#Compressed #Influenza #Vaccination in #US Older Adults: A Decision Analysis (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Compressed Influenza Vaccination in U.S. Older Adults: A Decision Analysis

Kenneth J. Smith, MD, MS, Glenson France, MA, Mary Patricia Nowalk, PhD, Jonathan M. Raviotta, MPH, Jay DePasse, BS, Angela Wateska, MPH, Eunha Shim, PhD, Richard K. Zimmerman, MD, MPH

DOI: https://doi.org/10.1016/j.amepre.2018.11.015

Published online: February 14, 2019




Tradeoffs exist between efforts to increase influenza vaccine uptake, including early season vaccination, and potential decreased vaccine effectiveness if protection wanes during influenza season. U.S. older adults increasingly receive vaccination before October. Influenza illness peaks vary from December to April.


A Markov model compared influenza likelihood in older adults with (1) status quo vaccination (August–May) to maximize vaccine uptake or (2) vaccination compressed to October–May (to decrease waning vaccine effectiveness impact). The Centers for Disease Control and Prevention data were used for influenza incidence and vaccination parameters. Prior analyses showed that absolute vaccine effectiveness decreased by 6%–11% per month, favoring later season vaccination. However, compressed vaccination could decrease overall vaccine uptake. Influenza incidence was based on average monthly incidence with earlier and later peaks also examined. Influenza strain distributions from two seasons were modeled in separate scenarios. Sensitivity analyses were performed to test result robustness. Data were collected and analyzed in 2018.


Compressed vaccination would avert ≥11,400 influenza cases in older adults during a typical season if it does not decrease vaccine uptake. However, if compressed vaccination decreases vaccine uptake or there is an early season influenza peak, more influenza can result. In probabilistic sensitivity analyses, compressed vaccination was never favored if it decreased absolute vaccine uptake by >5.5% in any scenario; when influenza peaked early, status quo vaccination was favored.


Compressed vaccination could decrease waning vaccine effectiveness and decrease influenza cases in older adults. However, this positive effect is negated when early season influenza peaks occur and diminished by decreased vaccine uptake that could occur with shortening the vaccination season.

© 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Keywords: Seasonal Influenza; Vaccines; USA.



Principal #Controversies in #Vaccine #Safety in the #USA (Clin Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Clin Infect Dis. 2019 Feb 12. doi: 10.1093/cid/ciz135. [Epub ahead of print]

Principal Controversies in Vaccine Safety in the United States.

DeStefano F1, Bodenstab HM2, Offit PA3.

Author information: 1 Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA. 2 Department of Pharmacy Services, The Children’s Hospital of Philadelphia, Philadelphia, PA. 3 Division of Infectious Diseases, The Children’s Hospital of Philadelphia, Philadelphia, PA.



Concerns about vaccine safety can lead to decreased acceptance of vaccines and resurgence of vaccine-preventable diseases. We summarize the key evidence on some of the main current vaccine safety controversies in the United States, including: 1) MMR vaccine and autism; 2) thimerosal, a mercury-based vaccine preservative, and the risk of neurodevelopmental disorders; 3) vaccine-induced Guillain-Barré Syndrome (GBS); 4) vaccine-induced autoimmune diseases; 5) safety of HPV vaccine; 6) aluminum adjuvant-induced autoimmune diseases and other disorders; and 7) too many vaccines given early in life predisposing children to health and developmental problems. A possible small increased risk of GBS following influenza vaccination has been identified, but the magnitude of the increase is less than the risk of GBS following influenza infection. Otherwise, the biological and epidemiologic evidence does not support any of the reviewed vaccine safety concerns.

PMID:  30753348  DOI: 10.1093/cid/ciz135

Keywords: Society; Vaccines; USA.


