[Clinical Picture] Hookworm in the eye
A 62-year-old man presented to the Southwest Eye Hospital (Chongqing, China) with a 4-month history of decreasing central vision in his right eye. His visual acuity was reduced to counting fingers in the right eye and was 6/6 in the left. There was no remarkable sign in the anterior segment of the right eye, but fundoscopy revealed a white, slim worm wiggling under the macular retina (figure). The patient recalled that his right eye had been injured by a branch 3 years previously, with no vision decrease and no treatment at that time. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Zui Tao, Ying Wang, Shasha Yu, Zheng Qin Yin, Yong Liu, Shiying Li Tags: Clinical Picture Source Type: research

[Obituary] David Cooper
Prof David Cooper was a pioneer in the care of patients with HIV and research into treatment. He died in Sydney on March 18, 2018. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Talha Burki Tags: Obituary Source Type: research

[Newsdesk] Research brief
Findings from a study done in 12 cynomolgus macaques suggest that common immune responses to Ebola virus could serve as an early marker for infection. The monkeys, which were infected intranasally with Ebola virus, presented with varying times to disease onset, but about 4 days before fever began in each one, researchers noticed a distinctive upregulation of interferon-stimulating genes. Comparison with data from the 2014 –16 Ebola outbreak in Guinea showed activation of the same genes, in the same order, in human beings. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Dara Mohammadi Tags: Newsdesk Source Type: research

[Newsdesk] Infectious disease surveillance update
On March 7, 2018, four cases in human beings of encephalitis associated with Borna disease virus 1 infection were reported in Germany, including three deaths. Of the four patients, three had received organs from the same donor who had no clinical signs of the illness, two of these recipients died from their illness. An additional case of encephalitis caused by Borna disease virus 1 was identified in southern Germany, this patient also died from their illness. No epidemiological link was identified between this case and the organ transplant recipients. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Ruth Zwizwai Tags: Newsdesk Source Type: research

[Newsdesk] Neglected tropical diseases: securing sustainability
Drug donations for mass drug administration have had great success. But there are drawbacks and experts are questioning the sustainability of such programmes. Clare Sansom reports. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Clare Sansom Tags: Newsdesk Source Type: research

[Newsdesk] North Korea and the Global Fund
The Global Fund's decision to withdraw from North Korea is jeopardising tuberculosis control in the country. Talha Burki reports. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Talha Burki Tags: Newsdesk Source Type: research

[Correspondence] Constantly high incidence of scarlet fever in Germany
Theresa Lamagni and colleagues1 reported the resurgence of scarlet fever in England: although only up to 50 cases of scarlet fever per 100  000 children (age (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Stefan O Brockmann, Linda Eichner, Martin Eichner Tags: Correspondence Source Type: research

[Correspondence] Adverse pregnancy outcomes due to Chlamydia trachomatis
Joanne Reekie and colleagues1 did a population-based cohort study on the association between a positive test for chlamydia and spontaneous preterm birth, having a baby who is small for gestational age, or stillbirth. On the basis of the findings from their study, the authors concluded that a genital chlamydia infection —presumably treated either before or during pregnancy, regardless of the trimester during which testing occurred—does not substantially increase a woman's risk of having one of these three adverse pregnancy outcomes. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Xiang-Sheng Chen Tags: Correspondence Source Type: research

[Correspondence] Influenza: the role of the Middle East and north Africa?
100 years have passed since the first well documented influenza pandemic of the 20th century. Today, the majority of the influenza virus burden is known to be caused by two main types of influenza virus —type A and type B. Human influenza A viruses generally stem from birds and swine, whereas influenza B viruses do not have a known animal reservoir, and simply circulate among human beings. Although pandemics occur unexpectedly, these outbreaks are theorised to emerge after a lengthy reassortment process, and not from the direct introduction of an avian virus into human beings. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Hossein Bannazadeh Baghi, Mohammad Hossein Soroush Tags: Correspondence Source Type: research

