News Article | May 19, 2017
A hay fever map of Britain - with the first ever guide to the location of plants in the UK that can trigger the allergy - has been produced to help sufferers cope, and warn them which 'hotspots' to avoid. Academics at the University of Exeter's Medical School have produced new, highly-detailed maps of the UK containing the location of key plants and trees known to produce pollen that triggers allergies and asthma. The maps, produced in collaboration with the Met Office, may help acute hay-fever or asthma sufferers decide where to live, or which areas to avoid at peak times when pollen is released. The study records areas where plants which hay fever sufferers are most likely to be sensitive to are most prevalent, including grasses and trees and plants such as birch, alder, oak and nettle. The plant maps, which include cities throughout the UK - with a detailed plan of London - will help medics further study the impact of air pollution on asthma. Around 80 per cent of people with asthma also have a pollen allergy and in the UK around 10 per cent of the adult population is affected by asthma - one of the highest levels of doctor-diagnosed asthma in the world. In 2001, thirteen per cent of people in the UK were diagnosed with hayfever by doctors. Most people with hay-fever are allergic to grass pollen, which is most common in late spring and early summer. Air pollution, for example from car exhaust fumes, is understood to exacerbate hospital admissions for asthma caused by allergies. The maps are released as new research carried out at the European Centre for Environment and Human Health at the University of Exeter's Medical School, shows that exposure to pollen can increase hospital admissions for asthma within days of exposure. The study of hospital admissions in London by Dr Nicholas Osborne, published in the International Journal of Biometeorology, found that four to five days after increased grass pollen counts there was a spike in hospital admissions for asthma. The study also found increased admissions for asthma 2-5 days later after Met Office pollen alert levels of very high pollen days. Dr Rachel McInnes and Dr Osborne of the European Centre for Environment and Human Health at the University of Exeter Medical School believe their maps of allergenic pollen-producing plants, in combined with pollen forecasts and calendars, could help sufferers manage their condition by reducing their exposure. The study examined the tree canopy, and the distribution of grasses to allow people to locate areas where they could be particularly affected. The resulting maps show where the allergenic plants and trees are located around Great Britain. The academics used sophisticated aerial mapping, as well as data from a variety of sources, to show the geographical distribution of the 12 key types of plants associated with hay fever and asthma brought on by allergies. In London, the prevalence of allergenic plants is broken down by neighbourhood. The maps were produced in collaboration with the Met Office, as part of the multi-institutional and interdisciplinary Health Protection Research Unit in Environmental Change and Health funded by NIHR (National Institute for Health Research). They include the location of grasses, weeds and trees producing pollen known to trigger hay-fever and asthma, including birch, alder, hazel, plane trees and oak, grass, nettles, mugwort and plantain. The maps show a higher percentage of allergenic grass in the northern and western regions of great Britain. The Eastern central area of the UK has the lowest percentage of allergenic grass. The North West and Western Scotland have the highest density of grass coverage. The detailed maps of the location of pollen, published in the journal Science of the Total Environment, may make it possible to identify plants increasing the risk of higher hospital admissions for asthma. Research by Dr Nicholas Osborne, an epidemiologist and toxicologist, at the University of Exeter's Medical School, said the maps will help doctors narrow down which pollens are most likely to trigger asthma attacks. "We hope that these maps will contribute to ongoing research that aims to better determine when plants pollenate, allowing us with time to provide better warning to allergy and asthma sufferers to enable them to better manage their disease," Dr Osborne said. "In the future, more people will know what species they are allergic to." The map of tree locations used data from a high-resolution National Tree Map produced by Bluesky International, which used high-resolution aerial photography and remote sensing, as well as information from the Forestry Commission. Dr Rachel McInnes, an honorary research fellow at the University of Exeter European Centre for Environment and Human Health and a Senior Climate Impacts Scientist at the Met Office, said: "These maps are a step towards a species-level pollen forecast. Pollen can have a serious impact on the well-being of those with hay fever or asthma. By working towards a localised, species-level forecast, vulnerable people can better plan their activities and manage their condition. These new maps could also provide local authorities and healthcare practitioners with information to assist patients with pollen allergies. While these allergenic plant and tree maps do not provide a forecast of pollen levels, they do provide the most likely locations of grass and of tree species which are the source of most allergenic pollen."
