“An Improved Alert System for Emerging Infectious Diseases”.
Published: JAMA 2024; Nov 6. https://doi.org/10.1001/jama.2024.22023
Editorial comment: Based on the author, current epidemiological alerts are inadequate because they do not account for uncertainty or provide actionable guidance needed if the situation evolves. An improved outbreak alert system is needed to ensure a coordinated response across health care and public health sectors, this viewpoint publication emphasizes on those defects, and proposes new methods to improve alert systems confronting a future outbreaks, and even new pandemic.
Identifying WHO global priority endemic pathogens for vaccine research and development (R&D) using multi-criteria decision analysis (MCDA): an objective of the Immunization Agenda 2030
Published: EbioMedicine 2024; November 4th: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(24)00460-2/fulltext
Editorial comment: A must-read publication. The World Health Organization’s (WHO) Immunization Agenda 2030 (IA2030) has established a structured approach to prioritize vaccine R&D for endemic pathogens based on regional and country-specific health needs. Through surveys conducted with policymakers and immunization stakeholders across WHO regions, eight criteria were used to assess pathogens, with two—annual deaths in children under five and contribution to antimicrobial resistance—emerging as top priorities in five of the six regions.
The survey responses revealed that these priority criteria did not significantly vary by region, demographic background, or expertise area of respondents. This consistency helped identify five pathogens—Mycobacterium tuberculosis, HIV-1, Klebsiella pneumoniae, Staphylococcus aureus, and extra-intestinal pathogenic Escherichia coli—as shared priorities across all regions. Additionally, six pathogens were uniquely prioritized in individual regions, reflecting localized health needs.
By merging the top ten pathogen lists from each region, WHO derived a global priority list of 17 pathogens for targeted vaccine R&D. To support this agenda, 34 distinct R&D use cases were identified, divided into categories based on necessary actions: Advance product development (the majority), Research, and Prepare to implement. This categorization helps streamline efforts to accelerate vaccine development and implementation for priority pathogens globally.
“Global landmark: 2023 marks the worst year for dengue cases with millions infected and thousands of deaths reported”.
Published: IJID Regions 2024; Dec: 100459. https://doi.org/10.1016/j.ijregi.2024.100459
Editorial comment: The authors collected data on reported Dengue cases and deaths from various countries submitted to the World Health Organization (WHO) and its regional offices. They estimated the incidence per million population and the case fatality ratio (CFR) among confirmed cases reported by each country. In 2023, over 6.5 million cases and more than 6,800 Dengue-related deaths were recorded globally, marking a historic high. South America and Southeast Asia showed the highest levels of endemicity and CFRs.
Impact of the 100 days mission for vaccines on COVID-19: a mathematical modelling study.
Published: Lancet Glob Health 2024; 12: e1764-74 (November-2024). https://doi.org/10.1016/S2214-109X(24)00286-9
Editorial comment: In this study, the authors used a previously published model of SARS-CoV-2 transmission dynamics, calibrated to excess mortality data from the COVID-19 pandemic, to project outcomes under three investment strategies: rapid vaccine development and manufacturing, expanded manufacturing capacity to overcome supply constraints, and strengthened health systems for faster vaccine distribution and global equity. Each scenario was evaluated against the actual COVID-19 pandemic to estimate both public health and economic impacts.
The findings indicate that, assuming countries implemented non-pharmaceutical interventions (NPIs) as they did historically, the “100 Days Mission” could have prevented an estimated 8.33 million deaths worldwide, primarily in lower-middle-income countries, translating to a potential economic savings of US$14.35 trillion. Further investments in manufacturing and health systems could increase the total deaths averted to 11.01 million. In an alternative scenario, where NPIs are lifted earlier based on vaccine coverage, the 100 Days Mission alone could have reduced global restriction days by 12,600 while still averting 5.76 million deaths.
“Real-World Assessment of Economic and Clinical Outcomes in Thai Patients With Respiratory Syncytial Virus Infection Across Age Groups: A Retrospective Cohort Analysis.”
