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Umbilical cord serum was available for testing from 55 infants, all but one of whom tested negative for anti-WNV IgM. The baby that tested positive at birth grew normally and tested negative at the age of 1 month and again at 8 months, suggesting that the original test was a false-positive. The authors say the sensitivity of tests for anti-WNV IgM in cord blood is unknown. Therefore, they write, “We cannot rule out the possibility that occult congenital WNV infection might have contributed to abnormalities that are temporally plausible with the timing of maternal WNV infection.” After the first US case of congenital WNV infection was reported in 2002, the Centers for Disease Control and Prevention (CDC) worked with state health departments to set up a surveillance registry for women who contracted WNV during pregnancy. The Pediatrics report was prepared by a team from the CDC and six state health departments, with the CDC’s Edward B. Hayes, MD, as senior author. The mother of the baby with Down syndromewhich occurs at conceptioncontracted WNV in her second trimester, the report says. The other three abnormalities are believed to originate in the first trimester, but the women didn’t contract WNV until the third trimester. Of the 77 women, 71 gave birth to a total of 72 babies; four women had miscarriages and two had abortions. Sixty-seven babies were born at term, while four were premature and the gestational age was unknown for one. “Thus, of the 7 infants with major malformations, only 3 had defects that could have been caused by maternal WNV infection based on the timing of the infections and the sensitive developmental period for the specific malformations, and none had any conclusive evidence of WNV etiology,” the article states. Seven of 72 children of mothers who had West Nile infection during pregnancy were born with major abnormalities, but the timing of the illnesses indicates that only three of the babies’ defects could have been caused by WNV, according to the report in Pediatrics. There was no clear evidence of WNV infection at birth in any of the three. Mar 9, 2006 (CIDRAP News) Pregnant women who come down with West Nile virus (WNV) infection probably run a fairly small risk of major birth defects in their babies, according to the first analysis of data collected in 16 states. But the authors concluded that only three of those abnormalities could have been related to the mother’s WNV infection, given the timing of the illnesses. These were the polydactyly case (infection in the first trimester) and microcephaly cases (infection in the the second trimester). For the registry, healthcare providers reported WNV cases in pregnant women to health departments, which reported laboratory-confirmed cases to the CDC. The CDC then asked the healthcare providers to ask patients to participate voluntarily in the registry. The rate of miscarriages, preterm delivery, and low-birth-weight babies was no higher in this group than in the general population, the report says. But 7 of the 72 babies had major abnormalities, which is above the general population rate (10.6% versus 5.5%). The defects included one case of polydactyly (an extra toe), two babies with an abnormally small head (microcephaly), one Down syndrome case, one aortic coarctation, one cleft palate, and one case of lissencephaly (lack of normal convolutions of the cerebral cortex). Three babies among the 72 might have been infected during gestation even though their blood tests were negative at birth, the report says. One of these had WNV meningitis at the age of 10 days, but recovered and grew normally. The baby with aortic coarctation had a positive blood test at the age of 1 month but was normal at 14 months. The infant with lissencephaly had WNV encephalitis at 17 days and died at 7 weeks. In 2003 and 2004, 77 women from 16 states had WNV illness and agreed to participate, according to the report. Of those, 52 had West Nile fever, while 18 had neuroinvasive disease, 6 had unspecified illness, and 1 had asymptomatic viremia. Roughly equal proportions of the women were believed to have contracted WNV in the first, second, and third trimesters of pregnancy. The report also says that eight babies had abnormal growth, though most of them eventually achieved age-appropriate growth. It is unclear whether congenital WNV could account for some of the growth abnormalities. Prospective studies are needed to clarify the issues, the authors conclude. O’Leary DR, Kuhn S, Kniss KL, et al. Birth outcomes following West Nile virus infection of pregnant women in the United States, 2003-2004. Pediatrics 2006;117(3):537-45 [Abstract]