News Article | May 8, 2017
-- The Department of Mechanical Engineering of The Hong Kong Polytechnic University (PolyU) has developed a novel bio-inspired nonlinear anti-vibration system that can significantly reduce vibration in various mechanic systems. The innovation far excels existing devices in cost-efficiency and performance reliability, and can have very wide applications.Inspired by the limb structures of birds and insects in motion vibration control, the novel X-shaped system is of capability to demonstrate nearly "zero response" to any vibration (quasi-zero low dynamic stiffness), but simultaneously of high loading capacity. It also features automatic high damping for strong vibration, and low damping for small vibration (thus preventing high damping's adverse effect on a system's normal functioning during small vibration). These advantages stem from the novel system's nonlinearity – a unique feature lacking in most vibration control systems nowadays which are usually following linear system design. The novel system can therefore be applied very widely in various engineering practices and vibration control devices.Superb Anti-vibration Device enhances Health Protection for WorkersAs a first step in transferring the innovation into daily life benefit, the research team led by Dr Xingjian Jing, Associate Professor of the department, has obtained funding, and facilities and trial support from the construction sector, to embark on research in applying the patented novel system to build an assistive anti-vibration exoskeleton for hand-held jackhammers.With superb anti-vibration performance, the new device can markedly help prevent hand-arm occupation diseases among construction workers. Using the new device, the vibration at hand/arm in drilling concrete ground can be significantly suppressed to the ideal safety level, compared with many commonly-used jackhammers in the market. The very low cost in manufacturing and maintenance, with great design flexibility for adapting to devices of different sizes and materials, can also enhance its potential popular use. At present, the market price of a common passive control jackhammer is around HK$1,000. It is estimated that PolyU's assistive anti-vibration exoskeleton added to such passive control system will need only an additional HK$1,000 - 2,000, yet with performance far excelling even good-quality active control device that cost about HK$,10,000 - 40,000.PolyU gains 3 TechConnect Global Innovation AwardsDr Jing's innovative bio-inspired system is one of the three PolyU innovations having won the TechConnect Global Innovation Awards 2017. It is the first time for a Hong Kong higher education institution receives the awards, along with other global-renowned research institutes (including US NASA, National Labs, Georgia Tech, Princeton Lab, UCLA, Australia National U etc), at the TechConnect World Innovation Conference and Expo, the largest multi-sector summit for supporting the development and commercialization of innovations. The annual event held in the US gathers more than 4,000 technology innovators, ventures, industrial partners and investors from over 70 countries.Only the top 20% of innovations submitted to TechConnect World will receive awards, with assessment based on the potential positive impact the submitted technology will have on a specific industry sector. PolyU is the only awardee from Hong Kong, and snatches 3 out of the 26 global awards presented to non-US-federal-funded innovations across the world. Another 60 national awards are granted to innovations with US federal funding. The PolyU delegation will present their innovations and receive the awards in mid-May at TechConnect World conference and expo held in Washington DC.For details of the award, please visit its official website: http://www.techconnectworld.com/ World2017/participate/ inn... Bio-inspired Nonlinear Passive Anti-Vibration System with Wide ApplicationsVibration can be controlled by passive systems, which isolate or mitigate vibration by passive techniques (e.g. rubber pads, mechanical springs, shock absorbers, base isolation), or via active systems, which apply force or energy in an equal and opposite fashion to the vibration force. In general, passive vibration control is most preferred in engineering practices, as its manufacturing, operating and maintenance cost is much lower than active system. It also consumes less energy, and is easier to repair, less complex and thus more reliable. However, the vibration control performance of active systems is much better.
