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Infectious Diseases of Poverty Nov 2023Respiratory infectious diseases (RIDs) remain a pressing public health concern, posing a significant threat to the well-being and lives of individuals. This study delves...
BACKGROUND
Respiratory infectious diseases (RIDs) remain a pressing public health concern, posing a significant threat to the well-being and lives of individuals. This study delves into the incidence of seven primary RIDs during the period 2017-2021, aiming to gain deeper insights into their epidemiological characteristics for the purpose of enhancing control and prevention strategies.
METHODS
Data pertaining to seven notifiable RIDs, namely, seasonal influenza, pulmonary tuberculosis (PTB), mumps, scarlet fever, pertussis, rubella and measles, in the mainland of China between 2017 and 2021 were obtained from the National Notifiable Disease Reporting System (NNDRS). Joinpoint regression software was utilized to analyze temporal trends, while SaTScan software with a Poisson probability model was used to assess seasonal and spatial patterns.
RESULTS
A total of 11,963,886 cases of the seven RIDs were reported during 2017-2021, and yielding a five-year average incidence rate of 170.73 per 100,000 individuals. Among these RIDs, seasonal influenza exhibited the highest average incidence rate (94.14 per 100,000), followed by PTB (55.52 per 100,000), mumps (15.16 per 100,000), scarlet fever (4.02 per 100,000), pertussis (1.10 per 100,000), rubella (0.59 per 100,000), and measles (0.21 per 100,000). Males experienced higher incidence rates across all seven RIDs. PTB incidence was notably elevated among farmers and individuals aged over 65, whereas the other RIDs primarily affected children and students under 15 years of age. The incidences of PTB and measles exhibited a declining trend from 2017 to 2021 (APC = -7.53%, P = 0.009; APC = -40.87%, P = 0.02), while the other five RIDs peaked in 2019. Concerning seasonal and spatial distribution, the seven RIDs displayed distinct characteristics, with variations observed for the same RIDs across different regions. The proportion of laboratory-confirmed cases fluctuated among the seven RIDs from 2017 to 2021, with measles and rubella exhibiting higher proportions and mumps and scarlet fever showing lower proportions.
CONCLUSIONS
The incidence of PTB and measles demonstrated a decrease in the mainland of China between 2017 and 2021, while the remaining five RIDs reached a peak in 2019. Overall, RIDs continue to pose a significant public health challenge. Urgent action is required to bolster capacity-building efforts and enhance control and prevention strategies for RIDs, taking into account regional disparities and epidemiological nuances. With the rapid advancement of high-tech solutions, the development and effective implementation of a digital/intelligent RIDs control and prevention system are imperative to facilitate precise surveillance, early warnings, and swift responses.
Topics: Child; Male; Humans; Aged; Mumps; Scarlet Fever; Whooping Cough; Influenza, Human; Communicable Diseases; Measles; Rubella; Tuberculosis, Pulmonary; China; Incidence
PubMed: 37953290
DOI: 10.1186/s40249-023-01147-3 -
Environmental Health Perspectives Dec 2023Prenatal exposures to certain poly- and perfluoroalkyl substances (PFAS) are associated with reduced humoral responses to some childhood immunizations.
Prenatal Exposure to Poly- and Perfluoroalkyl Substances (2009-2014) and Vaccine Antibody Titers of Measles, Mumps, Rubella, and Varicella in Children Four to Eight Years Old from the Healthy Start Cohort.
BACKGROUND
Prenatal exposures to certain poly- and perfluoroalkyl substances (PFAS) are associated with reduced humoral responses to some childhood immunizations.
OBJECTIVE
We estimated associations between prenatal PFAS exposure and child antibody titers for measles, mumps, rubella (MMR), and varicella after immunization.
METHODS
We measured serum antibody titers of 145 children (4-8 y old) enrolled in the Healthy Start cohort in Colorado, whose mothers had PFAS quantified mid-pregnancy (2009-2014). We used linear and logistic regression models to assess the relationship between five PFAS detected in of mothers and continuous or non-high-censored ("low") antibody titers and quantile g-computation to evaluate the overall effect of the PFAS mixture.
RESULTS
Median concentrations of individual PFAS were at or below the median reported among females in the United States. After receiving two vaccine doses, seropositive levels of antibodies were detected among most (93%-100%) children. Each log-unit increase in perfluorononanoate was associated with 2.09 [95% confidence interval (CI): 1.13, 3.87] times higher odds of a low measles titer, and each log-unit increase in perfluorooctanoate was associated with 2.46 (95% CI: 1.28, 4.75) times higher odds of a low mumps titer. Odds ratios for all other PFAS were elevated, but CIs included the null. Each quartile increase in the PFAS mixture was associated with 1.35 (95% CI: 0.80, 2.26) times higher odds of a low measles titer and 1.44 (95% CI: 0.78, 2.64) times higher odds of a low mumps titer. No significant associations were observed between PFAS and varicella or rubella antibodies. In stratified analyses, associations were negative among female children, except for perfluorohexane sulfonate and varicella, whereas they were positive among males.
