and in their recovery from surgery. The normothermia system consists of a warming gown attached to a small blower that circulates warm air to the patient 30 minutes before their surgery. The patient is continually warmed with a blanket during their surgery, and in recovery is connected to a portable system where they can safely control the temperature settings after waking up. “When patients wake up after surgery, keeping them warm is one way to reduce their risk of infection but also increases their comfort and care,” says Amy Rockwell, the NSQIP surgical clinical nurse reviewer at Valley Regional Hospital, who has been part of the initiative to bring the warming system to surgical patients. “Patients love the warming blankets. Having surgery can be stressful, but we find our patients wake up calmer after surgery. They are not shivering and feel like they have some sense of control in the recovery room,” says Rockwell. “Because normothermia decreases the need for anxiety medications and pain medications in the recovery room, it can often lead to quicker discharge times as well, since patients are not as drowsy and their vital signs are normal.” In her role, Rockwell spends a lot of time reviewing charts for information on patient outcomes and connecting with patients following their surgery. “Complications such as infections can result in patient discomfort, patients having to return to hospital, or visits to an emergency department or primary care clinics, so it important that our team works towards solutions that can reduce these occurrences and provide better care.” The warming systems are widely used in many Nova Scotia Health facilities currently and are being rolled out in other facilities across the province. Currently, the system is being used for patients undergoing scheduled surgeries longer than 30 minutes and Rockwell is already noticing improved patient outcomes. “It is rewarding for our teams to see initiatives like this one have a direct benefit for our patients. We have a wonderful team that care for patients and their families, and we are proud to be using our data to drive healthcare projects like this one that contribute to the well-being of Nova Scotians.” Quality improvement initiatives like these are part of Nova Scotia Health’s overall efforts to help patients get better results from their surgery and improve access to surgical care. Preventing infections helps reduce the time patients spend in hospital, the need to readmit patients to hospital, and visits to other services, saving vital healthcare resources to improve access and care for all.

Scarlet fever and streptococcal infections – What are they? What is a Streptococcal infection? These infections are caused by several strains of bacteria – the most common are streptococcus A and streptococcus B. These infections are extremely common and frequently responsible for sore throats experienced by millions of us every year. Most group A streptococcal bacteria cause relatively mild skin and throat infections, and are responsible for common conditions such as: strep throat (sore throat) impetigo (localised infection of the skin producing pus-filled blisters) cellulitis (infection of the skin, fat and underlying tissues) erysipelas (inflammation of the upper layers of the skin) tonsillitis (severe throat infection particularly impacting the tonsils) scarlet fever (infection causing sore throat, fever and rash) These infections are common and usually resolve quickly with antibiotics. It is rare for these infections to cause serious illness. If you or your child present with one of these infections contact your GP and get treatment early. It is not necessary to go to A&E. Invasive streptococcal infection However, Group A streptococcal bacteria can get into the blood, deep muscle or fat tissue and cause what are known as invasive streptococcal infections. These can be extremely serious and life threatening and are responsible for some of the following conditions: bacteraemia (blood infection) – which can lead to Sepsis endocarditis (heart lining infection) meningitis (brain and spinal cord inflammation) peritonitis (intestinal inflammation) urinary tract infection necrotising fasciitis (death of tissue under the skin which usually requires surgery) streptococcal toxic shock syndrome (infection causing low blood pressure and injury to organs such as the kidneys, liver and lungs – similar to Sepsis) Some people are natural carriers of streptococcal bacteria on their skin or in their throat, vagina, bladder or rectum. However, carriers do not usually develop an infection from this. How is it passed on? Streptococcal bacteria are spread by person-to-person contact with someone with an infection or less likely a carrier. Streptococcal bacteria can also spread in droplets from the nose or throat of someone with an infection. More rarely, streptococcal bacteria can enter the body in food contaminated with the bacteria – usually milk and milk products, and eggs. Invasive streptococcal infections develop when bacteria gets past the body’s natural defences such as a break in the skin. Health conditions that reduce immunity to infection make invasive infections more likely, so people with chronic illnesses like cancer, diabetes and kidney disease, and those who use medications such as steroids, are at greater risk. However invasive streptococcal infections can be a complication of other streptococcal conditions such as Scarlet Fever and so parents should be vigilant for early signs that their child may be getting worse or becoming seriously ill. Preventing the spread of Streptococcus The spread of bacteria can be reduced by good hand washing, especially after coughing and sneezing, before preparing foods and before eating. Cuts, grazes and other wounds should be kept clean and watched for signs of infection, including swelling, redness, pus and pain in the area of the wound. If you see any of these signs, you should visit your GP. What will the doctor do? Streptococcal infections are diagnosed by testing a swab from the throat, or by a blood or urine test. In all three cases, the test checks for the presence of streptococcal bacteria. Infections are treated with antibiotics. Invasive streptococcal infections usually require intravenous antibiotics given directly into a vein. The patient will need to be admitted to hospital and may require intensive care. Invasive infections that affect soft tissue, bone or muscle may require surgery. Early treatment improves the outlook greatly, but some invasive streptococcal infections and some group B streptococcal infections can be fatal. All strains of streptococcal bacteria can cause complications such as rheumatic fever (infection affecting the heart and joints) and glomerulonephritis (kidney inflammation). Sometimes Public Health will advise that all close contacts of people with streptococcal infection are given antibiotics. Streptococcus A infection is also responsible for Scarlet Fever and there has been a recent surge in cases of this infection post pandemic. Recognising if your child might have a streptococcal infection There are lots of viruses that cause sore throats, colds and coughs circulating. These should resolve without medical intervention. However, children can on occasion develop a bacterial infection on top of a virus