News Article | February 17, 2017
The researchers from Imperial College London analysed 20 pharmacies that were available for UK citizens to access online. This is one of the few studies to have examined the online availability of antibiotics and to have explored the potential effects on public health. The research is published in Journal of Antimicrobial Chemotherapy. Antibiotics are classed as prescription only medicines in the UK, meaning they cannot legally be sold to consumers without a valid prescription. In the study, the researchers found that although online versions of UK high street pharmacies were compliant with prescription regulations, 80 per cent of the online pharmacies surveyed let customers choose their dosages, the duration and choice of antibiotic treatments. This can lead to serious side effects in patients and increases the risk of antimicrobial resistance. Antimicrobial resistance is one the biggest threats to global health, food security, and development today, according to the World Health Organization (WHO).The study was carried out by academics from Imperial College London's NIHR Health Protection Research Unit for Healthcare Associated Infections and Antimicrobial Resistance, and Imperial College Healthcare NHS Trust. The team carried out their research by entering the search term 'buy antibiotics online' into Google and Yahoo. The team recognise that the study is a 'snapshot' of the online pharmacy industry, but it does provide insights into how it operates. The 20 pharmacies at the top of the search were analysed by the team. Dr Sara Boyd, a co-author and NIHR Academic Clinical Fellow in Infectious Diseases and Microbiology at Imperial, said: "These findings are a real concern, and raise several important issues regarding antibiotic resistance and patient safety with online pharmacies." All online medicine vendors selling to UK consumers must by law register with both the Medicines and Healthcare products Regulatory Agency (MHRA) and the General Pharmaceutical Council (or the Pharmaceutical Society of Northern Ireland). However, the researchers found that 75 per cent of online pharmacies included in the study lacked evidence of the appropriate registration status required by law. In other findings, the researchers discovered that 45 per cent of the online pharmacies analysed did not require a prescription from the patient. Only 30 per cent of websites in the survey asked consumers to complete a health questionnaire prior to purchase. Seventy per cent of the websites provided information on the safe usage of prescription medications, including potential side effects or adverse reactions when combined with other drugs. Professor Alison Holmes, of Imperial's Department of Medicine, added: "Improper use of antibiotics can mean that infections are not being treated appropriately, or that people are being unnecessarily exposed to antibiotics. This allows bacteria to become resistant to drugs that once killed them. As a result, it is essential that antibiotics are prescribed only when they are needed." Although a small study, the authors say that the research offers insight into the increasing use of the internet for a variety of purposes, including buying antibiotics. Dr Boyd said: "The way patients interact with healthcare is constantly evolving, and shifts in consumer behaviour mean more people are purchasing their goods online. Our study paves the way for larger, more thorough research into this worrying new trend so that we can ensure patient safety and promote the responsible use of antibiotics in all areas of healthcare provision." Martin Astbury, President of the Royal Pharmaceutical Society, said: "Unnecessary antibiotic use can result in serious side effects in individuals and has a major impact on wider public health by increasing antibiotic resistance. We cannot support access to antibiotics through a web form until the standards for prescribing by private providers reflect the standard of face to face consultations in the NHS. Those involved in supplying medicines online should ensure their processes are as robust as possible." All online pharmacies identified as illegally selling antibiotics to patients within the UK were reported to the Medicines and Healthcare products Regulatory Agency (MHRA), who promptly responded. The researchers are working together with numerous stakeholders to improve patient safety and antibiotic stewardship in this area. Anyone with a concern concerns about an online pharmacy should contact the MHRA directly. The study was partially funded by the National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, in partnership with Public Health England and Imperial College Healthcare NHS Trust.
