Milestones :: Perspectives

Lancet Infectious Diseases

Jul 2018 Volume 18 Number 7 p697-812  e183-e227
http://www.thelancet.com/journals/laninf/issue/current
Editorial
How to be ready for the next influenza pandemic
The Lancet Infectious Diseases
This year marks the 100th anniversary of the 1918 influenza pandemic, the worst acute infectious disease outbreak in modern history. The pandemic was caused by influenza virus H1N1 and emerged in the final stages of World War 1. It is estimated that between 20 million and 50 million people died during this pandemic, with a uniquely high mortality in young adults aged between 20 and 40 years. Low-income countries were hit particularly hard (17 million people are thought to have died in India alone) because of their poor health systems. Why the 1918 pandemic was so severe is still a matter of debate, but immunological factors and secondary bacterial infections were major contributors to the heavy death toll. Other influenza pandemics, albeit less severe, have then occurred in 1957, 1968, and 2009, so a new one appears inevitable at some point in the future. Thus, on the centenary of the 1918 pandemic, it is timely to ask ourselves whether the world would be prepared now for such an event.

The answer sadly is no: we do not know what virus will cause the next pandemic, there is no way to rapidly develop and deploy an effective vaccine against a pandemic virus, differences in quality of health systems hamper a prompt response, and surveillance data on influenza have major gaps. At the Massachusetts Medical Society’s annual meeting on April 27, American philanthropist Bill Gates presented a simulation by the Institute for Disease Modeling that found that a new influenza virus like the one that caused the 1918 pandemic would now most likely kill 30 million people within 6 months. Thus, an influenza pandemic represents a real threat that could only be managed with a rapid and effective response from both national governments and the international health community, something that was not seen for the most recent major oubreak of a deadly infectious disease, the emergence of Ebola virus disease in west Africa in 2014-16.

In order to improve the preparedness of the global health community to a pandemic, three areas are crucial: vaccination, surveillance, and building response capacity. As discussed in our May Editorial, the development of a universal influenza vaccine, the holy grail of influenza research, would enhance the capacity to protect people from infection. Gates’ announcement of a US$12 million donation to contribute to the development of such a vaccine is therefore welcome news. However, the development of an effective vaccine is expected to take at least 5–10 years.

Surveillance for influenza is of crucial importance but is also complex because it needs to cover two key populations: animals and humans. It is expected that the next pandemic influenza virus will originate from a spillover from birds, the natural reservoir of all influenza viruses, or pigs, in which avian and human viruses can coexist, thus favouring recombination. At the recent ECCMID meeting, Colin Russell presented the results of a study that mapped areas in the world at highest risk of spillover of avian and swine influenza virus into humans. Particularly ominous was the observation that surveillance for viruses circulating in birds and pigs in such areas is often very limited, so the rapid spread of an influenza virus of pandemic potential could easily go undetected. Equally patchy is the surveillance of human cases of influenza, which is essential to recognise unusual severity or incidence of cases which can be a prodrome for a pandemic. WHO has conducted monitoring through the Global Influenza Surveillance and Response System for over half a century, relying on collection and preliminary analysis of virus specimens from national influenza centres. Not all countries have such centres (for example, only 18 African countries have one) so the reporting of influenza cases remains suboptimum.

In case of an influenza pandemic, the capacity to respond promptly will play a key part because of airborne transmission. Antivirals and antibiotics to prevent secondary bacterial infections will be important, while awaiting development of an effective vaccine, but stockpiles of these are currently insufficient. Moreover, there is need to invest in strengthening health systems and microbiological capacities on the ground to enhance the rapid response to any outbreak.

Influenza is the infectious disease with a proven record of causing pandemics, so it is essential that it remains at the centre of efforts for pandemic preparedness. The next influenza pandemic will be a real test for the international health community. We should not find ourselves unprepared—to be so could cost millions of lives.

Milestones :: Perspectives

[U.S.] Appeals Court: Infants, Preschoolers Must Get Flu Shot
By The Associated Press
June 28, 2018
NEW YORK — New York City’s requirement that infants and preschoolers in city-regulated child care or school-based programs must get yearly flu shots was upheld Thursday by the state’s highest court.
The Court of Appeals said that the city’s Department of Health had the authority to require the shots, a rule the city first enacted in 2013 during Mayor Michael Bloomberg’s administration.
A group of mothers filed a lawsuit in 2015, saying officials had overstepped their authority in requiring the annual vaccinations for children between the ages of 6 months and 5 years.
In its unanimous ruling, the court said the “promulgation of the flu vaccine falls squarely within the powers specifically delegated to the department.”
Health Commissioner Dr. Mary Bassett says the ruling is a “great win for New York City children.”
“Children who receive the influenza vaccine are less likely to get sick, less likely to need medical attention and less likely to die from influenza,” she said. “This decision will help us protect more than 150,000 children in City-regulated day cares and preschools across the city.”
The city said the mandate would go into effect immediately, and the more than 150,000 children in programs that are regulated by the city would be required to get the flu vaccine by December 31…
 

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 26 June 2018 [GPEI]
:: The Republic of Korea becomes the first donor to support polio outbreak response in the Horn of Africa.
 
Summary of newly-reported viruses this week:
DRC : Three cVDPV cases type 2
Papua New Guinea: One  cVDPV case type 1
Somalia: One cVDPV case combining type 2 and type 3 and, two cVDPV cases type 3

