At the United Nations General Assembly meeting in New York City on September 23, 2019, the Center for Disease Control hosted the Antimicrobial Resistance Challenge: A night celebrating antimicrobial resistance fighters. The venue brought together representatives from various organizations and institutions engaged in the fight against antimicrobial resistance, including PIDS, and showcased artwork bringing attention to the fight against antimicrobial resistance. The event premiered the film “Antimicrobial Resistance Fighters,” which was directed by Michael Wech and introduced by Dame Sally Davies, the Chief Medical Officer for England and Chief Medical Advisor to the UK government.

This powerful and well-made documentary highlighted individual stories to explain the threat of antimicrobial resistance to the general public. One such story featured Mr. David Ricci, a white American young man who spoke passionately at the event about his journey combating an infection that he contracted while living in Calcultta, India. In 2011, Mr. Ricci worked as a volunteer at an orphanage for children living with HIV/AIDS, when he barely survived a horrific accident in which he was struck by a train, his bones and muscles crushed as he was dragged under. The film showed footage of the location where the accident took place, alongside piles of waste and trash where volunteers pulled him out from under the train. At a local clinic his leg was sawed off above the knee at the bedside without anesthesia. He was transferred to a hospital where he underwent multiple surgeries. Brief footage in the film flashed images of his initial wound against the backdrop of the grounds of his accident.  Mr. Ricci flew back home to the U.S. two weeks after the accident where he was cared for at the University of Washington Medical Center in Seattle. He was found to have a wound infection caused by multiple bacteria that harbored the New Delhi metallobetalactamse-1 enzyme. Dr. John Lynch, the infectious diseases physician caring for him at the University of Washington, explained that after several antibiotics failed, they ultimately treated Mr. Ricci’s infection with colistin and a series of surgical debridements.

Mr. Ricci, who is now a patient advocate and antimicrobial resistance fighter, described his body’s reaction to each dose of colistin as feeling like his organs were being eaten away. Later in the film, another story unfolds describing the use of colistin in agriculture. Mr. Ricci comments that despite the toxic effects that colistin had on his body, the effectiveness of this last line drug against his multi-drug resistant infection saved his life. He acknowledges that he is alive because the bacteria causing his infection were still susceptible to colistin. He expresses his astonishment that our society could allow widespread agricultural use of colistin that would threaten its effectiveness.

 “Antimicrobial Resistance Fighters” was powerful, and will raise awareness to the general public about the global threat of antimicrobial resistance. The film is an example of what events like the AMR Challenge strives to accomplish by bringing together advocates in the fight against antimicrobial resistance from all disciplines, reminding us that we must work together to share our experiences and expertise. 

By Rana Hamdy; Newsletter Edition 9.23.19

To learn more about PIDS AMR efforts, visit our Antibiotic Resistance page here.  U.S. Antibiotic Awareness Week is being observed November 18-24, 2019.

Dropulic LK,  et.al.  A Randomized, Double-Blinded, Placebo-Controlled, Phase 1 Study of a Replication-Defective Herpes Simplex Virus (HSV) Type 2 Vaccine, HSV529, in Adults With or Without HSV Infection. J Infect Dis 2019;220:990.

 

Background

Both genital and oral herpes simplex virus (HSV) infections are common throughout the world.  Most infections are asymptomatic but many produce painful ulcerations that often recur.  Further, neonatal HSV infections produce a severe disease while genital HSV-2 infections are a major risk factor for the acquisition and transmission of HIV.

Methods and results

In this manuscript the authors describe the initial clinical evaluation of a replication defective herpes simplex virus vaccine.  A replication defective vaccine is one in which one or more essential genes have been deleted so the vaccine virus, which is grown in a cell line that provides the missing gene product(s),  can infect a cell but the virus produced is non-infectious because of the deletions.  Thus, another term used is a single cycle vaccine.  This is one of several new approaches to vaccine development discussed briefly below.

