Category: Corona Virus Vaccine

Covid-19 vaccines have reduced deaths due to the pandemic by at least 57% and have saved more than 1.4 million lives in Europe, most of which were older patients, according to the World Health Organization (WHO).

The WHO/Europe study showed that mortality was reduced by 57% in those aged 7079 and by 54% in those aged 6069. Mortality was 52% lower in the 5059 age group. The over-80 age group benefited the most from vaccination, with a 62% reduction in mortality.

Among those aged 25 to 49, receiving a second vaccine dose resulted in a 48% reduction in mortality, though the uptake of vaccines for the second and third boosters was just 5% in this group.

WHO said that the Covid-19 death toll in the region, currently at 2.5 million, might be as high as 4 million without the vaccines and the first vaccine booster alone saved 700 000 lives.

Dr Hans Henri P. Kluge, WHO Regional Director for Europe, said: We have constantly stressed the importance of the Covid-19 vaccines, particularly for older people and the most vulnerable. This study documents the result of countries implementing that advice. The evidence is irrefutable.

Covid-19 vaccination saved most lives during the period when the Omicron variant was dominant, from December 2021 to April 2023. In terms of impact on mortality in the Region as a whole, Israel saw the biggest benefits for all age groups with a 75% reduction, followed by Malta and Iceland with a 72% and 71% reduction, respectively.

Broken down by age group, those aged 80 and older once again saw the most significant benefits from Covid-19 vaccination, with a reduction in mortality of 70% in Malta and 71% in the UK.

Countries that implemented early vaccination programmes covering large parts of the population such as Belgium, Denmark, Iceland, Ireland, Israel, Malta, the Netherlands and the United Kingdom saw the greatest benefit in terms of the number of lives saved overall through vaccination.

Dr Kluge added: Covid-19 hasnt gone away. We have merely learned to live with it. Much of society has acquired some level of immunity, either through vaccination, infection or both. Most of us are capable of assessing our own level of risk and our risk to others. And if we get sick with signs of Covid-19 or flu, most of us know its best to stay at home and away from others.

A Lancet study this week also found that rates of undervaccination against Covid-19 ranged from 328% to 498% across the four UK nations in summer, 2022 and this was associated with an elevated risk of severe Covid-19 outcomes.

The study found that between June and September 2022, the percentage of people not fully vaccinated against Covid was:

With about 40,000 severe hospital admissions related to Covid during that summer, the research estimates that more than 7,000 17% would have been avoided if everyone had taken up the offer of the vaccine and booster doses for which they were eligible.

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Covid-19 vaccines saved at least 1.4 million lives, say WHO - Pavilion Health Today

A University of Alberta professor is co-leading a new international vaccine safety network to examine why some people who received a COVID-19 vaccine experienced very rare adverse events associated with the vaccine.

The International Network of Special Immunization Services (INSIS), based at the U of A, is a consortium of academic medical centres around the world coming together to study very rare adverse events after vaccination. An adverse reaction is considered very rare when it affects less than .001 per cent of the population.

The bar for safety with vaccines is very high because were giving them to healthy people to prevent them from getting sick, says U of A pediatric infectious disease professor Karina Top, who alongside Robert T. Chen, scientific director of the Brighton Collaboration a leading non-profit vaccine safety organization is co-leading INSIS. We dont want these events to occur, and we want to understand why, so we can prevent them in the future.

INSIS is receiving up to US$15.3 million over four years from the Coalition for Epidemic Preparedness Innovations (CEPI) to study why these very rare adverse events happen and who is most at risk. The network aims to help manufacturers develop new vaccines that will be even safer.

Vaccines have helped to eradicate deadly diseases such as smallpox, they save two to three million children a year and they even help to combat certain types of cancer such as cervical and throat cancers, which are caused by HPV. The impact of COVID-19 vaccines has been even more striking. In the first year of their rollout during the pandemic, vaccines saved 20 million lives.