Papua New Guinea confirms poliovirus outbreak, launches response
PORT MORESBY, 25 June 2018 – The National Department of Health of Papua New Guinea and the World Health Organization (WHO) today confirmed that the strain of poliovirus first detected in a child from Morobe Province in April is now circulating in the same community.
The one confirmed case is a 6-year-old boy with lower limb weakness, first detected on 28 April 2018. A vaccine-derived poliovirus type 1 (VDPV1) had been isolated as the cause of the paralysis on 21 May 2018.
On 22 June 2018, the United States Centers for Disease Control and Prevention confirmed that the same virus was also isolated from stool specimens of two healthy children from the same community. This means that the virus is circulating in the community—representing an outbreak of the virus.
“We are deeply concerned about this polio case in Papua New Guinea, and the fact that the virus is circulating,” said Pascoe Kase, Secretary of the National Department of Health (NDOH). “Our immediate priority is to respond and prevent more children from being infected.”…
Public health response
Outbreak response activities are ongoing in Morobe Province. Experts from the NDOH, Papua New Guinea’s Central Public Health Laboratory, Provincial Health Authorities, UNICEF and WHO have conducted field missions to undertake clinical investigation, house-to-house surveys, sample collection and contact tracing.
The team also collected stool specimens from family members of the patient and from the community. A “mop up” immunization campaign was done in the community targeting children under 15 years old. To date, 845 children from the Lufa Mountain Settlement have been vaccinated…

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WHO Grade 3 Emergencies  [to 30 Jun 2018]
The Syrian Arab Republic
:: Syria crisis – SOUTHERN SYRIA UPDATE  Issue 1 – 26-28 June 2018
 
Iraq  – No new announcements identified
Nigeria  – No new announcements identified
South Sudan  – Webpage not responding at inquiry
Yemen  – No new announcements identified

::::::
 
WHO Grade 2 Emergencies  [to 30 Jun 2018]
[Several emergency pages were not available at inquiry]
Myanmar 
:: Additional workforce added to Cox’s Bazar hospital to strengthen Rohingya refugee response
Cox’s Bazar, Bangladesh, 21 June 2018: To strengthen health services for Rohingya refugees and their host communities in Cox’s Bazar, additional health workforce has been added to the district hospital here, the only facility providing referral services to nearly 1.3 million vulnerable population at increased risk of diseases in the ongoing rainy season.
“The additional staff will help augment service delivery at the hospital as we seek to enhance capacities to treat acute watery diarrhoea cases, in addition to trauma and obstetric care,” said Dr Bardan Jung Rana, WHO Representative to Bangladesh.
With funding from the King Salman Humanitarian Aid and Relief Centre (KSrelief), 86 additional staff including 25 medical officers and 40 nurses, have been hired by the Ministry of Health and Family Welfare for the Sadar district hospital…

Cameroon  – No new announcements identified
Central African Republic  – No new announcements identified.
Democratic Republic of the Congo  – No new announcements identified
Ethiopia  – No new announcements identified.
Libya – No new announcements identified.
Niger  – No new announcements identified.
Ukraine – No new announcements identified.

::::::
::::::
 
UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Yemen
:: Yemen: Al Hudaydah Update Situation Report No. 6, 27 June 2018

Syrian Arab Republic  – No new announcements identified.

::::::

UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Ethiopia  – No new announcements identified.
Somalia   – No new announcements identified.

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Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

EBOLA/EVD  [to 30 Jun 2018]
http://www.who.int/ebola/en/
Ebola situation reports: Democratic Republic of the Congo
Case numbers can fluctuate on a daily basis due to many factors including enhanced surveillance, local laboratory capacity, possible communication delays caused by the challenge of accessing remote locations and constant reclassification of cases. Suspected cases with conclusively negative laboratory tests are systematically removed from the case counts.
Latest numbers as of 28 June 2018
:: Confirmed cases: 38
:: Probable cases: 15
:: Suspect cases: 2
:: Total cases: 55 (including 29 deaths)
2018 Ebola outbreak situation reports
Ebola Outbreak in DRC: 26 June 2018

MERS-CoV [to 30 Jun 2018]
http://who.int/emergencies/mers-cov/en/
– No new announcements identified.
 
Yellow Fever  [to 30 Jun 2018]
http://www.who.int/csr/disease/yellowfev/en/
– No new announcements identified.
Zika virus  [to 30 Jun 2018]
http://www.who.int/csr/disease/zika/en/
– No new announcements identified.
 

WHO & Regional Offices [to 30 Jun 2018]

27 June 2018 – News Release, Geneva
WHO study shows drug could save thousands of women’s lives
A new formulation of a drug to prevent excessive bleeding following childbirth could save thousands of women’s lives in low- and lower-middle-income countries, according to a study led by the World Health Organization (WHO) in collaboration with MSD for Mothers and Ferring Pharmaceuticals.
Currently WHO recommends oxytocin as the first-choice drug for preventing excessive bleeding after childbirth. Oxytocin, however, must be stored and transported at 2–8 degrees Celsius, which is hard to do, in many countries, depriving many women of access to this lifesaving drug. When they can obtain it, the drug may be less effective because of heat exposure.
The study, published today in the New England Journal of Medicine, has shown an alternative drug – heat-stable carbetocin – to be as safe and effective as oxytocin in preventing postpartum haemorrhage. This new formulation of carbetocin does not require refrigeration and retains its efficacy for at least 3 years stored at 30 degrees celsius and 75% relative humidity…

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Weekly Epidemiological Record, 29 June 2018, vol. 93, 26 (pp. 369–380)
Index of countries/areas
Index, Volume 93, 2018, Nos. 1–26
:: WHO Alliance for the Global Elimination of Trachoma by 2020: progress report on elimination of trachoma, 2017

::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: Bringing Ebola vaccine to remote communities in the Democratic Republic of Congo
27 June 2018
:: Government launches new Rotavirus vaccine to protect children in Uganda from diarrhea
26 June 2018
:: Adamawa state gets over 700,000 doses of oral cholera vaccines for emergency vaccination
25 June 2018

WHO Region of the Americas PAHO
:: PAHO Executive Committee concludes its 162nd session on advancing health in the Americas region (06/27/2018)
Issues that were advanced during the Committee include: action plans to ensure the health of women, children and adolescents; the prevention and treatment of cervical cancer; and the human resources required for universal health access and coverage.
 
WHO South-East Asia Region SEARO
– No new announcements identified.
 
WHO European Region EURO
:: Primary health care: the bridge to universal health coverage in Greece 28-06-2018
:: Climate change increasingly affects small countries 25-06-2018

WHO Eastern Mediterranean Region EMRO
– No new announcements identified.