The vaccine HSV529 (HSV-2 dl5-29), a double deletion of  HSV-2 UL5 and UL 29, was evaluated in 60 healthy adults in a double blind study of participants who were either seronegative for HSV1 and HSV-2, or positive for either HSV-1 or HSV-2 or both.  The vaccine was provided in a 3 dose schedule administered IM at 0,1 and 6 months. Safety and both antibody and T cell responses were quantified.

The overall safety profile of the vaccine was acceptable although mild to moderate local reactions were common (89%).  There was no significant difference compared to placebo recipients in unsolicited adverse events.  A fourfold increase in neutralizing antibody titers was induced in 11 of 14 HSV seronegative participants after the third dose and titers remained elevated at 6 months. For those HSV seropositive, there was a mixed response but none of the recipients had a 4 fold increase.  There was also some evidence of T cell induction but CD8 responses were weak in seronegative participants and were even less for seropositive subjects.  CD4 responses were higher than CD8 for both groups.

 

Discussion

This is an interesting time for HSV vaccines.  The recent failure of a prophylactic (to prevent disease and persistent infection) monovalent glycoprotein D (gD) vaccine to protect against HSV-2 (1) and the sub optimal but significant decrease in recurrent HSV-2 disease and shedding by a bivalent therapeutic vaccine (to decrease recurrent disease and shedding in those already infected) (2) has led many to believe that a successful vaccine must present more HSV antigens.  Hence the development of this replication defective candidate as well as live attenuated vaccines that have deleted neuroinvasive HSV proteins (3,4) in order to present more HSV antigens.  On the positive side the prophylactic gD2 candidate did protect against HSV-1 genital disease and infection (1) and established a correlate of protection (5) providing encouragement to the field.  Similarly, the therapeutic vaccine established a proof of concept for therapeutic vaccines.  The vaccine evaluated in the current manuscript offers advantages to the subunit vaccines evaluated previously, in that it presents all the HSV antigens to the immune system.  However, it remains unclear as to whether a single round of virus replication will be sufficient to induce long lasting protection.  Also of interest, similar approaches have recently been used for cytomegalovirus (CMV) vaccines after the partial success of a monovalent glycoprotein B CMV vaccine (6).  Thus both replication defective (7) and live attenuated vaccines (8) are being developed.

Stay tuned for results of upcoming clinical trials for these and other herpes virus vaccines

References

  1. Belshe RB, Leone PA, Bernstein DI, et.al. Herpevac Trial for Women. Efficacy results of a trial of a herpes simplex vaccine. N Engl J Med. 366:34; 2012.
  2. Bernstein DI, Flechtner JB, McNeil et.al. Therapeutic HSV-2 vaccine decreases recurrent virus shedding and recurrent genital herpes disease. Vaccine.  37:3443; 2019.
  3. Bernstein DI, Pullum DA, Cardin RD, et.al.  The HSV-1 live attenuated VC2 vaccine provides protection against HSV-2 genital infection in the guinea pig model of genital herpes. Vaccine. 37:61; 2018
  4. Richards AL, Sollars PJ, Pitts JD, et.al.  The pUL37 tegument protein guides alpha-herpesvirus retrograde axonal transport to promote neuroinvasion. PLoS Pathog. 13: e1006741; 2017.
  5. Belshe RB, Heineman TC, Bernstein DI, et.al. Correlate of immune protection against HSV-1 genital disease in vaccinated women. J Infect Dis. 209:828; 2014.
  6. Bernstein DI, Munoz FM, Callahan ST, et. al.  Safety and efficacy of a cytomegalovirus glycoprotein B (gB) vaccine in adolescent girls: A randomized clinical trial. Vaccine.34:313; 2016
  7. Adler SP, Lewis N, Conlon A, et.al.  Clinical Trial of a Conditionally Replication-Defective Human Cytomegalovirus (CMV) Vaccine in CMV-Seronegative Subjects. J Infect Dis. 220:411; 2019
  8. Hansen SG, Marshall EE, Malouli D, et.al. A live-attenuated RhCMV/SIV vaccine shows long-term efficacy against heterologous SIV challenge. Sci Transl Med. Jul 17;11; 2019.