[Correspondence] Low procalcitonin, community acquired pneumonia, and antibiotic therapy – Authors' reply
We share, in principal, the concern of Ishan Kamat and colleagues that the diagnosis of community-acquired pneumonia is challenging, and that procalcitonin should not be used as a substitute for good clinical practice. Decisions regarding the potential benefit of starting antibiotic treatment in patients presenting with lower respiratory tract illnesses should be based on all available clinical and diagnostic parameters, including a thorough clinical assessment. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Philipp Schuetz, Angela Branche, Beat Mueller Tags: Correspondence Source Type: research

[Correspondence] Low procalcitonin, community acquired pneumonia, and antibiotic therapy
Our concerns about the meta-analysis of procalcitonin-guided therapy in patients with acute respiratory infections by Philipp Schuetz and colleagues1 go well beyond those expressed in an accompanying Comment.2 We fear that physicians will infer that antibiotic treatment can be given to or withheld from patients with community-acquired pneumonia on the basis of plasma procalcitonin concentrations. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Ishan S Kamat, Vignesh Ramachandran, Harish Eswaran, Michael S Abers, Daniel M Musher Tags: Correspondence Source Type: research

[Correspondence] Colistin versus colistin plus meropenem for severe infections Authors' reply
We appreciate Daniele Giacobbe's Correspondence regarding the importance of colistin minimum inhibitory concentrations. A study showed that both gradient-based and semi-automated devices can overestimate susceptibility to colistin.1 In our trial,2 we recruited patients who were infected with colistin-susceptible (carbapenem non-susceptible) Gram-negative bacteria on the basis of several tests —including the Etest (BioMérieux, Marcy-l'Étoile, France), Vitek-2 (BioMérieux), and BD Phoenix (BD Diagnostics, Sparks, NV, USA) for colistin susceptibilities—done in the clinical laboratories of part...
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Mical Paul, Yehuda Carmeli, George L Daikos, Emanuele Durante-Mangoni, Ursula Theuretzbacher, Johan W Mouton, Leonard Leibovici Tags: Correspondence Source Type: research

[Correspondence] Colistin versus colistin plus meropenem for severe infections
In their randomised controlled superiority trial, Mical Paul and colleagues1 found that the addition of meropenem to colistin did not improve clinical failure in patients with severe Acinetobacter baumannii infections. The study brings important high-level evidence to the discussion on the use of combination therapies against multidrug-resistant Gram negatives.2 (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Daniele Roberto Giacobbe Tags: Correspondence Source Type: research

[Correspondence] Colistin versus colistin plus meropenem for severe infections
Mical Paul and colleagues1 should be commended for conducting the investigator-initiated randomised trial addressing combination therapy with colistin plus meropenem. The limitations of the study have been elegantly discussed by the authors and in a Comment;2 however, a few points require further comments. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Alexandre P Zavascki Tags: Correspondence Source Type: research

[Correspondence] It's too soon to pull the plug on antibiotic cycling – Authors' reply
Daniel Nichol and colleagues express concern that the negative findings from our study1 will discourage future investigators from attempting to further study the effects of antibiotic rotation. Indeed, we concluded that antibiotic rotation (both mixing and cycling) is not justified as clinical practice, but we do not intend to halt further research and sincerely hope that it will not deter others from exploring antibiotic rotation strategies to reduce antibiotic resistance. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Pleun Joppe van Duijn, Marc Bonten Tags: Correspondence Source Type: research

[Correspondence] It's too soon to pull the plug on antibiotic cycling
Pleun Joppe van Duijn and colleagues1 investigated the relative merits of antibiotic mixing and antibiotic cycling using a cluster-randomised crossover study in eight intensive care units (ICUs); their findings suggested that 9-month periods of cycling and mixing did not change the unit-wide prevalence of antibiotic-resistant, Gram-negative bacteria. We commend the design of this study, both for its scale and grounding in evolutionary theory that was drawn from the work of both experimentalists and mathematical modellers. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Daniel Nichol, Robert A Bonomo, Jacob G Scott Tags: Correspondence Source Type: research

[Corrections] Corrections
Nguyen T-N, von Seidlein L, Nguyen T-V, et al. The persistence and oscillations of submicroscopic Plasmodium falciparum and Plasmodium vivax infections over time in Vietnam: an open cohort study. Lancet Infect Dis 2018; 18: 565 –72—In this Article, the lowest parasite densities shown in figure 3 were found to be below the lower limit of accurate quantification of the PCR method used in the study (22 parasites per mL). The analysis was therefore redone after excluding these low parasite densities. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Tags: Corrections Source Type: research

