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Study casts doubt on reliability of rapid antigen tests in kids; COVID transmission through breastmilk unlikely

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The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Rapid antigen tests may be unreliable in children

When used in children, rapid antigen tests for detecting the coronavirus do not meet accuracy criteria set by the World Health Organization and U.S. and UK device regulators, according to researchers who reviewed 17 studies of the tests.

The trials evaluated six brands of tests in more than 6,300 children and teenagers through May 2021. In all but one study, the tests were administered by trained workers. Overall, compared to PCR tests, the antigen tests failed to detect the virus in 36% of infected children, the researchers reported on Tuesday in BMJ Evidence-Based Medicine. Among children with symptoms, it missed 28% of infections. Among infected kids without symptoms, the tests missed the virus in 44%. Only about 1% of the time did the tests mistakenly diagnose the virus in a child who was not actually infected.

Given that more than 500 antigen tests are available in Europe alone, the authors said, “the performance of most antigen tests under real-life conditions remains unknown.” But the new findings “cast doubt on the effectiveness” of rapid antigen tests for widespread testing in schools, they concluded.

Breastmilk transmission of COVID-19 unlikely

A new study appears to confirm smaller, earlier studies that suggested nursing mothers are unlikely to transmit the coronavirus in breastmilk.

Between March and September 2020, researchers obtained multiple breastmilk samples from 110 lactating women, including 65 with positive COVID-19 tests, 36 with symptoms who had not been tested, and a control group of 9 women with negative COVID-19 tests. Seven women (6%) – six with positive tests and one who had not been tested – had non-infectious genetic material (RNA) from the virus in their breastmilk, but none of the samples had any evidence of active virus, according to a report published on Wednesday in Pediatric Research. Why breastmilk would contain coronavirus RNA but not infectious virus is unclear, said study leader Dr. Paul Krogstad of the David Geffen School of Medicine at UCLA, “Breastmilk is known to contain protective factors against infection, including antibodies that reflect both the mother’s exposure to viruses and other infectious agents and to vaccines she has received,” he noted.

The U.S. Centers for Disease Control and Prevention (CDC) advises that before breastfeeding, bottle-feeding, or expressing milk, women with COVID-19 should wash their hands or use hand sanitizer with at least 60% alcohol. The CDC also recommends that they wear a mask when within 6 feet (1.8 meters) of the baby.

New technique may speed vaccine, antibody drug development

Researchers are working on a way to speed development of vaccines and monoclonal antibody drugs for COVID-19 and other illnesses, shortening the time from collection of volunteers’ blood samples to identification of potentially useful antibodies from months to weeks.

As described in Science Advances on Wednesday, the new technique employs cryo-electron microscopy, or cryoEM, which involves freezing the biological sample to view it with the least possible distortion. Currently, “generation of monoclonal antibodies involves several steps, is expensive, and typically takes somewhere on the order of two to three months, and at the end of that process you still need to perform structural analysis of the antibodies” to figure out where they attach themselves to their target, and how they actually work, explained Andrew Ward of Scripps Research Institute in La Jolla, California.

In experiments using the new approach to look for antibodies to HIV, “we flipped the process on its head… by starting with structure,” Ward said. Because cryoEM affords such high resolution, instead of having to laboriously sort through antibody-producing immune cells one by one to identify promising antibodies, the process of identifying antibodies, mapping their structure and seeing how they are likely to attack viruses and other targets goes much faster, he added. “The ongoing COVID-19 pandemic has highlighted the need for such robust and rapid technologies,” his team concluded.

Click for a Reuters graphic on vaccines in development.

 

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

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B.C. launches Canada’s first lung cancer screening program for high-risk residents

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VANCOUVER — British Columbia has launched the country’s first provincewide lung cancer screening program for residents who are at high risk of getting the disease.

Health Minister Adrian Dix says the innovative program will both save lives and improve their quality.

Screening will be available at 36 centres across all health authorities using existing CT scans for those who are between 55 and 74, currently smoking or have previously smoked, and have a smoking history of 20 years or more.

People who meet that criteria are encouraged to call the program for a consultation and risk assessment to determine eligibility.

Dr. Stephen Lam, medical director of the screening program, says lung cancer is the leading cause of cancer death in Canada and worldwide.

He says 70 per cent of all cases are diagnosed at an advanced stage and the program aims to change that trend by detecting lung cancers earlier when treatment is more effective.

Dr. David Byers, CEO of the Provincial Health Services Authority, credits BC Cancer for making the launch possible, adding a centralized system will reduce the burden of cancer, “including among Indigenous people, who are disproportionately impacted by lung cancer.”

BC Cancer says that after an appointment, a radiologist would look for spots, or nodules, on a scan, and both the patient and their primary care provider would get results within three weeks.

It says screening works best when scans are done regularly to monitor for any changes.

The Health Ministry says in a release that an estimated 10,000 patients are expected to be screened in the first year of the program, and that number is expected to jump by about 15 per cent per year.

“It is estimated the program will diagnose approximately 150 lung cancer cases annually, with more than 75 per cent of these diagnosed at an earlier stage than without screening.”

This report by The Canadian Press was first published May 25, 2022.

 

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What vaccines, treatments do we have to combat monkeypox? – Financial Post

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LONDON — With cases of monkeypox inexplicably on the rise outside of Africa – where the viral disease is endemic – public health officials are using contact tracing, isolation and targeted vaccination to curb its spread.

Global health officials have tracked more than 200 suspected and confirmed cases of the usually mild viral infection in 19 countries since early May. The monkeypox variant implicated in the current outbreak has a case fatality rate of around 1%, though no deaths have been reported so far.