Reviewer

Joshua Wolf, MBBS, PhD, FRACP

Pediatric Infectious Diseases Physician and Medical Director of Antimicrobial Stewardship

Associate Member

Department of Infectious Diseases 

St. Jude Children's Research Hospital

IDSA, the Society for Healthcare Epidemiology of America, and the Pediatric Infectious Diseases Society were recently awarded a contract from the Centers for Disease Control and Prevention to continue the Leaders in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) Fellowship through the 2020-2021 academic year.

The LEAP Fellowship is a 1-year funded training program, aimed at developing late-stage ID trainees and early-stage ID physicians into health care leaders capable of working as clinical partners to local and national public health agencies.

Applicants are being sought for the LEAP program for the upcoming 2020-2021 academic year. Application criteria are still being finalized; however, preliminary criteria are as follows:

  • Applicants must be physicians between their first year of ID fellowship and up to two years post fellowship.
  • Applicants must be associated with an Infectious Diseases training program, and with a health care facility with robust antibiotic stewardship, infection control, and/or hospital epidemiology programs.
  • Applicants must have or be in the process of establishing a relationship with state or local health departments.

Final application instructions and criteria will be sent out in late 2019. The most up-to-date information can be obtained by visiting IDSA’s LEAP Fellowship webpage or by contacting LEAP Fellowship Program Manager Michele Wagner, at: This email address is being protected from spambots. You need JavaScript enabled to view it..

PIDS Journal Club, September 2019

Oral linezolid for routine treatment of uncomplicated Staphylococcus aureus bacteremia? Not ready yet.

Reviewing: Willekens R, et al, “Early oral switch to linezolid for low-risk patients with Staphylococcus aureus bloodstream infections: a propensity-matched cohort study”, Clin Infect Dis, 20181

Background

Management of apparently uncomplicated Staphylococcus aureus bacteremia (SAB) is challenging because relapse is common, probably related to unrecognized deep-seated infection .2 As oral antibiotic therapy is increasingly used for bloodstream infections, oral treatment for SAB is under consideration.3 In the pediatric world, infectious diseases physicians report using oral therapy for bacteremic osteomyelitis, but not proven SAB without a bony focus.4 This study, by Willekens et al, evaluated the effectiveness of oral linezolid, a highly bioavailable anti-staphylococcal antibiotic, to complete treatment of SAB in adults after initial parenteral therapy.1

Methods and Results

This was a subgroup analysis of a prospective observational cohort study comprising adults with SAB; it included participants judged to be at low risk of complications who received either entirely parenteral antibiotics or were switched to oral linezolid after 3-9 days of parenteral therapy at treating clinician discretion. The primary outcome was relapse of S. aureus infection within 90 days, and secondary outcomes included length of hospital stay (LOS), and 14- or 30-day mortality. A propensity score-matched sub cohort matched linezolid-treated participants with the two “most similar” parenteral-treated participants.

A total of 152 participants were identified (45 linezolid and 107 parenteral therapy); 135 were included in the propensity-matched sub cohort. Participants were treated for a median of 15 days in each group. Risk factors for treatment failure (e.g. chronic renal failure, risk factors for endovascular infection, unknown BSI source, sepsis and ICU admission) were much more common in the parenteral therapy group, even after propensity score matching. Although not statistically significant, patients who received oral linezolid were slightly less likely to have relapse of infection (RR 0.5; P=0.9) or to die by 14 days (RR ∞; P=0.2) or 30 days (RR 0.17; P=0.08). They did have significantly shorter median LOS (8 vs. 19 days; P<0.01). The authors concluded that treatment of SAB in selected low-risk patients with an oral switch to linezolid after initial parenteral therapy yielded similar clinical outcomes as parenteral therapy.

Critique

The main problem with interpreting this study is the possibility of indication bias.5 Clinicians appear to have been more inclined to give conservative (parenteral) therapy to participants at higher risk of treatment failure; there are differences in baseline characteristics and 14-day mortality (before any likely effect of the treatment). The authors did attempt to address this with propensity score matching but, because they had only a small group of potential matches and did not require close matching, the groups remained very different. Propensity score matching relies on selecting a comparator group that is similar to the intervention group.6 Other issues include unknown applicability to pediatric patients and to other special populations such as patients with neutropenia or other immunocompromise.