WHO Western Pacific Region
:: Papua New Guinea confirms poliovirus outbreak, launches response  25 June 2018
[See Polio above for more detail]

CDC/ACIP [to 30 Jun 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
No new digest content identified.

Africa CDC   [to 30 Jun 2018]
https://au.int/en/africacdc
No new digest content identified.

China CDC 
http://www.chinacdc.cn/en/ne/
Website not responding at inquiry…no connection since 2 June inquiry

ECDC – European Centre for Disease Prevention and Control  [to 30 Jun 2018]
https://ecdc.europa.eu/en/home
Publication
Achievements, challenges and major outputs 2017: Highlights from the Annual Report of the Director
This brochure briefly summarises the Centre’s accomplishments for the previous year. It covers all ECDC Disease Programmes and Programme activities, health communication, training activities and outbreak preparedness.

Announcements
 
AERAS  [to 30 Jun 2018]
http://www.aeras.org/pressreleases
No new digest content identified.
 
 
BMGF – Gates Foundation  [to 30 Jun 2018]
http://www.gatesfoundation.org/Media Center/Press-Releases
JUNE 20, 2018
Plans for Third Building on Seattle Campus
SEATTLE, June 20, 2018 — The Bill & Melinda Gates Foundation announced plans to move forward with a third building at their headquarters located in downtown Seattle, across from Seattle Center and the historic Space Needle. The foundation plans to break ground on the new building in Fall of 2019 with completion in Spring of 2022.

Bill & Melinda Gates Medical Research Institute    [to 30 Jun 2018]
https://www.linkedin.com/company/bill-melinda-gates-medical-research-institute/
   The Bill & Melinda Gates Medical Research Institute is a non-profit research organization dedicated to combating diseases that impact the world’s poorest. We strive to combat inequities in health by accelerating progress in translational science to ensure life-saving products are available and accessible to everyone. We consider ourselves pioneers dedicated to uncovering radical solutions that will close the gap between cutting-edge scientific innovation and its application to challenges in global health.
No new digest content identified..

CARB-X   [to 30 Jun 2018]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.
 
 
CEPI – Coalition for Epidemic Preparedness Innovations  [to 30 Jun 2018]
http://cepi.net/
No new digest content identified.

EDCTP    [to 30 Jun 2018]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
No new digest content identified.

Emory Vaccine Center    [to 30 Jun 2018]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency  [to 30 Jun 2018]
http://www.ema.europa.eu/ema/
29/06/2018
Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP) 25-28 June 2018
Nine medicines recommended for approval, including the first two CAR-T cell therapies in the EU

29/06/2018
First two CAR-T cell medicines recommended for approval in the European Union
Development of Kymriah and Yescarta supported through PRIME .
 
 
European Vaccine Initiative  [to 30 Jun 2018]
http://www.euvaccine.eu/news-events
27 June 2018
Registration for EVI 20th Anniversary Symposium now open
On 20/21 November, EVI will celebrate its 20th anniversary with a symposium in Heidelberg, Germany. A draft agenda is now…
 
 
FDA [to 30 Jun 2018]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.
 
 
Fondation Merieux  [to 30 Jun 2018]
http://www.fondation-merieux.org/
Support for Laboratories
The Ministry of Public Health and Population launches Haiti’s first National Laboratory Policy
June 28, 2018 – Port-au-Prince (Haiti)
As part of the SPHaïtiLAB project, the Ministry of Public Health and Population (MSPP) launched the first National Laboratory Policy in Haiti on June 19th. The Minister of Health, Dr. Marie Gréta Roy Clément, presided over the ceremony that brought together the local and international partners involved in the project. The European Union, GHESKIO Centres and the Mérieux Foundation were among the partners who met in Port-au-Prince to present the key points, strategies and implementation of this policy…

 
Gavi [to 30 Jun 2018]
http://www.gavi.org/library/news/press-releases/
26 June 2018
Gavi supports rotavirus vaccine introduction in Uganda
The vaccine will help save the lives of thousands of children by combating the leading cause of severe diarrhoea.
Uganda, Buikwe – The Government of Uganda has launched today a new rotavirus vaccine to protect under five-year-old children from diarrhoea. The vaccine, which will be available for free in health facilities throughout the country, is the 11th vaccine to be added into the national schedule of the expanded programme on immunisation in Uganda. Rotavirus vaccine is safe and can be administered simultaneously with other routine infant vaccines. It is given orally and requires two doses at 6 and 10 weeks of age, with an interval of at least 4 weeks between doses…
 
 
GHIT Fund   [to 30 Jun 2018]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that devastate the world’s poorest people. Other funders include six Japanese pharmaceutical
No new digest content identified.

Global Fund [to 30 Jun 2018]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
No new digest content identified.

Hilleman Laboratories   [to 30 Jun 2018]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 30 Jun 2018]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
 
 
IAVI  [to 30 Jun 2018]
https://www.iavi.org/
No new digest content identified.
 
 
IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.

IVAC  [to 30 Jun 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 30 Jun 2018]
http://www.ivi.int/
[Undated]
WHO and IVI Hold Joint Symposium for MERS-CoV Vaccine Development in Seoul on June 26, 27
– 120 experts and professionals are updating progress in MERS human and dromedary camel vaccine development, seeking next steps
– Symposium co-hosted by WHO and convened as the 4th IVI Global Vaccine Forum sponsored by WHO, Seoul Cyber University, Korea Support Committee for IVI

JEE Alliance  [to 30 Jun 2018]
https://www.jeealliance.org/
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 30 Jun 2018]
http://www.msf.org/en/updates
Report  27 June 2018
South Sudan
HIV Test and Treat pilot project in Yambio comes to a close
The Médecins Sans Frontières, Ministry of Health and the World Health Organization’s Test and Treat (T&T) HIV pilot project in Yambio county finished in June 2018.
The objective of the study was to assess feasibility and acceptability of the “treat all strategy” coupled with a community-based, patient-centred approach, based on HIV testing and same day antiretroviral treatment.
The report highlights the methodology used, the key learnings and the outcomes of the project.
The report found that bringing HIV testing and treatment closer to patients’ homes, with simplified protocols and less specialised health staff was feasible, resulting in comparable treatment outcomes to those of facility-based care.
 