DISCUSSION
Some prenatal PFAS were associated with lower antibody titers among fully immunized children. The potential for immunotoxic effects of PFAS requires further investigation in a larger study, because exposure is ubiquitous globally. https://doi.org/10.1289/EHP12863.
Topics: Child; Male; Pregnancy; Female; Humans; Child, Preschool; Chickenpox; Mumps; Prenatal Exposure Delayed Effects; Rubella; Measles; Vaccines; Fluorocarbons
PubMed: 38147368
DOI: 10.1289/EHP12863 -
Internal Medicine (Tokyo, Japan) Dec 2023
PubMed: 38104987
DOI: 10.2169/internalmedicine.3014-23 -
The Journal of Clinical Investigation Jan 2024The measles, mumps, and rubella (MMR) vaccine protects against all-cause mortality in children, but the immunological mechanisms mediating these effects are poorly... (Randomized Controlled Trial)
Randomized Controlled Trial
The measles, mumps, and rubella (MMR) vaccine protects against all-cause mortality in children, but the immunological mechanisms mediating these effects are poorly known. We systematically investigated whether MMR can induce long-term functional changes in innate immune cells, a process termed trained immunity, that could at least partially mediate this heterologous protection. In a randomized, placebo-controlled trial, 39 healthy adults received either the MMR vaccine or a placebo. Using single-cell RNA-Seq, we found that MMR caused transcriptomic changes in CD14+ monocytes and NK cells, but most profoundly in γδ T cells. Monocyte function was not altered by MMR vaccination. In contrast, the function of γδ T cells was markedly enhanced by MMR vaccination, with higher production of TNF and IFN-γ, as well as upregulation of cellular metabolic pathways. In conclusion, we describe a trained immunity program characterized by modulation of γδ T cell function induced by MMR vaccination.
Topics: Child; Adult; Humans; Infant; Mumps; Measles-Mumps-Rubella Vaccine; Rubella; Metabolic Reprogramming; Trained Immunity; Vaccination; Antibodies, Viral
PubMed: 38290093
DOI: 10.1172/JCI170848 -
Multiple Sclerosis (Houndmills,... Dec 2023Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart.... (Observational Study)
Observational Study
BACKGROUND
Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized.
OBJECTIVES
To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS.
METHODS
Retrospective observational study in pwMS vaccinated against VAR and/or MMR. We compared seroprotection rates and antibody geometric mean titers (GMTs) between the two strategies.
RESULTS
Ninety-six patients were included. Thirty-one patients received VAR and 67 MMR. In the SDA group, the seroprotection rate was 66.7% (95% confidence interval (CI): 53.3-78.3) versus 97.2% (95% CI: 85.5-99.9) in the SIS ( < 0.001). For the seroprotected patients, GMTs were similar for both schemes.
CONCLUSION
An SDA of VAR and/or MMR vaccines could be sufficient to protect almost two-thirds of patients. Testing immunogenicity after a single dose of VZ and/or MMR could be included in routine clinical practice to achieve rapid immunization.
Topics: Humans; Infant; Chickenpox Vaccine; Vaccines, Attenuated; Rubella; Multiple Sclerosis; Mumps; Measles; Vaccination; Antibodies, Viral
PubMed: 37728389
DOI: 10.1177/13524585231200303 -
Ear, Nose, & Throat Journal Mar 2024Neonatal suppurative parotitis is a rare condition that is diagnosed primarily through clinical evaluation. The prognosis is generally good. In this report, we present...
Neonatal suppurative parotitis is a rare condition that is diagnosed primarily through clinical evaluation. The prognosis is generally good. In this report, we present the case of a 21-day-old female infant who was treated in our ENT department for neonatal suppurative parotitis. The patient presented with a feverish, hard, red, and tender swelling of the parotid loge which displaced the right earlobe outward. In addition, purulent exudate was observed from Stensen's duct. A computed tomography scan of the cervical and cerebral regions revealed a swollen right parotid gland with heterogeneous density and enhancement, but no detectable collection. The patient received intravenous antibiotics for 48 hours, resulting in a favorable outcome without the need for surgical treatment. The aim of this study is to emphasize the diagnostic and therapeutic aspects of this clinical condition. Suppurative parotitis should be suspected by the clinician in newborns who present with an inflammatory preauricular swelling, with or without contributing factors. The outcome is generally favorable, and complications are rare with timely and appropriate medical treatment.