[Comment] 2018 WHO hand hygiene campaign: preventing sepsis in health care and the path to universal health coverage
Sepsis is a serious condition that has affected human beings since the dawn of time; the word sepsis itself originates from the ancient Greek era.1 More than 2000 years later, it remains a public health problem of global scope: every year, more than 30 million people worldwide are estimated to develop sepsis.2 To address this burden, many countries develop initiatives or participate in international efforts to fight sepsis. Each year, to raise awareness, the Global Sepsis Alliance coordinates World Sepsis Day on Sept 13. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Hiroki Saito, Benedetta Allegranzi, Didier Pittet Tags: Comment Source Type: research

[Comment] Global spread of antibiotic-resistant bacteria and mass-gathering religious events
The 2013 Lancet Infectious Diseases Commission on antimicrobial resistance (AMR)1 called for coordinated international action. Subsequently, the WHO global action plan on AMR was adopted by the 68th World Health Assembly in May, 2015,2 as a sustainable development goal to spur worldwide action to tackle a very serious issue threatening global health security. Because accurate data on AMR worldwide were scarce at that time, it was anticipated that any data collection, surveillance, and research work on AMR would be scientifically rigorous and deliver quality data. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: Alimuddin Zumla, Esam I Azhar, David S Hui, Shuja Shafi, Eskild Petersen, Ziad A Memish Tags: Comment Source Type: research

[Editorial] Plotting a route to a universal influenza vaccine
The 2017 –18 influenza season in the northern hemisphere was notably intense, similar to the immediately preceding season in the southern hemisphere. A likely factor influencing the intensity of these seasons was the effectiveness of the influenza vaccine both in terms of the matching of the components of the vaccine to the dominant circulating strains and the ability of these individual components to elicit protection. A universal influenza vaccine, which would offer broad and long-lasting protection, would overcome the shortcomings of the current cat-and-mouse approach. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - April 19, 2018 Category: Infectious Diseases Authors: The Lancet Infectious Diseases Tags: Editorial Source Type: research

[Corrections] Corrections
Zignol M, Maurizio Cabibbe A, Dean AS, et al. Genetic sequencing for surveillance of drug resistance in tuberculosis in highly endemic countries: a multi-country population-based surveillance study. Lancet Infect Dis 2018; published online March 21. https://doi.org/10.1016/S1473-3099(18)30073-2. The key for figure 4 was incorrect, and should have read “Genetic sequencing” and “Phenotypic testing”. This correction has been made to the online version as of March 27, 2018, and the printed Article will be corrected. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 27, 2018 Category: Infectious Diseases Tags: Corrections Source Type: research

[Clinical Picture] Plastic bronchitis associated with adenovirus infection
A previously healthy 3-year-old boy who presented with an 8-day history of persistent fever and cough was referred to our hospital. On physical examination the boy had signs of respiratory distress and a low-pitched breath sound on his left lung. He had no history of foreign-body aspiration. A chest radiograph done 2 days previously was normal. On the day of admission he had a CT scan of his chest, which revealed left lower lobe atelectasis (appendix). Results of direct immunofluorescence of nasopharyngeal swabs for the detection of respiratory syncytial virus, influenza A and B viruses, parainfluenza viruses, and adenovir...
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Zhiwei Lu, Yuejie Zheng Tags: Clinical Picture Source Type: research

[Clinical Picture] Streptococcus pyogenes subdural empyema and pre-eclampsia
A 30-year-old woman presented at the hospital emergency department of Ch âteauroux Hospital (Châteauroux, France) with a fever and headache. She was pregnant at 32-weeks gestation. A lumbar puncture was normal and CT scan showed a right maxillary sinusitis, therefore she was prescribed amoxicillin (1 g every 8 h, orally). The patient was re-admitted to the emergency de partment 2 days later with pre-eclampsia. Treatment for her maxillary sinusitis was changed from amoxicillin to ceftriaxone (1 g every 24 h, intravenously) and metronidazole (500 mg every 8 h, intravenously). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Simon Poignant, Pascaline Pigache, Eric Fournier, Djilali Elaroussi, Marc Laffon Tags: Clinical Picture Source Type: research