Conclusions

The study does not prove that oral linezolid is as safe and effective as parenteral therapy for treatment of SAB, since the patients receiving oral linezolid might have had a better chance of success.  It may provide some justification for occasional use following a short course of IV therapy, and sets the stage for a prospective randomized non-inferiority study (e.g. NCT01792804)7, but I will wait for those results before routinely using oral linezolid as completion therapy for uncomplicated SAB.

Author

Joshua Wolf MBBS, PhD, FPIDS, FRACP

St. Jude Children’s Research Hospital, Memphis, TN, USA 

Peer Reviewers

Sandra L Arnold MD (Le Bonheur Children’s Medical Center, Memphis, TN, USA)

Suchitra Rao MBBS, MSCS (Children’s Hospital Colorado, Aurora, CO, USA)

References

  1. Willekens R, Puig-Asensio M, Ruiz-Camps I, Larrosa MN, Gonzalez-Lopez JJ, Rodriguez-Pardo D, et al. Early oral switch to linezolid for low-risk patients with Staphylococcus aureus bloodstream infections: a propensity-matched cohort study. Clin Infect Dis. 2018.
  2. Berrevoets MAH, Kouijzer IJE, Aarntzen E, Janssen MJR, De Geus-Oei LF, Wertheim HFL, et al. (18)F-FDG PET/CT Optimizes Treatment in Staphylococcus Aureus Bacteremia and Is Associated with Reduced Mortality. J Nucl Med. 2017;58(9):1504-1510.
  3. Hospenthal DR, Waters CD, Beekmann SE, Polgreen PM. Practice patterns of infectious diseases physicians in transitioning from intravenous to oral therapy in patients with bacteremia. Open Forum Infect Dis. 2019.
  4. Wood JB, Fricker GP, Beekmann SE, Polgreen P, Buddy Creech C. Practice Patterns of Providers for the Management of Staphylococcus aureus Bacteremia in Children: Results of an Emerging Infections Network Survey. Journal of the Pediatric Infectious Diseases Society. 2018;7(3):e152-e155.
  5. Walker AM. Confounding by indication. Epidemiology. 1996;7(4):335-336.
  6. Joffe MM, Rosenbaum PR. Invited commentary: propensity scores. Am J Epidemiol. 1999;150(4):327-333.
  7. ClinicalTrials.gov. Staphylococcus Aureus Bacteremia Antibiotic Treatment Options (SABATO). https://clinicaltrials.gov/ct2/show/NCT01792804?id=NCT01792804&rank=1&load=cart. Published 2013. Accessed September 16, 2019.

 

PRESS RELEASE

For Immediate Release: September 5, 2019

Contact: Christy Phillips, (703) 299- 9865, This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Pediatric Infectious Diseases Society Honors Six Distinguished Physicians, Scientists

The world's largest organization of professionals dedicated to the treatment, control and eradication of infectious diseases affecting children, the Pediatric Infectious Diseases Society, has honored six distinguished physicians and scientists from the United States and around the world who were elected this year to be fellows of PIDS. 

The designation “fellow” in PIDS honors those who have achieved professional excellence and provided significant service to the profession. “PIDS fellows are national and international leaders and experts in the field of pediatric infectious diseases. Their expertise touches the lives of children not only on those larger stages, but also at the local level in their hospitals, clinics, research labs, institutions, and communities,” said PIDS President Paul W. Spearman, MD, FPIDS. “Fellowship in PIDS is our way of recognizing these accomplished physicians, researchers, and scientists for their important contributions to our field.” 

Applicants for PIDS fellowship must be nominated by their peers and meet specified criteria, including continuing identification with the field of pediatric infectious diseases, national or local recognition, and publication of their work in strong biomedical journals. Nominees are reviewed and elected by the PIDS Board of Directors. Fellows of PIDS work in many different settings, including clinical practice, teaching, research, public health, and health care administration.

