Healthcare & Laboratory News

The Hill (5/13, Mancini) reports, “The hantavirus outbreak grew to 11 cases on Tuesday, after a French woman became infected while aboard a cruise ship and is now being treated with an artificial lung in Paris and a Spanish passenger tested positive after departing the ship.” The WHO “confirmed nine of the 11 cases.”

MedPage Today (5/13, Rudd) reports a study found that “azithromycin exposure in pregnancy was not associated with neurodevelopmental disorders in offspring...and use in late pregnancy was linked with some lower risks.” Researchers observed that “among over 15,000 mother-infant pairs after a mean follow-up of 5.5 years, exposure to azithromycin at any time in pregnancy was not associated with risks of any neurodevelopmental disorder compared with no exposure or exposure to other antibiotics.” Furthermore, “prenatal azithromycin exposure in late pregnancy (from 20 weeks’ gestation to delivery) was associated with a lower risk of overall neurodevelopmental disorders compared with exposure to other antibiotics (adjusted HR 0.69), as well as a lower risk of speech and language disorder (aHR 0.59). In addition, late pregnancy azithromycin exposure was associated with a lower risk of speech and language disorder compared with no antibiotic exposure during pregnancy (aHR 0.61).” The study was published in JAMA Network Open.

Infectious Disease Advisor (5/13, Khaja) reports a study found that “among adults with HIV-1 and prior hepatitis B virus (HBV) exposure, treatment with dolutegravir plus lamivudine (DTG/3TC) is associated with high rates of virologic suppression without evidence of HBV reactivation.” Researchers observed that “among treatment-naive patients, virologic suppression rates with DTG/3TC were consistent with those observed with standard 3-drug therapy. In GEMINI-1/-2, 18 (78%) DTG/ 3TC recipients achieved HIV-1 RNA levels below 50 copies/mL at week 144 compared with 17 (74%) of DTG plus tenofovir/emtricitabine recipients. In STAT, 3 (60%) patients achieved HIV-1 RNA levels below 50 copies/mL at week 48, although nonefficacy-related discontinuations influenced classification outcomes.” Researchers noted that “among virologically suppressed patients at baseline, switching to DTG/3TC maintained durable virologic suppression.” The study was published in HIV Medicine.

MedPage Today (5/13, Rudd) reports, “Risk of getting sick from a household contact with COVID-19 dropped by more than half among those who took the antiviral ensitrelvir compared with placebo, a randomized trial showed.” Investigators found, “in a modified intention to treat (ITT) population of household contacts of a COVID patient, 2.9% of those who took at least one dose of oral ensitrelvir as postexposure prophylaxis (PEP) developed COVID within 10 days, as compared with 9% of those assigned to placebo (P<0.001).” MedPage Today adds, “Even in the study’s full ITT population, 4.4% of those randomized to ensitrelvir developed COVID by that point compared with 10.2% of the placebo group (P<0.001).” The findings were published in the New England Journal of Medicine.

Healio (5/13, Stitt) reports the results of two national trials published in The New England Journal of Medicine suggest the role of nirmatrelvir-ritonavir (Paxlovid) in “treating COVID-19 is not ending – it is evolving.” While both trials determined that nirmatrelvir-ritonavir “does not reduce the incidence of hospitalization or death among vaccinated high-risk patients with SARS-CoV-2 compared with usual care, the combination medication sped up recovery in a meaningful way, experts noted.”

Infectious Disease Advisor (5/12, Neale) reports a study found that “most young children with perinatal exposure to hepatitis C virus (HCV) do not receive guideline-concordant testing or treatment.” Researchers observed that “among a subset of 4103 exposed children aged 2 years and older born to 3419 parents...with probable or confirmed HCV infection, only 1718 (41.9%) underwent guideline-concordant testing. Among children in the subcohort born between 2014 and 2019 who completed guideline-concordant testing, 2.5% were diagnosed with HCV infection.” Researchers stated that “the rate of guideline-concordant testing decreased over time, from 45.7% in pediatric patients born in 2014 to a low of 32.3% in those born in 2020.” Notably, “infants who were less likely to undergo testing included those born to non-Hispanic Black vs White parents (aOR, 0.65) and those with private vs public insurance (aOR, 0.76).” The study was published in JAMA Network Open.

