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International Journal of Public Health Sep 2016Despite the availability of vaccines and the existence of public vaccination recommendations, outbreaks of vaccine-preventable childhood diseases still cause public... (Review)
Review
OBJECTIVES
Despite the availability of vaccines and the existence of public vaccination recommendations, outbreaks of vaccine-preventable childhood diseases still cause public health debate. The objective of this systematic review was to provide an overview of the current epidemiology and economic burden of measles, mumps, pertussis, and varicella in Germany.
METHODS
We systematically reviewed studies published since 2000. The literature search was conducted using PubMed and EMBASE. Also, we used German notification data to give an up-to-date overview of the epidemiology of the four diseases under consideration.
RESULTS
Thirty-six studies were included in our review. Results suggest that there is still considerable morbidity due to childhood diseases in Germany. Studies providing cost estimates are scarce. Comparative analyses of different data sources (notification data vs. claims data) revealed a potential underestimation of incidence estimates when using notification data. Furthermore, several studies showed regional differences in incidence of some of the diseases under consideration.
CONCLUSIONS
Our findings underline the need for improved vaccination and communication strategies targeting all susceptible age and risk groups on a national and local level.
Topics: Chickenpox; Chickenpox Vaccine; Germany; Humans; Incidence; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Vaccines, Combined; Virus Diseases; Whooping Cough
PubMed: 27488917
DOI: 10.1007/s00038-016-0842-8 -
BMC Veterinary Research May 2016Canine distemper virus (CDV) is the etiological agent of one of the most infectious diseases of domestic dogs, also known as a highly prevalent viral infectious disease... (Review)
Review
BACKGROUND
Canine distemper virus (CDV) is the etiological agent of one of the most infectious diseases of domestic dogs, also known as a highly prevalent viral infectious disease of carnivores and posing a conservation threat to endangered species around the world. To get a better panorama of CDV infection in different Orders, a retrospective and documental systematic review of the role of CDV in different non-dog hosts was conducted. The bibliographical data were collected from MedLine/PubMed and Scopus databases. Data related to Order, Family, Genus and Species of the infected animals, the presence or absence of clinical signs, mortality, serological, molecular or antigenic confirmation of CDV infection, geographic location, were collected and summarized.
RESULTS
Two hundred seventeen scientific articles were considered eligible which includes reports of serological evaluation, and antigenic or genomic confirmation of CDV infection in non-dog hosts. CDV infects naturally and experimentally different members of the Orders Carnivora (in 12 Families), Rodentia (four Families), Primates (two Families), Artiodactyla (three Families) and Proboscidea (one Family). The Order Carnivora (excluding domestic dogs) accounts for the vast majority (87.5%) of the records. Clinical disease associated with CDV infection was reported in 51.8% of the records and serological evidence of CDV infection in apparently healthy animals was found in 49.5% of the records. High mortality rate was showed in some of the recorded infections in Orders different to Carnivora. In non-dog hosts, CDV has been reported all continents with the exception of Australasia and in 43 different countries.
CONCLUSIONS
The results of this systematic review demonstrate that CDV is able to infect a very wide range of host species from many different Orders and emphasizes the potential threat of infection for endangered wild species as well as raising concerns about potential zoonotic threats following the cessation of large-scale measles vaccination campaigns in the human population.
Topics: Animals; Animals, Domestic; Distemper; Distemper Virus, Canine; Endangered Species; Humans; Morbillivirus Infections; Zoonoses
PubMed: 27170307
DOI: 10.1186/s12917-016-0702-z -
Vaccine May 2016Measles is one of the most contagious human diseases. Administration of the live attenuated measles vaccine has substantially reduced childhood mortality and morbidity... (Review)
Review
Measles is one of the most contagious human diseases. Administration of the live attenuated measles vaccine has substantially reduced childhood mortality and morbidity since its licensure in 1963. The live but attenuated form of the vaccine describes a virus poorly adapted to replicating in human tissue, but with a replication yield sufficient to elicit an immune response for long-term protection. Given the high transmissibility of the wild-type virus and that transmission of other live vaccine viruses has been documented, we conducted a systematic review to establish if there is any evidence of human-to-human transmission of the live attenuated measles vaccine virus. We reviewed 773 articles for genotypic confirmation of a vaccine virus transmitted from a recently vaccinated individual to a susceptible close contact. No evidence of human-to-human transmission of the measles vaccine virus has been reported amongst the thousands of clinical samples genotyped during outbreaks or endemic transmission and individual case studies worldwide.
