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The Infectious Diseases Society Of America Video

IDSA Board Member John Lynch, MD, MPH, FIDSA on capacity for testing and contact tracing

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Influenza vaccine effectiveness against influenza and noninfluenza respiratory viruses NIRVs was assessed by test-negative design using historic datasets of the community-based Canadian Sentinel Practitioner Surveillance Network, spanning — to — See the Editorial Commentary by Sullivan on pages — The core prerequisite for valid VE estimation by TND is that vaccine has no effect on alternate etiologies of the same clinical syndrome included in the control group. Comparison of per-protocol and TND analyses of several large randomized controlled trial RCT datasets involving more than participants has verified this prerequisite for influenza VE estimation, with the OR for influenza vaccine effect against noninfluenza causes of influenza-like illness ILI approximating 1. If, however, influenza infection induces immunity that is cross-protective against noninfluenza respiratory viruses NIRVs; eg, through nonspecific innate immunity , then vaccination that effectively prevents influenza may indirectly result in greater NIRV risk among vaccinated compared with unvaccinated individuals. Cowling et al [ 2 ] hypothesized such vaccine interference with infection-induced immunity to explain a significant 4-fold increased NIRV risk among 69 children randomized to receive the — influenza vaccine compared with 46 children receiving placebo. Conversely, in TND analysis of 6 study seasons — to — , Sundaram et al [ 3 ] reported that influenza vaccine significantly halved the risk of acute respiratory illness due to influenza virus, but on univariate analysis showed no vaccine effect on NIRV risk, with comparable rates of vaccination among NIRV-positive versus NIRV-negative controls. The Infectious Diseases Society Of America.

A New Combined Program for Medical Students: G.E.R.M.

Richard T. Infect Control Hosp Epidemiol Oct The Society for Healthcare Epidemiology of America provides updated guidelines for management of healthcare workers with chronic hepatitis B virus, hepatitis C virus, and HIV infection. Target Audience: Infectious disease specialists, academic medical centers, hospitals, healthcare facilities, medical schools and other healthcare professional schools.

This update incorporates advances in measuring viral load and in treatments.

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Viral load thresholds should be revised to allow HCP to participate in higher-risk healthcare-associated procedures. Institutions should continue to update their categorization of higher-risk procedures as surgical techniques improve and consider HCP experience and expertise in determining what procedures those individuals can perform.

The update places increased emphasis on the responsibilities of academic institutions, professional schools, hospitals, and healthcare facilities to provide detailed training and education to trainees, medical staff, and other HCP on the bidirectional risk for exposure to and infection with bloodborne pathogens, the ethical obligation among HCP to be aware of their own infection status, and institutional postexposure management protocols. HCP living with bloodborne pathogen infection must receive oversight from an expert review panel that, in general, can be based at an institutional level except in states that have established state panels.

Improved treatments and safety devices and surgical techniques have essentially eliminated likelihood that HCP will transmit bloodborne pathogen infections to patients. However, this remains true only if infected HCP link aware of these issues and receive appropriate medical treatment and monitoring to assure effective viral load suppression. I think that the most important updates are in defining the institutional responsibilities for implementing policies and procedures at all levels of training in academic medical centers and for all HCP at hospitals and healthcare facilities to make sure that these measures are accomplished.

EDITOR DISCLOSURES AT TIME OF PUBLICATION

Henderson DK et al. Management of healthcare personnel living with hepatitis B, hepatitis C, or human immunodeficiency virus in US healthcare institutions. Infect Control Hosp Epidemiol Oct 14; [e-pub].]