Health
Major test of 1st potential Lyme disease vaccine in 20 years begins in U.S., Europe – CBC.ca
Researchers are seeking thousands of volunteers in the U.S. and Europe to test the first potential vaccine against Lyme disease in 20 years in hopes of finding a better way to fight the tick-borne threat.
Lyme disease, caused by bacteria entering the body through the bite of an infected tick, is a growing problem, with reports of case numbers rising and warming weather helping ticks expand their habitat.
While a vaccine for dogs has long been available, the only Lyme disease vaccine for humans was pulled from the U.S. market in 2002 due to lack of demand, leaving people to rely on bug spray and tick checks.
“There’s currently no Lyme disease vaccine available for humans,” according to Health Canada. “However, there are clinical trials taking place in Europe and the U.S.”
Those trials involve Pfizer and French biotech company Valneva. They are aiming to avoid previous pitfalls in developing a new vaccine to protect both adults and kids as young as five from the most common Lyme strains on two continents.
When the last vaccine was pulled from the market, Pfizer vaccine chief Annaliesa Anderson told the Associated Press that “there wasn’t such a recognition, I think, of the severity of Lyme disease.”
Robert Terwilliger, an avid hunter and hiker, was first in line Friday when the study opened in central Pennsylvania. He’s seen lots of friends get Lyme and is tired of wondering if his next tick bite will make him sick.
“It’s always a worry, you know? Especially when you’re sitting in a tree stand hunting and you feel something crawling on you,” said Terwilliger, 60, of Williamsburg, Pa. “You’ve got to be very, very cautious.”
Canadian cases under-reported
Exactly how often Lyme disease strikes isn’t clear.
The U.S. Centers for Disease Control and Prevention cites insurance records suggesting 476,000 people are treated for Lyme in the U.S. each year. Pfizer’s Anderson put Europe’s yearly infections at about 130,000.
In Canada, provincial public health units have reported 14,616 human cases of Lyme disease between 2009 and 2021. But the federal government says on its website the numbers are like under-reported “because some cases are undetected or unreported.”
Black-legged ticks, also called deer ticks, carry bacteria that cause Lyme disease. The infection initially causes fatigue, fever and joint pain. Often — but not always — the first sign is a circular red rash around the spot of the tick bite.
Early antibiotic treatment is crucial, but it can be hard for people to tell if they have been bitten, since some ticks are as small as a pin.
Untreated Lyme disease can cause severe arthritis and damage the heart and nervous system. Some people have lingering symptoms even after treatment.
How the vaccine works
Most vaccines against other diseases work after people are exposed to a germ. The Lyme vaccine offers a different strategy — working a step earlier to block a tick bite from transmitting the infection, according to Dr. Gary Wormser, a Lyme expert at New York Medical College who isn’t involved with the new research.
It does this by targeting an “outer surface protein” of the Lyme bacterium called OspA that’s present in the tick’s gut.
It’s estimated a tick must feed on someone for about 36 hours before the bacteria spreads to its victim. That delay provides time for the antibodies the tick ingests from a vaccinated person’s blood to attack the germs right at the source.
In small, early-stage studies, Pfizer and Valneva reported no safety problems and a good immune response.
The newest study will test the safety and efficacy of the new vaccine, called VLA15. The companies aim to recruit at least 6,000 people in Lyme-prone areas including the Northeast U.S. plus Finland, Germany, the Netherlands, Poland and Sweden.
Subjects will receive three shots of either the vaccine or a placebo between now and next spring’s tick season. A year later, they’ll get a single booster dose.
“We’re really looking at something that’s a seasonal vaccine,” Anderson said, so people have high antibody levels during the months when ticks are most active.
Volunteers for the study can be as young as five and should be at high risk because they spend a lot of time in tick-infested areas, such as hikers, campers and hunters, said Dr. Alan Kivitz, who heads one of the study sites at Altoona Center for Clinical Research in Duncansville, Pa.
In his own practice, Kivitz said “not a single day goes by that someone either has a concern about Lyme disease, could possibly have Lyme disease.”
Tick-bite prevention vaccine
The new Pfizer-Valneva vaccine is engineered somewhat differently than its predecessor and also targets six Lyme strains in the U.S. and Europe instead of just one.
The Pfizer study will span two tick seasons to get answers — but it’s not the only research into new ways to prevent Lyme.
The University of Massachusetts scientists are working on a vaccine alternative, shots of pre-made Lyme-fighting antibodies. And Yale University researchers are in the early stages of designing a vaccine that recognizes a tick’s saliva — which in animal testing sparked a skin reaction that made it harder for ticks to hang on and feed.