Published: Influenza and other respiratory viruses – Wiley; November 4th, 2024. https://doi.org/10.1111/irv.70039
Editorial comment: In this study conducted in Thailand, among RSV-positive patients, younger children experienced the highest disease burden, while older adults faced poorer health outcomes. Older age, comorbidities, and critical care needs were associated with increased healthcare costs. Understanding the economic burden of RSV is essential for evaluating the cost-effectiveness and public health impact of vaccination programs that prioritize at-risk groups to reduce RSV’s overall impact on public health.
“Excess mortality associated with chikungunya epidemic in Southeast Brazil, 2023.”
Published: Front Trop Dis 2024; 5 (October). https://doi.org/10.3389/fitd.2024.1466207
Editorial comment: In 2023, a significant chikungunya epidemic struck Minas Gerais, one of Brazil’s most populous states. The authors focused on the North and Northeast Health Macroregions of Minas Gerais, covering 2.5 million residents. Using epidemiological data from the Ministry of Health’s laboratory surveillance, disease notification, and mortality systems, they developed a robust Poisson regression model to estimate expected monthly mortality. Excess deaths were determined by comparing observed deaths to model estimates during the epidemic period. The analysis revealed 890 excess deaths attributed to chikungunya, resulting in a mortality rate of 35.1 per 100,000 inhabitants—approximately 60 times higher than the 15 deaths officially reported by surveillance. This study underscores the need for complementary tools to traditional surveillance to better assess the true impact of outbreaks on morbidity and mortality and to inform public health priorities and interventions more effectively.
Arbovirosis in Europe
Published: Enfermedades infecciosas y microbiologia clinica (English ed.), Volume 42, Issue 9, 2024, https://doi.org/10.1016/j.eimce.2024.09.008
Editorial Comment: This review highlights the ecological and epidemiological aspects of arboviruses, emphasizing the roles of diverse hosts and reservoirs, including humans, animals, and vectors, in their life cycles. The influence of climate change on the ecology of the vector, which potentially favors the arbovirus transmission, is also reviewed. Focusing on diagnosis, prevention and in the absence of specific treatments, the importance of understanding vector–host interactions and environmental impacts to develop effective control and prevention strategies is emphasized.
Lassa fever research priorities: towards effective medical countermeasures by the end of the decade
Published:The Lancet Infectious Diseases, Volume 24, Issue 11, e696 – e706 https://doi.org/10.1016/S1473-3099(24)00229-9
Editorial Comment: In 2016, WHO designated Lassa fever a priority disease for epidemic preparedness as part of the WHO Blueprint for Action to Prevent Epidemics. One aspect of preparedness is to promote development of effective medical countermeasures (ie, diagnostics, therapeutics, and vaccines) against Lassa fever. Diagnostic testing for Lassa fever has important limitations and key advancements are needed to ensure rapid and accurate diagnosis. Additionally, the only treatment available for Lassa fever is ribavirin, but controversy exists regarding its effectiveness. Finally, no licensed vaccines are available for the prevention and control of Lassa fever.
Current Epidemiological Status of Chikungunya Virus Infection in East Africa: A Systematic Review and Meta-Analysis
Published: Journal of Tropical MedicineVolume 2024, Article ID 7357911 https://onlinelibrary.wiley.com/doi/10.1155/2024/7357911
Editorial Comment: This study highlights the significant burden of chikungunya in East Africa, and the findings underscore the need for targeted public health interventions and improved surveillance to manage and control chikungunya outbreaks in the region.
Clinical characteristics and in-hospital outcomes associated with RSV-ALRI compared to other viral ALRI in hospitalised children under two years old
Published: The Journal of Infectious Diseases, 2024; jiae543 https://doi.org/10.1093/infdis/jiae543
Editorial Comment: Children with RSV-ALRI exhibited more severe symptoms, received more antibiotics, and had longer hospital stays compared to those with other viral ALRIs, underscoring the need for effective prevention and treatment strategies for RSV.