Very rare adverse events associated with immunizations tend to be detected after vaccines are rolled out at a population level. Clinical trials typically include a relatively small number of participants, which may not fully represent the diverse population that will receive a vaccine after its approval. When the vaccine is rolled out to millions of people, a broader range of individuals with varying health conditions and genetic backgrounds may receive a vaccine. This increased sample size allows for detection of very rare adverse events that might occur.

The INSIS team will use cutting-edge techniques to measure the types of cells and molecules in human blood samples to identify how a vaccine may trigger an adverse event. The INSIS team will compile unprecedented amounts of data from around the world to compare information about people who experienced very rare adverse events and those who did not.

The ultimate goal of this project will be to enhance the safety assessment of vaccine candidates developed to combat emerging infectious threats before emergency authorization. This will be critical for achieving the 100 Days Mission, which aims to compress vaccine development against such pathogenic threats with pandemic potential to within just 100 days of their identification.

Compressing vaccine development against emerging pathogens down to 100 days will be critical to combatting future pandemic threats, explains Jakob Cramer, director of clinical development at CEPI. Data from INSIS will help to inform health authorities on the most appropriate type of vaccine that should be used in specific outbreak settings and populations. If we can identify risk factors and identify causal mechanisms for potential serious adverse events ahead of time, immunization campaigns can be adapted to mitigate such risks in those who are potentially vulnerable to harm, contributing to increased levels of public confidence in vaccines and enabling the development of even safer vaccines.

This global study brings together researchers from the University of Alberta, B.C. Childrens Hospital Research Institute and institutions in at least seven countries, including the Precision Vaccines Program at Boston Childrens Hospital, Mayo Clinics Vaccine Research Group, the Vanderbilt Vaccine Research Program at Vanderbilt University Medical Centre, Murdoch Childrens Research Institute in Australia, the Global Vaccine Data Network co-ordinated from New Zealand, Ospedale Pediatrico Bambino Ges in Italy, Global Healthcare Consulting co-ordinated from India, and the African Leadership in Vaccinology Expertise (Wits-ALIVE).

with files from Gillian Rutherford

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New U of A-based study to examine very rare adverse events linked to COVID-19 vaccines - University of Alberta

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Memphis area hospitals slammed but operating amid COVID-19, flu outbreaks - Commercial Appeal

More than half of Illinois counties are at an elevated level of COVID-19 hospitalizations, but overall respiratory illness appears to be in decline over the past week according to the Illinois Department of Public Health.

The Centers for Disease Control and Preventions latest update of its COVID Data Tracker indicates that as of the week ending January 13, Illinois is at the medium level for COVID-19 hospitalizations for a fourth straight week with a total of 1,393 hospitalizations reported during the week. A total of 54 counties were at an elevated level for COVID-19 hospitalizations with 50 of those at medium level (between 10 and 20 COVID-19 hospitalizations per 100,000 of population) compared with 57 counties the previous week. Four counties were at high level (more than 20 hospitalizations per 100,000) compared with seven the previous week.

Locally, Will, Grundy, DuPage, Cook, Lake, McHenry, Ogle and Lee counties are at medium risk. Only 24% of Illinois adults are up to date on their COVID-19 vaccination, according to the CDC.

IDPH has also confirmed this week that there was a third pediatric death from influenza, all with December onsets.

Although I am happy to report that Illinoiss overall respiratory illness activity is currently trending downward, respiratory viral season is still upon us with more than half of our counties still experiencing elevated levels of COVID-19 hospitalizations, IDPH Director Dr. Sameer Vohra said in a news release. If you develop respiratory symptoms, please contact your health care provider, and seek treatment as quickly as possible. We have effective treatments for COVID-19, the flu, and RSV. These treatments are especially important and can prevent severe disease for those with underlying medical conditions.

Every household in the U.S. is eligible to receive four free at-home tests through the COVID.gov website. IDPH has also made available a single-swab, triple-test for Flu/RSV and COVID-19, at no cost, to high-risk congregate care settings and local health departments.

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IDPH: Respiratory illnesses appear to be in decline; COVID-19 hospitalizations remain elevated - Shaw Local

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Shares of Moderna closed more than 13% higher on Tuesday after Oppenheimer upgraded the stock to "outperform," saying the Covid vaccine maker could market five products by 2026.