[Media Watch] A story of quiet heroes
“The sexual revolution has begun to devour its children”, thundered Pat Buchanan in a 1983 opinion piece for the New York Post. “And among the revolutionary vanguard, as gay rights activists, the morality rate is highest and climbing.” The conservative columnist and advisor to three American presidents could barely contain his exultation. “The poor homosexuals”, he sneered. “They have declared war upon nature, and now nature is exacting an awful retribution.” (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Talha Burki Tags: Media Watch Source Type: research

[Profile] Kit Fairley: a pioneer in STI research
Christopher (Kit) Fairley had a grandfather and both parents as doctors to look up to while growing up in Melbourne, but he also felt the strain of having dyslexia and the stigma and classroom bullying it led to. However, he and his twin brother Stephen gained much of their confidence and love of nature through weekend visits to the farm their patents owned in countryside Victoria state. “I think it was constantly seeing mum and dad and their love and excitement of working in research as doctors that made me want to follow in their footsteps”, Fairley told The Lancet Infectious Diseases. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Tony Kirby Tags: Profile Source Type: research

[Newsdesk] Research brief
Artificial intelligence can accurately diagnose eye diseases and childhood pneumonia. Using machine learning and convolutional neural networks (computational networks designed to make sense of overlapping, three-dimensional images), an algorithm scanned through pre-existing eye scans and chest x-rays, identified discreet anatomical structures, and assessed them for disease. It could differentiate between viral and bacterial pneumonia with more than 90% accuracy and could detect two common degenerative eye diseases with more than 95% accuracy. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Dara Mohammadi Tags: Newsdesk Source Type: research

[Newsdesk] Infectious disease surveillance update
Between Jan 1, 2018, and Feb 25, 2018, 1081 cases of Lassa fever have been reported in Nigeria, including 90 deaths. 317 cases have been confirmed and eight have been classified as probable, including 72 deaths —a case fatality rate of 22% for confirmed or probable cases. Cases have been reported across 18 states, with 2845 contacts having been identified. 14 cases have been reported in health-care workers, including four deaths. Four Lassa fever case management centres have been set up in Anambra, Abaka liki, Edo, and Ondo states. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Ruth Zwizwai Tags: Newsdesk Source Type: research

[Newsdesk] Known unknowns and unknown unknowns
WHO's latest list of priority infections includes Disease X, an unknown illness. But how do we prepare for such a disease? Talha Burki reports. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Talha Burki Tags: Newsdesk Source Type: research

[Newsdesk] New clinical recommendations for Clostridium difficile
Updated US guidelines for Clostridium difficile infection change approaches to diagnosis, alter first-line treatment, and introduce faecal microbiota transplantation. Ammara Mushtaq reports. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Ammara Mushtaq Tags: Newsdesk Source Type: research

[Correspondence] Reassessing the 1  + 1 pneumococcal conjugate vaccine schedule – Authors' reply
Stephanie Perniciaro and Mark Van der Linden, and Raul Isturiz and colleagues, are concerned that the post-booster endpoint in our 1  + 1 pneumococcal conjugate vaccine (PCV) 13 immunogenicity study1 is a poor indicator of direct protection during the first year of life. We agree, but the rationale for a 1 + 1 vaccine schedule is the maintenance of indirect protection through herd immunity, generated by sustained high cov erage in the UK, first with PCV7 then with PCV13. Only 23 cases of PCV13-type invasive pneumococcal disease were identified in infants aged 2 years and younger in England and Wales in 2016–1...
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: David Goldblatt, Elizabeth Miller Tags: Correspondence Source Type: research

[Correspondence] Reassessing the 1  + 1 pneumococcal conjugate vaccine schedule
Pneumococcal conjugate vaccines (PCVs) are approved and given to populations on the basis of large immunogenicity and safety databases after meeting strict prespecified immunological non-inferiority criteria in appropriately powered clinical studies. David Goldblatt and colleagues1 describe the response to a single dose of PCV in the first year of life followed by a booster in the second year (1  + 1 schedule), and compare this to the standard 2 + 1 schedule. Based on previous experience in the clinical setting, the results were not surprising. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Raul Isturiz, Bradford D Gessner, Harish Madhava, Peter Paradiso, Luis Jodar Tags: Correspondence Source Type: research

