1
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Monge S, Humphreys J, Nicolay N, Braeye T, Van Evercooren I, Holm Hansen C, Emborg H, Sacco C, Mateo‐Urdiales A, Castilla J, Martínez‐Baz I, de Gier B, Hahné S, Meijerink H, Kristoffersen A, Machado A, Soares P, Nardone A, Bacci S, Kissling E, Nunes B. Effectiveness of XBB.1.5 Monovalent COVID-19 Vaccines During a Period of XBB.1.5 Dominance in EU/EEA Countries, October to November 2023: A VEBIS-EHR Network Study. Influenza Other Respir Viruses 2024; 18:e13292. [PMID: 38654485 PMCID: PMC11040092 DOI: 10.1111/irv.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
Using a common protocol across seven countries in the European Union/European Economic Area, we estimated XBB.1.5 monovalent vaccine effectiveness (VE) against COVID-19 hospitalisation and death in booster-eligible ≥ 65-year-olds, during October-November 2023. We linked electronic records to construct retrospective cohorts and used Cox models to estimate adjusted hazard ratios and derive VE. VE for COVID-19 hospitalisation and death was, respectively, 67% (95%CI: 58-74) and 67% (95%CI: 42-81) in 65- to 79-year-olds and 66% (95%CI: 57-73) and 72% (95%CI: 51-85) in ≥ 80-year-olds. Results indicate that periodic vaccination of individuals ≥ 65 years has an ongoing benefit and support current vaccination strategies in the EU/EEA.
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Affiliation(s)
- Susana Monge
- Department of Communicable Diseases, National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
- CIBER on Infectious DiseasesMadridSpain
| | | | - Nathalie Nicolay
- Vaccine Preventable Diseases and ImmunisationEuropean Centre for Disease Prevention and Control (ECDC)SolnaSweden
| | | | | | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology and PreventionStatens Serum InstitutCopenhagenDenmark
| | - Hanne‐Dorthe Emborg
- Department of Infectious Disease Epidemiology and PreventionStatens Serum InstitutCopenhagenDenmark
| | - Chiara Sacco
- Infectious Diseases DepartmentIstituto Superiore di SanitàRomeItaly
- European Programme on Intervention Epidemiology Training (EPIET)European Centre for Disease Prevention and ControlStockholmSweden
| | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra – IdiSNAPamplonaSpain
- CIBER on Epidemiology and Public HealthMadridSpain
| | - Iván Martínez‐Baz
- Instituto de Salud Pública de Navarra – IdiSNAPamplonaSpain
- CIBER on Epidemiology and Public HealthMadridSpain
| | - Brechje de Gier
- Center for Infectious Disease ControlNational Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - Susan Hahné
- Center for Infectious Disease ControlNational Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | | | | | - Ausenda Machado
- Departamento de EpidemiologiaInstituto Nacional de Saúde Doutor Ricardo JorgeLisboaPortugal
| | - Patricia Soares
- Departamento de EpidemiologiaInstituto Nacional de Saúde Doutor Ricardo JorgeLisboaPortugal
| | | | - Sabrina Bacci
- Vaccine Preventable Diseases and ImmunisationEuropean Centre for Disease Prevention and Control (ECDC)SolnaSweden
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2
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Huiberts AJ, Hoeve CE, de Gier B, Cremer J, van der Veer B, de Melker HE, van de Wijgert JH, van den Hof S, Eggink D, Knol MJ. Effectiveness of Omicron XBB.1.5 vaccine against infection with SARS-CoV-2 Omicron XBB and JN.1 variants, prospective cohort study, the Netherlands, October 2023 to January 2024. Euro Surveill 2024; 29:2400109. [PMID: 38456217 PMCID: PMC10986669 DOI: 10.2807/1560-7917.es.2024.29.10.2400109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
We estimated vaccine effectiveness (VE) of SARS-CoV-2 Omicron XBB.1.5 vaccination against self-reported infection between 9 October 2023 and 9 January 2024 in 23,895 XBB.1.5 vaccine-eligible adults who had previously received at least one booster. VE was 41% (95% CI: 23-55) in 18-59-year-olds and 50% (95% CI: 44-56) in 60-85-year-olds. Sequencing data suggest lower protection against the BA.2.86 (including JN.1) variant from recent prior infection (OR = 2.8; 95% CI:1.2-6.5) and, not statistically significant, from XBB.1.5 vaccination (OR = 1.5; 95% CI:0.8-2.6).