Neutralizing #Antibody against #Enterovirus D68 in #Children and #Adults before 2014 #Outbreak, Kansas City, #Missouri, #USA (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 3—March 2019 / Dispatch

Neutralizing Antibody against Enterovirus D68 in Children and Adults before 2014 Outbreak, Kansas City, Missouri, USA

Christopher J. Harrison  , William C. Weldon2, Barbara A. Pahud2, Mary Anne Jackson2, M. Steven Oberste2, and Rangaraj Selvarangan2

Author affiliations: The Children’s Mercy Hospital, Kansas City, Missouri, USA (C.J. Harrison, B.A. Pahud, M.A. Jackson, R. Selvarangan); University of Missouri at Kansas City, Kansas City (C.J. Harrison, B.A. Pahud, M.A. Jackson, R. Selvarangan); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (W.C. Weldon, M.S. Oberste)



We evaluated enterovirus D68 seroprevalence in Kansas City, Missouri, USA, from samples obtained during 2012–2013. Neutralizing antibodies against Fermon and the dominant 2014 Missouri isolate were universally detected. Titers increased with age. Widespread circulation of enterovirus D68 occurred before the 2014 outbreak. Research is needed to determine a surrogate of protection.

Keywords: EV-D68, Seroprevalence, Missouri, USA.


#Shedding of clade #H5N8 and #H5N2 highly pathogenic #avian #influenza viruses in peridomestic #wildbirds in the #US (Transbound Emerg Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Transbound Emerg Dis. 2019 Feb 10. doi: 10.1111/tbed.13147. [Epub ahead of print]

Shedding of clade H5N8 and H5N2 highly pathogenic avian influenza viruses in peridomestic wild birds in the U.S.

Bosco-Lauth AM1, Marlenee NL1, Hartwig AE1, Bowen RA1, Root JJ2.

Author information: 1 Colorado State University, Fort Collins, CO, USA. 2 United States Department of Agriculture, National Wildlife Research Center, Fort Collins, CO, USA.



European starlings (Sturnus vulgaris), house sparrows (Passer domesticus) and rock pigeons (Columba livia) are all wild birds commonly found in large numbers in and around human dwellings and domestic livestock operations. This study evaluated the susceptibility of these species to three strains of highly pathogenic avian influenza virus (HP AIV) clade isolated in the US. Experimental infection of European starlings and rock pigeons did not result in any overt signs attributable to AIV infection and no virus shedding was detected from the oral and cloacal routes. House sparrows shed by the oral route and exhibited limited mortality. Individuals from all three species seroconverted following infection. These data suggest that none of these birds are a likely potential bridge host for future HP AIV outbreaks but that their seroconversion may be a useful surveillance tool for detection of circulating H5 HP AIV.

This article is protected by copyright. All rights reserved.

KEYWORDS: Columba livia ; Passer domesticus ; Sturnus vulgaris ; Avian influenza virus; Biosecurity; Clade; European starling; Experimental infection; H5N2; H5N8; Highly pathogenic; House sparrow; Outbreak; Rock pigeon

PMID: 30740920 DOI: 10.1111/tbed.13147

Keywords: Avian Influenza; H5N2; H5N8; Wild Birds; USA.


#Circulation of #plasmids harboring #resistance genes to #quinolones and/or extended spectrum #cephalosporins in multiple #Salmonella enterica serotypes from #swine in the #US (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Circulation of plasmids harboring resistance genes to quinolones and/or extended spectrum cephalosporins in multiple Salmonella enterica serotypes from swine in the United States

Ehud Elnekave, Samuel L. Hong, Seunghyun Lim, Shivdeep Singh Hayer, Dave Boxrud, Angela J. Taylor, Victoria Lappi, Noelle Noyes, Timothy J. Johnson, Albert Rovira, Peter Davies,Andres Perez, Julio Alvarez

DOI: 10.1128/AAC.02602-18



Nontyphoidal Salmonella enterica (NTS) poses a major public-health risk worldwide that is amplified by the existence of antimicrobial resistant strains, especially to quinolones and extended-spectrum cephalosporins (ESC). Little is known on the dissemination of plasmids harboring the acquired genetic determinants that confer resistance to these antimicrobials across NTS serotypes from livestock in the United States.