Since different tick species carry many diseases other than Lyme, ultimately “we’re all hoping for a tick-bite prevention vaccine,” Wormser said.
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More than 1,900 elementary school students in Windsor and Essex County have been suspended for out-of-date immunization records, the Windsor-Essex County Health Unit said Monday.
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Parents must provide the health unit with an up-to-date immunization record for the suspension to be lifted and the student to return to school. Immunization clinics are available at both health unit locations in Windsor and Leamington on Monday and throughout this week, while immunization records are accepted in-person between 8:30 a.m. and 4:30 p.m. Monday to Friday at both locations.
Students who were suspended but attend and receive vaccinations at the health unit clinics, or who update their records with the health unit, will receive a notice and can return to school the same day.
Proof of immunization can also be submitted online at immune.wechu.org. Primary care providers can also send immunization records to the health unit at 519-258-7288.
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The Immunization of School Pupils Act requires local health units to maintain and review vaccination records for all students and to enforce school suspensions if records are incomplete. These routine immunizations are often administered by primary care providers, but records must still be updated and on file with the health unit.
The review of student immunization records began in December 2022, when more than 12,000 students received notice their records were not up to date.
Earlier this month the health unit warned 3,200 students faced suspension for incomplete records; ultimately 1,908 were suspended on Monday, according to health officials.
Visit wechu.org/getimmunized for information and clinic times.
The list of ways a COVID-19 infection disrupts the body’s natural functions is long and diverse, and, as Viktorya Skrypnyk’s clients have come to learn, includes hair loss.
Skrypnyk is a registered nurse who owns and operates VBeauty Spa, a medical aesthetic clinic in Toronto. The last two years have sent a parade of people through the doors of her clinic struggling with hair loss they say began after a COVID-19 infection.
“Lately, I do see that there’s people that are coming in that have no history of hair loss in the family, no history of alopecia that are developing these symptoms of alopecia within last few years,” she told CTVNews.ca on Friday. “Most of them are saying that they generally noticed an increase in the year loss specifically after acquiring COVID.”
Multiple published studies have shown COVID infections can trigger a type of hair shedding called telogen effluvium (TE). With TE, thinning typically occurs around the top of the head.
When clients suffering from TE come to Skrypnyk, it’s usually for a treatment she offers known as platelet-rich plasma (PRP) therapy. Before the pandemic, Skrypnyk estimates 70 per cent of her PRP therapy clients were men. Now?
“Lately I’ve noticed, after COVID especially, it’s been more popular among women,” she said.
WHAT IS PRP THERAPY?
Platelet-rich plasma therapy is a form of regenerative medicine that uses a patient’s own blood cells – specifically platelets – to accelerate healing in a specific area of the body.
Plasma is the liquid portion of blood; the medium that carries red and white blood cells and platelets through the body. It’s made mostly of water and proteins. Platelets are blood cells that aid in blood clotting and contain a naturally-occurring substance called growth factor, which stimulates cell growth and wound healing.
In PRP therapy, a patient’s blood is collected and spun in a centrifuge to concentrate the platelet component of the blood. The patient’s own platelet-rich plasma is then injected into an area of the body that needs help with growth or healing, like an injured muscle or, in some cases, a scalp losing hair.
“We usually withdraw the platelets and re-inject them back into the hairline, specifically where there’s a lot of hair loss,” Skrypnyk said.
PRP meets the definition of a drug under Canada’s Food and Drugs Act, but isn’t covered by provincial health insurance plans. At VBeauty Spa, a treatment typically costs $600, though other clinics may charge more or less.
According to an entry by doctors Neera Nathan and Maryanne Makredes Senna in the Harvard Health Blog, most of the research on PRP for hair loss has looked at its use to treat androgenetic alopecia, also known as hormone-related baldness. Androgenetic alopecia affects both men and women, resulting in balding at the crown and front of the head in men, and balding that begins with a widening of the part in women.
“There is not enough evidence to make conclusions about the effectiveness of PRP for other types of hair loss, like telogen effluvium, alopecia areata or forms of scarring hair loss,” Nathan and Senna wrote.
YOUR MILEAGE MAY VARY
A person can elect to receive PRP therapy for any type of hair loss, but Dr. Jeff Donovan cautions it should only be considered as a second- or third-line treatment for most patients and most types of hair loss.
“PRP is very popular, but the overwhelming message that I would have is that there is no hair loss condition for which PRP is the first-line option,” Donovan told CTVNews.ca in a phone interview on Friday.
