Phylodynamic characteristics of the Russian population of rotavirus А (Reoviridae: Sedoreovirinae: Rotavirus) based on the VP6 gene

Introduction. Rotavirus A is one of the leading causes of acute gastroenteritis in children in the first years of life. Rotavirus infection is currently classified as a preventable infection. The most abundant rotavirion protein is VP6.Material and methods. Phylogenetic analysis and calculation of phylodynamic characteristics were carried out for 262 nucleotide sequences of the VP6 gene of rotavirus species A, isolated in Russia, using the BEAST v.1.10.4 software package. The derivation and analysis of amino acid sequences was performed using the MEGAX program.Results. This study provides phylodynamic characteristics of the rotaviruses in Russia based on the sequences coding VP6 protein. Bayesian analysis showed the circulation of rotaviruses of three sublineages of genotype I1 and three sublineages of genotype I2 in Russia. The level of accumulation of mutations was established, which turned out to be similar for genotypes I1 and I2 and amounted to 7.732E-4 and 1.008E-3 nucleotides/site/year, respectively. The effective population sizes based on nucleotide sequences of the VP6 I1 and I2 genotypes are relatively stable while after the 2000s there is a tendency of its decreasing. Comparative analysis of the amino acid sequences in the region of the intracellular neutralization sites A (231–260 aa) and B (265–292 aa) made it possible to reveal a mutation in position V252I in a proportion of Russian strains of genotype I1 some strains of genotypes I1 and I2 had mutation I281V. These substitutions were not associated with any sublineages to which the strains belong. The analysis of three T-cell epitopes revealed four amino acid differences (in aa positions 305, 315, 342, 348) that were associated with the first or second genogroup.Conclusion. Based on the phylodynamic characteristics and amino acid composition of antigenic determinants, it was concluded that the VP6 protein is highly stable and could potentially be a good model for development of a rotavirus vaccine.

Opportunistic influenza vaccination in the home: broadening access in isolated times

BackgroundInfluenza is a vaccine-preventable infection that causes serious illness. The mandate to prevent an influenza epidemic has increased with the COVID-19 pandemic. However, isolation restrictions have reduced interactions with healthcare professionals. We aimed to determine whether these barriers could be overcome by offering vaccination via an ambulatory setting for the first time.MethodsDuring a 12-week period, patients receiving care through the Hospital-in-the-Home programme were offered immunisation during their home visit. Logistical cold chain barriers were addressed, and patient acceptance was measured.ResultsCooler boxes with temperature loggers were designed to monitor the cold chain. 157 eligible patients were contacted, of whom 96 (61%) consented and received in-home injectable influenza vaccine, with no major adverse events. 52/96 (54%) were first-time influenza vaccine recipients. Most refusals (28/41, 68%) were for immunisation concerns, not home administration.ConclusionThis pilot shows ambulatory influenza vaccination is feasible, safe and overcomes some barriers.

Post Vaccine Rubella During a Measles Outbreak: Clinical Case

Rubella is a vaccine preventable infection, and congenital rubella the most feared complication of this disease. Although young adult women are at greatest risk of post-vaccine rubella, this is also the group who potentially benefits the most from vaccine protection. Since post-vaccine disease has a mild and self-limited course, the benefit clearly exceeds the risk. During a measles outbreak in the north of Portugal, a 38-year-old woman presented with cervical posterior lymphadenopathies, fever and a maculo-papular rash one week after the administration of the measles, mumps and rubella vaccine. Measles was discarded and rubella viremia was demonstrated. Symptoms of rubella are non-specific and laboratory confirmation is essential. This is particularly relevant during a measles outbreak.

Hepatitis A immunisation need in nursing students in Turkey

Hepatitis A is a worldwide vaccine-preventable infection. The aim of our study was to determine the serological status of hepatitis A virus (HAV) among first-year nursing students in Turkey. A sample of 423 students was used and immunoglobulin G antibodies against HAV were determined quantitatively by enzyme-linked immunosorbent assay on each. Overall, 84.6% had no immunity to HAV, making them at risk for HAV, and so susceptible to nosocomial transmission. Nursing students who work in high-risk wards must be vaccinated against hepatitis A.