Topics: Genotype; Humans; Measles; Measles Vaccine; Measles virus; Vaccines, Attenuated
PubMed: 27083423
DOI: 10.1016/j.vaccine.2016.03.092 -
Human Vaccines & Immunotherapeutics 2014A number of Japanese encephalitis (JE) vaccines have been used for preventing Japanese encephalitis around the world. We here reviewed the immunogenicity and safety of... (Review)
Review
A number of Japanese encephalitis (JE) vaccines have been used for preventing Japanese encephalitis around the world. We here reviewed the immunogenicity and safety of the currently available Japanese encephalitis vaccines. We searched Pubmed, Embase, Web of Science, the Cochrane Library and other online databases up to March 25, 2014 for studies focusing on currently used JE vaccines in any language. The primary outcomes were the seroconversion rate against JEV and adverse events. Meta-analysis was performed for the primary outcome when available. A total of 51 articles were included. Studies were grouped on the basic types of vaccines. This systematic review led to 2 aspects of the conclusions. On one hand, all the currently available JE vaccines are safe and effective. On the other hand, the overall of JE vaccine evaluation is disorganized, the large variation in study designs, vaccine types, schedules, doses, population and few hand-to-hand trails, make direct comparisons difficult. In order to make a more evidence-based decision on optimizing the JE vaccine, it is warranted to standardize the JE vaccine evaluation research.
Topics: Animals; Clinical Trials as Topic; Humans; Japanese Encephalitis Vaccines; Vaccination
PubMed: 25668666
DOI: 10.4161/21645515.2014.980197 -
American Journal of Epidemiology Nov 2014The serial interval of an infectious disease represents the duration between symptom onset of a primary case and symptom onset of its secondary cases. A good evidence... (Meta-Analysis)
Meta-Analysis Review
The serial interval of an infectious disease represents the duration between symptom onset of a primary case and symptom onset of its secondary cases. A good evidence base for such values is essential, because they allow investigators to identify epidemiologic links between cases and serve as an important parameter in epidemic transmission models used to design infection control strategies. We reviewed the literature for available data sets containing serial intervals and for reported values of serial intervals. We were able to collect data on outbreaks within households, which we reanalyzed to infer a mean serial interval using a common statistical method. We estimated the mean serial intervals for influenza A(H3N2) (2.2 days), pandemic influenza A(H1N1)pdm09 (2.8 days), respiratory syncytial virus (7.5 days), measles (11.7 days), varicella (14.0 days), smallpox (17.7 days), mumps (18.0 days), rubella (18.3 days), and pertussis (22.8 days). For varicella, we found an evidence-based value that deviates substantially from the 21 days commonly used in transmission models. This value of the serial interval for pertussis is, to the best of our knowledge, the first that is based on observations. Our review reveals that, for most infectious diseases, there is very limited evidence to support the serial intervals that are often cited.
Topics: Disease Outbreaks; Family Characteristics; Humans; Influenza, Human; Models, Statistical; Respiratory Syncytial Virus Infections; Respiratory Tract Infections; Severe Acute Respiratory Syndrome; Virus Diseases
PubMed: 25294601
DOI: 10.1093/aje/kwu209 -
Evidence Report/technology Assessment Jul 2014To conduct a systematic review of the literature on the safety of vaccines recommended for routine immunization of children, adolescents, and adults in the United States...
OBJECTIVES
To conduct a systematic review of the literature on the safety of vaccines recommended for routine immunization of children, adolescents, and adults in the United States as of 2011.