[Correspondence] Reassessing the 1  + 1 pneumococcal conjugate vaccine schedule
The primary endpoint selected by David Goldblatt and colleagues,1 which was used to support a pneumococcal conjugate vaccine (PCV) programme consisting of one primary dose and one booster dose (1  + 1), is a poor indicator of protection during the first year of life, and contrary to O'Brien's Comment,2 this programme is not likely to be feasible for implementation in countries supported by Gavi, the Vaccine Alliance. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Stephanie Perniciaro, Mark van der Linden Tags: Correspondence Source Type: research

[Correspondence] Extended infusion —putting the benefit into context
In their meta-analysis, Konstantinos Vardakas and colleagues found a significant decrease in all-cause mortality, the most challenging clinical endpoint, by using prolonged rather than short-term infusion for antipseudomonal β-lactams.1 On the basis of mortality in both groups (159 [19·8%] of 805 events with short-term infusion vs 108 [13·6%] of 792 events with prolonged infusion), we can calculate an absolute risk reduction of 6·1% and a number needed to treat of 16·4. This estimate implies that we have to use ext ended infusions in the described setting in approximately 17 patients to sav...
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Markus Zeitlinger Tags: Correspondence Source Type: research

[Correspondence] The fourth HIV epidemic
In The Lancet Infectious Diseases, Ravindra Gupta and colleagues1 present alarming results on the development of pre-treatment viral resistance to the most commonly used drugs to treat HIV infection in resource-limited countries. These findings complete the bleak picture of antiretroviral (ARV) treatment failure that is gradually emerging in these countries. An increase in virological failure rates among adults has been reported in Africa, ranging from 5% to 31% after 12 months and up to 38% beyond 48 months of treatment. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Gabri èle Laborde-Balen, Bernard Taverne, Cheikh Tidiane Ndour, Charles Kouanfack, Martine Peeters, Ibra Ndoye, Eric Delaporte Tags: Correspondence Source Type: research

[Correspondence] Hepatitis C virus treatment as prevention in people who inject drugs
Alexei Zelenev and colleagues presented an elegant analysis of treatment-as-prevention (TasP) for hepatitis C virus (HCV) infection in people who inject drugs (PWID),1 using a model capturing the dynamics of the injecting-partnership network, which is superior to the more common approaches of compartmental modelling (omitting network structure) and static network modelling (omitting changes in partnerships over time). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Peter J White, Ibrahim Abubakar Tags: Correspondence Source Type: research

[Correspondence] Post-exposure prophylaxis in Ebola virus disease: don't forget the psychological factors
In their Article on post-exposure prophylaxis in Ebola virus disease, William Fischer and colleagues1 exhaustively reviewed the medical countermeasures that could be used after accidental exposure, and their indications according to the risk of transmission. On the basis of our experience of 77 accidental exposures in the health-care workers' treatment centre in Conakry, Guinea,2 we would like to highlight the importance of psychological and psychiatric factors in the management of accidental exposures in Ebola treatment centres. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: H élène Savini, Cécile Ficko, Fabrice Simon Tags: Correspondence Source Type: research

[Correspondence] Tuberculosis on Lesvos: barriers to treatment
We read with interest the molecular epidemiological study by Timothy Walker and colleagues,1 as well as the accompanying Comment by Masoud Dara and Rony Zachariah.2 As health workers on the Greek island of Lesvos, we have encountered inadequate screening and diagnostic methods and denial of tuberculosis treatment to clinically diagnosed patients. Of particular concern are two Congolese asylum seekers in our care: one had a confirmed diagnosis of tuberculosis in his home country by sputum smear and received appropriate therapy for a month before fleeing to Europe; and the other developed symptoms en route and was diagnosed ...
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Jacob Clary, Richard Dean Tags: Correspondence Source Type: research

