Volume 230, Issue 5, 15 November 2024

Measles cases are increasing globally and in the United States because of low routine measles vaccine coverage and disruptions to immunization services during the coronavirus disease 2019 (COVID-19) pandemic. To achieve and sustain measles elimination requires maintaining high coverage with 2 doses of measles vaccine, addressing vaccine hesitancy and misinformation, strong political commitment, and the necessary financial resources.

Quality measurement research and development are critical to the future of infectious diseases in the era of value-based care. Prioritizing quality measurement will bolster the infectious diseases workforce, driving greater recognition of the specialty's value and contribution to clinical outcomes.

The abundance of clinical publications using machine learning models places demands on clinicians seeking to properly critique and interpret these results. This review illustrates best practices and pitfalls inherent to handling electronic health record data and employing machine learning.

ChAdOx1-biEBOV, an adeno-vectored vaccine encoding the glycoproteins of Sudan and Ebola virus, induces a robust humoral response but does not protect against Sudan virus challenge in cynomolgus macaques.

In this phase 1, randomized, double-blinded, placebo-controlled trial, the recombinant hepatitis E virus vaccine (HEV-239) was found to be safe and immunogenic through at least 6 months in healthy US adults.

A New York City serosurvey in Summer 2022 found that 6% of participants without prior mpox diagnoses or histories of smallpox or mpox vaccination had antibodies to mpox, indicating the presence of infections that can contribute to asymptomatic transmission.

This study improves our understanding of smallpox vaccination-mediated cross-reactivity to orthopox viruses and the durability of childhood smallpox vaccination-mediated immune responses in PWH. Both MVA vaccination and mpox infection evoked mpox-specific immune responses mediated by T and B cells.

Our multistep proof-of-concept study demonstrates that the urinary polyomavirus (PyV)-haufen test is specific for PyV-induced end-organ kidney injury with lytic viral replication (ie, BKPyV nephropathy). Thus, the biomarker can now be incorporated into management guidelines for kidney transplant recipients.

Among patients aged >75 years presenting at the emergency department with respiratory or infectious symptoms, respiratory syncytial virus shares a comparable mortality rate with influenza but is associated with higher rates of lower tract respiratory infection, pneumonia, hospitalization, intensive care unit admissions, and extended hospital stays.

In a cohort of patients with brain injury, longitudinal analysis of anelloviruses showed a decrease in viral loads associated with hospital-acquired pneumonia and acute respiratory distress syndrome in blood and respiratory samples, suggesting changes in virome composition possibly linked to immune disturbances.

Antibodies to dengue virus NS1 protein activated NK cells and mediated antibody-dependent cellular cytotoxicity. Higher preexposure antibody responses to NS1 in cohort subjects who experienced subclinical compared to symptomatic dengue virus infections point to a protective role against illness.

Children <5 years old with rotavirus had the highest clinical severity compared with other gastrointestinal viruses. Rotavirus and adenovirus 40/41 cases detected only with quantitative molecular assays were slightly less severe than cases detected with conventional enzyme immunoassays.

The occurrence of rotavirus-related hospitalizations during early childhood is linked to suspected delays in neurodevelopment among 6 year olds, particularly evident in fine motor function and cognition.

In a randomized controlled trial of anti-SARS-CoV-2 polyclonal antibody SAB-185 compared to casirivimab/imdevimab, efficacy against hospitalizations/deaths could not be determined due to low event rates with Omicron. SAB-185 demonstrated acceptable safety, with faster symptom resolution in the Omicron population.

We report for the first time the effect of monoclonal antibody (mAb) treatment on SARS-CoV-2–specific human memory B cells of SARS-CoV-2–infected humans receiving, or not receiving, mRNA immunization. Our data show that mAb treatment alters later immune memory responses to vaccination.

Within a viral genomic surveillance program, the proportions of severe acute respiratory syndrome coronavirus 2 infections from JN.1 and HV.1 variants, compared with EG.5, were lower among inpatients versus outpatients. These variants may pose a lower risk of severe illness.

The improvements in the 95-95-95 targets in China were accompanied by a reduction in both the population-level HIV transmission rate and incidence. These reductions may indicate the effectiveness of the WHO/UNAIDS-recommended “treat all” policy that has been implemented for 7 years.

Postmortem analysis of CNS tissues reveals heterogenous antiretroviral distribution.

Our findings from the randomized controlled clinical trial IMPAACT 2010/VESTED suggest that cellular uptake of folate and transport of folate to the infant do not differ in pregnant women starting dolutegravir- versus efavirenz-based antiretroviral therapy (nor tenofovir alafenamide vs tenofovir disoproxil fumarate).

Pneumococcal isolates from nasopharyngeal colonization and middle ear fluid from community-based children with acute otitis media in Rochester, New York, differ in serotype distribution and antibiotic susceptibility compared to invasive pneumococcal disease isolates from multisite active laboratory- and population-based surveillance.

Capsule and wall teichoic acids shape the cell envelope of Staphylococcus aureus and are key virulence determinants of the bacterium. We show the capsule obstructs major functions of wall teichoic acids such as cell adhesion, phage absorption, and IgG deposition.

The subunit tuberculosis (TB) vaccine candidate H56:IC31 is safe and induces a predominant CD4⁺ T-cell response in adults recently treated for drug-susceptible, uncomplicated pulmonary TB.

We detected anti-rifapentine and anti-isoniazid antibodies, but there was no correlation between presence of antibodies and development of flu-like reactions among persons who received 3 months of weekly isoniazid plus rifapentine or 9 months of daily isoniazid for M. tuberculosis infection.