 
NIH  [to 30 Jun 2018]
http://www.nih.gov/news-events/news-releases
No new digest content identified.

PATH  [to 30 Jun 2018]
http://www.path.org/news/index.php
No new digest content identified.

Sabin Vaccine Institute  [to 30 Jun 2018]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 30 Jun 2018]
http://www.unaids.org/en
Feature story
New UNAIDS web portal reinforces its commitment to accountability and transparency
27 June 2018
UNAIDS has launched a revamped transparency portal, open.unaids.org, which presents current data on how UNAIDS is working to end AIDS as a public health threat by 2030.
The portal features joint results, country-level information, financial reporting, donor contributions, indicator trends and detailed information on the achievements of the UNAIDS Cosponsors.
“This portal is part of our collective efforts to ensure that we strengthen our transparency, accountability and communications around how we work and what we achieve. It provides Member States, donors, partners and staff alike with an excellent and highly accessible resource,” says Gunilla Carlsson, UNAIDS Deputy Executive Director…

Update
UNAIDS Programme Coordinating Board opens
26 June 2018
The 42nd meeting of the UNAIDS Programme Coordinating Board (PCB) is taking place in Geneva, Switzerland, from 26 to 28 June…
Mr Sidibé also emphasized the need for a transformative approach to the epidemic that will include reforming laws and policies to end discrimination, expand community-led, people-centred approaches to HIV service delivery, the use of timely location–population data to inform decision-making, close the funding gap to achieve the Fast-Track Targets and reinforce the linkages between ending AIDS and achieving universal health coverage…

UNICEF  [to 30 Jun 2018]
https://www.unicef.org/media/
Selected Press Releases/Reports
No new digest content identified…most recent press release dated 15 May 2018]

 
Vaccine Confidence Project  [to 30 Jun 2018]
http://www.vaccineconfidence.org/
No new digest content identified.
 

Vaccine Education Center – Children’s Hospital of Philadelphia  [to 30 Jun 2018]
http://www.chop.edu/centers-programs/vaccine-education-center
June 2018
Announcements: Vaccine safety references; vaccines and fevers 
::News & views – Best practices: Responding to vaccine deniers in public
Charlotte A. Moser, Assistant Director, and Paul A. Offit, Director, Vaccine Education Center at Children’s Hospital of Philadelphia
 
 
Wellcome Trust  [to 30 Jun 2018]
https://wellcome.ac.uk/news
Published: 27 June 2018
New antibiotic approved for drug-resistant infections
A new antibiotic, developed with support from Wellcome, has been approved for patient use in the US.
The US Food and Drug Administration (FDA) has approved the use of plazomicin (opens in a new tab) (brand name ZEMDRI) for the treatment of complicated, drug-resistant urinary tract infections.
Wellcome supported development of the new medicine, including £8.1m funding for pre-clinical research and Phase 2 development.
The rapid rise and spread of untreatable superbugs is a serious and global health threat, currently killing around 700,000 people a year globally.
Tim Jinks, Head of Wellcome’s Drug-Resistant Infections Programme said: “This new antibiotic will be a vital last-resort treatment for patients with complicated and life-threatening urinary tract infections. As with any new antibiotic, ensuring appropriate use is essential…

 
The Wistar Institute   [to 30 Jun 2018]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE)   [to 30 Jun 2018]
http://www.oie.int/en/for-the-media/press-releases/2018/
No new digest content identified.

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BIO    [to 30 Jun 2018]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network  [to 30 Jun 2018]
http://www.dcvmn.org/
No new digest content identified.
 

IFPMA   [to 30 Jun 2018]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.
 

PhRMA    [to 30 Jun 2018]
http://www.phrma.org/press-room
No new digest content identified.

Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

No new digest content identified..

Journal Watch

   Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.

If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

American Journal of Preventive Medicine
July 2018 Volume 55, Issue 1, p1-132, e1-e18
http://www.ajpmonline.org/current

Trends in High-Grade Cervical Cancer Precursors in the Human Papillomavirus Vaccine Era
Fredrick Oakley, Mohamed M. Desouki, Manideepthi Pemmaraju, Julia M. Gargano, Lauri E. Markowitz, Martin Steinau, Elizabeth R. Unger, Yuwei Zhu, Oluwole Fadare, Marie R. Griffin
p19–25
Published online: May 17, 2018

American Journal of Preventive Medicine
July 2018 Volume 55, Issue 1, p1-132, e1-e18
http://www.ajpmonline.org/current

Addressing Parents’ Vaccine Concerns: A Randomized Trial of a Social Media Intervention
Matthew F. Daley, Komal J. Narwaney, Jo Ann Shoup, Nicole M. Wagner, Jason M. Glanz
p44–54
Published online: May 14, 2018

American Journal of Public Health
July 2018  108(7)
http://ajph.aphapublications.org/toc/ajph/current
HUMAN PAPILLOMAVIRUS VACCINE

Addressing the Declining Rates of Completion and Gender Coverage Inequity in Human Papillomavirus Vaccination in the United States
Franklin D. Pratt
108(7), pp. 853–854

American Journal of Public Health
July 2018  108(7)
http://ajph.aphapublications.org/toc/ajph/current
HUMAN PAPILLOMAVIRUS VACCINE

Predictors of Human Papillomavirus Vaccine Follow-Through Among Privately Insured US Patients
Jennifer C. Spencer, Noel T. Brewer, Justin G. Trogdon, Steph

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 30 Jun 2018)

Research article
Uptake of hepatitis B vaccination and its determinants among health care workers in a tertiary health facility in Enugu, South-East, Nigeria
Hepatitis B vaccination is the most effective method of prevention for hepatitis B virus infection. It is a major public health problem in Nigeria, and health workers are at increased risk. This study determined the uptake of hepatitis B vaccination and assessed its determinants among health care workers (HCWs).
Authors: I. B. Omotowo, I. A. Meka, U. N. Ijoma, V. E. Okoli, O. Obienu, T. Nwagha, A. C. Ndu, D. O. Onodugo, L. C. Onyekonwu and E. O. Ugwu
Citation: BMC Infectious Diseases 2018 18:288
Published on: 28 June 2018