The upgrade follows a dismal 2023 for Moderna, whose only commercially available product is its Covid shot. The company's stock has long been tied to its vaccine, and its shares fell nearly 45% last year as demand for Covid products plummeted worldwide.

Oppenheimer analyst Hartaj Singh said the company's Covid sales could hit a low point in 2024 due to factors such as vaccine fatigue. But the firm expects Covid vaccine sales to rise in 2025 and beyond as education about Covid and spending on awareness about the disease increase.

Singh was even more upbeat about Moderna's pipeline potential, highlighting a handful of possible product launches over the next 12 to 18 months that could boost sales in 2025.

That includes a potential approval this year for Moderna's experimental vaccine that aims to protect older adults from respiratory syncytial virus, which typically causes mild, cold-like symptoms but more severe cases in seniors and children.

The company has said that the Food and Drug Administration will make a decision on its RSV vaccine in April.

Moderna's experimental flu vaccine could also win approval in 2024 or 2025, Singh said. In September, the company said its shot produced a stronger immune response against four strains of the virus than a currently available flu vaccine in a late-stage trial.

Singh also said Moderna could file for FDA approval of its experimental personalized cancer vaccine in 2024 or 2025. The company may apply under the FDA's accelerated approval pathway, which allows for expedited approval of drugs that treat serious conditions and fill what the agency calls an "unmet medical need" based on a specific clinical trial metric.

Moderna and its partner Merck are currently studying the shot in combination with Merck's blockbuster therapy Keytruda for the treatment of patients with a deadly skin cancer called melanoma and other cancers.

Also on Tuesday, Moderna reiterated in a shareholder letter that it expects to see sales growth in 2025. The company highlighted its RSV vaccine and the possible approval for its combination shot targeting Covid and the flu, which could come "as early as 2025."

Moderna in its third-quarter earnings release in November said it expects revenue to fall to $4 billion in 2024 before it grows again in 2025.The company expects to "break even" in 2026. The company also said in November that it would only hit the low end of its sales forecast of $6 billion to $8 billion for 2023, reflecting weaker demand for Covid vaccines.

Moderna has also said it plans to launch up to 15 products in the next five years a goal it first outlined during its annual research and development day in September.

Don't miss these stories from CNBC PRO:

Correction: Moderna shares fell nearly 45% last year. An earlier version misstated the percentage.

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Moderna stock pops after Oppenheimer says Covid shot maker could launch more products over next two years - CNBC

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Urgent Care facilities and emergency departments are seeing a lot of new patients coming in with respiratory symptoms. It's a viral "soup" of seasonal flue, colds, RSV and COVID-19 infections. Here's what you should do if you feel yourself getting sick.

ATLANTA - As the holiday travel season winds down, and people head back to work and school, COVID-19 infections continue to rise.

As of December 23. 2021, the latest Centers for Disease Control and Prevention estimate, 29,059 Americans were hospitalized with COVID-19, with infants and adults over 75 being hit the hardest.

Dr. Felipe Lobelo, who is a physician and epidemiologist with Kaiser Permanente Georgia, says U.S. hospitals are beginning to feel the impact of a combination of COVID-19, seasonal flu, and RSV.

"We're right on that border of things starting to become a stress on the health care systems," Dr. Lobelo says. "All the health care systems are thinking right now, Do we need to bring back masks, for example, for our physicians and our health care providers to protect themselves and also to protect others?"

A new highly contagious COVID-19 variant, JN.1, is driving about 44% of new U.S. infections, according to the CDC.

The agency says JN.1 does not appear to be more severe than other circulating or past strains of the virus, and the symptoms have stayed pretty consistent.

The most common symptoms include fever or chills, coughing, shortness of breath or difficulty breathing, fatigue and muscle or body aches.

Some people may experience headache, a new loss of taste or smell, a sore throat, congestion or a runny nose.

Nausea or vomiting and diarrhea are also symptoms of COVID-19.

The only way to know if you have a COVID-19 infection is to take a test, either an at-home rapid test or a PCR test available from a health care provider.

