Comparison of influenza antibody titers among women who were vaccinated in the 2nd and the 3rd trimesters of pregnancy

BackgroundWe compared cord blood antibody titers in unvaccinated pregnant women to those vaccinated with seasonal influenza vaccine during the 2^nd and the 3^rd trimesters.MethodsPregnant women had cord blood collected at delivery for hemagglutination inhibition assay against vaccine reference viruses: A/California/07/2009 (H1N1)pdm09, A/Switzerland/9715293/2013 (H3N2), and B/Phuket/3073/2013 (Yamagata lineage). Geometric mean titer (GMT) ratios were calculated comparing vaccinated versus unvaccinated pregnant women, and women vaccinated in the 2^nd and the 3^rd trimesters. Proportions of women achieving defined titers were compared using the χ² test.ResultsOf 307 women, 190 (62%) were unvaccinated. Fifty and 67 were vaccinated during the 2^nd and the 3^rd trimesters, respectively. Median enrollment age was 29 years (interquartile range 24–34). Sixteen (5%) women had pre-existing conditions, but none were immunocompromised. GMT ratios comparing vaccinated and unvaccinated women were 5.90 (95% confidence interval [CI] 5.06–6.96) for influenza A/California, 5.39 (95% CI 4.18–6.08) for influenza A/Switzerland, and 5.05 (95% CI 4.43–5.85) for influenza B/Phuket. Similarly, the GMT ratios comparing the 3^rd and the 2^nd trimester vaccinated women were 2.90 (95% CI 2.54–3.39), 2.82 (95% CI 2.56–3.13), and 2.83 (95% CI 2.56–3.14), respectively. The proportions of women with defined titers for the three vaccine reference viruses did not differ between 2^nd and 3^rd trimester vaccinated women (titers ≥40: 68–92% versus 70–93%; ≥110: 32% versus 33–63%; and ≥330: 4–10% versus 3–21%).ConclusionsPregnant women vaccinated against influenza had more placental transfer of influenza antibodies to their infants than unvaccinated women. Placental transfer of antibodies was higher among those vaccinated in the 3^rd trimester than in the 2^nd trimester. There was no difference in the proportions of women achieving antibody titers corresponding to protection against influenza in children. Findings support the current World Health Organization’s recommendation that pregnant women may be vaccinated in either 2^nd or 3^rd trimester of pregnancy.     

Development of Epstein-Barr virus-associated gastric cancer: Infection,inflammation, and oncogenesis

Epstein-Barr virus (EBV)-associated gastric cancer (EBVaGC) cells originate from a single-cell clone infected with EBV. However, more than 95% of patients with gastric cancer have a history of Helicobacter pylori (H. pylori) infection, and H. pylori is a major causative agent of gastric cancer. Therefore, it has long been argued that H. pylori infection may affect the development of EBVaGC, a subtype of gastric cancer. Atrophic gastrointestinal inflammation, a symptom of H. pylori infection, is observed in the gastric mucosa of EBVaGC. Therefore, it remains unclear whether H. pylori infection is a cofactor for gastric carcinogenesis caused by EBV infection or whether H. pylori and EBV infections act independently on gastric cancer formation. It has been reported that EBV infection assists in the onco-genesis of gastric cancer caused by H. pylori infection. In contrast, several studies have reported that H. pylori infection accelerates tumorigenesis initiated by EBV infection. By reviewing both clinical epidemiological and experimental data, we reorganized the role of H. pylori and EBV infections in gastric cancer formation.     