Long-term dynamics of measles virus-specific neutralizing antibodies in children vaccinated before 12 months of age
Published: Clinical Infectious Diseases, 2024;, ciae537. https://doi.org/10.1093/cid/ciae537
Editorial Comment: Children vaccinated before 8·5 months of age exhibited a markedly faster antibody decay and lost their protective neutralizing antibody levels over 6 years.
Routine vaccination of infants under 8·5 months of age may lead to blunted MeV-specific antibody responses to subsequent MMR vaccination. Early MMR vaccination should only be considered during measles outbreaks or in other situations of increased risk of MeV infection.
Hajj vaccination strategies: Preparedness for risk mitigation
Published: Journal of Infection and Public Health,Volume 17, Issue 11, 2024. https://doi.org/10.1016/j.jiph.2024.102547
Editorial Comment: On top of meningococcal vaccines much more much more vaccines are recommended for Hajj pilgrims. Drawing from the collective experience, the annual planning process emphasizes the importance of adapting vaccination approaches to address new threats and emerging public health concerns.
The role of antibody-dependent enhancement in dengue vaccination
Published: Trop Dis Travel Med Vaccines 10, 22 (2024). https://doi.org/10.1186/s40794-024-00231-2
Editorial Comment: Antibody-dependent enhancement is a phenomenon causing worldwide morbidity and mortality in dengue virus infections. Additionally, in the search for a vaccine against DENV, vaccine-induced ADE has caused several setbacks for the use of a vaccine on a larger scale. Despite this, a recently licensed live attenuated vaccine (Qdenga, TAK-003, Takeda) has not shown signs of ADE. Long-term data has yet to show whether new candidates in phase 2 and 3 trials such as TV003/TV005 with both structural as well as non-structural proteins have a higher efficacy. Another big question remaining is if vaccine efficacy is waning, could that result in more ADE?
“Effect of COVID-19 vaccination on the risk of developing post-COVID conditions: The VENUS study”.
Published: Vaccine 2025; 43: 126497. https://doi.org/10.1016/j.vaccine.2024.126497
Editorial comment: This retrospective cohort study analyzed a database containing medical claims, COVID-19 case data, and vaccination records from residents of four Japanese municipalities. Among 84,464 participants, 9,642 (11.4%) developed post-COVID-19 conditions over an 8-month period. The risk of developing 28 out of 36 targeted conditions—including various respiratory, cardiovascular, inflammatory, immune, physical, psychiatric, and endocrine disorders—was significantly lower for individuals who had received a COVID-19 vaccination within 14 to 149 days prior to infection. These findings suggest that COVID-19 vaccination, particularly when administered within 5 months before infection, can reduce the incidence and risk of post-COVID-19 conditions. Notably, despite having the highest mean age and prevalence of comorbidities, those most recently vaccinated experienced a lower risk of developing post-COVID-19 conditions. These results offer valuable insights for shaping future COVID-19 vaccination strategies.
“Does Tobacco Smoking Affect Vaccine-Induced Immune Response? A Systematic Review and Meta-Analysis”
Published: Vaccines 2024; 12: 1260. https://doi.org/10.3390/vaccines12111260
Editorial comment: This review provides a comprehensive overview of the literature on how smoking diminishes the effectiveness of active immunization by impairing vaccine-induced immune responses. Thirty-four studies were included in the analysis. Overall, smoking was associated with reduced antibody levels and avidity, as well as lower immune cell production. The meta-analysis revealed a weighted mean difference of 0.65 (95% CI: 0.10–1.19, p = 0.02) in vaccine effectiveness between smokers and non-smokers for vaccines against COVID-19, influenza, pneumococcus, HBV, HPV, tetanus, pertussis, polio, Haemophilus influenzae type b, measles-mumps-rubella, and recurrent urinary tract infections. The findings suggest that smoking cessation programs should be integrated into vaccination strategies to enhance vaccine effectiveness and improve public health outcomes, and maybe vaccination schemes should be different between smokers and non-smokers.