NTS isolates (n=183) from U.S. swine clinical cases retrieved during 2014-2016 were selected for sequencing based on their phenotypic resistance to enrofloxacin (quinolone) or ceftiofur (3rd-generation cephalosporin). De-novo assemblies were used to identify chromosomal mutations and acquired antimicrobial resistance genes (AARGs). In addition, plasmids harboring AARGs were identified using short-read assemblies and characterized using a multi-step approach that was validated by long-read sequencing.

AARGs to quinolones (qnrB15/qnrB19/qnrB2/qnrD/qnrS1/qnrS2/aac(6′)Ib-cr) and ESC (blaCMY-2/blaCTX-M-1/blaCTX-M-27/blaSHV-12) were distributed across serotypes, and were harbored by several plasmids. In addition, chromosomal mutations associated with resistance to quinolones were identified in the target enzyme and efflux pump regulation genes. The predominant plasmid harboring the prevalent qnrB19 gene was distributed across serotypes. It was identical to a plasmid previously reported in S. Anatum from swine in the U.S. (KY991369.1), and similar to Escherichia coli plasmids from humans in South America (GQ374157.1 and JN979787.1). Our findings suggest that plasmids harboring AARGs to critically important antimicrobials are present in multiple NTS serotypes circulating in swine in the U.S. and can contribute to resistance expansion through horizontal transmission.

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Cephalosporins; Quinolones; Pigs; USA.


Conjugal Transfer, #WGS, and #Plasmid Analysis of Four #mcr1–bearing Isolates from #US Patients (Antimicrob Agents Chemother., asbtract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Conjugal Transfer, Whole Genome Sequencing, and Plasmid Analysis of Four mcr-1–bearing Isolates from U.S. Patients

Wenming Zhu, Adrian Lawsin, Rebecca L. Lindsey, Dhwani Batra, Kristen Knipe, Brian B. Yoo, K. Allison Perry, Lori A. Rowe, David Lonsway, Maroya S. Waters, J. Kamile Rasheed, Alison Laufer Halpin

DOI: 10.1128/AAC.02417-18



Four Enterobacteriaceae clinical isolates bearing mcr-1 gene-harboring plasmids were characterized. All isolates demonstrated the ability to transfer colistin resistance to E. coli;plasmids were stable in conjugants after multiple passages on non–selective media. mcr-1 was located on an IncX4 (n=3) or IncN (n=1) plasmid. The IncN plasmid harbored 13 additional antimicrobial resistance genes. Results indicate the mcr-1-bearing plasmids in this study are highly transferable in vitro and stable in the recipients.

This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply.

Keywords: Antibiotics; Drugs Resistance; USA; E. Coli; Enterobacteriaceae; Colistin; MCR1.


Estimating #Risk to #Responders Exposed to #Avian #Influenza A #H5 and #H7 Viruses in #Poultry, #USA, 2014–2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 5—May 2019 / Dispatch

Estimating Risk to Responders Exposed to Avian Influenza A H5 and H7 Viruses in Poultry, United States, 2014–2017

Sonja J. Olsen  , Jane A. Rooney, Lenee Blanton, Melissa A. Rolfes, Deborah I. Nelson, Thomas M. Gomez, Steven A. Karli, Susan C. Trock, and Alicia M. Fry

Author affiliations: Thailand Ministry of Public Health, Nonthaburi, Thailand (S.J. Olsen); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.J. Olsen, L. Blanton, M.A. Rolfes, S.C. Trock, A.M. Fry); US Department of Agriculture, Riverdale, Maryland, USA (J.A. Rooney, D.I. Nelson); US Department of Agriculture, Ames, Iowa, USA (T.M. Gomez, S.A. Karli)



In the United States, outbreaks of avian influenza H5 and H7 virus infections in poultry have raised concern about the risk for infections in humans. We reviewed the data collected during 2014–2017 and found no human infections among 4,555 exposed responders who were wearing protection.

Keywords: Avian Influenza; H5; H7; Poultry; Human; USA.