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 30 Jun 2018)

Correspondence
|   26 June 2018
Cross-border movement, economic development and malaria elimination in the Kingdom of Saudi Arabia
Malaria at international borders presents particular challenges with regards to elimination. International borders share common malaria ecologies, yet neighboring countries are often at different stages of the control-to-elimination pathway. Herein, we present a case study on malaria, and its control, at the border between Saudi Arabia and Yemen.
Authors: Mohammed H. Al Zahrani, Abdiasiis I. Omar, Abdelmohsin M. O. Abdoon, Ali Adam Ibrahim, Abdullah Alhogail, Mohamed Elmubarak, Yousif Eldirdiry Elamin, Mohammed A. AlHelal, Ali M. Alshahrani, Tarig M. Abdelgader, Ibrahim Saeed, Tageddin B. El Gamri, Mohammed S. Alattas, Abdu A. Dahlan, Abdullah M. Assiri, Joseph Maina…

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 30 Jun 2018)

Research article
The role of severity perceptions and beliefs in natural infections in Shanghai parents’ vaccine decision-making: a qualitative study
China has reduced incidence of vaccine-preventable diseases through its Expanded Program on Immunization (EPI). Vaccines outside of the EPI are not provided for free by the government, however. This study expl…
Authors: Xiaodong Sun, Zhuoying Huang, Abram L. Wagner, Lisa A. Prosser, Erzhan Xu, Jia Ren, Bei Wang, Wenlu Yan and Brian J. Zikmund-Fisher
Citation: BMC Public Health 2018 18:813
Published on: 28 June 2018

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 30 Jun 2018)

Research article
A postpartum vaccination promotion intervention using motivational interviewing techniques improves short-term vaccine coverage: PromoVac study
Due to the increasing number of vaccine-hesitant parents, new effective immunization promotion strategies need to be developed to improve the vaccine coverage (VC) of infants. This study aimed to assess the im…
Authors: Arnaud Gagneur, Thomas Lemaître, Virginie Gosselin, Anne Farrands, Nathalie Carrier, Geneviève Petit, Louis Valiquette and Philippe De Wals
Citation: BMC Public Health 2018 18:811
Published on: 28 June 2018

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 30 Jun 2018)

Research article
Evaluation of the impact of immunization policies, including the addition of pharmacists as immunizers, on influenza vaccination coverage in Nova Scotia, Canada: 2006 to 2016
Influenza is a serious public health concern, resulting in morbidity, mortality and significant expense to healthcare systems worldwide. Annual vaccination is the most effective way to prevent influenza. The N…
Authors: Jennifer E. Isenor, Beth A. O’Reilly and Susan K. Bowles
Citation: BMC Public Health 2018 18:787
Published on: 26 June 2018
 
 

Current Opinion in Infectious Diseases
August 2018 – Volume 31 – Issue 4
http://journals.lww.com/co-infectiousdiseases/pages/currenttoc.aspx

NOSOCOMIAL AND HEALTHCARE RELATED INFECTIONS
Edited by Trish M. Perl
Planning for large epidemics and pandemics: challenges from a policy perspective
Jain, Vageesh; Duse, Adriano; Bausch, Daniel G.
Current Opinion in Infectious Diseases. 31(4):316-324, August 2018.

Global Health: Science and Practice (GHSP)
June 2018 | Volume 6 | Number 2
http://www.ghspjournal.org/content/current

EDITORIALS
Evidence-Based Programs, Yes—But What About More Program-Based Evidence?
Global Health: Science and Practice June 2018, 6(2):247-248; https://doi.org/10.9745/GHSP-D-18-00192
Policy makers and program managers are better enabled to draw relevant lessons from implementation research and program experience elsewhere when there is richer documentation on what was done and what key contextual factors may have influenced outcomes. Newly developed Program Reporting Standards from WHO provide helpful guidance on what is needed for optimally useful documentation

Global Health: Science and Practice (GHSP)
June 2018 | Volume 6 | Number 2
http://www.ghspjournal.org/content/current

VIEWPOINTS
Open Access
Eliminating Mother-to-Child Transmission of HIV by 2030: 5 Strategies to Ensure Continued Progress
Alexandra C. Vrazo, David Sullivan and Benjamin Ryan Phelps
Global Health: Science and Practice June 2018, 6(2):249-256; https://doi.org/10.9745/GHSP-D-17-00097
To keep up momentum in preventing mother-to-child transmission we propose: (1) advocating for greater political and financial commitment; (2) targeting high-risk populations such as adolescent girls and young women; (3) implementing novel service delivery models such as community treatment groups; (4) performing regular viral load monitoring during pregnancy and postpartum to ensure suppression before delivery and during breastfeeding; and (5) harnessing technology in monitoring and evaluation and HIV diagnostics.

Health Economics, Policy and Law 
Volume 13 – Special Issue 3-4 – July 2018
https://www.cambridge.org/core/journals/health-economics-policy-and-law/latest-issue
SPECIAL ISSUE: Canadian Medicare: Historical Reflections, Future Directions

[New issue; No digest content identified]

Humanitarian Exchange Magazine
Number 71  March 2018
https://odihpn.org/magazine/humanitarian-response-urban-areas/

Humanitarian response in urban areas
Humanitarian crises are increasingly affecting urban areas either directly, through civil conflict, hazards such as flooding or earthquakes, urban violence or outbreaks of disease, or indirectly, through hosting people fleeing these threats. The humanitarian sector has been slow to understand how the challenges and opportunities of working in urban spaces necessitate changes in how they operate. For agencies used to working in rural contexts, the dynamism of the city, with its reliance on markets, complex systems and intricate logistics, can be a daunting challenge. Huge, diverse and mobile populations complicate needs assessments, and close coordination with other, often unfamiliar, actors is necessary.

