ProMED-mail 情報: 2023年6月19日

COVID-19　ウイルス感染実験 Lancet、ワクチンとギラン・バレー Eurosurveillance

●　COVID-19　

PRO/AH/EDR> COVID-19 update (23): EU transition plan, viral emission, vacc hesitancy, GBS, WHO

Archive Number: 20230619.8710662

[1] Country updates

　[A] ニュージーランド New Zealand: 8544 new cases, 39 deaths

　情報源 Radio New Zealand 2023年6月19日

There were 8544 new cases of COVID-19 reported in Aotearoa [New Zealand] in the week to midnight on Sunday [18 Jun 2023], and a further 39 deaths were attributed to the virus. ... The 7-day rolling average of cases was 1217.

Last week [week of 12 Jun 2023], 9883 new COVID-19 cases were reported and a further 37 deaths were attributed to the virus.

　[B] 米国 USA: CDC interim recommendations for the use of bivalent mRNA COVID-19 vaccines for persons aged 6 months or older

　情報源 CDC. MMWR Morb Mortal Wkly Rep 2023 6月16日

原著タイトル Interim recommendations for use of bivalent mRNA COVID-19 vaccines for persons aged ≥6 months -- United States, April 2023. MMWR Morb Mortal Wkly Rep 2023; 72: 657-662

Summary

What is already known about this topic?

What is added by this report?

　- During December 2022-April 2023, CDC は、6歳以上の小児に対する2価ワクチンの1回接種と、生後6ヶ月から5歳までの小児の2価ワクチン接種と、生後6ヶ月以上の中等度から重度の免疫不全の患者と65歳以上の高齢者に対する optional additional bivalent booster doses を推奨した。

What are the implications for public health practice?

　[C] ベトナム Viet Nam: no COVID-19 free treatment when disease downgraded

　情報源 Vietnam+ 2023年6月15日

治療費無料化の終了。

　[D] フィリピン The Philippines: positivity rate drops to 8.6% as of 18 Jun 2023

　情報源 Inquirer 2023年6月19日

The COVID-19 positivity rate in the country has further dipped to 8.6 percent as of 18 Jun 2023 from 10.3 percent as of the day before, according to Octa Research fellow Guido David.

　[E] オランダ The Netherlands: COVID-19 no longer classified as top infectious disease

　情報源 NL Times 2023年6月18日

COVID-19 is no longer a status A infectious disease, Health Minister Ernst Kuipers announced 　

[2] WHO/Europe: transition plan

　情報源 World Health Organization news release 2023年6月12日

Making the transition to the next stage

...

The transition plan sets out how COVID-19 activities should be managed and integrated within 5 core components of WHO's proposed global health architecture for Health Emergency Preparedness, Response and Resilience (HEPR):

　- collaborative surveillance, including sustaining and building laboratory capacity and using digital tools to collect and analyse COVID-19 data;

　- community protection across the emergency cycle to enable and empower communities to take informed decisions to uptake measures that protect their health in emergencies;

　- clinical care, ranging from training frontline health workers and strengthening the foundations for safe, scalable, and high-quality care to ensuring sustained investment in health services and emergency care systems;

　- countermeasures, such as learning from and sustaining the COVID-19 vaccination roll-out as part of wider immunization efforts; and

　- coordination, from hazard-specific COVID-19 and influenza pandemic response plans to integrated respiratory virus pandemic planning.

[3] 英国 UK (England): Viral emissions into the air and environment after SARS-CoV-2 human challenge

　情報源 The Lancet Microbe 2023年6月9日

原著タイトル Viral emissions into the air and environment after SARS-CoV-2 human challenge: A phase 1, open label, first-in-human study. Lancet Microbe. 2023: S2666-5247(23)00101-5

Summary

Background

We aimed to correlate viral emissions（ウイルス排出）, viral load in the upper respiratory tract（上気道のウイルス量）, and symptoms（症状）, longitudinally, in participants who were experimentally infected with SARS-CoV-2.

Methods

In this phase 1, open label, 1st-in-human SARS-CoV-2 experimental infection study at the quarantine unit at the Royal Free London NHS Foundation Trust, London, UK, healthy adults aged 18-30 years who were unvaccinated for SARS-CoV-2, not previously known to have been infected with SARS-CoV-2, and seronegative at screening were recruited. （18－30歳の健康成人ボランティアへの感染実験）

Participants were inoculated with 10 50% tissue culture infectious dose of pre-alpha wild-type SARS-CoV-2 (Asp614Gly) by intranasal drops and remained in individual negative pressure rooms for a minimum of 14 days.（最低14日間、陰圧室内でウイルスを点鼻）

Nose and throat swabs were collected daily.（毎日スワブ検体採取）

Emissions were collected daily from the air (using a Coriolis μ air sampler and directly into facemasks) and the surrounding environment (via surface and hand swabs). ...