News Article | December 19, 2016
Scientists at the University of Liverpool have shown that a change in weather patterns, brought on by the 'Godzilla' El Niño of 2015, fuelled the Zika outbreak in South America. The findings were revealed using a new epidemiological model that looked at how climate affects the spread of Zika virus by both of its major vectors, the yellow fever mosquito (Aedes aegypti) and the Asian tiger mosquito (Aedes albopictus). The model can also be used to predict the risk of future outbreaks, and help public health officials tailor mosquito control measures and travel advice. The model used the worldwide distribution of both vectors as well as temperature-dependent factors, such as mosquito biting rates, mortality rates and viral development rates within mosquitoes, to predict the effect of climate on virus transmission. It found that in 2015, when the Zika outbreak occurred, the risk of transmission was greatest in South America. The researchers believe that this was likely due to a combination of El Niño - a naturally occurring phenomenon that sees above-normal temperatures in the Pacific Ocean and causes extreme weather around the world - and climate change, creating conducive conditions for the mosquito vectors. El Niños occur every three to seven years in varying intensity, with the 2015 El Niño, nicknamed the 'Godzilla', one of the strongest on record. Effects can include severe drought, heavy rains and temperature rises at global scale. Dr Cyril Caminade, a population and epidemiology researcher who led the work, said: "It's thought that the Zika virus probably arrived in Brazil from Southeast Asia or the Pacific islands in 2013. "However, our model suggests that it was temperature conditions related to the 2015 El Niño that played a key role in igniting the outbreak - almost two years after the virus was believed to be introduced on the continent." "In addition to El Niño, other critical factors might have played a role in the amplification of the outbreak, such as the non-exposed South American population, the risk posed by travel and trade, the virulence of the Zika virus strain and co-infections with other viruses such as dengue." The World Health Organisation recently declared that Zika, which has been linked to birth defects and neurological complications, will no longer be treated as an international emergency, but as a "significant enduring public health challenge." Professor Matthew Baylis, from the University's Institute of Infection and Global Health, added: "Zika is not going away, and so the development of tools that could help predict potential future outbreaks and spread are extremely important. "Our model predicts a potential seasonal transmission risk for Zika virus, in the south eastern United States, southern China, and to a lesser extent over southern Europe during summer." The researchers now plan to adapt the model to other important flaviviruses, such as Chikungunya and Dengue fever, with the aim of developing disease early warning systems that could help public health officials prepare for, or even prevent, future outbreaks. The research was funded by the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections, a collaboration between the University of Liverpool, Liverpool School of Tropical Medicine and Public Health England. The paper 'Global risk model for vector-borne transmission of Zika virus reveals the role of El Niño 2015' is published in the Proceedings of the National Academy of Sciences.
News Article | December 7, 2015
Whole Genome Sequencing is a faster, cheaper and more effective way of diagnosing tuberculosis says a new study published in the journal Lancet Respiratory Medicine. Dr. Louise Pankhurst of the University of Oxford and a team of worldwide collaborators including Public Health England utilised innovative DNA technology to diagnose cases of tuberculosis (TB) up to eight times faster than traditional methods. While Whole Genome Sequencing has been previously used in TB research studies, this is the first time the technology was applied in real world scenarios. The researchers at Oxford's John Radcliffe Hospital were able to detect presence of TB and whether it was resistant to commonly used antibiotics within one week – up to eight times faster than utilising traditional diagnosis methods. In addition to facilitating faster and more targeted treatment of people with TB, the speedy diagnosis also meant the scientists were able to detect and respond to potential outbreaks as they happen. The innovative technology also proved more cost effective, at an average cost of £481 per positive case, compared to £517 per case using current technologies. The stunning results of this trial have implications for TB prevention in the UK. It was funded by the Health Innovation Challenge Fund (HIC Fund) and supported by the NIHR Oxford Biomedical Research Centre and the NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance. The new technique will be adopted by Public Health England (PHE) and is expected to reduce transmission of TB. Tuberculosis is a major part of PHE's strategy for infectious diseases due to some increases in incidence and emergence of multi-drug resistant infections. PHE is also working with Genomics England as part of the 100,000 Genomes Project to further understanding of why some people develop severe reactions to infections. Lead author Dr. Louise Pankhurst, University of Oxford, said: 'This is a really exciting time to be working in infectious disease research. The UK is poised to become the first country in the world to replace traditional tuberculosis diagnosis with whole genome sequencing. Our study has shown how this will dramatically speed up the time taken to diagnose TB, helping patients be placed on the most effective treatment as soon as possible and reducing the risk of disease transmission.' Professor Derrick Crook, Director of the Public Health England National Infections Service said: 'This ground-breaking research provides a roadmap for faster, cheaper and more effective diagnosis of TB, and is a crucial step in Public Health England’s goal of eliminating TB as a public health problem in England. 'This marks a significant milestone in the way we tackle TB, yet things are going to get better as whole genome sequencing technology is rapidly becoming much faster and less expensive and will ultimately inform the way we deal routinely with all infectious disease diagnosis.'