The beneficial effect of low-dose chemotherapy drug 5-FU was observed following the selective depletion of MDSCs, leading to improved Th1 and Th17 responses in the infectious disease paracoccidioidomycosis, without adversely affecting other immunological populations.

Cryptococcal polysaccharide antigen persisted in the serum and cerebrospinal fluid of patients with cryptococcal meningitis far beyond clinical cure, falling more slowly in serum than cerebrospinal fluid and in Cryptococcus gattii than Cryptococcus neoformans infection and more slowly in patients with a ventriculoperitoneal shunt.

During the SARS-CoV-2 pandemic, respiratory syncytial virus hospitalization patterns in children aged <2 years changed. Although a shift to older age was seen in the Netherlands, we did not observe an increase in age in the other 3 participating countries in Europe.

mRNA-1345 vaccine enhanced levels of RSV-A and RSV-B neutralizing antibody and preF binding antibody compared with placebo in adults (≥60 years) across various subgroups, including those at risk for severe disease, consistent with its demonstrated efficacy in the prevention of RSV disease.

In a 3-year prospective, population-based incidence study, respiratory syncytial virus hospitalization rates among adults aged ≥65 years were 3–9 and 3–4 times higher for those admitted from assisted living or skilled nursing facilities, respectively, compared with community-dwelling adults.

HBV and HCV impair mitochondrial function. HCV infection reduces breakdown of fat, causing lipid accumulation and fatty liver disease. HBV infection affects pyruvate processing resulting in lactate accumulation, causing cellular stress and increasing the risk of liver disease and cancer.

This study provides policy-relevant evidence that children routinely immunized with inactivated polio vaccine in the United States and who had no known contact with a live poliovirus had detectable nasal and pharyngeal mucosal immunity to poliovirus.

We use a nationally representative seroprevalence study to estimate the underlying burden of chikungunya before a major outbreak in 2017. We found that the population had very limited immunity at the time, but the vector was widespread.

In a cohort of young Canadian gay, bisexual, and other men who have sex with men (approximately 37% vaccinated), prevalence of oral human papillomavirus infection was relatively low overall with estimates higher for those unvaccinated compared to those vaccinated.

Quantitative point-of-care blood myxovirus resistance protein A measurement had an acceptable analytical accuracy compared to the enzyme immunoassay analysis. It differentiated viral from bacterial infections in febrile children with 92% sensitivity and 91% specificity.

Zika virus seroprevalence was high in rural and remote Ecuadorian communities in 2018. Seroprevalence declined from 2018 to 2019, indicating substantial rural transmission during the 2015–2016 epidemic and underscoring the need for rural health system preparedness and vaccine efforts.

HLA-I/KIR genotypes impact HIV-1 progression, but their role in primary infection is debated. A new genome-wide association study shows no role in sexual transmission susceptibility. The genetic basis of HIV-1 progression differs from resistance, presenting a paradox worth exploring.

Lung ultrasound findings were predictive of worsening acute COVID-19 in an international multicenter cohort. Previously derived ultrasound prediction models were evaluated and validated across diverse clinical settings in the United States and at a remote hospital in Uganda.

Recurrent urinary tract infections occurred commonly in a large cohort of women and were associated with ages 18 to 27 or ≥78 years, comorbidities, history of frequent health care utilization and antibiotic prescriptions, and antibiotic-resistant urine pathogens.

Measuring 30 cytokines in 936 sputum samples from patients with chronic obstructive pulmonary disease, we observed significant increases (IL-17A, TNF-α, IL-1β, IL-10) between stable and exacerbation states. We also identified a combination of cytokines (IL-1α, IL-1β, or TNF-α) as suitable biomarkers for bacteria-associated exacerbations.

The prevalence of cefixime-resistant Neisseria gonorrhoeae among sexually active individuals in Melbourne exceeds the threshold of the 5% resistance level recommended by the World Health Organization. Thus, cefixime treatment would have limited benefits in Australia.

Boosting of airway Toll-like receptor 5 signaling by intranasal flagellin enhances amoxicillin efficacy against pneumococcal pneumonia, enables 200-fold antibiotic dose reduction, and curbs resistance selection. Moreover, mathematical modeling predicts 20-fold immune enhancement, further highlighting flagellin's use in advanced treatment strategies.

In this study, associations between virulence factors and phylogeny in neonatal E. coli bloodstream infections were investigated. Also, a newly created virulence database was introduced. Phylogroup B2 and colibactin were linked to mortality and severe outcomes, with sex-based differences observed.

Opn depletion in nonhematopoietic cells but not hematopoietic cells contributes to improved sepsis outcomes. Knockdown of Opn effectively reduced bacterial loads in the gut by increasing the expression of antimicrobial peptides through the AKT-FOXO3a signaling pathway.

Recognition of the variety of disease pathways experienced by individuals with tuberculosis highlights how many are not served by the current passive case-finding system and how much transmission is missed, including transmission from subclinical disease.

This study highlights the key role of the GSH/GPX4/HO-1 axis in subjects with active M. tuberculosis infection compared to those with latent infection and provides additional tools to understand the redox background in asymptomatic and active disease.

Liver fine-needle aspiration biopsy, analyzed via single-cell RNA sequencing, proved safe and acceptable, including when performed longitudinally, among participants in an HBV cohort in Zambia, offering a promising method to study HBV immunopathogenesis, including in low- and middle-income countries.

Rotavirus remains a significant cause of diarrhea among children in Rwanda but with a 10-fold lower odds ratio as compared with the period before introduction of rotavirus vaccination and with shifting genotypes.