[Correspondence] EUSeqMyTB to set standards and build capacity for whole genome sequencing for tuberculosis in the EU
In The Lancet Infectious Diseases, Timothy Walker and colleagues1 reported on the use of whole-genome sequencing (WGS) for the investigation of a cross-border outbreak of multidrug-resistant tuberculosis among migrants.1 The results showed how WGS can be applied in cross-border cluster investigations and the authors concluded that it needs to be integrated as a routine component of outbreak response efforts. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Elisa Tagliani, Daniela Maria Cirillo, Csaba K ödmön, Marieke J van der Werf, EUSeqMyTB Consortium Tags: Correspondence Source Type: research

[Comment] Impact of enhanced viral haemorrhagic fever surveillance on outbreak detection and response in Uganda
The recent outbreak of Marburg virus disease in Kween District, eastern Uganda, reported in The Lancet Infectious Diseases,1 marks the 13th independent viral haemorrhagic fever outbreak identified and confirmed via laboratory test by the Uganda Virus Research Institute (UVRI)'s viral haemorrhagic fever surveillance and laboratory programme since 2010. This Marburg virus disease outbreak was followed closely by three independent confirmations of human Rift Valley fever virus infection in three districts in central Uganda, and now brings the total viral haemorrhagic fever outbreak detections to 16. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Trevor R Shoemaker, Stephen Balinandi, Alex Tumusiime, Luke Nyakarahuka, Julius Lutwama, Edward Mbidde, Aaron Kofman, John D Klena, Ute Str öher, Pierre E Rollin, Stuart T Nichol Tags: Comment Source Type: research

[Comment] Pigs, pathogens, and public health
On Nov 8, 2017, Presidents Donald Trump and Xi Jinping announced a US$8 billion trade agreement, part of which will further increase US pork and animal feed exports to China. Given this expansion of global pork trade, now seems an appropriate time to consider emerging pathogen threats that accompany modern pork production, particularly in China. China has been implicated as the site of origin of the 1957 and 1968 influenza pandemics1 and is thought to be an epicentre for future novel influenza virus emergence. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Gregory C Gray, James A Merchant Tags: Comment Source Type: research

[Editorial] Lassa fever and global health security
Seeing the terms “viral haemorrhagic fever” and “west Africa” together will conjure grave images for our readers. The 2013–16 Ebola virus disease epidemic was an unprecedented event, not only in terms of illness and death but also for showing the frailties of international preparedness for infectious disea se outbreaks. Nigeria is in the midst of its largest ever outbreak of Lassa fever. At the same time, a mooted 80% cut to the US CDC's Global Health Security Agenda threatens to create a vacuum in essential epidemic mitigation activities. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: The Lancet Infectious Diseases Tags: Editorial Source Type: research

[Media Watch] Deadly delays and disparities
The HIV/AIDS epidemic changed our world. WHO estimates that 35 million people have died since it began in 1981, and another 36 ·7 million still live with the disease. We see its impact, too, in our response to it. An entirely new field—global health—emerged. The US Food and Drug Administration created a provisional accelerated approval pathway for potentially life-saving drugs to enter the market with preliminary evide nce of efficacy. And societally, explicit and implicit tolerance of homophobia has rightly declined, although much work still needs to be done. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Authors: Mohsin Ali Tags: Media Watch Source Type: research

[Corrections] Corrections
Discussion, the sentence ‘whereas in the UK only two doses and a booster dose are recommended for all infants and children after age 5 months. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 22, 2018 Category: Infectious Diseases Tags: Corrections Source Type: research

[Corrections] Corrections
Okokhere P, Colubri A, Azubike C, et al. Clinical and laboratory predictors of Lassa fever outcome in a dedicated treatment facility in Nigeria: a retrospective, observational cohort study. Lancet Infect Dis 2018; published online March 6. http://dx.doi.org/10.1016/S1473-3099(18)30121-X —In this Article, in the eleventh paragraph of the Results, the sentence beginning on the ninth line should have read “This difference in case-fatality rate is considerably smaller than that for creatinine (25% vs 62%)”. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 16, 2018 Category: Infectious Diseases Tags: Corrections Source Type: research