News Article | December 20, 2016
The study, led by the London School of Hygiene & Tropical Medicine with Public Health England, found that the fall in visits was biggest among young children (the age group that receives the rotavirus vaccination), but there was also a decrease in visits by older children and adults. This suggests herd immunity from the vaccination programme; individuals were protected even if unvaccinated due to the decrease in circulating rotavirus. Rotavirus is highly infectious and is the commonest cause of acute gastroenteritis in young children, causing diarrhoea, vomiting and fever. Infection with rotavirus results in considerable use of health services in the UK. The UK-wide rotavirus vaccination programme was introduced in 2013. The vaccine is given as oral drops in two doses, to babies aged between two and three months old. Previous research has shown that the introduction of the programme has resulted in a decrease in hospitalisations and Emergency Department visits for acute gastroenteritis among adults and children. The new study used primary care data to look at the impact on GP visits and went on to estimate the visits and healthcare costs averted in England across all healthcare settings. In GP surgeries, rates of acute gastroenteritis in young children fell by 15% overall after the vaccine introduction, and by 41% in the months where rotavirus circulation was historically high. Rates also decreased in older children and to a lesser degree in adults. The researchers went on to estimate that across GPs, hospital admissions and Emergency Departments, 87,376 visits by children under five were averted in the first year of the vaccination programme. This was associated with an estimated £12.5 million reduction in healthcare costs. Lead author Dr Sara Thomas from the London School of Hygiene & Tropical Medicine, said: "This study helps to give a more complete picture of the impact of rotavirus vaccination, and shows the rapid reduction in the burden of acute gastroenteritis seen in GP surgeries. "We found that the expected seasonal peak of acute gastroenteritis in the months when rates historically would have been high completely disappeared. The fact that GP visits for gastroenteritis in other age groups fell provides evidence that unvaccinated older individuals are also benefitting from the vaccine being introduced. "Our new estimates of the tens of thousands of health service visits by young children that have been averted, with a reduction in annual healthcare costs of more than £12 million, also provide important information for assessing the overall benefits of introducing the vaccine." Study co-author Dr Shamez Ladhani, Immunisation Consultant at Public Health England, said: "This is good news and it is reassuring that the rotavirus vaccine is preventing so many cases of vomiting and diarrhoea since it was introduced three years ago. This is thanks to the high vaccine uptake in infants, which has also helped to protect older unvaccinated children and adults of all ages across the UK. It is also further evidence that our UK Immunisation programme is playing a vital role in protecting the public's health." Nicola Blackwood, the Minister for Public Health and Innovation said: "This research shows the overwhelming public health benefit of giving young children the rotavirus vaccination. This vaccine is keeping children safe whilst freeing up more of doctors' and nurses' time and saving money for the NHS." The authors say that one potential limitation of the study is that the decrease in acute gastroenteritis observed could be due to factors other than the introduction of the vaccine. Analyses are now underway to compare rates of acute gastroenteritis in vaccinated and unvaccinated infants, to obtain direct estimates of the effectiveness of the vaccine. The study was funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England. For more information, please contact the London School of Hygiene & Tropical Medicine press office on firstname.lastname@example.org / +44(0)2079272802. Copies of this paper are available to credentialed journalists upon request; please contact Elsevier's Newsroom at email@example.com or +31 20 485 2492. The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with more than 4,000 students and 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, is among the world's leading schools in public and global health, and was named University of the Year in the Times Higher Education Awards 2016. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. http://www. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www. ). Vaccine is the pre-eminent journal for those interested in vaccines and vaccination. It is the official journal of The Edward Jenner Society and The Japanese Society for Vaccinology and is published by Elsevier http://www.
