IDSA warns about impacts to science of US travel ban

The Infectious Diseases Society of America (IDSA) today, along with several other science and medical groups, issued a statement today expressing deep concerns about the impact of a recent executive order restricting entrance by foreign nationals into the United States.

In a press release, IDSA said "Infectious diseases do not respect national borders, and success in fighting them requires a global response. Broad international collaboration is critical to our ability to identify, track and respond to emerging infectious diseases."

Medical advances result from collaboration that depends on travel and attending international conferences, including those held in the United States, the IDSA said, adding that the executive order may also negatively impact the nation's medical and scientific workforce. Over the past 10 years, about a third of physicians entering the infectious disease specialty have come from outside the United States, including from countries affected by the travel ban.

The IDSA said it and the HIV Medicine Association have already heard of members who fear they won't be able to reenter the United States after visiting their families in their home countries, despite having valid visas. "Limiting the capabilities of physicians and scientists to collaborate around the world threatens the very national security the administration is committed to protecting."

The IDSA represents 10,000 doctors and scientists from 100 different countries.
Feb 2 IDSA statement

New MERS case reported in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) said there was a new case of MERS-CoV in the  city of Hafar Al Batin.

A 57-year-old Saudi man is in critical condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). The source of his infection is listed as primary, meaning he did not contract the disease from another person.

The new case raises Saudi Arabia's MERS-CoV total to 1,550 infections, including 643 deaths. Eight people are still in treatment or monitoring.
Feb 2 Saudi MOH report

Vast majority of Americans support childhood vaccines

Most Americans (88%) believe that the benefits of childhood vaccines outweigh any risks, and 82% believe that parents should be required to vaccinate their children before sending them to public school. These numbers come from a new survey conducted by the Pew Research Trust.

The survey was conducted before the presidential election, but the results come just weeks after President Donald Trump made headlines after meeting with Robert Kennedy Jr., a noted critic of vaccines. In the past, Trump has tweeted that childhood immunizations may be linked to autism spectrum disorders.

Pew researchers said that while most Americans are not "vaccine hesitant," some groups, including those under the age of 30 and black Americans, are more likely to perceive high risks associated with vaccines. And the majority of Americans, 68%, did not correctly identify what "herd immunity" was or why it was important for public health.

"Overall, public perceptions of the benefits and risks of the measles, mumps and rubella vaccine are strongly positive," the Pew authors report. "Some 73% of US adults rate the preventive health benefits of the MMR vaccine as high, and 66% of the public says the risk of side effects from the vaccine is low."

The survey included a nationally representative sample of 1,549 adults age 18 and older and was conducted between May 10 and June 6, 2016. It has a sampling error of plus or minus 4 percentage points.
Feb 2 Pew press release

Outbreak trial of killed oral cholera vaccine shows safety in pregnancy

Adding to the evidence for the safety of cholera vaccines during pregnancy, an observational cohort study yesterday in The Lancet Infectious Diseases demonstrated that the killed oral vaccine Shanchol was not associated with increased adverse outcomes in pregnant women or their newborns when administered during a 2015 outbreak in Malawi.

US and Malawi researchers analyzed data from 361 pregnant women immunized from Mar 30 to Apr 30, 2015, during a cholera outbreak and 327 who were not. They found no increased incidence of adverse events in either the women or their newborn babies.

"Our study provides evidence that fetal exposure to oral cholera vaccine confers no significantly increased risk of pregnancy loss, neonatal mortality, or malformation," the authors wrote. "These data, along with findings from two retrospective studies, support use of oral cholera vaccine in pregnant women in cholera-affected regions," they added, referring to studies involving Dukoral and Shanchol, respectively.

While noting the positive findings, a commentary in the same issue said about the low incidence of birth defects, "However, the small number of exposures in the first trimester limits the clinical importance of this finding."

The study was funded by the Bill & Melinda Gates Foundation.
Feb 1 Lancet Infect Dis study
Feb 1 Lancet Infect Dis commentary

Study shows link between NSAIDs, ARIs, and heart attacks

The common pain-relieving, anti-inflammatory drugs known as NSAIDs may raise the risk of a heart attack when used during a cold or influenza-like illness, according to a study today in the Journal of Infectious Diseases.

In an observational study—which can demonstrate a link but cannot prove that a substance causes a poor outcome—Taiwanese researchers analyzed claims from Taiwan's National Health Insurance Program from 2005 through 2011, which included data on almost 10,000 patients who were hospitalized for a heart attack (acute myocardial infarction).

The investigators found that use of NSAIDS (nonsteroidal anti-inflammatory drugs like ibuprofen, aspirin, and naproxen) was associated with 1.5 times the risk of a heart attack, while having an acute respiratory infection (ARI) was tied to 2.7 times the risk. Among those taking an NSAID while having an ARI, however, the risk rose to 3.4-fold. And, if ARI patients received an NSAID intravenously in the hospital, the risk climbed to 7.2-fold.

"Physicians should be aware that the use of NSAIDs during an acute respiratory infection might further increase the risk of a heart attack," said senior author Cheng-Chung Fang, MD, in a news release from the Infectious Diseases Society of America (IDSA). 

In a related commentary in the journal, two experts not involved in the study said the findings highlight the need for caution when using NSAIDs until more is known. "Clinicians should consider both medical conditions and existing medications when prescribing NSAIDs for symptomatic acute respiratory infection relief," they wrote.
Feb 2 J Infect Dis study
Feb 2 IDSA press release
Feb 2 J Infect Dis commentary