[Articles] Sustained transmission of high-level azithromycin-resistant Neisseria gonorrhoeae in England: an observational study
Sustained transmission of a successful HL-AziR clone was seen across England. Mutation 2059A →G was found in isolates with lower azithromycin MICs. Azithromycin exposure might have provided the selection pressure for one or two mutated copies of the 23S rRNA gene to recombine with wild-type copies, leading to three or four mutated copies and the HL-AziR phenotype. HL-AziR could emerge in isolates with low azithromycin MICs and eliminate the effectiveness of azithromycin as part of dual therapy for the treatment of gonorrhoea. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 6, 2018 Category: Infectious Diseases Authors: Helen Fifer, Michelle Cole, Gwenda Hughes, Simon Padfield, Christa Smolarchuk, Neil Woodford, Adrian Wensley, Nazim Mustafa, Ulf Schaefer, Richard Myers, Kate Templeton, Jill Shepherd, Anthony Underwood Tags: Articles Source Type: research

[Comment] Dual antimicrobial therapy for gonorrhoea: what is the role of azithromycin?
Antimicrobial resistance in Neisseria gonorrhoeae compromises the treatment of gonorrhoea globally.1,2 After the reports of the first gonococcal strains with high-level resistance to ceftriaxone, the last remaining option for empirical gonorrhoea monotherapy, dual antimicrobial therapy (mainly ceftriaxone plus azithromycin) was implemented as the first-line treatment for uncomplicated gonorrhoea in many countries.2 –7 Azithromycin resistance is described in many countries, which might threaten this dual therapy in the longer term. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 6, 2018 Category: Infectious Diseases Authors: Magnus Unemo, Kimberly Workowski Tags: Comment Source Type: research

[Articles] A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before –after, cohort study
Implementation of our intervention is feasible in African hospitals. Improvement was observed across all perioperative prevention practices. A significant effect on the overall SSI risk was observed, but with some heterogeneity between sites. Further large-scale experimental studies are needed to confirm these results and to improve the sustainability and long-term effect of such complex programmes. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 5, 2018 Category: Infectious Diseases Authors: Benedetta Allegranzi, Alexander M Aiken, Nejla Zeynep Kubilay, Peter Nthumba, Jack Barasa, Gabriel Okumu, Robert Mugarura, Alexander Elobu, Josephat Jombwe, Mayaba Maimbo, Joseph Musowoya, Ang èle Gayet-Ageron, Sean M Berenholtz Tags: Articles Source Type: research

[Comment] Cold steel might cure, but it takes a village to prevent surgical infections
Surgical infections are the most common cause of hospital-acquired infections in resource-poor settings;1 a prospective study in sub-Saharan Africa, published in 2018, reported an infection rate of one in ten surgical patients.2 Infections can double the length of hospital stay, and lead to financially devastating costs for patients, facilities, and health systems.3,4 Patients who develop infections also have a much higher risk of death than those who do not. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 5, 2018 Category: Infectious Diseases Authors: Kathryn Chu, Thomas G Weiser Tags: Comment Source Type: research

[Corrections] Corrections
T ängdén T, Pulcini C, Aagaard H, et al. Unavailability of old antibiotics threatens effective treatment for common bacterial infections. Lancet Infect Dis 2018; 18: 242–44—In the author byline of this Comment on page 243, the third coauthor's name was misspelt and should read “Helle Aagaard” . This correction has been made to the online version as of Feb 28, 2018. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 28, 2018 Category: Infectious Diseases Tags: Corrections Source Type: research

[Clinical Picture] Advanced Kaposi's sarcoma in a 2-year-old child
A 2-year-old boy with HIV infection receiving combination antiretroviral therapy (cART) for 2 months presented with a 3-month history of high-grade fever, diarrhoea, and progressive generalised lymphadenopathy (figure). Laboratory results showed severe pancytopenia (haemoglobin, 3 ·3 g/dL; neutrophil count, 0·48 cells per nL; platelets, 6 cells per nL), moderately decreased CD4 cell count (900 cells per μL [normal range>1000 cells per μL]), and low HIV-1 RNA plasma viral load (346 copies per mL). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Cornelia Feiterna-Sperling, Ioannis Anagnostopoulos, J örg Hofmann, Renate Krüger Tags: Clinical Picture Source Type: research