Findings

Between 6 Mar and 8 Jul 2021 の期間に36 participants (10 female and 26 male) が参加し、18 (53%) of 34 participants が感染し、短い潜伏期間を経て、鼻腔と咽頭にウイルスを保有し protracted high viral loads in the nose and throat、軽症から中等症の症状を示した。

Viral RNA was detected in 63 (25%) of 252 Coriolis air samples from 16 participants, 109 (43%) of 252 mask samples from 17 participants, 67 (27%) of 252 hand swabs from 16 participants, and 371 (29%) of 1260 surface swabs from 18 participants.

Viable SARS-CoV-2 was collected from breath captured in 16 masks and from 13 surfaces, including 4 small frequently touched surfaces and 9 larger surfaces where airborne virus could deposit.

Viral emissions correlated more strongly with viral load in nasal swabs than throat swabs.（ウイルス排出とスワブのウイルス量に強い相関）

2 individuals emitted 86% of airborne virus, and the majority of airborne virus collected was released [in] 3 days.

Interpretation

... a minority of participants were high airborne virus emitters, giving support to the notion of superspreading individuals or events.（スーパースプレッダーの可能性）

Our data implicate the nose as the most important source of emissions. Frequent self-testing coupled with isolation upon awareness of 1st symptoms could reduce onward transmissions.

[4] 米国 USA: COVID-19 vaccine hesitancy and health literacy in Southern states

　情報源 The American Journal of Managed Care (AJMC) 2023年6月6日

原著タイトル COVID-19 vaccine hesitancy and health literacy in US Southern States. Am J Manag Care. 2023; 29(6)

Abstract

...

Conclusions

health literacy (HL) was not a significant indicator of vaccine hesitancy in the study population, suggesting that generally low rates of vaccination in the Southern region may not be due to knowledge about COVID-19. This indicates a critical need for place-based or contextual research on why vaccine hesitancy in the region transcends most sociodemographic differences.

[5] ドイツ Germany: rare cases of Guillain-Barré syndrome after COVID-19 vaccination, December 2020-August 2021

　情報源 Eurosurveillance 2023 6月15日

原著タイトル Rare cases of Guillain-Barré syndrome after COVID-19 vaccination, Germany, December 2020 to August 2021. Eurosurveillance. 2023; 28(24): pii=2200744

Key public health message

What did you want to address in this study?

Guillain-Barré-Syndrome (GBS、ギラン・バレー症候群) は、感染症やごくまれにワクチン接種後に発生することのある自己免疫状態 an autoimmune condition である (incidence: 1.77/100 000 person-years) 。COVID-19 ワクチン接種後に GBS を発症する可能性と、発生した場合の臨床上の特性について調べた。

What have we learnt from this study?

ベクターワクチン the vector-based vaccines (Vaxzevria and COVID-19 Vaccine Janssen) ではそれぞれ3倍および4倍多く more GBS cases than expected 報告された。COVID-19 mRNA vaccines (Comirnaty and Spikevax) とインフルエンザワクチンについては、予想された症例数を超えることはなかった。

What are the implications of your findings for public health?

Although rare, GBS could be an adverse event after vaccination with vector-based COVID-19 vaccines. Bifacial paresis（両側性顔面麻痺）was more common in cases with GBS following vaccination with vector-based than mRNA-based COVID-19 vaccines.

[Mod.LWW－ ... the authors note in their conclusions that the risk of suffering acute and long-term effects of a SARS-CoV-2 infection is much higher. ]

[6] WHO: weekly epidemiological update on COVID-19 (15 Jun 2023)

　情報源 WHO 2023年6月15日

[7] Global update: Worldometer accessed 15 Jun 2023 23:30 GMT

　Total number of reported cases: 690 365 371

　Total number of reported deaths: 6 891 504

　Number of newly confirmed cases in the past 7 days: 297 220

　Number of newly reported deaths in the past 7 days: 2072

ProMED-mail 情報

ページ

2023年6月19日

Disclaimer

記事分類（以前の記事のみ）