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Here’s what we know about the existing range of vaccines and treatments:

VACCINES

The smallpox and monkeypox viruses are closely related, and the first generation of smallpox vaccines appear up to 85% effective in preventing monkeypox, the World Health Organization has said.

There are currently two smallpox vaccines available.

One made by Danish company Bavarian Nordic goes by the brand name Jynneos, Imvamune or Imvanex – depending on geography.

It contains a weakened form of the vaccinia virus that is closely related to, but less harmful than, than the viruses that cause smallpox and monkeypox. This modified version of vaccinia does not cause disease in humans and cannot reproduce in human cells.

It has U.S. approval for the prevention of both smallpox and monkeypox. European Union approval is for smallpox, although doctors can prescribe it off-label for monkeypox. Bavarian Nordic said it would probably apply for a label extension with the EU’s drug watchdog to include monkeypox.

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The reported side-effects include pain and swelling at the injection site as well as headache and fatigue.

The other, older vaccine, currently made by Emergent Biosolutions, is called ACAM2000.

It also contains the vaccinia virus, but it is infectious and can replicate in humans. As a result, it can be transmitted from the vaccine recipient to unvaccinated people who have close contact with the inoculation site.

Apart from side-effects associated with many vaccines, such as a sore arm and fatigue, it also carries a serious warning for a potential range of severe complications, including heart inflammation, blindness and death.

It is also not designed to be used in certain groups of people, such as those with compromised immune systems.

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ACAM2000 has U.S. approval for people at high risk for smallpox infection. It does not have EU authorisation.

ANTIVIRALS

Symptoms of monkeypox – which can include fever, headaches, distinctive rashes and pus-filled skin lesions – can last for two to four weeks and often resolve on their own.

Patients may receive extra fluids and treatment for secondary bacterial infections. An antiviral agent called tecovirimat – branded as TPOXX and made by SIGA Technologies – has U.S. and EU approval for smallpox, while its European approval also includes monkeypox and cowpox.

Another drug, branded as Tembexa and developed by Chimerix , has U.S. approval to treat smallpox. It is not clear whether it could help people infected with monkeypox.

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Both TPOXX and Tembexa were approved based on studies in animals showing they are likely to be effective, because they were developed after smallpox in human beings had been eradicated through mass vaccination.

STOCKPILES

The WHO classified smallpox as an eradicated disease in 1980, but there have been longstanding concerns that the virus could be used as a bioweapon, leading countries to stockpile vaccines.

The WHO holds 2.4 million doses at its Swiss headquarters dating from the final years of the eradication program. The agency also has pledges from donor countries for more than 31 million additional doses.

U.S. officials say there are more than 1,000 doses of the Bavarian Nordic vaccine in the national stockpile and expect that level to ramp up very quickly in the coming weeks. The country also has 100 million doses of ACAM2000.

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Germany has said it had ordered 40,000 doses of Bavarian Nordic’s vaccine, to be ready to vaccinate contacts of cases if needed.

Other countries, including Britain and France, are also offering or recommending vaccines to people with close contact to infected people and healthcare workers.

Bavarian Nordic, which has an annual production capacity of 30 million doses, told Reuters multiple countries have approached it interested in buying its vaccine, without providing details. A spokesperson said it does not need to expand production.

(Reporting by Natalie Grover in London; Twitter @NatalieGrover; Additional reporting by Nikolaj Skydsgaard in Copenhagen and Michael Erman in New Jersey; editing by Michele Gershberg, Josephine Mason and Jane Merriman)

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Scientists concerned over rising case of monkeypox: How does the virus spread? – India Today

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The Monkeypox virus has now been reported from 20 countries of the world, where the viral infection is not endemic. This is one of the biggest outbreaks of the virus outside of West Africa, where it has been endemic for years. The virus has been reported in over 100 people as countries look to get ready for a counterattack with vaccines.

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The cases have now been reported in the US, the UK, Australia, Austria, Belgium, Denmark, Finland, France, Italy among others. So far, no cases have been reported in India.

While the US has said that it has a smallpox vaccine stockpile in case of an outbreak, Germany has ordered 40,000 doses of a Bavarian Nordic vaccine to be ready to vaccinate contacts of those infected with monkeypox if an outbreak in Germany becomes more severe. The fast pace of transmission has baffled scientists, who have raised alarm bells over the developments.

The monkeypox cases so far have been mild. (Photo: Reuters)

HOW DOES MONKEYPOX SPREAD?

Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. It belongs to the same virus family as smallpox.

The virus transmits when a person comes in contact with the virus from an animal, human, or materials contaminated with the virus. According to the US Based Centre for Disease Control and Prevention (CDC), the virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth). Meanwhile, Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding.

Scientists are also looking into human-to-human contact behind the rise in cases of the monkeypox virus. A World Health Organisation (WHO) has also speculated sexual activity at two recent raves in Europe to be the reason of the spread.

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A child affected by monkeypox, sits on his father’s legs while receiving treatment at the centre of the International medical NGO Doctors Without Borders (Medecins sans frontieres – MSF), in Zomea Kaka, in the Lobaya region, in the Central African Republic. (Photo: AFP)

Dr. David Heymann, who formerly headed WHO’s emergencies department, told The Associated Press that the leading theory to explain the spread of the disease was sexual transmission at raves held in Spain and Belgium.

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The CDC does state that while human-to-human transmission is thought to occur primarily through large respiratory droplets, other methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.

The monkeypox cases so far have been mild, with no deaths reported. Typically, the virus causes fever, chills, rash and lesions on the face or genitals. Most people recover within several weeks without requiring hospitalization.

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