DATA SOURCES
We included placebo-controlled clinical trials and cohort studies comparing vaccinated and unvaccinated patients. We also included the following types of post-licensure analyses: case-control studies, self-controlled case series, and multivariate risk factor analyses. We conducted an electronic search of PubMed from inception through August 2013, and reviewed Advisory Committee for Immunization Practices statements, vaccine package inserts, and previously published reviews to identify studies. Scientific Information Packets were requested from vaccine manufacturers.
REVIEW METHODS
We reviewed the methodology of the 2011 Institute of Medicine (IOM) consensus report "Adverse Effects of Vaccines: Evidence and Causality" and accepted their findings. We augmented their work with new studies and additional vaccines. For studies not included in the IOM report, we abstracted data on the presence or absence of adverse health outcomes, characteristics of patients, study design, and vaccine description, including brand, potency, dosage, timing, and formulation, where available. We excluded formulations not used in the United States. The McHarm instrument was used to evaluate the quality of adverse events collection and reporting in each study. We were unable to pool results; we rated the overall strength of evidence (SOE) as high, moderate, low, or insufficient by using guidance suggested by the Agency for Healthcare Research and Quality for its Effective Health Care Program.
RESULTS
A total of 20,478 titles were identified; after title, abstract, and full-text review, 166 studies were accepted for abstraction. The vast majority of studies either did not investigate or could not identify risk factors for adverse events (AEs) associated with vaccination. Similarly, the severity of AEs was inconsistently reported, as was information that would make independent severity determination possible.
UNLABELLED
SOE was high for the following associations in nonpregnant adults: seasonal influenza vaccine and arthralgia, myalgia, malaise, fever, pain at injection site; 2009 monovalent H1N1 vaccine and Guillain-Barré syndrome (GBS); and a lack of association between influenza and pneumococcal vaccines and cardiovascular events in the elderly. Risk of GBS was estimated at 1.6 excess cases per million persons vaccinated. SOE was high for the following associations in children and adolescents: measles, mumps, rubella (MMR) vaccine and febrile seizures in children under age 5; lack of association between MMR vaccine and autism spectrum disorders; and varicella vaccine and disseminated Oka strain varicella zoster virus with associated complications (i.e., meningitis, encephalitis) in individuals with demonstrated immunodeficiencies. There is moderate SOE that vaccines against rotavirus are associated with intussusception in children; risk was estimated as 1 to 5 cases per 100,000 vaccine doses, depending on brand. Moderate-strength evidence exists regarding human papillomavirus vaccine and a lack of association with onset of juvenile rheumatoid arthritis, type 1 diabetes, and GBS. Moderate-strength evidence shows no association between inactivated influenza vaccine and serious AEs in pregnant women.
UNLABELLED
Evidence was insufficient to make conclusions regarding whether several routinely recommended vaccines are associated with serious conditions such as multiple sclerosis, transverse myelitis, and acute disseminated encephalomyelitis.
CONCLUSIONS
There is evidence that some vaccines are associated with serious adverse events; however, these events are extremely rare and must be weighed against the protective benefits that vaccines provide. Careful consideration should be given to the investigation of research gaps, including patient risk factors that may be associated with AEs; however, important factors must be taken into account when determining whether studies are warranted, including the severity and frequency of the AE being studied and the challenges of conducting sufficiently powered studies when investigating rare events.