and that can make them more unwell. As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact NHS 111 or your GP if your child/baby is: getting worse feeding or eating much less than normal not drinking and not passing much urine is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher feels hotter than usual when you touch their back or chest, or feels sweaty your child is very tired or irritable Call 999 or go to A&E if your child: is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs there are pauses when your child breathes your child’s skin, tongue or lips are blue is floppy and will not wake up or stay awake isn’t drinking and hasn’t had a wee or a wet nappy in the last 12 hours they have mottled skin and their limbs are abnormally cold What are the symptoms? Streptococcal bacteria cause a wide range of infections. Each infection produces different symptoms. Symptoms of the most common streptococcal infection – strep throat – include: sore, red throat fever, headache swollen lymph nodes (lumps) in the neck and under the jaw Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infections. Scarlet fever Scarlet

11/29/2023 Scientists Believe They Can Use One Vaccine to Study Others Each year, tuberculosis (TB) kills more people than any other infectious disease, falling out of the top spot only temporarily during the COVID-19 pandemic. Director of the Saint Louis University Center for Vaccine Development Daniel Hoft, M.D., Ph.D., works with colleagues in the lab. SLU File Photo. Despite TB’s wide reach and some lost progress during the COVID-19 pandemic, researchers believe it is possible to eradicate TB through advances in vaccine development and public health. To cross the finish line, scientists must find ways to test new vaccines rapidly to prevent TB infections more effectively. In a paper published in The Journal of Infectious Diseases, Daniel Hoft, M.D., Ph.D., director of the Saint Louis University Center for Vaccine Development, and colleagues from Saint Louis University, Emory University School of Medicine, The Emmes Company, LLC, the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, and New York University Grossman School of Medicine, report a promising new approach to speed vaccine testing for TB. Hoft, who also serves as professor and chair of infectious diseases, allergy, and immunology at the Saint Louis University School of Medicine, sought data that could only be gathered by challenging the human immune system directly. This approach, Hoft hypothesized, could provide answers to some TB unknowns. For example, TB animal models do not fully mimic how the bacteria behaves in people, and vaccine developers do not have well-defined data about what TB immune responses offer optimal protection against the bacteria. To test new vaccines, infectious diseases researchers sometimes conduct human challenge studies to quickly learn about how well a vaccine candidate works against an infectious disease, such as influenza. In these studies, researchers first deliver an investigational vaccine or placebo to separate groups of healthy volunteers, and then intentionally infect study participants with a flu virus, all in carefully controlled settings and under close medical supervision, to determine whether the investigational experimental vaccine provides protection compared with the control group. This approach can be instrumental in generating data supporting the approval of novel vaccines. Mycobacterium tuberculosis, the bacteria that cause TB, however, is too dangerous for human challenge with the fully pathogenic bacteria. The team needed to find another, safer way to challenge the human immune system to find answers to their questions. Hoft found a workaround in the Bacillus Calmette-Guérin (BCG) vaccine. The most widely used vaccine in history, with more than 4 billion doses given to patients since 1921, the BCG vaccine contains a live but weakened version of the TB bacteria. The BCG vaccine is given to newborns to reduce their TB risk, but it is less effective against pulmonary TB and often wanes in effectiveness, providing little to no protection in adults. With the BCG vaccine, Hoft saw a chance to gather data about TB in a human study without the risk of exposing participants to full strength M. tuberculosis bacteria. To test this idea, the researchers gave 92 healthy adults the BCG vaccine, with participants receiving one of four different doses. With participants’ immune response to the BCG vaccine serving as a proxy for their exposure to a true infection, the researchers gathered much-needed data about how the immune system responds when it encounters TB. The team applied a battery of analysis methods to samples collected from the BCG challenge sites and blood, looking for associations between BCG at the injection site, and immune responses as well as gene expression changes in blood. The findings open up new doors for TB vaccine development. “Our findings are important for two reasons,” Hoft said. “First, this approach could enable us to screen new TB vaccines early in the pipeline and prioritize the most promising concepts, saving time and money.” “Second, we have a model to better determine what a new vaccine needs to do to protect against TB. We will be able to identify biomarkers indicating whether new vaccines could better protect someone against TB.” Among the findings that will help vaccine developers as they create new vaccines, The researchers determined that BCG challenge doses of up to 8 x 106 CFU were safe. They found that BCG at the challenge sites increases as the BCG dose increases. The researchers identified the most consistent and precise measure of BCG at challenge sites. Gene expression analysis found potential biomarkers of immunity that correlated with inhibition of BCG in people that may provide a TB protective signature. And they uncovered immunological and gene expression differences that could underlie the different risks of men and women developing active TB. This last point is an intriguing finding. Doctors have long observed that men appear to be more at risk of developing an active form of TB infection, but they do not know why. In this study, researchers found differences in the immune responses of men and women to the BCG challenge, a finding that parallels doctors’ observations with patients who develop the illness. Researchers hope this new model will help advance our understanding of why men and women have different levels of general immunity. Hoft is enthused by the study’s findings, which he says could provide a road map for future TB vaccine testing. “The BCG human challenge model is a promising approach for studying TB immunity,” Hoft said. “The new data will facilitate the vaccine development process, allowing us to make progress toward our ultimate goal of eradicating TB.” Research reported in this study was supported by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health under award numbers HHSN272200800003C (SLU), HHSN272201300021I (SLU), HHSN272200800005C (Emory), and HHSN272201300018I (Emory). The content in this press release is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. About the Saint Louis University Center for Vaccine Development Saint Louis University has been on the front lines in the fight against pandemics and global health crises for