This year, the following individuals were honored as fellows of PIDS:

Nazha Abughali, MD, FPIDS

Ann Chahroudi, MD, PhD, FPIDS

Stephanie Fritz, MD, MS, FPIDS

David P. Greenberg, MD, FPIDS

Dean L. Winslow, MD, FPIDS

Joshua Wolf, MBBS, FPIDS

 

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About PIDS

PIDS membership encompasses leaders across the global scientific and public health spectrum, including clinical care, advocacy, academics, government, and the pharmaceutical industry. From fellowship training to continuing medical education, research, regulatory issues and guideline development, PIDS members are the core professionals advocating for the improved health of children with infectious diseases both nationally and around the world, participating in critical public health and medical professional  advisory committees that determine the treatment and prevention of infectious diseases, immunization practices in children, and the education of pediatricians. For more information, visit http://www.pids.org.

 

The PIDS Foundation Board of Trustees invites you to Party on the Potomac!  An evening of fun, fellowship and discussion of vaccine challenges in the 21st century.  Our guest speaker, Dr. Peter Hotez, will describe recent changes to the pediatric and adult vaccine schedules, focusing primarily on newer vaccine technologies and vaccine adjuvants and share common misconceptions regarding vaccine safety.  In addition to the mini-lecture, The PIDS Distinguished Physician and Young Investigator Awards will be presented.

Here are 5 reasons why should you attend:

  1. Meet your old Pediatric ID friends
  2. Make new Pediatric ID friends
  3. Share fond memories with PIDS members and other colleagues
  4. Network…for research ideas, for job opportunities, for FUN
  5. "Grab a prop and strike a pose” at the ID-themed photo booth

 

 
One more thing: we have some PIDS gear!  We will have PIDS-branded hats, water bottles, ties, and scarves available for a small donation to the PIDS Foundation. Please visit the PIDS booth or pick up your PIDS swag at the dinner celebration.

We hope to see you there!

Janet Gilsdorf, MD
PIDS Foundation Chair
 
Paul Spearman, MD
PIDS President
 
PIDS would like to thank our sponsors, Horizon Therapeutics, Karius, and Sanofi Pastuer, for their generous support.

For Health Care Professionals: Preparing Your Practice/Fight Flu Toolkit

As healthcare professionals prepare to have conversations with patients around flu vaccination, CDC has pulled together a suite of digital and print-off materials to help in effectively conveying the threat of flu and why flu vaccination is so important. 

These resources include:

For the General Public/Patients: CDC Digital Media Toolkit

We have updated this webpage and related social media images and messages to reflect the upcoming flu season. 

#WhyIFightFlu

CDC is currently collecting a variety of Flu Fighter profiles through partners, describing how members of the American public have been affected by flu and why they fight the often devastating disease. We are aiming to post these profiles after the annual flu vaccination season kickoff press conference hosted by NFID on 9/26.

This hashtag campaign is focused on reinforcing the negative impact of flu and positive benefits of flu vaccine. In that vein, we are inviting all of our partners to use the hashtag #WhyIFightFlu and share an answer to the question "why do you fight flu?" as we move forward with flu season.

ADDITIONAL RESOURCES

SAVE THE DATE

  • August 28, 2019: To conclude National Immunization Awareness Month (NIAM), CDC is hosting a webinar on 8/28 focused on addressing vaccine hesitancy in the practice. This will not be flu-specific, but will have some overarching strategies on addressing vaccine misinformation. More information and registration here.
  • September 26, 2019: Watch and promote the livestream of the annual flu vaccination season kickoff press conference hosted by the National Foundation for Infectious Diseases (NFID). Link will be shared closer to the kickoff.
  • December 1-7, 2019: Join CDC in promoting flu vaccination before and during National Influenza Vaccination Week (NIVW). NIVW-specific updates, events, and resources will be posted on CDC's NIVW website.
  • TBD: Webinar focused on talking through the many different flu vaccines for the 2019-20 flu season and making a strong flu vaccine recommendation – tentatively set for early October; more details coming soon
  • Throughout flu season: We will be sharing stories of why members of the American public fight flu with the hashtag #WhyIFightFlu

The CDC released results from the National Immunization Survey-Teen (NIS-Teen) in the Morbidity and Mortality Weekly Report, which provides the latest estimates of vaccination rates among adolescents in the United States.