Occurrence of a mosquito vector in bird houses: Developmental consequences and potential epidemiological implications

Even with continuous vector control, dengue is still a growing threat to public health in Southeast Asia. Main causes comprise difficulties in identifying productive breeding sites and inappropriate targeted chemical interventions. In this region, rural families keep live birds in backyards and dengue mosquitoes have been reported in containers in the cages. To focus on this particular breeding site, we examined the capacity of bird fecal matter (BFM) from the spotted dove, to support Aedes albopictus larval growth. The impact of BFM larval uptake on some adult fitness traits influencing vectorial capacity was also investigated. In serial bioassays involving a high and low larval density (HD and LD), BFM and larval standard food (LSF) affected differently larval development. At HD, development was longer in the BFM environment. There were no appreciable mortality differences between the two treatments, which resulted in similar pupation and adult emergence successes. BFM treatment produced a better gender balance. There were comparable levels of blood uptake and egg production in BFM and LSF females at LD; that was not the case for the HD one, which resulted in bigger adults. BFM and LSF females displayed equivalent lifespans; in males, this parameter was shorter in those derived from the BFM/LD treatment. Taken together these results suggest that bird defecations successfully support the development of Ae. albopictus. Due to their cryptic aspects, containers used to supply water to encaged birds may not have been targeted by chemical interventions.     

Indirect effects of cigarette butt waste on the dengue vector Aedes aegypti (Diptera: Culicidae)

Despite major insecticide-based vector control programs, dengue continues to be a major threat to public health in urban areas. The reasons for this failure include the emergence of insecticide resistance and the narrowing of the spectrum of efficient products. Cigarette butts (CBs), the most commonly discarded piece of waste, also represent a major health hazard to human and animal life. CBs are impregnated with thousands of chemical compounds, many of which are highly toxic and none of which has history of resistance in mosquitoes. This study was performed to examine whether exposure to CB alters various biological parameters of parents and their progeny. We examined whether the mosquito changes its ovipositional behaviors, egg hatching, reproductive capacity, longevity and fecundity in response to CB exposure at three different concentrations. Females tended to prefer microcosms containing CBs for egg deposition than those with water only. There were equivalent rates of eclosion success among larvae from eggs that matured in CB and water environments. We also observed decreased life span among adults that survived CB exposure. Extracts of CB waste have detrimental effects on the fecundity and longevity of its offspring, while being attractive to its gravid females. These results altogether indicate that CB waste indirectly affect key adult life traits of Aedes aegypti and could conceivably be developed as a novel dengue vector control strategy, referring to previously documented direct toxicity on the larval stage. But this will require further research on CB waste effects on non-target organisms including humans.     

Profile of the customers and the pattern of purchasing in sweet shops, Kuwait

PURPOSE: This study aimed to describe the profile and the purchasing pattern of the customers of two sweet shops in Kuwait. MATERIALS AND METHODS: The data were collected by observing 500 customers in two sweet shops between 11 a.m. and 2 p.m. and between 5 p.m. and 10 p.m. during a two-week period. One shop was in the city (Capital Governorate; n = 330) and the other was in the suburban area (Ahmadi Governorate; n = 170). Every tenth adult customer was also interviewed, when they had completed their purchasing. RESULTS: There were 58.2% females and 41.8% males among the customers. The mean estimated age of the customers was 29.6 (SD = 13.8) years. The mean payment for the purchase was $5.32 USD (SD 2.350). Females commonly purchased larger amount of sweets (42.6%) compared with males (30.1%; p<0.001). Chocolate was the most common choice of purchase (71%), and only 10% of the products were sugar-free products. The mean age of the customers interviewed was 35.6 years (SD = 9.4). The favourite sugar product of the interviewed customers was also chocolate (36%). The proportion of the customers considering sugar-free products as their favourite decreased consistently with increasing age. More than half of the customers used soft drinks every day (58%). CONCLUSION: Knowledge of the caries risk from sweets needs to be increased with a health education programme. Increasing the availability of sugar-free or tooth-friendly products should be one of the aims of the Kuwait Ministry of Health.     

SARS changes the ED paradigm

Severe acute respiratory syndrome (SARS) is an emerging viral infectious disease. The SARS outbreak in Singapore started in mid-March 2003. Emergency departments, being the primary portal of entry into the hospitals, had to come up with rapid strategic changes and modifications to accommodate and manage this public health problem effectively. This report discusses the changes in the Department of Emergency Medicine at Singapore General Hospital, the largest public, teaching and tertiary hospital in Singapore, during this outbreak. It will highlight the safety aspects and universal precautions undertaken, the changes to the triage system, working hours, admission policies, as well as the fluctuations in the patient load.