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Affiliation(s)
- Anne J Huiberts
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Christina E Hoeve
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Jeroen Cremer
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Bas van der Veer
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Janneke Hhm van de Wijgert
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Dirk Eggink
- These authors contributed equally to this article and share last authorship
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- These authors contributed equally to this article and share last authorship
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
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3
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van Werkhoven CH, Valk AW, Smagge B, de Melker HE, Knol MJ, Hahné SJ, van den Hof S, de Gier B. Early COVID-19 vaccine effectiveness of XBB.1.5 vaccine against hospitalisation and admission to intensive care, the Netherlands, 9 October to 5 December 2023. Euro Surveill 2024; 29:2300703. [PMID: 38179623 PMCID: PMC10905658 DOI: 10.2807/1560-7917.es.2024.29.1.2300703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/06/2024] Open
Abstract
We present early vaccine effectiveness (VE) estimates of the 2023 seasonal COVID-19 XBB.1.5 vaccine against COVID-19 hospitalisation and admission to an intensive care unit (ICU) in previously vaccinated adults ≥ 60 years in the Netherlands. We compared vaccination status of 2,050 hospitalisations including 92 ICU admissions with age group-, sex-, region- and date-specific population vaccination coverage between 9 October and 5 December 2023. VE against hospitalisation was 70.7% (95% CI: 66.6-74.3), VE against ICU admission was 73.3% (95% CI: 42.2-87.6).
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Affiliation(s)
- C Henri van Werkhoven
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anne-Wil Valk
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Bente Smagge
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Susan Jm Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Susan van den Hof
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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4
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Fontán-Vela M, Kissling E, Nicolay N, Braeye T, Van Evercooren I, Holm Hansen C, Emborg HD, Fabiani M, Mateo-Urdiales A, AlKerwi A, Schmitz S, Castilla J, Martínez-Baz I, de Gier B, Hahné S, Meijerink H, Starrfelt J, Nunes B, Caetano C, Derrough T, Nardone A, Monge S. Relative vaccine effectiveness against COVID-19 hospitalisation in persons aged ≥ 65 years: results from a VEBIS network, Europe, October 2021 to July 2023. Euro Surveill 2024; 29:2300670. [PMID: 38179626 PMCID: PMC10905661 DOI: 10.2807/1560-7917.es.2024.29.1.2300670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024] Open
Abstract
To monitor relative vaccine effectiveness (rVE) against COVID-19-related hospitalisation of the first, second and third COVID-19 booster (vs complete primary vaccination), we performed monthly Cox regression models using retrospective cohorts constructed from electronic health registries in eight European countries, October 2021-July 2023. Within 12 weeks of administration, each booster showed high rVE (≥ 70% for second and third boosters). However, as of July 2023, most of the relative benefit has waned, particularly in persons ≥ 80-years-old, while some protection remained in 65-79-year-olds.
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Affiliation(s)
- Mario Fontán-Vela
- National Centre of Epidemiology, Carlos III National Health Institute (ISCIII), Madrid, Spain
- Public Health and Epidemiology research group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | | | - Nathalie Nicolay
- Vaccine Preventable Diseases and Immunisation, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | | | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut (SSI), Copenhagen, Denmark
| | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut (SSI), Copenhagen, Denmark
| | - Massimo Fabiani
- Infectious Diseases Department, Istituto Superiore di Sanità, Rome, Italy
| | | | - Ala'a AlKerwi
- Ministry of Health, Directorate of Health, Service epidemiology and statistics, Luxembourg
| | - Susanne Schmitz
- Ministry of Health, Directorate of Health, Service epidemiology and statistics, Luxembourg
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Iván Martínez-Baz
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Susan Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Departamento de Epidemiologia, Lisboa, Portugal
| | - Constantino Caetano
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Departamento de Epidemiologia, Lisboa, Portugal
| | - Tarik Derrough
- Vaccine Preventable Diseases and Immunisation, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Susana Monge
- National Centre of Epidemiology, Carlos III National Health Institute (ISCIII), Madrid, Spain
- CIBER on Infectious Diseases (CIBERINFEC), Madrid, Spain
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5
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Hoeve CE, de Gier B, Huiberts AJ, de Melker HE, Hahné SJM, van den Hof S, Knol MJ. Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 Delta and Omicron Infection and Infectiousness Within Households in the Netherlands Between July 2021 and August 2022. J Infect Dis 2023; 228:431-438. [PMID: 37093964 PMCID: PMC10428192 DOI: 10.1093/infdis/jiad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/07/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND We aimed to estimate vaccine effectiveness against infection (VE-infection) and against further transmission (VE-infectiousness) in a household setting during Delta and Omicron. Knowing these effects can aid policy makers in deciding which groups to prioritize for vaccination. METHODS Participants with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test were asked about coronavirus disease 2019 (COVID-19) vaccination status and SARS-CoV-2 testing of their household members 1 month later. VE-infection and VE-infectiousness were estimated using generalized estimating equation logistic regression adjusting for age, vaccination status, calendar week, and household size. RESULTS A total of 3399 questionnaires concerning 4105 household members were included. During the Delta period, VE-infection and VE-infectiousness of primary series were 47% (95% confidence interval [CI], -27% to 78%) and 70% (95% CI, 28% to 87%), respectively. During the Omicron period, VE-infection was -36% (95% CI, -88% to 1%) for primary series and -28% (95% CI, -77% to 7%) for booster vaccination. VE-infectiousness was 45% (95% CI, -14% to 74%) for primary series and 64% (95% CI, 31% to 82%) for booster vaccination. CONCLUSIONS Our study shows that COVID-19 vaccination is effective against infection with SARS-CoV-2 Delta and against infectiousness of SARS-CoV-2 Delta and Omicron. Estimation of VE against infection with SARS-CoV-2 Omicron was limited by several factors. Our results support booster vaccination for those in close contact with vulnerable people to prevent transmission.