The key findings from the report include:

  • HPV vaccination rates increased slightly, but there was no increase in rates among girls, highlighting the need for continued efforts to ensure all boys and girls are vaccinated on time.
  • Vaccination rates are lower in rural areas, and differ by insurance status.
  • This report reinforces the important role that healthcare professionals can play in increasing vaccination rates and addressing disparities.

Based on the findings, everyone has a role to play in improving vaccination rates. CDC is emphasizing the following calls to action:

Call to Action: Public health programs should work with doctors and their practices to develop better tools to meet the needs of parents to encourage vaccine acceptance. 

  • Parents
    • Ask your child’s doctor about the HPV vaccine when they are 11 or 12 years old.
  • Immunization Programs and Partners
    • Share resources with healthcare professionals to support them in making effective vaccine recommendations and addressing parents’ questions.
    • Partner with organizations focused on rural health to disseminate resources to healthcare professionals in rural areas.
    • Remind parents about the vaccines that are recommended for their child before the start of the school year.

This week’s MMWR also included a report on the latest estimates of HPV cancers in the United States, which found that HPV vaccination could prevent 92% of cancers estimated to be caused by HPV.

To support healthcare professionals in making effective recommendations, addressing parents’ questions and concerns, and reinforce the message that HPV vaccination is cancer prevention, CDC has developed a number of educational resources, which can be found here. Below are a few specific resources we’d like to highlight to assist you in your efforts to reach healthcare professionals and parents.

Resources for Healthcare Professionals

Resources for Parents

Last week, CDC published updated recommendations for HPV vaccination of adults in the MMWR: https://www.cdc.gov/mmwr/volumes/68/wr/mm6832a3.htm. CDC has updated its web content to reflect the latest recommendations among adults, including developing a new HPV Vaccine Schedules and Dosing page for healthcare professionals to outline HPV vaccine recommendations and guidance for how to talk with parents and patients about vaccine recommendations.

Finally, we encourage you to attend, and inform your members about, next week’s webinar on Strategies for Addressing Vaccine Misinformation in the Practice Setting.

August 21, 2019

 

Customs and Border Patrol’s Flu Vaccine Policy Breaches Basic Public Health Tenet

 

Statement from IDSA President Cynthia Sears, MD, FIDSA, HIVMA Chair W. David Hardy, MD, SHEA President Hilary Babcock, MD, MPH, FIDSA, FSHEA, PIDS President Paul Spearman, MD, FPIDS, and ASTMH President Chandy C. John, MD, MS:

The U.S. Customs and Border Patrol’s decision to withhold vaccinations against seasonal influenza from migrants in border detention facilities is a violation of the most basic principles of public health and human rights. It runs directly counter to the imperative that no individual should be harmed as a result of being detained, and that the community standard of medical care be available to persons in the custody of the U.S. government.

An essential tool in protecting both individual and public health, vaccinations against potentially life-threatening and preventable illnesses are an indispensable component of routine healthcare. Since 2010, the U.S. Centers for Disease Control and Prevention has recommended annual influenza vaccination for ALL persons 6 months of age or older in the absence of medical reasons not to be vaccinated, a recommendation that, as organizations of more 16,000 infectious diseases specialists, we stand firmly behind. According to the CDC, seasonal influenza was associated with over 57,000 deaths – 129 in children—during the recent 2018-2019 season. In conditions of overcrowding poor sanitation and emotional stress involving vulnerable populations such as pregnant women and young children, choosing not to follow the CDC recommendations is particularly egregious.

The Infectious Diseases Society of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society, the Society for Healthcare Epidemiology of America, and the American Society of Tropical Medicine and Hygiene call for the immediate articulation and implementation of a plan to administer vaccinations against seasonal influenza and to ensure the delivery of all other routine medical immunizations in facilities under the oversight of U.S. Customs and Border Patrol. We remain deeply concerned about the treatment of immigrants at our borders and in federal detention, and we call for a comprehensive investigation of the agency’s protocol for providing health care at its facilities.