Apr 16, 2008 (CIDRAP News) – Seasonal influenza viruses flow out of overlapping epidemics in East and Southeast Asia, then trickle around the globe before dying off, researchers from the World Health Organization (WHO) committee that selects the viral strains for the annual flu vaccine said today.At a press conference, researchers said the findings, released ahead of print today in the Apr 18 issue of Science, could influence how experts pick the flu strains that will be included in each year’s vaccine. Derek Smith of the University of Cambridge in the United Kingdom told reporters that identifying the source of the viruses allows global health officials to better predict which viruses are most likely to cause the most disease over the next year.”We now know that East and Southeast Asia is where we should be paying the most attention,” he said. The findings will likely pave the way for greater collaboration on flu virus surveillance in those regions, he added.”Flu science and flu public health have to go hand and hand, because it [the influenza virus] is a very complicated pathogen,” he said.The group analyzed 13,000 samples of influenza A/H3N2 virus that were collected across six continents from 2002 to 2007 by the WHO’s Global Influenza Surveillance Network. They said they chose that influenza subtype because it is currently the major cause of flu-related illness and deaths. They compared differences in hemagglutinin (HA), a surface protein, among the different samples.In 10% of the samples, the researchers also compared the sequences of the gene that codes for HA. The two analyses enabled the researchers to identify different strains of H3N2 as they arrived at new sites over the 5-year period.The results revealed that newly emerging strains of H3N2 appeared in East and Southeast Asian countries about 6 to 9 months earlier than anywhere else. The strains generally reached Australia and New Zealand next, followed by North America and Europe. The new variants typically reached South America after an additional 6 to 9 months, the group reported.Though the findings didn’t suggest that any particular Asian country was a frequent source of the new strains, researchers reported that influenza viruses in Thailand, Malaysia, and Japan were antigenically less advanced than those in the rest of the region, implying that those countries were less likely to produce new strains.Once the strains leave East and Southeast Asia, they enter an “evolutionary graveyard,” the authors said in a press release today from the American Association for the Advancement of Science (AAAS), the publisher of Science. Older flu strains that leave North America, for example, aren’t likely to infect people in Asian countries again, because populations would be immune to them, and the viruses would become extinct, Colin Russell, also from the University of Cambridge, told reporters.The new findings on the travel routes of seasonal flu viruses cast doubt on other migration theories, Smith said. Some experts have suspected that the viruses migrate between the northern and southern hemispheres, come from tropical areas, or originate in China.It’s unclear why new variants appear in Asian countries first, but Russell said one contributing factor could be continually overlapping influenza epidemics in Asian countries. “It’s like runners passing a baton, and evolution is occurring in that context,” he said.Though countries East Asia aren’t very far apart, many have different climates and rainy seasons that occur at different times of the year. For example, Smith said Bangkok and Kuala Lumpur are only 700 miles apart, but their flu seasons occur at different times of the year. He also said Asian countries have intensive contact through air travel, which could also contribute to viral movement patterns.The next step is to reach back into the WHO’s surveillance database to analyze H3N2 viruses from the years before 2002 to see how robust the circulation pattern findings are, Smith said.When journalists asked if the findings had any bearing on likely circulation patterns for pandemic influenza strains, Russell said the findings apply only to seasonal flu viruses that were included in the study. “It [seasonal flu] is completely distinct,” he said.Russell CA, Jones TC, Barr IG, et al. The global circulation of seasonal influenza A (H3N2) viruses. Science 2008 Apr 18;320(5874):340-6See also:Apr 16 Science press release
May 2, 2008 (CIDRAP News) – Technical barriers have prevented the widespread use of human monoclonal antibodies as potent diagnostic and treatment tools, but scientists now say they have found a way to produce antibodies against seasonal influenza much faster than was previously possible.The researchers, from Emory University in Atlanta and the Oklahoma Medical Research Foundation (OMRF) in Oklahoma City, produced influenza-specific monoclonal antibodies in about a month, rather than the typical 2 to 3 months, using blood from volunteers who had received a seasonal influenza vaccine. They said the new technique could be used to rapidly create monoclonal antibodies for a range of infectious diseases, including pandemic influenza and anthrax.The scientists released their findings on Apr 30 in a letter in an early online edition of the journal Nature.Monoclonal antibodies—highly-specific infection-fighting proteins made in a lab in cell lines derived from a single antibody-producing cell—are used to treat some cancers and immunologic diseases.Only 20 therapeutic monoclonal antibodies have been approved by the US Food and Drug Administration (FDA), and only two of them are from humans, according to an Apr 30 press release from the National