[Reviewed earlier]

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 14, Issue 6 2018
http://www.tandfonline.com/toc/khvi20/current

Review
Seasonal influenza vaccine in immunocompromised persons
Mohammad Bosaeed & Deepali Kumar
Pages: 1311-1322
Published online: 21 Mar 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 14, Issue 6 2018
http://www.tandfonline.com/toc/khvi20/current

Article
Cost-effectiveness analysis of different seasonal influenza vaccines in the elderly Italian population
Stefano Capri, Marco Barbieri, Chiara de Waure, Sara Boccalini & Donatella Panatto
Pages: 1331-1341
Published online: 26 Feb 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 14, Issue 6 2018
http://www.tandfonline.com/toc/khvi20/current

Article
Cost-effectiveness analysis of routine 13-valent pneumococcal conjugate vaccinations in Chinese infants
Hua Zhou, Jinchun He, Bin Wu & Datian Che
Pages: 1444-1452
Published online: 09 Apr 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 14, Issue 6 2018
http://www.tandfonline.com/toc/khvi20/current

Article
Immune response to the hepatitis B antigen in the RTS,S/AS01 malaria vaccine, and co-administration with pneumococcal conjugate and rotavirus vaccines in African children: A randomized controlled trial
Innocent Valéa, Samuel Adjei, Effua Usuf, Ousmane Traore, Daniel Ansong, Halidou Tinto, Harry Owusu Boateng, Amanda Leach, Athanase Mwinessobaonfou Some, Patrick Buabeng, Johan Vekemans, Louis Arnaud Nana, Amos Kotey, Pascale Vandoolaeghe, Florence Ouedraogo, David Sambian, Marc Lievens, Marc Christian Tahita, Theresa Rettig, Erik Jongert, Palpouguini Lompo, Ali Idriss, Dorota Borys, Sayouba Ouedraogo, Frank Prempeh, Md Ahsan Habib, Lode Schuerman, Hermann Sorgho & Tsiri Agbenyega
Pages: 1489-1500
Published online: 13 Apr 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 14, Issue 6 2018
http://www.tandfonline.com/toc/khvi20/current

article commentary
The need for sustainability and alignment of future support for National Immunization Technical Advisory Groups (NITAGs) in low and middle-income countries
Natasha Howard, Sadie Bell, Helen Walls, Laurence Blanchard, Logan Brenzel, Mark Jit & Sandra Mounier-Jack
Pages: 1539-1541
Published online: 26 Mar 2018

International Health
Volume 10, Issue 4, 1 July 2018
http://inthealth.oxfordjournals.org/content/current

ORIGINAL ARTICLES
Impact of mass drug administration campaigns depends on interaction with seasonal human movement
Mass drug administration (MDA) is a control and elimination tool for treating infectious diseases. For malaria, it is widely accepted that conducting MDA during the dry season results in the best outcomes. However, seasonal movement of populations into and out of MDA target areas is common in many places and could potentially fundamentally limit the ability of MDA campaigns to achieve elimination.
Jaline Gerardin; Amelia Bertozzi-Villa; Philip A Eckhoff; Edward A Wenger
International Health, Volume 10, Issue 4, 1 July 2018, Pages 252–257, https://doi.org/10.1093/inthealth/ihy025

International Journal of Community Medicine and Public Health
Vol 5, No 7 (2018)  July 2018
http://www.ijcmph.com/index.php/ijcmph/issue/view/40

Review Articles
Effectiveness of influenza vaccine in children
Nof Saadi AlQarni, Alzain Mohammid Abdulla, Reham Hassan Abdulaziz Abdu, Basim Faiqe Noor Khan, Ahmed Hussain D. Alherz, Mohamed Ahmed M. Waznah, Mariam Naif W. Alotaibi, Wed Ziyad Alnajjar, Khaled Abdulaziz Alasous, Ahmed Khaled Almarri
DOI: 10.18203/2394-6040.ijcmph20182492

International Journal of Community Medicine and Public Health
Vol 5, No 7 (2018)  July 2018
http://www.ijcmph.com/index.php/ijcmph/issue/view/40

Original Research Articles
Measles outbreak amongst Manymar population of Jeddah City, Saudi Arabia
Nabeela Abdullah Al-Abdullah
DOI: 10.18203/2394-6040.ijcmph20182420

International Journal of Community Medicine and Public Health
Vol 5, No 7 (2018)  July 2018
http://www.ijcmph.com/index.php/ijcmph/issue/view/40

Knowledge and practice of polio vaccination among mothers of infants attending community health centre of northern Kerala
Nivya Noonhiyil Kaithery, Jayasree Anandabhavan Kumaran
DOI: 10.18203/2394-6040.ijcmph20182621

International Journal of Community Medicine and Public Health
Vol 5, No 7 (2018)  July 2018
http://www.ijcmph.com/index.php/ijcmph/issue/view/40

Measles rubella campaign: coverage among slum children of Udupi municipality area in Karnataka
Ashwini Kumar, Divya V. Pai, Aparna Sen Chaudhary, Mahathi Ramireddy, Asha Kamath
DOI: 10.18203/2394-6040.ijcmph20182638

International Journal of Community Medicine and Public Health
Vol 5, No 7 (2018)  July 2018
http://www.ijcmph.com/index.php/ijcmph/issue/view/40

Compliance of post exposure rabies vaccination among patients attending anti-rabies OPD in the Government Medical College, Nagpur
Rushali Rajan Lilare, Neeta Rathod, Uday W. Narlawar
DOI: 10.18203/2394-6040.ijcmph20182646

JAMA
June 26, 2018, Vol 319, No. 24, Pages 2453-2566
http://jama.jamanetwork.com/issue.aspx

Viewpoint
QALYs in 2018—Advantages and Concerns
Peter J. Neumann, ScD; Joshua T. Cohen, PhD
JAMA. 2018;319(24):2473-2474. doi:10.1001/jama.2018.6072
This Viewpoint reviews the rationale for measuring health outcomes using quality-adjusted life-years (QALYs) and discusses the advantages and limitations of the measure and its role in attempts to define and promote the practice of high-value medicine.