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Affiliation(s)
- Christina E Hoeve
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Anne J Huiberts
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan J M Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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6
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de Gier B, Huiberts AJ, Hoeve CE, den Hartog G, van Werkhoven H, van Binnendijk R, Hahné SJM, de Melker HE, van den Hof S, Knol MJ. Effects of COVID-19 vaccination and previous infection on Omicron SARS-CoV-2 infection and relation with serology. Nat Commun 2023; 14:4793. [PMID: 37558656 PMCID: PMC10412579 DOI: 10.1038/s41467-023-40195-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
An increasing proportion of the population has acquired immunity through COVID-19 vaccination and previous SARS-CoV-2 infection, i.e., hybrid immunity, possibly affecting the risk of new infection. We aim to estimate the protective effect of previous infections and vaccinations on SARS-CoV-2 Omicron infection, using data from 43,257 adult participants in a prospective community-based cohort study in the Netherlands, collected between 10 January 2022 and 1 September 2022. Our results show that, for participants with 2, 3 or 4 prior immunizing events (vaccination or previous infection), hybrid immunity is more protective against infection with SARS-CoV-2 Omicron than vaccine-induced immunity, up to at least 30 weeks after the last immunizing event. Differences in risk of infection are partly explained by differences in anti-Spike RBD (S) antibody concentration, which is associated with risk of infection in a dose-response manner. Among participants with hybrid immunity, with one previous pre-Omicron infection, we do not observe a relevant difference in risk of Omicron infection by sequence of vaccination(s) and infection. Additional immunizing events increase the protection against infection, but not above the level of the first weeks after the previous event.
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Affiliation(s)
- Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Anne J Huiberts
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Christina E Hoeve
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Gerco den Hartog
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Henri van Werkhoven
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Rob van Binnendijk
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan J M Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan van den Hof
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
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7
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de Gier B, van Asten L, Boere TM, van Roon A, van Roekel C, Pijpers J, van Werkhoven CHH, van den Ende C, Hahné SJM, de Melker HE, Knol MJ, van den Hof S. Effect of COVID-19 vaccination on mortality by COVID-19 and on mortality by other causes, the Netherlands, January 2021-January 2022. Vaccine 2023:S0264-410X(23)00660-6. [PMID: 37328352 PMCID: PMC10247887 DOI: 10.1016/j.vaccine.2023.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/25/2023] [Accepted: 06/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND We aimed to estimate vaccine effectiveness (VE) against COVID-19 mortality, and to explore whether an increased risk of non-COVID-19 mortality exists in the weeks following a COVID-19 vaccine dose. METHODS National registries of causes of death, COVID-19 vaccination, specialized health care and long-term care reimbursements were linked by a unique person identifier using data from 1 January 2021 to 31 January 2022. We used Cox regression with calendar time as underlying time scale to, firstly, estimate VE against COVID-19 mortality after primary and first booster vaccination, per month since vaccination and, secondly, estimate risk of non-COVID-19 mortality in the 5 or 8 weeks following a first, second or first booster dose, adjusting for birth year, sex, medical risk group and country of origin. RESULTS VE against COVID-19 mortality was > 90 % for all age groups two months after completion of the primary series. VE gradually decreased thereafter, to around 80 % at 7-8 months post-primary series for most groups, and around 60 % for elderly receiving a high level of long-term care and for people aged 90+ years. Following a first booster dose, the VE increased to > 85 % in all groups. The risk of non-COVID-19 mortality was lower or similar in the 5 or 8 weeks following a first dose compared to no vaccination, as well as following a second dose compared to one dose and a booster compared to two doses, for all age and long-term care groups. CONCLUSION At the population level, COVID-19 vaccination greatly reduced the risk of COVID-19 mortality and no increased risk of death from other causes was observed.