Institutes of Health (NIH), which supported the study through the National Institute of Allergy and Infectious Diseases (NIAID) and National Center for Research Resources.The authors reported that antibody or serum therapy is effective for a wide range of conditions, but the treatments are not widely used because they sometimes cause fatal anaphylactic reactions and serum sickness. “These obstacles can only be overcome by using fully human monoclonal antibodies,” they wrote.In developing the new technique, the researchers explored whether immune system cells called antibody-secreting plasma cells (ASCs) could be used to produce monoclonal antibodies. ASCs play a key role in the initial response to infection or vaccination, the NIH said, but their activity drops sharply and is barely detectable after 2 weeks.Emory University researchers found a way to capture the ASCs that produce the initial wave of influenza antibodies, the NIH said. A notable finding was that 80% of the purified ASCs produced influenza-specific antibodies, the investigators reported.In the next phase of the study, researchers from the OMRF used the vaccine-generated, influenza-specific ASCs to create the monoclonal antibodies. After the volunteers were vaccinated, it took researchers only a few weeks to produce a purified human monoclonal antibody that had a high affinity for the influenza virus, the NIH said.Patrick Wilson, PhD, an immunologist at OMRF, said in the NIH press release, “With just a few tablespoons of blood, we can now rapidly generate human monoclonal antibodies that potentially could be used for diagnosis and treatment of newly emerging strains of influenza. In the face of a disease outbreak the ability to produce infection-fighting human monoclonal antibodies swiftly would be invaluable.”Though the study did not involve a potential pandemic flu strain such as H5N1, Rafi Ahmed, PhD, an immunologist at the Emory Vaccine Center, said in the press release that the team plans to use the technique to generate monoclonal antibodies against the H5N1 virus and other pathogens.Wrammert J, Smith K, Miller J, et al. Rapid cloning of high-affinity human monoclonal antibodies against influenza virus. Nature 2008; Apr 30 early online publicationSee also:Apr 30 NIH press release
After the CDC completes more analysis of the study data in 2009, the company may seek FDA clearance to further shorten the vaccine course, if the strategy is supported by the data, Emergent said in its press release. The FDA’s approval is based on early findings from a large multicenter trial that was initiated by the US Centers for Disease Control and Prevention (CDC) in 2002, according to the statement from Emergent. The goal of the study is to evaluate if as few as three doses of the vaccine administered over 6 months with booster doses up to 3 years apart will offer sufficient protection. The vaccine is required for US military members who are deployed to the Middle East, but some have objected to the vaccine because of side effects. Emergent BioSolutions, maker of BioThrax, said in a Dec 19 press release that the FDA’s approval of the company’s supplemental biologics license application for its anthrax vaccine adsorbed (AVA) allows a new schedule for the vaccine: five intramuscular (IM) doses compared with the previous regimen of six subcutaneous doses. Dec 22, 2008 (CIDRAP News) – The US Food and Drug Administration (FDA) recently approved a new version of BioThrax—the nation’s only licensed anthrax vaccine—that requires fewer doses and changes the injection route. See also: Daniel Abdun-Nabi, Emergent’s chief operating officer and president, said in the statement that the FDA’s approval is an important milestone in the company’s mission to advance the usefulness of BioThrax. “We are pleased that the US government shares our commitment to enhancing this critical countermeasure. The CDC is to be applauded for their hard work and diligence throughout this important effort,” he said. Oct 6 CIDRAP News story “Trial offers hope for shortening anthrax-shot series” Dec 19 Emergent BioSolutions press release According to the new schedule, the vaccine is administered at 0, 1, 6, 12, and 18 months. The previous course involved the same schedule, plus a dose at 2 weeks. The company recommends annual booster doses with the new dosing, the same as for the previous schedule. The report said the subcutaneous injection route might make the vaccine more tolerable and that reducing the number of doses in the AVA schedule could help conserve the vaccine supply. Since 1998, federal officials have ordered 32 million doses of BioThrax, and nearly 7.9 million doses have been administered to more than 2 million military members, the company said. In October, researchers published their interim findings on the new BioThrax schedule in the Journal of the American Medical Association. Investigators reported that the subjects who received three or four IM, doses over 6 months had similar antibody responses to those who received four subcutaneous doses over 6 months. The volunteers who received four IM doses had fewer injection-site reactions than those who received four subcutaneous doses.