Childrens Healthcare of Atlanta has since a significant rise in patients during the COVID-19 pandemic. (FOX 5)

If you test positive for the virus, the CDC recommends you stay home and isolate yourself from others in your home for at least 5 days.

People at increased risk of severe complications of COVID-19 may qualify for Paxlovid or Molnupiravir, two antiviral therapies that can reduce the risk of hospitalization and death.

Both need to be started within 5 days of the onset of symptoms.

"With testing, we can sort of pinpoint the right treatment, if it's necessary for particular individuals that may need it," Dr. Lobelo says. "You want to start that early as possible."

The CDC is urging Americans ages 6 months and older to get an updated 2023-2024 COVID-19 vaccine.

But only about 18% of U.S. adults and 38% of seniors 75 and older have gotten the shot since it was recommended in September 2023.

Dr. Lobelo says most Americans have some level of immunity to the coronavirus, either from prior infections or previous vaccinations.

Still, he cautions that protection wanes with time.

"Really, after 4, 5, 6 months, your levels of protection start to drop off," Lobelo says.

So, he says, if it has been a couple of months since you have had COVID-19, or you haven't gotten an updated shot, get vaccinated soon.

"I strongly recommend it because the activity just keeps increasing," Dr. Lobelo says.

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As Americans return to work, school after holiday break, COVID-19 hospitalizations rise - FOX 5 Atlanta

Patients with rheumatoid arthritis (RA) receiving disease-modifying antirheumatic drugs (DMARDs) showed reduced immune responses to the COVID-19 vaccine compared with controls, in a recent study published in Journal of Rheumatic Diseases.1

Patients with RA carry increased risks for developing infections, including COVID-19. Since the introduction of the COVID-19 vaccine, additional concerns have emerged regarding the potential of vaccine-induced RA flare-ups or other forms of autoimmune or inflammatory phenomena. As DMARDs have provided benefits to patients with RA, such as reducing and modulating inflammatory and immune system responses, researchers conducted a cross-sectional study to investigate lacking data on COVID-19 vaccine responses in patients with RA receiving DMARDs.

From May 2022 to April 2023, patients with RA receiving DMARDs were evaluated at 2 tertiary care centers. Patients with seropositive as well as seronegative status were accepted. Investigators gathered data on individual COVID-19 infection and vaccination histories, prescribed and administered medications (DMARDs), as well as scaling on the Disease Activity Score-28 (DAS28). Blood samples of 10 mL were also taken for examination of erythrocyte sedimentation rate (ESR), complete blood count, C-reactive protein (CRP), liver and renal function, and neutralizing antibodies for COVID-19.

In total, 103 patients with RA were recruited and compared with 185 controls. In the RA group, 42% of individuals had comorbiditiesmost commonly, hypothyroidism (16.5%). The RA group was also vaccinated against COVID-19 at rates of 79.6% compared with 91.3% in the controls. No controls had a history of COVID-19 infection, but 13.6% of patients with RA did. Most of the patients with RA were identified as having low disease activity (mean DAS28 of 2.9).

Researchers observed that patients with RA had overall higher mean levels of ESR and elevated IL-6 compared with controls (ESR: 26.0 vs 19.2; P = .0004; IL-6: 15.8 vs 3.7; P < .0001).

Each group registered positive results for antispike antibodies; this was significantly higher in controls compared with patients with RA (95.9 vs 89.5; P < .0001). Interestingly, in patients with RA, age was positively correlated with levels of anti-spike antibodies (P = .0015), but this was not significant in controls. Antibody status in groups using different amounts of DMARDs were statistically significant, especially between individuals on a 3-drug regimen compared with those on a single-drug regimen of hydroxychloroquine alone (P = .0192). The authors noted that neither the presence of comorbidities nor the type of COVID-19 vaccine received, prior infection, or booster status had a statistically significant effect on antibody concentration.

The authors noted the positive takeaway that patients with RA exhibited robust immune responses following their COVID-19 vaccination, although this response was reduced compared with controls. They theorized that this could be due to disease-related or immunosuppressive treatment factors, and advocated for future research to be conducted to analyze responses following second vaccination doses.