CBS News (5/12, Czachor) reports that “infectious disease specialists and public health officials say there are clear differences” between the deadly cruise ship outbreak of hantavirus and the early days of the COVID-19 pandemic “that make the risk to the public extremely low.” WHO Director-General Dr. Tedros Adhanom Ghebreyesus told CBS News on Sunday, “This is not another COVID.” He explained, “Based on scientific assessment and based on evidence...the risk is low,” adding that concerned Americans “shouldn’t worry.” CBS News medical correspondent Dr. Céline Gounder, an infectious disease specialist, “likened the properties of COVID-19, when it first surfaced, to conditions that create a favorable environment for wildfires to spread,” while hantavirus is more like “a wet log in a stone fireplace.” Gounder added, “This is not infectious in the way COVID was, or is. The incubation periods are different, and that’s actually helpful for us in containing it.” Nevertheless, NBC News (5/12, Cohen) reports global health officials warned “that the number of hantavirus cases – which was 11 as of Tuesday – could rise.” Given hantavirus’ long incubation period of 42 days, “we might see more cases in the coming weeks,” said Tedros. Of the 18 American passengers who arrived stateside this week, two are in biocontainment units “out of an abundance of caution,” the Department of Health and Human Services said in a statement. As of Tuesday afternoon, none of the 16 patients quarantined at the University of Nebraska Medical Center “were experiencing symptoms, HHS said on X.” Two other Americans “who returned from the voyage are at Emory University Hospital in Atlanta.”

The Washington Post (5/11, A1, Vazquez) reports, “The 17 Americans evacuated from a cruise ship hit with a deadly hantavirus outbreak arrived in the United States early Monday and will be assessed at a specialized treatment facility in Nebraska, including one passenger who tested positive for the Andes virus and another who has mild symptoms.” The cruise ship “passengers will receive clinical assessments and care at the ASPR Regional Emerging Special Pathogen Treatment Center at the University of Nebraska Medical Center in Omaha, the Health and Human Services Department said in a statement.” The one “positive test marks the first confirmed case in an American passenger of the Hondius cruise ship.” The affected “passenger is asymptomatic, Nebraska Medicine said.” The Hill (5/11, Suter) reports, “A French passenger also tested positive, according to officials, while nearly all passengers on the ship have been evacuated.” Also reporting was Politico (5/10, Gardner, Lim).

STAT (5/11, Branswell, Subscription Publication) reports European researchers have “diagnosed a number of men who have sex with other men with dermatophilosis, a skin disease that normally infects livestock, even though the cases had no known exposure to affected animals.” In two studies published ahead of print in the CDC’s Emerging Infectious Diseases journal, “doctors reported small clusters of infections” in Barcelona and Lyon, “with the latter group having some ties to Paris and several other French cities.” According to STAT, the “clusters of infections are in some ways reminiscent of the emergence of mpox in 2022 in networks of gay men and other men who have sex with men. But people who have diagnosed some of these dermatophilosis cases describe a disease that is much milder in presentation.” To date, all diagnosed cases have “either cleared up on their own or were treated successfully with antibiotics.”

Infectious Disease Advisor (5/11, Neale) reports a study found that “men who have sex with men (MSM) receiving HIV pre-exposure prophylaxis (PrEP) may be at increased risk of acquiring other sexually transmitted infections (STIs).” The study included 1,017 HIV-negative MSM, “of whom the median age was 33 years. More than half (54.7%) of patients were receiving PrEP at baseline, with 83.7% reporting ongoing use during the study period.” Researchers observed that “approximately 71.8% of patients were diagnosed with at least 1 STI, with multiple infections frequently detected.” Compared with patients who indicated no PrEP use, “those receiving PrEP exhibited a higher prevalence of C trachomatis (43.1% vs 26.5%). When focusing on anorectal infections, patients receiving PrEP demonstrated higher prevalences of C trachomatis (35.3% vs 20.5%), M genitalium (31.4% vs 23.5%), and N gonorrhoeae (26.1% vs 16.9%).” The study was published in Open Forum Infectious Diseases.