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COV-BOOST trial data show value of fourth dose

Administering a fourth dose of an mRNA COVID-19 vaccine provides a stronger level of protection than a third
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Administering a fourth dose of an mRNA COVID-19 vaccine provides a stronger level of protection than a third dose, particularly in the over-70s, according to the latest readout from the UK COV-BOOST trial.

The trial showed that a second booster with the mRNA shots developed by Moderna and Pfizer/BioNTech given around seven months after the first booster is safe, and generates strong antibody and T-cell responses.

Experts say however it is likely that the protection is likely to wane quickly, as seen in other studies of the vaccines, and with levels of COVID-19 in decline among the population of many countries including the UK the need for a further booster round in the autumn remains uncertain.

The UK rolled out fourth doses to over-75s and other vulnerable people last month, but there’s no decision yet on whether the programme may be offered more broadly.

Israel and Germany meanwhile are among a group of other countries that have opted for a broad rollout of another booster to all adults, but the European Commission said last month there is not yet enough evidence to warrant widespread use.

A green light for second boosters could be pivotal if Pfizer/BioNTech and Moderna are to meet their expectations for sales of the two mRNA-based shots in 2022.

The latest COV-BOOST findings are published in the Lancet Infectious Diseases journal, and according to the authors are the first data from a randomised trial of a second booster of Pfizer/BioNTech’s Comirnaty and Moderna’s SpikeVax vaccines.

The authors said “peak responses after the fourth dose were similar to, and possibly better than, peak responses after the third dose.”

They went on: “Our results for immunogenicity are also consistent with the little observational evidence on vaccine effectiveness available from Israel, which indicates increased protection against symptomatic infection and severe illness from a fourth-dose booster.”

The majority of people in the UK received their third vaccine last winter, in response to the rapid emergence of the Omicron variant of SARS-CoV-2.

Health secretary Sajid Javid said the study provides “further evidence underlining the importance of people coming forward for their booster as soon as they are eligible.”

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Shedding light on reptilian health: Researchers investigate origins of snake fungal disease in U.S.

Although only recently recognized as an issue in wildlife ecology, snake fungal disease (SFD) is of emerging concern in the U.S., with parallels among…

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Although only recently recognized as an issue in wildlife ecology, snake fungal disease (SFD) is of emerging concern in the U.S., with parallels among other better-known wildlife fungal diseases such as white-nose syndrome in bats. SFD can be deadly to snakes, and even in milder cases disrupts an animal’s abilities to perform normal biological functions such as hibernation, eating and avoiding predators.

Credit: Northern Arizona University

Although only recently recognized as an issue in wildlife ecology, snake fungal disease (SFD) is of emerging concern in the U.S., with parallels among other better-known wildlife fungal diseases such as white-nose syndrome in bats. SFD can be deadly to snakes, and even in milder cases disrupts an animal’s abilities to perform normal biological functions such as hibernation, eating and avoiding predators.

To better understand SFD, a team of researchers, including assistant professor Jason Ladner of Northern Arizona University’s Pathogen and Microbiome Institute, conducted a genetic study of the pathogen that was recently published in PLOS Biology, “The population genetics of the causative agent of snake fungal disease indicate recent introductions to the USA.”

Collaborating with study co-author Jeff Lorch of the U.S. Geological Survey (USGS) and other scientists from the USGS, Genencor Technology Center, the University of California-Riverside, Stetson University, the Institute of Zoology, the University of Kentucky and Holyoke Community College, Ladner’s goal was to determine whether SFD originated in the U.S. or was introduced from outside the country, which could provide a historical basis for how it emerged—and ultimately inform management of the disease. 

“Snake fungal disease first came to be recognized in the U.S. around 2008. There happened to be a well-studied population of rattlesnakes in Illinois that started coming down with some very severe fungal infections. People asked, ‘OK, what is this thing? Where is it? What’s going on? Is this a new emerging fungal pathogen or not?’ What they eventually found was that it was already almost everywhere, at least in the eastern half of the U.S.,” Ladner said. 

SFD, though seemingly not as deadly as other wildlife fungal diseases, is still a worrying threat to animals that represent an important part of the ecosystem. “We’re very concerned, not just about SFD’s effect to drive population declines, but also as a contributing factor amongst many other threats that snakes are already facing, like habitat destruction or over-collection for the pet trade,” Lorch said. 

Understanding wildlife diseases is critical, both in the context of ecosystem health and in their potential effects on humans. “I have a lot of interest in wildlife diseases, partially because wildlife serves as important reservoirs for diseases that could potentially emerge in humans; SARS-coronavirus-2 is a great example of that. If we want to be prepared for the next emerging infectious disease in humans, we need to better understand the pathogens currently circulating in wildlife populations which may have the potential to be transmitted to humans,” Ladner said. 

The study presented unique difficulties, however. “For snakes, there’s almost no long-term population trend data, especially when we compare snakes to an animal like bats, which have suffered from white-nose syndrome,” Lorch said. “In many states, historical data on bat populations exists because they’re not generally as difficult to monitor as some other types of wildlife.”