News Article | November 29, 2016
The first available dengue vaccine, CYD-TDV (Dengvaxia), is estimated to reduce the burden of dengue and be potentially cost effective in settings where infections with dengue are common, according to a study published by Stefan Flasche from the London School of Hygiene & Tropical Medicine, UK and an international consortium of dengue experts, in PLOS Medicine. The researchers used dynamical models informed by the results of efficacy trials combined with assumptions on vaccine mechanisms, to estimate the impact and cost-effectiveness of CYD-TDV over a 30-y post-vaccination period in a variety of epidemiological settings. In settings with moderate to high dengue transmission intensity, i.e. where at least 50% of children get infected with dengue before they are nine years old, they estimated that a routine vaccination policy involving a three-dose schedule in 9-y-old children at 80% coverage would reduce the burden of dengue disease for the population by 6%-25% and that vaccination would be potentially cost-effective if priced competitively. However, in settings where dengue infections are uncommon, they identified a risk of potential increase in hospitalizations for dengue disease. These findings were an important contribution to the evidence base that led the WHO to recommend countries to consider the use of CYD-TDV only in settings with a high burden of dengue disease. The authors say: "Our results can guide countries on the general suitability of Dengvaxia introduction; however, local factors related to treatment costs, intensity of dengue transmission and age groups particularly exposed to dengue will need to be considered." In a linked Perspective, Jacqueline Deen from the University of the Philippines, Manila, discusses challenges in balancing the individual and population risks and benefits for CYD-TDV. SF and MJ received funding from WHO and Gavi, the Vaccine Alliance, to conduct this work. LC is a paid employee at Sanofi Pasteur. GM and JK were funded by the University of Western Australia, with computing resources provided by the Pawsey Supercomputing Centre, which is funded by the Australian Government and the Government of Western Australia. MR is funded by a Royal Society University Research Fellowship. NF, ID and DJL received research funding from the UK Medical Research Council, the UK NIHR under the Health Protection Research Unit initiative, NIGMS under the MIDAS initiative, and the Bill and Melinda Gates Foundation. IRB and DATC were funded by MIDAS Center Grant NIH/NIGMS U54-GM088491 and the Bill and Melinda Gates Foundation. DATC was also supported by NIH/NIAID R01-AI114703. TJH, IL, and CABP were funded by a Dengue Vaccine Initiative Grant to IL, NIH/NIAID R37 AI32042. THJ, IL, and KK were funded by MIDAS Center Grant NIH/NIGMS 1135 U54 GM111274. All other authors have received no specific funding to conduct this work. The funders had no role in the study design, data analyses, decision to publish or preparation of the manuscript. I have read the journal's policy and the authors of this manuscript have the following competing interests: LC is employed by Sanofi Pasteur. KV is a staff member of the World Health Organization. TAP and GE receive support from GlaxoSmithKline for unrelated work on dengue vaccine modelling. IL, TJH, and CABP have received travel support from Sanofi Pasteur to present other work on dengue vaccine modelling. Sanofi Pasteur has not funded any of their research and was not involved in any research decisions related to their work presented. NF gave advice to Sanofi-Pasteur and the World Health Organization on the efficacy profile and potential public health impact of Dengvaxia. He is also collaborating with Sanofi-Pasteur on secondary analyses of Dengvaxia clinical trial data. He has received no remuneration, grant income, expense payments or in-kind benefit from Sanofi-Pasteur. DATC and IRB have advised WHO on the use of the Sanofi vaccine in a number of meetings and as part of a consortium of modelers who estimated the potential impact of the vaccine. On occasion they received travel expenses for visits to WHO. They have also advised Sanofi Pasteur Ltd. on the implications their work has for use of their vaccine. They have not received any financial or in-kind payment from Sanofi. All other authors have declared that no competing interests exist. Flasche S, Jit M, Rodríguez-Barraquer I, Coudeville L, Recker M, Koelle K, et al. (2016) The Long-Term Safety, Public Health Impact, and Cost-Effectiveness of Routine Vaccination with a Recombinant, Live-Attenuated Dengue Vaccine (Dengvaxia): A Model Comparison Study. PLoS Med 13(11): e1002181. doi:10.1371/journal.pmed.1002181 London School of Hygiene and Tropical Medicine, London, United Kingdom Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America