Topics: Vaccines; Immunization; United States; Humans; Child; Adolescent; Young Adult; Adult
PubMed: 30257278
DOI: 10.23970/AHRQEPCERTA215 -
Vaccine Mar 2014Although immune response to vaccines can be influenced by several parameters, human genetic variations are thought to strongly influence the variability in vaccine... (Meta-Analysis)
Meta-Analysis Review
Although immune response to vaccines can be influenced by several parameters, human genetic variations are thought to strongly influence the variability in vaccine responsiveness. Systematic reviews and meta-analyses are needed to clarify the genetic contribution to this variability, which may affect the efficacy of existing vaccines. We performed a systematic literature search to identify all studies describing the associations of allelic variants or single nucleotide polymorphisms in immune response genes with vaccine responses until July 2013. The studies fulfilling inclusion criteria were meta-analyzed. Thirteen studies (11,686 subjects) evaluated the associations of human leukocyte antigen (HLA) and other immunity gene variations with the responses to single vaccines, including MMR-II (measles and rubella virus), HepB (hepatitis virus), influenza virus, and MenC (serogroup C meningococcus) vaccines. Seven HLA genetic variants were included in the meta-analyses. The pooled ORs showed that DRB1*07 (2.46 [95% CI=1.60-3.77]; P for heterogeneity=0.117; I(2)=49.1%), DQA1*02:01 (2.21 [95% CI=1.22-4.00]; P for heterogeneity=0.995; I(2)=0.0%), DQB1*02:01 (2.03 [95% CI=1.35-3.07]; P for heterogeneity=0.449; I(2)=0.0%), and DQB1*03:03 (3.31 [95% CI=1.12-9.78]; P for heterogeneity=0.188; I(2)=42.4%) were associated with a significant decrease of antibody responses to MMR-II, HepB, and influenza vaccines. The pooled ORs showed that DRB1*13 (0.52 [95% CI=0.32-0.84]; P for heterogeneity=0.001; I(2)=85.1%) and DRB1*13:01 (0.19 [95% CI=0.06-0.58]; P for heterogeneity=0.367; I(2)=0.0%) were associated with a significant increase of antibody responses to the above vaccines. While our findings reinforce the concept that individuals with a particular HLA allelic composition are more likely to respond efficiently to vaccines, future studies should be encouraged to further elucidate the link between genetic variation and variability of the human immune response to vaccines.
Topics: Antibody Formation; HLA-DQ Antigens; HLA-DRB1 Chains; Humans; Polymorphism, Single Nucleotide; Vaccines
PubMed: 24513009
DOI: 10.1016/j.vaccine.2014.01.057 -
The Cochrane Database of Systematic... Jan 2014Reduced vitamin A concentration increases the risk of blindness in children infected with the measles virus. Promoting vitamin A supplementation in children with measles... (Review)
Review
BACKGROUND
Reduced vitamin A concentration increases the risk of blindness in children infected with the measles virus. Promoting vitamin A supplementation in children with measles contributes to the control of blindness in children, which is a high priority within the World Health Organization (WHO) VISION 2020 The Right to Sight Program.
OBJECTIVES
To assess the efficacy of vitamin A in preventing blindness in children with measles without prior clinical features of vitamin A deficiency.
SEARCH METHODS
We searched CENTRAL 2013, Issue 2, MEDLINE (1950 to November week 2, 2013), EMBASE (1974 to November 2013) and LILACS (1985 to November 2013).
SELECTION CRITERIA
Randomised controlled trials (RCTs) assessing the efficacy of vitamin A in preventing blindness in well-nourished children diagnosed with measles but with no prior clinical features of vitamin A deficiency.
DATA COLLECTION AND ANALYSIS
For the original review, two review authors independently assessed studies for eligibility and extracted data on reported outcomes. We contacted trial authors of the included studies for additional information on unpublished data. We included two RCTs which were clinically heterogenous. We presented the continuous outcomes reported as the mean difference (MD) with 95% confidence interval (CI). Due to marked clinical heterogeneity we considered it inappropriate to perform a meta-analysis.
MAIN RESULTS
For the first publication of this review, two RCTs involving 260 children with measles which compared vitamin A with placebo met the inclusion criteria. Neither study reported blindness or other ocular morbidities as end points. One trial of moderate quality suggested evidence of a significant increase in serum retinol levels in the vitamin A group one week after two doses of vitamin A (MD 9.45 µG/dL, 95% CI 2.19 to 16.71; 17 participants) but not six weeks after three doses of vitamin A (MD 2.56 µG/dL, 95% CI -5.28 to 10.40; 39 participants). There was no significant difference in weight gain six weeks (MD 0.39 kg, -0.04 to 0.82; 48 participants) and six months (MD 0.52 kg, 95% CI -0.08 to 1.12; 36 participants) after three doses of vitamin A. The second trial found no significant difference in serum retinol levels two weeks after a single dose of vitamin A (MD 2.67 µG/dL, 95% CI -0.29 to 5.63; 155 participants). No adverse event was reported in either study. We did not find any new randomised controlled trials for this update.