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Contact

IDSA: Jennifer Morales 
This email address is being protected from spambots. You need JavaScript enabled to view it. 
(703) 299-0412

PCI: Lauren Martin
(312) 558-1770 
This email address is being protected from spambots. You need JavaScript enabled to view it.

View Press Release PDF copy

Statement from IDSA President Cynthia Sears, MD, FIDSA, HIVMA Chair W. David Hardy, MD, SHEA President Hilary Babcock, MD, MPH, FIDSA, FSHEA, and PIDS President Paul Spearman, MD, FPIDS:

 

Press Release

______________________________________________________________________________________

Embargoed 1 PM ET                                                                                         Contact: CDC Media Relations

July 9, 2019                                                    July 9, 2019                                                                                                                                (404) 639-3286

 

CDC Urges Doctors to Rapidly Recognize and Report AFM Cases

Intense effort underway to understand and prevent this serious neurologic syndrome

As the late summer/early fall “season” for acute flaccid myelitis (AFM) nears, CDC is calling on medical professionals to quickly recognize AFM symptoms and report all suspected cases to their health department. Early recognition and reporting are critical for providing patients with appropriate care and rehabilitation, and better understanding AFM, according to a new Vital Signs report.

The majority of AFM patients are previously healthy children who had respiratory symptoms or fever consistent with a viral infection less than a week before they experienced limb weakness. Since AFM can progress quickly from limb weakness to respiratory failure requiring urgent medical intervention, rapidly identifying symptoms and hospitalizing patients are important.

Dr. Robert Redfield, CDC Director

_______________________________________________________

“Timing is key for responding to AFM and outbreaks. The quicker doctors recognize symptoms, collect specimens, and report suspected cases to health departments, the more insight we gain into this serious illness,” said CDC Director Robert Redfield, M.D. “AFM is a national public health priority. CDC is working with the AFM Task Force to strengthen the knowledge base about how viruses cause AFM, and best practices around patient treatment and rehabilitation.”

__________________________________________________________________________________________

Late summer and early fall is AFM “season”

CDC began tracking AFM in 2014, when the first outbreak of 120 cases occurred. Another outbreak occurred in 2016 with 149 cases, and again with 233 patients in 41 states in 2018– the largest outbreak so far. AFM cases have so far followed a seasonal and biennial pattern, spiking between August and October every other year.

In an analysis of cases confirmed in 2018, CDC detected enteroviruses and rhinoviruses in nearly half of respiratory and stool specimens. Of the 74 cases with a cerebral spinal fluid specimen, only two were positive for enteroviruses (EV-A71 and EV-D68). CDC and other scientists continue to investigate how enteroviruses, including EV-D68, might initiate AFM. All specimens tested negative for poliovirus, a related enterovirus that can cause AFM. 

Dr. Tom Clark, deputy director, Division of Viral Diseases

____________________________________

“Our thorough investigation of AFM will help lead to more answers about this severe disease,” said Tom Clark, M.D., M.P.H, deputy director, Division of Viral Diseases. “We are monitoring AFM trends and the clinical presentation, conducting research to identify possible risk factors, using advanced lab testing and research to understand how viral infections may lead to AFM, and tracking long-term outcomes of AFM patients.”

_________________________________________________________________________________________  

CDC, with experts from the National Institutes of Health, academia, health departments, and parent advocacy groups, is committed to increasing awareness of AFM, and moving national priorities forward to advance our understanding of AFM and its prevention, treatment, and outcomes.

To read more about the Nationwide Outbreak of Acute Flaccid Myelitis—United States, 2018 and the entire Vital Signs report, visit www.cdc.gov/vitalsigns.

About Vital Signs

Vital Signs is a report that appears as part of the CDC’s Morbidity and Mortality Weekly Report. Vital Signs provides the latest data and information on key health indicators.