PubMed: 38476055
DOI: 10.1177/01455613241234281 -
Cureus Apr 2024Parotid abscesses are sequelae of acute parotitis that are rare in pediatric patients. Common inciting causes of parotid abscesses include infection, inflammatory...
Parotid abscesses are sequelae of acute parotitis that are rare in pediatric patients. Common inciting causes of parotid abscesses include infection, inflammatory conditions, and ductal obstruction. This case presents a parotid abscess found in an otherwise healthy four-year-old girl. Further evaluation revealed no evidence of infection, no anatomical ductal obstruction, and no evidence of autoimmune conditions that could have caused the abscess. Nonetheless, the patient was treated with an incision and drainage procedure and antibiotic therapy with full recovery. Development of a parotid abscess with no identifiable cause is exceedingly rare with limited documented instances. From this case, idiopathic parotid abscesses may be considered as a diagnosis of exclusion after ruling out common causes, though management still follows the standard of care.
PubMed: 38765350
DOI: 10.7759/cureus.58464 -
Cureus Feb 2024Parotid gland swelling, or parotitis, typically associated with infectious causes, can uncommonly result from non-infectious factors such as mechanical trauma following...
Parotid gland swelling, or parotitis, typically associated with infectious causes, can uncommonly result from non-infectious factors such as mechanical trauma following endoscopic procedures. We present a case of a 46-year-old female with liver cirrhosis who developed right parotid swelling shortly after undergoing endoscopy for evaluation of gastrointestinal symptoms. The patient's clinical course, imaging findings, and successful resolution with conservative measures are detailed. The etiology of post-endoscopy parotid swelling is multifactorial, involving potential mechanisms such as mechanical trauma, salivary gland dysfunction, infection, ductal obstruction, or allergic reactions to medications. Diagnosing this rare complication requires a comprehensive clinical evaluation, including a detailed history, symptom assessment, and imaging studies such as ultrasound. Management involves a combination of symptomatic relief, identification, and treatment of the underlying cause, emphasizing the importance of early recognition to prevent complications. In our case, warm compression provided pain relief, and the swelling subsided without the need for medical or surgical intervention. Regular follow-up evaluations and imaging studies are crucial to assess treatment response and ensure the resolution of the swelling. This case contributes to the limited literature on post-endoscopy parotid swelling, emphasizing the significance of recognizing and managing this rare complication promptly. Healthcare professionals should be vigilant, and further research is encouraged to better understand its pathophysiology and optimize management strategies in order to improve patient outcomes.
PubMed: 38529457
DOI: 10.7759/cureus.54804 -
Cureus Apr 2024Primary tuberculous parotitis is an extremely rare entity presenting with nonspecific symptoms, variable clinical signs, and imaging features mimicking parotid...
Primary tuberculous parotitis is an extremely rare entity presenting with nonspecific symptoms, variable clinical signs, and imaging features mimicking parotid neoplasm. It is a clinical and diagnostic challenge, and a confirmed histological diagnosis would indicate nonoperative management, thus avoiding unwarranted surgery and associated morbidity. Tuberculosis of the salivary gland is a relatively rare extrapulmonary manifestation of tuberculosis, with the incidence of tuberculous parotitis being 2%-9%. The prevalence of disseminated tuberculosis has increased in recent times because of the use of immunosuppressive therapy for organ transplantation and chemotherapy. However, the incidence of concurrent pulmonary tuberculosis in patients with tuberculous parotitis is a rarer scenario. Fine-needle aspiration cytology (FNAC) can confirm the diagnosis of tuberculous parotitis with a high sensitivity (84%-100%) and specificity (94%-100%). The utility of FNAC is also enhanced as the aspirate can be utilized for cartridge-based nucleic acid amplification test (CBNAAT) testing for mycobacterium and drug sensitivity testing, thereby further increasing its sensitivity and specificity. This translates to a lesser chance of unnecessary surgical intervention and the potential surgical morbidity. Here, we report a case of parotid swelling in a 72-year-old male, with no evidence of any pulmonary or systemic tuberculosis, with clinical and imaging features suggestive of parotid neoplasm but diagnosed as tubercular parotitis on FNAC. He was started on antitubercular therapy, which resulted in the progressive diminution of the size of the lesion. Primary tuberculous parotitis should be considered a possibility while managing the parotid neoplasm.
PubMed: 38745804
DOI: 10.7759/cureus.58217 -
Minerva Medica Aug 2023
Topics: Humans; Parotitis; Foreign Bodies; Acute Disease
PubMed: 35332755
DOI: 10.23736/S0026-4806.21.07827-7