AUTHORS' CONCLUSIONS
We did not find any trials assessing whether or not vitamin A supplementation in children with measles prevents blindness, as neither study reported blindness or other ocular morbidities as end points. However, vitamin A use in children should be encouraged for its proven clinical benefits.
Topics: Adolescent; Blindness; Child; Child, Preschool; Humans; Infant; Measles; Randomized Controlled Trials as Topic; Vitamin A; Vitamins
PubMed: 24436005
DOI: 10.1002/14651858.CD007719.pub3 -
European Archives of... Jul 2013Acute isolated velopharyngeal insufficiency (VPI) is a clinical entity mainly reported in children. We undertook a systematic review in order to better characterize its... (Review)
Review
Acute isolated velopharyngeal insufficiency (VPI) is a clinical entity mainly reported in children. We undertook a systematic review in order to better characterize its features. Following a Medline search (1960-2012), the authors reviewed and analyzed the cases of acute VPI in children; 36 cases were found. The most common presenting features were hypernasal speech (97 %), nasal reflux (73 %), and dysphagia (49 %). 73 % of the children were males and 27 % females, of 8.9 ± 2.5 years. In all the cases the VPI was unilateral. One quarter of the children had a recent episode of febrile illness and 11 % of the children had an identified infection at the time of presentation (HAV, parvovirus B19, measles, and Coxsackie virus). No associated cause was found in the other cases. All cases resolved completely (67 %) or partially (33 %) without any treatment (89 %) or with prednisolone (11 %). Acute VPI represents a separate entity within the spectrum of VPI and it is a benign self-limiting disorder. The cause remains undetermined but an infectious disorder may play a role at least in some cases. Follow-up is mandatory in order to eliminate progressive conditions such as brainstem neoplasms or inflammatory diseases.
Topics: Acute Disease; Child; Female; Humans; Male; Velopharyngeal Insufficiency; Virus Diseases
PubMed: 23053390
DOI: 10.1007/s00405-012-2215-0 -
Reviews in Medical Virology May 2013The aetiology of Crohn's disease (CD) is currently unknown. A viral trigger was proposed more than 40 years ago and has been the focus of many investigations. We... (Review)
Review
The aetiology of Crohn's disease (CD) is currently unknown. A viral trigger was proposed more than 40 years ago and has been the focus of many investigations. We summarised the current literature surrounding the association between viruses and CD and conducted a systematic review of all studies investigating this association quantitatively. Studies were identified by searching for 13 specific virus names or the general term 'virus' and 'Crohn's disease' in search engines PubMed and OVID. A total of 1315 studies were identified, of which 78 studies had a laboratory result. Of the 78, 46 case-control studies met all the inclusion criteria for forest plot analysis. The most common viruses studied were EBV, CMV and measles virus (MV). Forest plot analysis for each virus was carried out (fitted using random effects) and identified evidence of an association between CD and CMV (risk ratio [RR] 1.602, 95% confidence interval [CI] 1.069 to 2.400) with some suggestion that EBV may also be associated with CD (RR 1.366, 95% CI 0.996 to 1.873). However, there was evidence of large heterogeneity in the results from the identified studies for EBV. There was little evidence of an association with CD for MV, human herpes virus 6, human herpes virus 8, human simplex virus, varicella-zoster virus, mumps virus, Rubella virus, rotavirus, norovirus and adenovirus. There is still some question around whether CD is associated with the presence of a currently known virus.
Topics: Crohn Disease; Humans; Virus Diseases
PubMed: 22674582
DOI: 10.1002/rmv.1720