The Lancet
Jun 30, 2018 Volume 391 Number 10140 p2575-2692
https://www.thelancet.com/journals/lancet/issue/current

The Lancet Commissions
Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher–Lancet Commission
Ann M Starrs, Alex C Ezeh, Gary Barker, Alaka Basu, Jane T Bertrand, Robert Blum, Awa M Coll-Seck, Anand Grover, Laura Laski, Monica Roa, Zeba A Sathar, Lale Say, Gamal I Serour, Susheela Singh, Karin Stenberg, Marleen Temmerman, Ann Biddlecom, Anna Popinchalk, Cynthia Summers, Lori S Ashford
Key messages
:: Sexual and reproductive health and rights (SRHR) are essential for sustainable development because of their links to gender equality and women’s wellbeing, their impact on maternal, newborn, child, and adolescent health, and their roles in shaping future economic development and environmental sustainability.
:: Everyone has a right to make decisions that govern their bodies, free of stigma, discrimination, and coercion. These decisions include those related to sexuality, reproduction, and the use of sexual and reproductive health services.
:: SRHR information and services should be accessible and affordable to all individuals who need them regardless of their age, marital status, socioeconomic status, race or ethnicity, sexual orientation, or gender identity.
:: The necessary investments in SRHR per capita are modest and are affordable for most low-income and middle-income countries. Less-developed countries will face funding gaps, however, and will continue to need external assistance.
:: Countries should incorporate the essential services defined in this report into universal health coverage, paying special attention to the poorest and most vulnerable people.
:: Countries must also take actions beyond the health sector to change social norms, laws, and policies to uphold human rights. The most crucial reforms are those that promote gender equality and give women greater control over their bodies and lives.

Lancet Infectious Diseases
Jul 2018 Volume 18 Number 7 p697-812  e183-e227
http://www.thelancet.com/journals/laninf/issue/current

Editorial
How to be ready for the next influenza pandemic
The Lancet Infectious Diseases
This year marks the 100th anniversary of the 1918 influenza pandemic, the worst acute infectious disease outbreak in modern history. The pandemic was caused by influenza virus H1N1 and emerged in the final stages of World War 1. It is estimated that between 20 million and 50 million people died during this pandemic, with a uniquely high mortality in young adults aged between 20 and 40 years. Low-income countries were hit particularly hard (17 million people are thought to have died in India alone) because of their poor health systems. Why the 1918 pandemic was so severe is still a matter of debate, but immunological factors and secondary bacterial infections were major contributors to the heavy death toll. Other influenza pandemics, albeit less severe, have then occurred in 1957, 1968, and 2009, so a new one appears inevitable at some point in the future. Thus, on the centenary of the 1918 pandemic, it is timely to ask ourselves whether the world would be prepared now for such an event.

The answer sadly is no: we do not know what virus will cause the next pandemic, there is no way to rapidly develop and deploy an effective vaccine against a pandemic virus, differences in quality of health systems hamper a prompt response, and surveillance data on influenza have major gaps. At the Massachusetts Medical Society’s annual meeting on April 27, American philanthropist Bill Gates presented a simulation by the Institute for Disease Modeling that found that a new influenza virus like the one that caused the 1918 pandemic would now most likely kill 30 million people within 6 months. Thus, an influenza pandemic represents a real threat that could only be managed with a rapid and effective response from both national governments and the international health community, something that was not seen for the most recent major oubreak of a deadly infectious disease, the emergence of Ebola virus disease in west Africa in 2014-16.

In order to improve the preparedness of the global health community to a pandemic, three areas are crucial: vaccination, surveillance, and building response capacity. As discussed in our May Editorial, the development of a universal influenza vaccine, the holy grail of influenza research, would enhance the capacity to protect people from infection. Gates’ announcement of a US$12 million donation to contribute to the development of such a vaccine is therefore welcome news. However, the development of an effective vaccine is expected to take at least 5–10 years.

Surveillance for influenza is of crucial importance but is also complex because it needs to cover two key populations: animals and humans. It is expected that the next pandemic influenza virus will originate from a spillover from birds, the natural reservoir of all influenza viruses, or pigs, in which avian and human viruses can coexist, thus favouring recombination. At the recent ECCMID meeting, Colin Russell presented the results of a study that mapped areas in the world at highest risk of spillover of avian and swine influenza virus into humans. Particularly ominous was the observation that surveillance for viruses circulating in birds and pigs in such areas is often very limited, so the rapid spread of an influenza virus of pandemic potential could easily go undetected. Equally patchy is the surveillance of human cases of influenza, which is essential to recognise unusual severity or incidence of cases which can be a prodrome for a pandemic. WHO has conducted monitoring through the Global Influenza Surveillance and Response System for over half a century, relying on collection and preliminary analysis of virus specimens from national influenza centres. Not all countries have such centres (for example, only 18 African countries have one) so the reporting of influenza cases remains suboptimum.

In case of an influenza pandemic, the capacity to respond promptly will play a key part because of airborne transmission. Antivirals and antibiotics to prevent secondary bacterial infections will be important, while awaiting development of an effective vaccine, but stockpiles of these are currently insufficient. Moreover, there is need to invest in strengthening health systems and microbiological capacities on the ground to enhance the rapid response to any outbreak.

Influenza is the infectious disease with a proven record of causing pandemics, so it is essential that it remains at the centre of efforts for pandemic preparedness. The next influenza pandemic will be a real test for the international health community. We should not find ourselves unprepared—to be so could cost millions of lives.