Sanofi Pasteur, Brussels, Belgium University of Exeter, Exeter, United Kingdom Duke University, Durham, North Carolina, United States of America University of Western Australia, Crawley, Australia University of Florida, Gainesville, Gainesville, Florida, United States of America University of Notre Dame, Notre Dame, Indiana, United States of America Imperial College London, London, United Kingdom University of Oxford, Oxford, United Kingdom Indiana University, Bloomington, Indiana, United States of America World Health Organization, Geneva, Switzerland IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:http://journals. No funding was received for this work. I have read the journal's policy and have the following conflicts: I was an unpaid external consultant in the "Extended Study Group for dengue vaccine effectiveness evaluation studies in Asia" from 6 April 2015 to 31 August 2015 convened by Sanofi Pasteur. I was a WHO temporary adviser in a meeting entitled "Targeting Vaccination and Post-licensure Studies for the Licensed Dengue Vaccine" in Geneva from 14 to 15 June 2016 convened by the WHO. I am an unpaid co-investigator of a study entitled "Effectiveness of the tetravalent dengue vaccine, CYD-TDV (Dengvaxia) in the Philippines" currently in preparation, sponsored by the University of the Philippines-Manila and funded by Sanofi Pasteur. Deen J (2016) The Dengue Vaccine Dilemma: Balancing the Individual and Population Risks and Benefits. PLoS Med 13(11): e1002182. doi:10.1371/journal.pmed.1002182 Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:http://journals.
News Article | November 16, 2016
Experts are warning of a significant increase in the number of people in the UK who are living with invasive and serious fungal diseases that affect the lungs, bloodstream and brain and can sometimes lead to death. While invasive fungal infections were estimated by the Health Protection Agency in 2006 a new report is the first comprehensive attempt to capture how many people in the UK suffer from fungal asthma. Asthma in adults is common in the UK with over 4 million reported cases, and researchers in Manchester believe as many as 300,000 of them are affected by fungal asthma. The research from the National Aspergillosis Centre based at The University of Manchester -- is published by the British Infection Association. Fungal asthma is such a big problem because the UK has one of the highest rates of asthma internationally. The range of estimate reflects uncertainty as no community study has ever been done, despite the large number affected. Asthmatics allergic to and exposed to higher amounts of fungi that they breathe in usually have poor asthma control and require steroid boosters. Antifungal therapy benefits these people, and may prevent deaths from asthma, doctors believe. Invasive aspergillosis is the commonest missed infectious diagnosis in intensive care in the UK. It is always fatal without therapy and affects from 3,288 to 4,257 patients each year, most undiagnosed. Treated invasive aspergillosis has a 30-85 per cent mortality depending on the patient group. Dr Bradford Winters in 2012 analysed deaths in intensive care, and invasive aspergillosis was the commonest missed infectious diagnosis. Pneumocystis pneumonia has been increasing, especially in the non-HIV group, and probably affects over 500 annually. 15-50 per cent of these patients die, even if treated. Although 1,700 cases of Candida bloodstream infections are reported annually, the actual estimate of tissue invasive cases in hospitalised and critically ill people is 5,124. This carries a ~45% mortality, if diagnosed and treated. A Health Protection Agency report from 2006 estimated that ~66 per cent of those who die of fungal infection could have been saved with faster recognition and rapid diagnosis. Experts believe rarer infections and antifungal resistant infections are probably on the increase, including Candida auris and multi-resistant Aspergillus fumigatus derived from the environment. The University of Manchester's Professor David Denning Director of the National Aspergillosis Centre, explained: "While the UK is rich in data sources, there is a remarkable poverty of contemporary studies of fungal diseases. An accurate estimate of total burden will ultimately rely on improved diagnostic testing and laboratory reporting. "This report gets us closer to true burden of fungal diseases in the UK -- necessary for improved diagnosis and reducing death. The scale of the 'fungal asthma' problem is staggering, and potentially remediable with antifungal therapy, as I know from treating hundreds of affected patients," he added. The paper, 'Estimating the burden of invasive and Q13 serious fungal disease in the United Kingdom' M. Pegorie, D.W. Denning, W. Welfare will be published in the Journal of Infection.