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Affiliation(s)
- Brechje de Gier
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Liselotte van Asten
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Tjarda M Boere
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Annika van Roon
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Caren van Roekel
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Joyce Pijpers
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - C H Henri van Werkhoven
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Caroline van den Ende
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Susan J M Hahné
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Hester E de Melker
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Mirjam J Knol
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Susan van den Hof
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
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8
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van der Putten BCL, Bril-Keijzers WCM, Rumke LW, Vestjens SMT, Koster LAM, Willemsen M, van Houten MA, Rots NY, Vlaminckx BJM, de Gier B, van Sorge NM. Novel emm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022. Microb Genom 2023; 9. [PMID: 37261428 DOI: 10.1099/mgen.0.001026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Invasive group A streptococcal (iGAS) disease cases increased in the first half of 2022 in the Netherlands, with a remarkably high proportion of emm4 isolates. Whole-genome sequence analysis of 66 emm4 isolates, 40 isolates from the pre-coronavirus disease 2019 (COVID-19) pandemic period 2009-2019 and 26 contemporary isolates from 2022, identified a novel Streptococcus pyogenes lineage (M4NL22), which accounted for 85 % of emm4 iGAS cases in 2022. Surprisingly, we detected few isolates of the emm4 hypervirulent clone, which has replaced nearly all other emm4 in the USA and the UK. M4NL22 displayed genetic differences compared to other emm4 strains, although these were of unclear biological significance. In publicly available data, we identified a single Norwegian isolate belonging to M4NL22, which was sampled after the isolates from this study, possibly suggesting export of M4NL22 to Norway. In conclusion, our study identified a novel S. pyogenes emm4 lineage underlying an increase of iGAS disease in early 2022 in the Netherlands and the results have been promptly communicated to public health officials.
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Affiliation(s)
- Boas C L van der Putten
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMCs location University of Amsterdam, Amsterdam, Netherlands
- Present address: National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Wendy C M Bril-Keijzers
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMCs location AMC, Amsterdam, Netherlands
| | | | | | - Linda A M Koster
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMCs location University of Amsterdam, Amsterdam, Netherlands
| | - Marloes Willemsen
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMCs location University of Amsterdam, Amsterdam, Netherlands
- Present address: Hartwig Medical Foundation, Amsterdam, Netherlands
| | | | - Nynke Y Rots
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Bart J M Vlaminckx
- Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, Netherlands
| | - Brechje de Gier
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Nina M van Sorge
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMCs location University of Amsterdam, Amsterdam, Netherlands
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMCs location AMC, Amsterdam, Netherlands
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9
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van der Putten BCL, Vlaminckx BJM, de Gier B, Freudenburg-de Graaf W, van Sorge NM. Group A Streptococcal Meningitis With the M1UK Variant in the Netherlands. JAMA 2023; 329:1791-1792. [PMID: 37027150 PMCID: PMC10082416 DOI: 10.1001/jama.2023.5927] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
This study reports an epidemiological assessment of laboratory-confirmed group A streptococcal meningitis cases in the Netherlands using more than 40 years of national bacteriological surveillance data.