This article originally appeared in AJMC.

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COVID-19 Vaccine Shows Reduced Effect in Patients With RA Receiving DMARDs - Drug Topics

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Two separate analyses of studies and trials suggest that COVID-19 rebound is not linked to Paxlovid or other antiviral drugs.

The findings contradict other studies that indicated a higher frequency of COVID-19 rebound among people treated with Paxlovid (nirmatrelvir/ritonavir, Pfizer).

Rebound is typically described as a recurrence of symptoms after recovery or a new positive viral test after testing negative, Pragna Patel, MD, MPH, DRM&H, chief medical officer in the Coronavirus and Other Respiratory Viruses division of the CDCs National Center for Immunization and Respiratory Diseases, told Healio. We found that there was no consistent association between treatment for COVID-19 and COVID-19 rebound. Also, we found that COVID-19 rebound can happen among patients whether they received antiviral treatments or not.

It was the top story in infectious disease last week.

Another top story was a collection of articles about ID-related guidelines released in 2023, including recommendations on sexually transmitted disease prevention, diabetic foot infections and more.

Read these and more top stories in infectious disease below:

Paxlovid unlikely to contribute to COVID-19 rebound

SARS-CoV-2 rebound risk is more likely related to the individual person, rather than reinfection or resistance to treatment such as Paxlovid, according to two studies. Read more.

Doxy-PEP, diabetic foot infections and more: The year in ID guidelines

New guidance was published in 2023 for STD prevention, diabetic foot infections, infective endocarditis and more. Read more.

COVAX to end as COVID-19 vaccines move to routine immunization programs

COVAX, the multinational program launched in 2020 to deliver COVID-19 vaccines to low- and lower-middle income countries, will end on Dec. 31, 2023, as the vaccines shift to routine immunization programs. Read more.

Pneumonia, candidiasis and more: The non-vaccine approvals of 2023

The FDA in 2023 approved treatments for several hospital-associated infections and fully approved a long-used COVID-19 medication, among other non-vaccine-related regulatory decisions. Read more.

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As viral hepatitis continues to be a major health concern in the infectious disease field, recent research has highlighted the importance of testing and treatment. Read more.

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Top in ID: Paxlovid unlikely contributes to COVID-19 rebound; a roundup of 2023 guidelines - Healio

Study design and participants

A retrospective cohort study was conducted at Nhan Dan Gia Dinh (NDGD) Hospital, a general tertiary hospital in Vietnam. Participant recruitment was taken by screening a sampling frame of patients under the management of NDGD Hospital from January 1, 2021, to January 31, 2022. We included patients who: (1) were 18 years old; (2) were fully vaccinated against COVID-19 before infection (received at least 2 doses, either homologous or heterologous, of the following vaccines: BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), AZD1222 (AstraZeneca), or BBIBP-CorV (Sinopharm), at least 2 weeks before getting first COVID-19); (3) had a confirmative diagnosis of COVID-19 (positive to either real-time polymerase chain reaction test or rapid antigen test with typical symptom(s) of COVID-19); and (4) agreed to participate. Patients were excluded if they: (1) were pregnant or breastfeeding; (2) were severely or critically ill before treatment (based on the clinical spectrum proposed by the NIH [13]); (3) were moderately or severely immunocompromised (immunosuppressive medications, moderate or severe primary immunodeficiency, advanced or untreated human immunodeficiency virus infection, active cancer treatment, or white blood cell count<4109/L); (4) were renally impaired (estimated glomerular filtration rate<30 mL/minutes/1.73 m2); or (5) were hepatically impaired (ChildPugh class B or C).

We followed the participants until March 31, 2022, or until they left the study. We reported this study in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement (Supplementary Checklist, available in the Supplementary File).