Snakes, in contrast, “are pretty secretive animals. They’re not something that you probably see on the landscape routinely, unless you’re looking for them,” Lorch explains. Without a large body of historical data on North American snake populations, “it makes it hard to say what snake populations were doing before SFD was noticed. Long-term trends are really difficult to decipher.”

Prior to beginning research, the team had two hypotheses on how the disease originated in the U.S. “One hypothesis was that the fungus that causes this disease may have been introduced only recently into the U.S. and then has been spreading within the past several decades, maybe 100 years. The alternative hypothesis was that this pathogen has been here for a long time and is essentially native to the U.S.; maybe it’s been here for thousands of years and has been co-evolving with these snake populations. In the latter case, maybe it seems to be emerging simply because we’re looking for it now. Or there’s been some type of environmental change, maybe something linked to climate change, that is leading to an increase in the number of cases even though this pathogen has been here all along,” Ladner said.

In order to track the disease’s evolution, Ladner and Lorch created a “family tree” for strains of the fungus that causes SFD found in the U.S. “One of the ways we could reconstruct the history of the disease was to look at the genetics of the pathogen to get an idea of how long it’s been here and how it’s changed over time,” Lorch said. 

Studying the genetics of SFD provided the team with a trail of breadcrumbs, revealing more about its history and throwing light on SFD cases in the U.S. “The reason that genomic data is useful for doing this is because each time this fungus replicates, grows and divides, the polymerase (the molecule that makes the new copy) sometimes makes mistakes. Those mistakes result in mutations. And then those mutations will be passed on through the generations. By looking at those different mutations in the population, we can understand how long certain lineages have existed and have some idea of how the different strains are related to each other. And that can tell us something about how long SFD has been here,” Ladner said. 

After taking samples from different SFD-affected snakes, the team performed genetic sequencing on 82 strains of the fungus. This included strains of SFD isolated from wild snakes in the U.S. and Europe, as well as captive snakes from three different continents. Based on the genetic similarities and differences among the strains, the team was able to partially reconstruct the evolutionary history of this fungus. “In the U.S., we found that there are several divergent lineages of this fungus circulating, but a lack of intermediates between these lineages, which would be expected if they originated in the U.S. Because of that, we think that there were likely multiple, somewhat recent introductions of this fungus to the U.S., and that an unsampled population, somewhere else in the world, acted as a source,” Ladner said.

This evidence allowed the team to form conclusions on how SFD arrived in America. “It suggests that this fungus was introduced to the United States through anthropogenic means—humans moving these snakes around. The most likely culprit is the trading of captive snakes as pets: the different clonal lineages that we see in the U.S., we also see represented in captive snake populations,” Ladner said. 

The study provides guidance for future management of SFD in the U.S., as well as a better understanding of how it was introduced. “If we had caught SFD being introduced very early on, then you can imagine trying to stop the spread of the disease in the U.S. and potentially even eradicate it. I think that’s unlikely at this point, given how widespread it is. However, I think it’s still helpful to better understand the mechanism for how SFD was introduced, as there’s still the potential for new introductions of diverse strains from these source populations. If we know that this fungus was introduced several times over the past several decades through the captive animal trade, then putting more restrictions and controls and testing animals in that process could be important for preventing further spread,” Ladner said. 

Though their work provides critical insight on SFD, its treatment and movement in the U.S., both scientists stress the need for further research. “What I’m hoping is that this study increases awareness of the disease. I think SFD warrants more of our attention,” Lorch said. 

More work needs to be done to assess the ecosystem, population and species effects of SFD. “The broader question of, ‘what is going to be the impact of this fungal pathogen on these snake populations?’ is a very open question and needs more research,” Ladner said.

About Northern Arizona University

Founded in 1899, Northern Arizona University is a higher-research institution providing exceptional educational opportunities and outcomes in Arizona and beyond. NAU delivers a student-centered experience to its nearly 30,000 students in Flagstaff, statewide and online through rigorous academic programs in a supportive, inclusive and diverse environment. As a community-engaged engine of opportunity, NAU powers social impact and economic mobility for the students and communities it serves. The university’s longstanding history of educating and partnering with diverse students and communities throughout Arizona is enhanced by its recent designation as a Hispanic-Serving Institution (HSI). Dedicated, world-renowned faculty and staff help ensure students achieve academic excellence, experience personal growth, have meaningful research and experiential learning opportunities and are positioned for personal and professional success. Located on the Colorado Plateau, in one of the highest-ranked college towns in the country, the NAU Flagstaff Mountain Campus is truly a jewel of the Southwest.

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China Suggests It Could Maintain ‘Zero COVID’ Policy For 5 Years

China Suggests It Could Maintain ‘Zero COVID’ Policy For 5 Years

Authored by Paul Joseph Watson via Summit News,

China has suggested it will…

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China Suggests It Could Maintain 'Zero COVID' Policy For 5 Years

Authored by Paul Joseph Watson via Summit News,

China has suggested it will maintain its controversial ‘zero COVID’ policy for at least 5 years, eschewing natural immunity and guaranteeing repeated rounds of new lockdowns.