News Article | November 16, 2016
Experts are warning of a significant increase in the number of people in the UK who are living with invasive and serious fungal diseases that affect the lungs, bloodstream and brain and can sometimes lead to death. While invasive fungal infections were estimated by the Health Protection Agency in 2006 a new report is the first comprehensive attempt to capture how many people in the UK suffer from fungal asthma. Asthma in adults is common in the UK with over 4 million reported cases, and researchers in Manchester believe as many as 300,000 of them are affected by fungal asthma. The research from the National Aspergillosis Centre based at The University of Manchester - is published by the British Infection Association. Fungal asthma is such a big problem because the UK has one of the highest rates of asthma internationally. The range of estimate reflects uncertainty as no community study has ever been done, despite the large number affected. Asthmatics allergic to and exposed to higher amounts of fungi that they breathe in usually have poor asthma control and require steroid boosters. Antifungal therapy benefits these people, and may prevent deaths from asthma, doctors believe. Invasive aspergillosis is the commonest missed infectious diagnosis in intensive care in the UK. It is always fatal without therapy and affects from 3,288 to 4,257 patients each year, most undiagnosed. Treated invasive aspergillosis has a 30-85 per cent mortality depending on the patient group. Dr Bradford Winters in 2012 analysed deaths in intensive care, and invasive aspergillosis was the commonest missed infectious diagnosis. Pneumocystis pneumonia has been increasing, especially in the non-HIV group, and probably affects over 500 annually. 15-50 per cent of these patients die, even if treated. Although 1,700 cases of Candida bloodstream infections are reported annually, the actual estimate of tissue invasive cases in hospitalised and critically ill people is 5,124. This carries a ~45% mortality, if diagnosed and treated. A Health Protection Agency report from 2006 estimated that ~66 per cent of those who die of fungal infection could have been saved with faster recognition and rapid diagnosis. Experts believe rarer infections and antifungal resistant infections are probably on the increase, including Candida auris and multi-resistant Aspergillus fumigatus derived from the environment. The University of Manchester's Professor David Denning Director of the National Aspergillosis Centre, explained: "While the UK is rich in data sources, there is a remarkable poverty of contemporary studies of fungal diseases. An accurate estimate of total burden will ultimately rely on improved diagnostic testing and laboratory reporting. "This report gets us closer to true burden of fungal diseases in the UK - necessary for improved diagnosis and reducing death. The scale of the 'fungal asthma' problem is staggering, and potentially remediable with antifungal therapy, as I know from treating hundreds of affected patients," he added. The paper, 'Estimating the burden of invasive and Q13 serious fungal disease in the United Kingdom' M. Pegorie, D.W. Denning, W. Welfare will be published in the Journal of Infection.
Addiman S.,Public Health England |
Maimaris W.,Public Health |
Thomas H.L.,Health Protection |
White G.,North East and North Central London |
And 2 more authors.
Public Health | Year: 2013
Objectives: To evaluate the public health management Salmonella enterica serovar Typhi (typhoid) and Salmonella enterica serovar Paratyphi (paratyphoid) cases and their contacts to assess the outcome of screening. Study design: Retrospective case note review. Methods: 329 cases and 1153 contacts from North London over a four year period were reviewed. Structured questionnaires were developed to capture travel history, relationship between case/contact and the number, timing and documented results of faecal specimens. Evaluation of compliance with the clearance/screening schedule was examined and the positive yield of faecal samples for cases and contacts was calculated. Results: 1% (3/329) of cases had a positive clearance sample; all were identified on their first faecal specimen. Of the 645 contacts who were screened, only 10 (1.5%), all of whom had travelled with the index case, were positive. Person-to-person transmission was only identified for two UK acquired cases, where possible carrier sources were identified outside the screening schedule. Conclusion: The lack of evidence of secondary transmission from acute cases, coupled with the low positive yield from clearance samples support the revision of the national guidance for the public health management of cases of enteric fever and their contacts. © 2013 The Royal Society for Public Health.