Donovan is a dermatologist and member of the Canadian Dermatology Association who specializes in hair loss. Like Skrypnyk, he sometimes treats patients using PRP therapy. However, he rarely uses it to treat the type of hair loss most commonly linked to COVID-19 infections – telogen effluvium – and he never prescribes it as a first-line treatment.
For one thing, he explained, TE normally resolves on its own after four to eight months, as long as the condition that triggered it has resolved. It often doesn’t respond to the typical hair loss treatments.
“Telogen effluvium is a hair loss condition that happens due to a trigger,” Donovan told CTVNews.ca on Friday. “The treatment for telogen effluvium involves treating the trigger, not a bandaid with some other treatment plan.”
If a patient’s TE was triggered by low iron, treatment would involve restoring their iron levels, he said. Likewise, TE triggered by a thyroid condition, or a condition like anorexia nervosa, should resolve after the underlying condition has been treated.
In rare cases, Donovan will recommend PRP therapy for a patient suffering from TE for which an underlying cause can’t be pinpointed. More often, he’ll recommend it for patients suffering from other types of hair loss, but even then, only after exhausting other treatment options.
“When we speak about treatment for hair loss, we must speak about what is the first line treatment, what is the second line treatment and what is the third line treatment,” he said. “These are treatment ladders according to evidence-based medicine.”
For a client with alopecia areata, a type of hair loss that results in circular bald patches, Donovan said the first-line treatments are topical steroid injections and topical minoxidil, which is the active ingredient in Rogaine. For genetic hair loss or androgenetic hair loss, Donovan would first recommend oral and topical minoxidil as well as topical and oral anti-androgens.
Among clients who do end up using PRP therapy, Donovan said between 20 and 40 per cent will see mild benefits, such as a slower rate of hair loss or some modest growth. In order for PRP therapy to provide long-term benefits, however, Donovan said clients typically need to return for treatments three times per year, indefinitely.
Like Skrypnyk, Donovan has noticed more people seeking out PRP therapy for TE in the past year or two. However, he cautions against shelling out for the treatment before speaking to a doctor.
“Due to the popular nature of PRP and the marketing that goes into PRP, there has been an increase in the number of patients demanding that therapy,” he said. “However, that is not necessarily reflective of the benefit of the treatment. Nor is it reflective of how these conditions should be managed based on current scientific evidence.”
Instead, Dovovan said anyone who has hair loss concerns should start by seeking a diagnosis from their usual health-care provider, who can screen for underlying triggers and suggest treatments.
“In my practice, I really prefer when patients come after having tried several therapies,” he said, “because then I get a sense of how well the hair is responding to certain types of treatments.”
A drug-resistant and potentially deadly fungus is spreading rapidly through US health facilities, according to a government study.
Researchers from the Centres for Disease Control and Prevention (CDC) reported the fungus, a type of yeast called Candida auris or C. auris, can cause severe illness in people with weakened immune systems.
The number of people diagnosed, as well as the number who were found through screening to be carrying C. auris, has been rising at an alarming rate since the fungus was first reported in the US in 2016.
The fungus was identified in 2009 in Asia, but scientists have said C. auris first appeared around the world about a decade earlier.
Dr Meghan Lyman, chief medical officer of the CDC’s mycotic diseases branch, said the increases, “especially in the most recent years, are really concerning to us”.
“We’ve seen increases not just in areas of ongoing transmission, but also in new areas,” she said.
Dr Lyman also said she was concerned about the increasing number of fungus samples resistant to the common treatments for it.
Dr Waleed Javaid, an epidemiologist and director of infection prevention and control at Mount Sinai Downtown in New York, said the fungus was “worrisome”.
“But we don’t want people who watched ‘The Last Of Us’ to think we’re all going to die,” Dr Javaid said.
“This is an infection that occurs in extremely ill individuals who are usually sick with a lot of other issues.”
Read more:
Is The Last Of Us’ real ‘zombie’ fungus an actual threat?
The fungus, which can be found on the skin and throughout the body, is not a threat to healthy people.
But about one-third of people who become sick with C. auris die.
The fungus has been detected in more than half of all US states. The number of infections in the US increased by 95% between 2020 and 2021.
Read more:
Species of fungus discovered in Scotland
Fungal infections ‘increased significantly’ during COVID pandemic
The new research comes as Mississippi is facing a growing outbreak of the fungus.
Since November, 12 people in the state have been infected with four “potentially associated deaths”, according to the state’s health department.
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