The Observatory and Fast Facts

June 24, 2019

AACC

The 71st American Association for Clinical Chemistry (AACC) Annual Scientific Meeting & Clinical Lab Expo is taking place August 4–8, 2019 at the Anaheim Convention Center in Anaheim, CA.

Attendees will have the opportunity to connect with leaders in clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas in laboratory medicine. 

In addition, the AACC Clinical Lab Expo has more than 200 new product introductions each year.

Attendees also have the chance to hear significant research and learn about important changes in the field in the almost 300 educational opportunities in the form of lectures, plenary sessions, scientific sessions, and roundtable sessions. 

Be sure to visit the MLO team at booth number 4049!

Ebola

Threats to Ebola health workers. Threats of death and more violence in the Democratic Republic of the Congo (DRC) Ebola outbreak region kept the response on shaky security ground, with nurses threatening to strike if government officials don’t take action and some health facilities closing as health workers flee the deteriorating conditions.

The outbreak has reached a total of 1,888 cases according to the World Health Organization (WHO) online Ebola dashboard. Health officials are still investigating 293 suspected Ebola cases, and the death toll stands at 1,248.

The DRC’s health ministry said nurses in Musienene health zone had a meeting to denounce death threats and destruction of health facilities. The facilities were targeted over their participation in the Ebola response. The nurses asked local authorities to take steps to tamp down the violent threats and said they will go on strike if the threats don’t stop.

Also, the ministry said targeted violence in Beni and Lubero has led several doctors and nurses to move or temporarily leave their homes, forcing some health facilities to close their doors. It added that the worst area is Kyondo health zone, where

Kyakumba Reference Health Center has been closed since May 21 owing to physician and nursing staff fearing for their safety.

Since August 1, 2018, 132 attacks against medical units have been reported, which has resulted in 38 injuries and four deaths in health workers and patients, the ministry said. 

Outbreak workers, local health providers, and community members cooperating with the response have been increasingly subjected to threats—spelled out on leaflets or communicated directly—from armed groups present in epicenters such as Katwa and Butembo. Also affected are smaller hot spots such as Lubero, Masereka, Mabalako, Kalunguta, and Vuhovi. 

Regarding the continued steady rise in Ebola cases, the WHO said that over the past three weeks transmission is most intense in seven locations that have seen 93 percent of cases during that timeframe; they are Beni, Butembo, Kalunguta, Katwa, Mabalako, Mandima, and Musienene.

Measles

U.S. measles cases in first five months of 2019 surpass total cases for any year since 1994. As of May 30, 2019, the Centers for Disease Control and Prevention (CDC) is reporting 971 cases of measles in the United States thus far in 2019. This is the greatest number of cases reported in the U.S. since 1994, when 963 cases were reported for the entire year. CDC continues to work with affected state and local health departments to get ongoing outbreaks under control. 

Outbreaks in New York City and Rockland County, New York have continued for nearly seven months. If these outbreaks continue through summer and fall, the U.S. may lose its measles elimination status. That loss would be a huge blow for the nation and erase the hard work done by all levels of public health. The measles elimination goal, first announced in 1963 and accomplished in 2000, was a monumental task. Before widespread use of the measles vaccine, an estimated 3 to 4 million people got measles each year in the U.S., along with an estimated 400 to 500 deaths and 48,000 hospitalizations.

Measles was eliminated in the U.S. for two main reasons:

  • Availability and widespread use of a safe and highly effective measles vaccine, and
  • strong public health infrastructure to detect and contain measles. 

CDC encourages parents with questions about measles vaccine to consult with their child’s pediatrician.

Assays

A new era of comprehensive and objective diagnostic testing for vaginitis. Hologic announced that the FDA has granted clearance for its new Aptima BV and Aptima CV/TV assays, which provide an accurate and objective method for diagnosing vaginitis, a very common and complex health issue affecting millions of women each year.