Mapping Pediatric Tetanus Cases in Central Pennsylvania and Analyzing Hospital Costs Associated with Treatment

Background Pennsylvania is home to Amish and Mennonite communities with an estimated combined population of over 90,000 people. Under-immunization is common with vaccine preventable diseases, including tetanus, periodically presenting among children from these communities. Nearly 20% of nationally reported pediatric tetanus cases in the past 10 years were treated at our institution, the tertiary care center which serves these unique populations. We characterize demographics and costs of treating this rare, but largely preventable infection. Methods Chart review based on ICD-9 codes for tetanus infection in patients aged 0–17 years treated for clinically diagnosed tetanus infection between January 2006 and December 2015. Cost data were extracted from Horizon Business Insight software and analyzed in Microsoft Excel. Cases were mapped using UDS Mapper. Results Four cases of pediatric tetanus infection were identified with 100% occurring in unimmunized patients and 3 of 4 (75%) in Amish individuals. Treatment costs amounted to $121,170 with estimated payment of $80,664 resulting in a net loss to the hospital of $40,506 over the course of 10 years. Each case treated resulted in a median loss of $4,402 to the hospital. Conclusion The costs of treating this vaccine preventable disease for both hospitals and under-immunized Amish and Mennonite communities, who tend to pay out-of-pocket, should be emphasized in targeted outreach and education programs at the population level. Disclosures All authors: No reported disclosures.

The hazards of unvaccination to the vaccinated ones

One of the more successive cases of antivaccine activists frequently comes as a guileful inquiry. All things considered, possibly it's not by any means insincere, given that numerous antivaccinationists appear to trust premise behind it. The inquiry for the most part takes a structure something like, "If your kid is inoculated, why are you agonized over my youngsters? They don't represent any peril to you." obviously, the reason behind that question is, humorously, one that contentions with a large portion of the convictions behind antivaccinationism, specifically the conviction that antibodies are inadequate. Yet, the reason behind this inquiry is that antibodies are effective to the point that there's no purpose behind the folks of an inoculated tyke to be concerned if that youngster interacts with another tyke with an immunization preventable infection. Obviously, nobody ever blamed antivaccine activists for being predictable in their convictions.

Analysis of neurosurgical reoperations: use of a surgical checklist and reduction of infection-related and preventable complication-related reoperations

OBJECT Use of the WHO surgical checklist has been proven to reduce surgical morbidity and mortality, but its effect on surgical complications requiring reoperation has not been previously studied. The aim of this study was to determine whether the use of the WHO surgical checklist would have an impact on the number and causes of neurosurgical complications leading to a reoperation. METHODS The authors retrospectively gathered information on all neurosurgical reoperations using hospital discharge data as well as the operations and procedures registry, and tracked all primary neurosurgical operations (n = 175) preceding a complication-related reoperation from 2007 to 2011. There were a total of 5418 neurosurgical operations during the study period. For further analysis of electronic patient records, the primary operations were divided into 2 groups based on the time of the WHO surgical checklist implementation in the authors' unit: 103 operations before and 72 after the introduction of the checklist. Observed adverse events and reoperations were categorized as preventable or unpreventable, and the actual use of the checklist during each operation was recorded. RESULTS The overall rate of preventable complication-related neurosurgical reoperations decreased from 3.3% (95% CI 2.7%–4.0%) to 2.0% (95% CI 1.5%–2.6%) after the checklist implementation. The reoperations were mainly due to wound infections, 46% before and 39% after the checklist. All infection-related reoperations proportioned to all neurosurgical operations (2.5% before vs 1.6% after checklist implementation) showed a significant reduction (p = 0.02) after the implementation of the checklist. In particular, there was a significant decrease (p = 0.006) in the rate of preventable infections associated with reoperations, i.e., 2.2% before versus 1.2% after checklist implementation. The overall adherence to checklist use (the “time out” phase) in neurosurgical operations was 78%, and adherence was 70% in primary operations preceding a complication-related reoperation regarded as preventable. CONCLUSIONS The implementation of the WHO surgical checklist in neurosurgery was associated with a decrease in complication-related reoperations, especially those due to preventable infection complications, the majority of which were wound infections. The adherence to checklist use in individual operations after the checklist implementation did not appear to have an impact on the results.