Two groups were investigated, of which patients were given: (1) standard of care (SoC, control group) or (2) standard of care plus antiviral (SoC+antiviral). In our study setting, SoC referred to treatment with appropriate medications (excluding antivirals) and supportive care that aligned with the guidelines of Vietnams Ministry of Health [14], WHO [11, 15], IDSA [12], and NIH [13]. Antivirals included remdesivir, molnupiravir, and favipiravir. Remdesivir was given by intravenous infusion to hospitalized patients, with 200mg on the first day and 100mg on the next 4 days. Molnupiravir was taken orally, with 800mg twice daily for 5 days. Favipiravir was also an oral antiviral with dosage of 1,600mg twice daily on the first day and 600mg twice daily on the next days (duration of 57 days).

The primary outcome was residual respiratory symptoms of COVID-19 breakthrough (including but not be limited to cough, dyspnea/shortness of breath/difficulty breathing, congestion, sore throat, loss of smell), measured in frequency. Based on our pilot data, the proposed timeframe cut-off to classify residual symptoms in COVID-19 breakthrough was 7 days. Thus, patients having respiratory symptoms after day 7 (from the day with first symptoms or diagnosis, whichever happened first) were counted towards the primary outcome. As these participants were under the management of NDGD Hospital, they were encouraged to self-report symptoms of COVID-19 every 12 days until resolution using MyCap platform [16]. For data collection, patients without self-reported records were contacted to retrieve the this outcome.

The secondary outcome was long COVID-19 [17,18,19], measured in frequency. This was diagnosed by specialized physicians in COVID-19 at NDGD Hospital using the guideline of the National Institute for Health and Care Excellence [19]. Following that, long COVID-19 includes ongoing symptomatic COVID-19 (signs and symptoms of COVID-19 from 4 weeks up to 12 weeks) and post-COVID-19 syndrome (signs and symptoms that develop during or after an infection consistent with COVID19, continue for more than 12 weeks and are not explained by an alternative diagnosis) [19]. We collected these data by screening patient health records for long COVID-19 diagnosis.

We calculated the sample size using the online website Power and Sample Size [20], with type I error rate () of 5%, power (1 - ) of 80%, and a sampling ratio of 1:1. Following the findings of Bergwerk et al., 31% of infected healthcare workers had residual symptoms 14 days after diagnosis [21]. Given that our study was conducted on the general population with a 7-day cut-off, we estimated the primary outcome could be found in at least 41% of the patients. For antivirals to be considered effective against COVID-19 breakthrough in low and middle-income countries like Vietnam, we expected a reduction of at least 50% in the primary outcome, resulting in a minimum sample size of 144 patients. Thus, we decided to recruit 150 patients.

Considering our study setting, the following factors were identified as potential confounders: gender (female/male), age (in years), weight (in kg), height (in cm), comorbidities, and concurrent medications. To avoid overadjustment bias, we excluded medications for comorbidities, keeping only those that were used for COVID-19 treatment.

We removed observations that were missing or lost to follow-up from analysis. We presented demographic and baseline data as mean with standard deviation for continuous variables or as frequency with percentage for categorical variables. Incidence rates (using Poisson regression) and odds ratio (OR, using logistic regression) were given with 95% confidence intervals (95% CI). As there were 3 nationally approved antivirals for COVID-19 in Vietnam during this study timeframe (remdesivir, molnupiravir, and favipiravir), effect estimates might be biased by favipiravir due to its lack of evidence. To test the robustness of our findings, we conducted a sensitivity analysis by removing observations with favipiravir use. Since antivirals were primarily recommended for high-risk patients, we also wanted to explore these medications effects on both outcomes with a priori subgroup analysis. The subgroups were pre-specified based on the following variables: gender (male/female), age (<65/ 65), comorbidities (yes/no), and corticosteroid use (yes/no). This subgroup analysis was considered exploratory to generate new hypotheses (if available), so we did not attempt to adjust for multiplicity. All statistical hypotheses were tested with a confidence level of 95%. We performed all analyses using R software (version 4.2.1, R Foundation for Statistical Computing, Vienna, Austria).

This study was approved by the Institutional Review Board of NDGD Hospital, Ho Chi Minh City, Vietnam, under approval number 85-2021/CN-HDDD. All recruited participants gave their informed consent.

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Effects of antivirals on patients with COVID-19 breakthrough - BMC Infectious Diseases - BMC Infectious Diseases