Apr 10, 2009No low-path spread in Kentucky poultryVeterinary officials in Kentucky said yesterday that initial tests of poultry within a 2-mile radius of a commercial farm where birds showed exposure to the low-pathogenic H7N9 avian influenza were negative for the virus. Further tests are pending, and authorities said they will expand testing to a 10-km (6.2-mile) radius. Local and state health officials are following up on potential human exposure to the virus.Expert: Egypt’s H5N1 spike points to policy gapsThe recent spike in H5N1 avian influenza illnesses in Egypt, particularly among children, is a sign of gaps in disease prevention policies and efforts, a virology expert in Egypt said yesterday. Diaa Salman told Daily News Egypt that the country should consider upgrading its laboratory capabilities, reassess components of the poultry vaccine policy, and foster inter-departmental collaboration on monitoring wild birds and virus changes. He added that the health ministry and local authorities need to do more to ensure that farmers in rural areas are applying biosecurity measures to their backyard flocks.Researchers find low-path exposure in US turkey workersA serologic investigation of turkey farm workers found that they were exposed to a several low-pathogenic avian influenza subtypes, according to a study in the Apr 8 early online edition of Zoonoses and Public Health. They looked for serologic evidence of exposure to eight avian influenza subtypes in 95 adults with occupational exposure to turkeys. They found that the workers had been exposed to five of the subtypes (H4, H5, H6, H9, and H10) and had antibody titers that were 3.9 to 15.3 times higher than those without occupational exposure. The authors said the findings suggest agriculture workers should be included in pandemic influenza priority groups and that more surveillance should be done at both commercial and small-scale poultry farms.[Apr 8 Zoonoses and Public Health abstract]Texas fines PCA plant $14 millionThe Texas Department of State Health Services (TDSHS) assessed the Peanut Corporation of America’s (PCA) Plainview plant—implicated in a nationwide Salmonella outbreak—$14.6 million in administrative penalties for allegedly violating state food safety regulations. The charges include unsanitary conditions, product contamination, illnesses from peanuts processed at the plant, and operating for nearly 4 years without a state food manufacturers license. The TDSHS said PCA can pay the penalty, ask for an informal conference to discuss the allegations and penalty, or request a formal administrative hearing.[Apr 9 TDSHS press release]No source found on E coli O111 outbreakIn a final report on the nation’s largest Escherichia coli O111 outbreak, linked in August 2008 to a Locust Grove, Okla., restaurant, officials said they still don’t know the food or environmental source of the pathogen, though the investigation revealed that it was a point-source outbreak. Investigators weren’t able to determine the mode of the outbreak, though they said evidence suggests ongoing E coli O111 transmission to restaurant patrons between Aug 15 and Aug 24, 2008. The outbreak was linked to 341 cases, 70 hospitalizations, and 1 death.Tests show no Salmonella in NY pistachio plantThe New York State Department of Agriculture (NYSDA) announced today that food and environmental samples from a Setton Farms facility in Commack, N.Y., were negative for Salmonella. Kraft Foods previously found four Salmonella strains in Setton Farms pistachios used in certain brands of trail mix, and the findings have sparked a national recall of many products that contain pistachios. No illnesses have yet to be officially linked to the contaminated pistachios.[Apr 10 NYSDA press release]