 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

 

 

//IDSA / HIVMA /PIDS logos//

NEWS RELEASE
June 24, 2019

Physicians, Health Providers and Researchers Call on Presidential Candidates to Back Funding, Preparedness and Evidence-based Responses to Infectious Diseases, HIV

Contact IDSA: Jennifer Morales This email address is being protected from spambots. You need JavaScript enabled to view it. (703) 299-0412 PCI Public Relations (312) 558-1770  This email address is being protected from spambots. You need JavaScript enabled to view it.

In a bipartisan-aimed petition, more than 500 members of the Infectious Diseases Society of America, its HIV Medicine Association and the Pediatric Infectious Diseases Society are calling on all presidential candidates to commit themselves to public health policies, programs, and investments necessary to protect the lives and health of Americans and reduce the impact of infectious diseases globally, including from the threats of growing and emerging infectious diseases, vaccine preventable diseases, infections increasingly resistant to existing treatments, as well as from the impacts of climate change.

Urging strong stances, support and funding for public health measures against leading domestic and global health challenges, the signers urge White House aspirants to articulate their priorities for tackling infectious diseases opportunities and threats, including with interventions to:

  • Increase vaccine access and uptake;
  • Strengthen responses to the opioid crisis and associated infectious disease impacts;
  • Build antibiotic stewardship, research and development;
  • Sustain U.S. leadership of global HIV and TB responses, while enhancing global health security efforts;
  • Expand interventions to reverse increased rates of sexually transmitted diseases;
  • Use existing tools to end the HIV epidemic and eliminate hepatitis C virus in America;
  • Confront climate change;
  • And build the infectious diseases and HIV trained health workforce necessary to meet these challenges.

The full petition, with further information on infectious diseases priorities and actions, is here.

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10th Annual International Pediatric Antimicrobial Stewardship Conference
 
 
Record Number of Abstracts Submitted to 2019 Antimicrobial Stewardship Conference - St. Louis, MO
 

During this year's Antimicrobial Sterwardship Conference, We had a record number of participants (220) and abstracts (77) this year. Leading experts from around the country discussed important antimicrobial stewardship topics including Gram-negative resistance (Latania Logan MD), stewardship for the pediatric intensive care unit (Kathleen Chiotos MD) and communication insights for stewards (Julia Szymczak, PhD). The three Pediatric ID ASP Fellow award winners (Rebecca Same, MD, Sophie Katz, MD and Maria Equiguren Jimenez, MD) presented their outstanding research.   Two ASP conference attendees had the following to say about the 2019 conference:

"This was my first time attending this conference.  I absolutely loved it. It was for two days so not too long. Lectures were all pediatric relevant and in line with ASP priorities.  Networking with colleagues in other places is invaluable. Will surely go back next year!"  ~ Dr. Upadhyayula
 
"The PIDS ASP conference was a fantastic opportunity to talk to other stewards about their programs and research and discuss some of the obstacles that we face at my home institution. I came away from the conference with multiple ideas for our program from small tweaks to larger policy goals." ~ Dr. TeKippe
 

SAVE THE DATE for next year on May 28th and 29th for the 11th annual International Pediatric ASP meeting.

   
 

Please be aware that www.idweek.org is the only official site for registering for IDWeek 2019. Experient is the official housing provider for IDWeek 2019 and their site can only be accessed through www.idweek.org. International groups can also use www.idweekinternational.com for housing and travel assistance.

Fraudulent websites have been reported, so it is critical that you use only the official IDWeek websites mentioned above to register for the meeting and for booking a hotel reservation through IDWeek. We do not ask for member identification numbers during registration, and no one will email you to ask for your membership password. Please do not provide this information if requested, and be aware that you are using an illegitimate website.

IDWeek cannot guarantee your registration or housing if you purchase using an illegitimate website.
 

IDWeek staff make every effort to shut down illegitimate websites as soon as we are made aware of them; however, new attempts to create fraudulent sites occur regularly. If you are concerned about your registration, please contact IDWeek staff at This email address is being protected from spambots. You need JavaScript enabled to view it..