“In the next five years, Beijing will unremittingly grasp the normalization of epidemic prevention and control,” said a story published by Beijing Daily.

The article quoted Cai Qi, the Communist Party of China’s secretary in Beijing and a former mayor of the city, who said that ‘zero COVID’ approach would remain in place for 5 years.

After the story prompted alarm, reference to “five years” was removed from the piece and the hashtag related to it was censored by social media giant Weibo.

“Monday’s announcement and the subsequent amendment sparked anger and confusion among Beijing residents online,” reports the Guardian.

“Most commenters appeared unsurprised at the prospect of the system continuing for another half-decade, but few were supportive of the idea.”

Although western experts severely doubt official numbers coming out of China, Beijing claimed success in limiting COVID deaths by enforcing the policy throughout 2021.

However, this meant that China never achieved anything like herd immunity, and at one stage the Omicron variant caused more more coronavirus cases in Shanghai in four weeks than in the previous two years of the entire pandemic.

Back in May, World Health Organization Director General Tedros Adhanom Ghebreyesus suggested that China would be better off if it abandoned the policy, but Beijing refused to budge.

As we previously highlighted, the only way of enforcing a ‘zero COVID’ policy is via brutal authoritarianism.

In Shanghai, children were separated from their parents in quarantine facilities and others were left without urgent treatment like kidney dialysis.

Panic buying of food also became a common occurrence as the anger threatened to spill over into widespread civil unrest.

Former UK government COVID-19 advisor Neil Ferguson previously admitted that he thought “we couldn’t get away with” imposing Communist Chinese-style lockdowns in Europe because they were too draconian, and yet it happened anyway.

“It’s a communist one party state, we said. We couldn’t get away with it in Europe, we thought,” said Ferguson.

“And then Italy did it. And we realised we could,” he added.

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University of Cincinnati enrolling patients for PTSD clinical trials

About 8% of Americans will experience post-traumatic stress disorder at some point in their lives, but there are still few effective options to treat the…

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About 8% of Americans will experience post-traumatic stress disorder at some point in their lives, but there are still few effective options to treat the condition.

Credit: Photo/University of Cincinnati

About 8% of Americans will experience post-traumatic stress disorder at some point in their lives, but there are still few effective options to treat the condition.

“There are some medical treatments for PTSD and psychotherapies for PTSD, but patients continue to suffer with symptoms that aren’t responsive to the currently available treatments,” said Lesley Arnold, MD.

June is PTSD Awareness Month, and the University of Cincinnati is currently enrolling patients for clinical trials examining the effectiveness of different medications to better treat PTSD symptoms.

The basics

Arnold said PTSD is a common and often chronic disorder that develops after a traumatic event that is either personally experienced or witnessed by a person.

“People with PTSD often re-experience aspects of the original trauma and can develop symptoms such as avoidance of trauma reminders, negative thoughts and feelings and increased alertness to their surroundings,” said Arnold, director of the Women’s Health Research Program and professor in the Department of Psychiatry and Behavioral Neuroscience in the UC College of Medicine.

Most people who are exposed to a trauma will have an acute stress response in the moment, Arnold said, but about 30% of those who experience a trauma develop PTSD. Symptoms can last for months or years and also include disrupted sleep or nightmares, issues with memory or focus and depression and anxiety. 

In people who are at higher risk for exposure to trauma, such as war veterans, PTSD occurs in even higher proportions, Arnold said. The COVID-19 pandemic has also exacerbated symptoms of PTSD for some individuals.

“It led to some isolation and made it difficult for individuals to seek treatment or to continue to engage in treatment,” Arnold said. 

New trials

Arnold and her team are focused on testing medication-based treatments that could help alleviate the symptoms of PTSD that have not responded to currently available medications, including sleeplessness and nightmares among others.

“The problem that we have is that there are two FDA medications approved for the treatment of PTSD, but these medications aren’t effective for everybody, and they take a long time to work,” Arnold said. 

Each of the clinical trials will test different novel drugs that take new approaches to treat unregulated neurotransmitters in the brain that are involved in PTSD. The randomized trials will measure the effectiveness of the medications compared to a placebo control group.

“We are in urgent need of treatments for PTSD,” Arnold said. “That’s why these trials are so important because they offer a novel approach that we hope to be effective in helping patients overcome the problems associated with PTSD and return to full function.”

Adults, both women and men, over the age of 18 with PTSD are eligible to participate in the trials, with patients with a variety of different trauma experiences being recruited. The trials will involve about three months of participation from patients.

“We’re asking for volunteers to help us with our trials, those individuals who continue to have symptoms of PTSD,” Arnold said. “We are conducting these trials actively, and I would encourage individuals to come forward to help.”

Arnold said there has been an increased interest in finding drug treatments for PTSD in about the last five years.

“This is an exciting time and a hopeful time for people with PTSD because we are actively seeking out better treatments,” she said. “There’s been a growing interest and a recognition of the unmet need in this population, so I’m really gratified to be able to have these trials going on now and to be able to offer some hope to individuals with PTSD.”

For more information on the PTSD trials at UC, call 513-558-6612.


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