About 90 percent of vaginitis is caused by bacterial vaginosis (BV), vulvovaginal candidiasis (Candida vaginitis, CV, also commonly known as yeast infections), or Trichomonas vaginalis (TV) infections, either individually or in combination.

In fact, BV is the most common vaginal infection in the United States, affecting an estimated 21 million women ages 14 to 49 years old. Diagnosis can be especially complicated due to the prevalence of co-infections, as approximately 20 to 30 percent of women with BV are co-infected with Candida species. Traditional methods for diagnosing vaginitis (including microscopy, pH determination, and Nugent scoring) are highly subjective, leading to misdiagnosis and ineffective treatment. When diagnosed using traditional methods and treated based on those subjective results, more than 50 percent of women with vaginitis experience recurring symptoms. 

Unfortunately, many women self-diagnose and self-treat before visiting a healthcare provider, assuming that abnormal vaginal discharge, itching or irritation is due to a simple yeast infection. When BV or TV are left untreated or not properly treated, these infections can put women at risk for a wide variety of complications, including an increased chance of getting a sexually transmitted infection (STI) such as chlamydia or HIV, pelvic inflammatory disease, and pregnancy-related risks including premature delivery, low birth weight and infertility.

Influenza

NIH announces two awards for multi-year studies of influenza immunity in children. The National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, has announced two awards for the study of influenza immunity in children. The awards, which may total more than $64 million over seven years, will support studies led by Cincinnati Children’s Hospital Medical Center in Ohio and St. Jude Children’s Research Hospital in Memphis, TN, examining how young children’s immune systems respond over multiple years to their initial influenza infection and first vaccination.

Studies suggest that a person’s first encounter with an influenza virus or vaccine, which usually occurs in early childhood, influences how their immune system reacts to subsequent influenza virus or vaccine exposures. This phenomenon, called “immunologic imprinting,” may help protect against future infections with similar influenza subtypes. It may also impact—and, in some cases, negatively influence—how a person’s immune system responds to a seasonal influenza vaccination.

However, the specific effects of imprinting are still poorly understood. By studying children’s immune responses to early influenza infection and subsequent exposures as they mature, researchers hope to understand the factors underlying immune memory and a person’s ability to mount an immune response to different influenza subtypes. Such insights could help scientists design more effective influenza vaccines. The research will also address a knowledge gap identified in NIAID’s strategic plan for developing a universal

influenza vaccine—a vaccine that can provide durable protection for all age groups against multiple influenza strains, including those that might cause a pandemic.

Principal investigators Paul Thomas, PhD, of St. Jude Children’s Research Hospital, and Aubree Gordon, PhD, of the University of Michigan School of Public Health, will lead studies designed to follow more than 3,000 infants and young children in Los Angeles; Managua,

Nicaragua; and Wellington, New Zealand for seven years. This grant may provide up to $34.3 million in support over seven years.

Another grant will fund principal investigator Mary A. Staat, MD, of Cincinnati Children’s to follow more than 2,000 infants and their mothers from sites in Cincinnati and Mexico City for at least three years, using weekly clinical visits to gather valuable data about the changes in their immune systems. This award may total as much as $29.9 million over seven years. 

Both research teams will regularly collect nasal swabs and blood samples from participating infants and young children to understand immune B-cell and T-cell responses and function, the antibodies produced, and other changes as the children’s immune systems develop and encounter the influenza virus and influenza vaccines for the first time. Parents or caregivers will be asked to provide informed consent for their children to participate in the studies. 

Investigators hope that their findings may provide insight into how imprinting may be used to boost the effectiveness of influenza vaccines, or how a new vaccine may provide broader immunity against influenza early in a child’s life.

Correction

Please note a correction in MLO’s June Product Focus found on page 38; the digital link to Thermo Fisher Scientific’s “Fully automated random access bench-top systems” was printed incorrectly. It has since been updated on all electronic versions. We apologize for the inconvenience.