From 2019, direct flights to the USA will start from Dubrovnik, reports from Dubrovnik Airport.Thus, after a long 28 years, the Republic of Croatia will again be directly connected to the United States through Dubrovnik Airport, thanks to the long-lasting negotiations between Dubrovnik Airport and American Airlines. Dubrovnik and the USA will be connected from June 7, 2019 to September 27, 2019, three times a week with the American city of Philadelphia, and the world’s largest airline “American Airlines” will operate.A Boeing 767-300 aircraft with a capacity of 28 highly luxurious seats in business class and 181 seats in economy class will fly to Dubrovnik, and Wi-Fi service will be available to passengers throughout the flight. “Given the growing number of tourist arrivals from the United States to the Dubrovnik area, we consider this a huge step forward for Dubrovnik and the entire Republic of Croatia.”Point out from Dubrovnik Airport.BY THE WAY, IN 1783, THE REPUBLIC OF DUBROVNIK WAS THE FIRST STATE IN THE WORLD TO RECOGNIZE THE UNITED STATES OF AMERICA.American Airlines is a member of the global aviation association Oneworld and currently owns 955 aircraft and employs 122.000 people. It operates 6.700 flights a day to 350 destinations. Philadelphia, located in the state of Pennsylvania, is the largest hub of American Airlines on the East Coast and the most important transfer airport for the entire United States. On behalf of American Airlines, the vice president of the flight planning company, Mr. Vasu Raja stated the following: “Philadelphia is the largest hub of American Airlines in the northeastern United States and offers connections to the rest of the United States, Canada, and the Caribbean. The most important destinations are Los Angeles, Miami, Toronto, New Orleans and the Bahamas.”By the way, in the first seven months in the Dubrovnik-Neretva County there were 93.912 arrivals and 262.264 overnight stays of tourists from the USA, while in the city of Dubrovnik the number of tourist arrivals from the USA in the first seven months was 77 (047% more than last year). ), and 24 overnight stays were realized, which is 215% more than in the first seven months of 457.RELATED NEWS: PROMOTION OF CROATIA AT VIRTUOSO TRAVEL WEEK
The event was held under the auspices of the Ministry of Tourism of the Republic of Croatia, the Ministry of the Sea, Transport and Infrastructure of the Republic of Croatia, the Ministry of Environment and Energy, the Central State Office for Sports of the Republic of Croatia, the City of Zagreb and the Environmental Protection and Energy Efficiency Fund. The partners were the Croatian National Tourist Board and the Zagreb Tourist Board. Representatives of the diving tourism community of the Croatian Chamber of Commerce, which gathers all diving centers on the Adriatic, pointed out that more should be invested in the promotion of existing wealth and work on joint promotion through events, professional gatherings and investment in modernization of the promotion. for diving) sought a chair more. Diving has been one of the most important activities in the tourist offer in the last 15 years, while we cannot imagine the protection of the seabed without divers, and scientific diving as well as other dives is also an important topic. Great emphasis is placed on the ecology and protection of the Adriatic Sea. It is diving clubs that keep our underwater world clean with their continuous underwater cleaning actions. Apart from them, cities that gravitate to tourism and life at sea and from the sea also give a great deal of cleanliness to the seabed. The local government has recognized diving and diving events as one of the essential marketing tools and platforms for promoting the destination and extending the tourist season. The common assessment is that diving, according to the profession, is not fully used, as one of the best and most profitable tourist products. In addition to tourism, the congress touched on promotions at all levels, ecology, the health aspect of diving and diving safety. For more than fifteen years he waited for the moment of gathering of the diving profession in one place which he had gathered 1st Croatian Diving Congress in Zagreb organized by the Diving Promotion Agency. The congress gathered more than four hundred participants from all parts of Croatia, but also from neighboring countries, who participated in numerous, educational and interesting panels and lectures.