Lancet Infectious Diseases
Jul 2018 Volume 18 Number 7 p697-812  e183-e227
http://www.thelancet.com/journals/laninf/issue/current

Articles
Effectiveness of the DTPa-HBV-IPV/Hib vaccine against invasive Haemophilus influenzae type b disease in the Netherlands (2003–16): a case-control study
Susana Monge, Susan JM Hahné, Hester E de Melker, Elisabeth AM Sanders, Arie van der Ende, Mirjam J Knol

Lancet Infectious Diseases
Jul 2018 Volume 18 Number 7 p697-812  e183-e227
http://www.thelancet.com/journals/laninf/issue/current

Series
Tuberculosis
Tuberculosis: progress and advances in development of new drugs, treatment regimens, and host-directed therapies
Simon Tiberi, Nelita du Plessis, Gerhard Walzl, Michael J Vjecha, Martin Rao, Francine Ntoumi, Sayoki Mfinanga, Nathan Kapata, Peter Mwaba, Timothy D McHugh, Giuseppe Ippolito, Giovanni Battista Migliori, Markus J Maeurer, Alimuddin Zumla

Lancet Infectious Diseases
Jul 2018 Volume 18 Number 7 p697-812  e183-e227
http://www.thelancet.com/journals/laninf/issue/current

Tuberculosis: advances and challenges in development of new diagnostics and biomarkers
Gerhard Walzl, Ruth McNerney, Nelita du Plessis, Matthew Bates, Timothy D McHugh, Novel N Chegou, Alimuddin Zumla

Lancet Infectious Diseases
Jul 2018 Volume 18 Number 7 p697-812  e183-e227
http://www.thelancet.com/journals/laninf/issue/current

Review
Development of vaccines against Zika virus
Gregory A Poland, Richard B Kennedy, Inna G Ovsyannikova, Ricardo Palacios, Paulo Lee Ho, Jorge Kalil
Summary
Zika virus is an emerging pathogen of substantial public health concern to human beings. Although most infections are asymptomatic or present with benign, self-limited symptoms, a small percentage of patients have complications, such as congenital anomalies in the developing fetus of pregnant women infected with the virus and neurological complications (eg, Guillain-Barré syndrome). To date, there is no vaccine, antiviral drug, or other modality available to prevent or treat Zika virus infection. In this Review, we examine vaccine development efforts for Zika virus to date and research gaps in the development of candidate vaccines against Zika virus. Top research priorities should include development of a better understanding of immunity to Zika virus to establish clear correlates of protection; determination of what effect, if any, Zika vaccine-induced immune responses will have on subsequent dengue virus infection; evaluation of vaccine immunogenicity and efficacy in healthy adults and in the various subpopulations affected by Zika virus infection (children, pregnant women, women of childbearing age, and eldery people); and identification of the molecular mechanisms that underlie birth defects and neurological sequelae related to Zika virus.

Nature 
Volume 558 Issue 7711, 28 June 2018
http://www.nature.com/nature/current_issue.html

Editorial | 26 June 2018
Worrying changes in Hungary
The European country’s autocratic government has made a disturbing grab at the nation’s scientific institutions.

Nature Reviews Immunology
Volume 18 Issue 7, July 2018
https://www.nature.com/nri/volumes/18/issues/7

Review Article | 16 April 2018
Clocking in to immunity
This Review considers the importance of the core circadian clock for regulating both innate and adaptive immune cell responses. The authors consider the implications for vaccination and other clinical strategies, highlighting the emerging field of chrono-immunotherapy.
Christoph Scheiermann, Julie Gibbs[…] & Andrew Loudon

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
[Accessed 30 Jun 2018]

Lessons Learnt from Epidemiological Investigation of Lassa Fever Outbreak in a Southwest State of Nigeria December 2015 to April 2016
June 29, 2018 · Research Article
Introduction: An outbreak of Lassa Fever (LF) reported and confirmed in Ondo state, Southwest Nigeria in January 2016 was investigated. This paper provides the epidemiology of the LF and lessons learnt from the investigation of the outbreak.
Methods: The incidence management system (IMS) model was used for the outbreak coordination. Cases and deaths were identified through the routine surveillance system using standard definitions for suspected and confirmed cases and deaths respectively. Blood specimens collected from suspect cases were sent for confirmation at a WHO accredited laboratory. Active case search was intensified, and identified contacts of confirmed cases were followed up for the maximum incubation period of the disease. Other public health responses included infection prevention and control, communication and advocacy as well as case management. Data collected were analysed using SPSS 20, by time, place and persons and important lessons drawn were discussed.
Results: We identified 90 suspected LF cases of which 19 were confirmed by the laboratory. More than half (52.6%) of the confirmed cases were females with majority (73.7%) in the age group ≥ 15 years. The Case Fatality Rate (CFR) of 63.2% among the laboratory-confirmed positive cases where 9 of 19 cases died, was significantly higher compared to the laboratory confirmed negative cases where 6 of the 65 cases died ( CFR; 8.5%) p ≤ 0.05. Two hundred and eighty-seven contacts of the confirmed cases were identified, out of which 267(93.0%) completed  the follow-up without developing any symptoms and 2 (0.7%) developed symptoms consistent with LF and were confirmed by the laboratory. More than half of the contacts were females (64.5%) with most of them (89.2%) in the age group ≥ 25 years.
Discussion: One key lesson learnt from the investigation was that the confirmed cases were mainly primary cases; hence the needs to focus on measures of breaking the chain of transmission in the animal-man interphase during Lassa fever epidemic preparedness and response. In addition, the high case fatality rate despite early reporting and investigation suggested the need for a review of the case management policy and structure in the State. Key Words: Lassa fever, Outbreak Response, Incident Management System, Nigeria

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 30 Jun 2018)

Antibiotic prophylaxis—Preventing severe infections and saving lives in poor countries with very high mortality risk
Keith P. Klugman, Rasa Izadnegahdar
Perspective | published 26 Jun 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002594

PLoS One
http://www.plosone.org/
[Accessed 30 Jun 2018]

Research Article
Choosing the perfect shot – The loaded narrative of imagery in online news coverage of vaccines
Andrew G. Wu, Ashish S. Shah, Tara S. Haelle, Scott A. Lunos, Michael B. Pitt
Research Article | published 27 Jun 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0199870

PLoS One
http://www.plosone.org/
[Accessed 30 Jun 2018]

Intermediate levels of vaccination coverage may minimize seasonal influenza outbreaks
Veronika I. Zarnitsyna, Irina Bulusheva, Andreas Handel, Ira M. Longini, M. Elizabeth Halloran, Rustom Antia
Research Article | published 26 Jun 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0199674