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Affiliation(s)
- Boas C. L. van der Putten
- Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bart J. M. Vlaminckx
- Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Brechje de Gier
- Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Nina M. van Sorge
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMCs, Amsterdam, the Netherlands
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10
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van Iersel SCJL, McDonald SA, de Gier B, Knol MJ, de Melker HE, Henri van Werkhoven CH, Hahné SJM. Number of COVID-19 hospitalisations averted by vaccination: Estimates for the Netherlands, January 6, 2021 through August 30, 2022. Vaccine 2023:S0264-410X(23)00545-5. [PMID: 37202273 DOI: 10.1016/j.vaccine.2023.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Vaccines against COVID-19 have proven effective in preventing COVID-19 hospitalisation. In this study, we aimed to quantify part of the public health impact of COVID-19 vaccination by estimating the number of averted hospitalisations. We present results from the beginning of the vaccination campaign ('entire period', January 6, 2021) and a subperiod starting at August 2, 2021 ('subperiod') when all adults had the opportunity to complete their primary series, both until August 30, 2022. METHODS Using calendar-time specific vaccine effectiveness (VE) estimates and vaccine coverage (VC) by round (primary series, first booster and second booster) and the observed number of COVID-19 associated hospitalisations, we estimated the number of averted hospitalisations per age group for the two study periods. From January 25, 2022, when registration of the indication of hospitalisation started, hospitalisations not causally related to COVID-19 were excluded. RESULTS In the entire period, an estimated 98,170 (95 % confidence interval (CI) 96,123-99,928) hospitalisations were averted, of which 90,753 (95 % CI 88,790-92,531) were in the subperiod, representing 57.0 % and 67.9 % of all estimated hospital admissions. Estimated averted hospitalisations were lowest for 12-49-year-olds and highest for 70-79-year-olds. More admissions were averted in the Delta period (72.3 %) than in the Omicron period (63.4 %). CONCLUSION COVID-19 vaccination prevented a large number of hospitalisations. Although the counterfactual of having had no vaccinations while maintaining the same public health measures is unrealistic, these findings underline the public health importance of the vaccination campaign to policy makers and the public.
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Affiliation(s)
- Senna C J L van Iersel
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| | - Scott A McDonald
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C H Henri van Werkhoven
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Susan J M Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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11
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Huiberts AJ, de Gier B, Hoeve CE, de Melker HE, Hahné SJM, Hartog GD, Grobbee DE, van de Wijgert JHHM, den Hof SV, Knol MJ. Vaccine effectiveness of primary and booster COVID-19 vaccinations against SARS-CoV-2 infection in the Netherlands from 12 July 2021 to 6 June 2022: a prospective cohort study. Int J Infect Dis 2023; 133:36-42. [PMID: 37086863 PMCID: PMC10118053 DOI: 10.1016/j.ijid.2023.04.401] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 04/24/2023] Open
Abstract
INTRODUCTION We estimated VE of primary and booster vaccinations, against SARS-CoV-2 infection overall, and in four risk groups defined by age and medical risk condition, in the Delta and Omicron BA.1/BA.2 periods. METHODS VASCO is an ongoing prospective cohort study among Dutch adults. The primary endpoint was a self-reported positive SARS-CoV-2 test during 12 July 2021-6 June 2022. The analyses included only participants without a prior SARS-CoV-2 infection, based on a positive test or serology. We used Cox proportional hazard models with vaccination status as time-varying exposure and adjustment for age, sex, educational level, and medical risk condition. RESULTS 37,170 participants (mean age 57 years) were included. In the Delta period, VE <6 weeks after primary vaccination was 80% (95%CI 69-87) and decreased to 71% (65-77) after 6 months. VE increased to 96% (86-99) shortly after the first booster vaccination. In the Omicron period these estimates were 46% (22-63), 25% (8-39) and 57% (52-62), respectively. For the Omicron period, an interaction term between vaccination status and risk group significantly improved the model (p<0.001), with generally lower VEs for those with a medical risk condition. CONCLUSIONS Our results show the benefit of booster vaccinations against infection, also in risk groups, although the additional protection wanes quite rapidly.
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Affiliation(s)
- Anne J Huiberts
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Christina E Hoeve
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Susan J M Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Gerco den Hartog
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
| | - Janneke H H M van de Wijgert
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands.
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12
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Vinkeles Melchers NVS, Nawijn F, Rümke LW, Dix LML, Vestjens SMT, Hietbrink F, Tjon-Kon-Fat R, Verspui-van der Eijk E, de Gier B, Vlaminckx BJM, Içli C, Quaak MSW, Huijskens EIGW. [Invasive group A streptococcal infections in the Netherlands]. Ned Tijdschr Geneeskd 2023; 167. [PMID: 36928399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Group A streptococcal (GAS) infections are caused by the Gram-positive bacterium Streptococcus pyogenes. Infection can occur via droplet infection from the throat and via (in)direct contact with infected people. GAS can cause a wide variety of diseases, ranging from superficial skin infections, pharyngitis and scarlet fever, to serious invasive diseases such as puerperal sepsis, pneumonia, necrotising soft tissue infections (NSTI) (also known as necrotising fasciitis/myositis), meningitis and streptococcal toxic shock syndrome (STSS). In invasive GAS infections, the bacteria has penetrated into a sterile body compartment (such as the bloodstream, deep tissues, or the central nervous system). Invasive GAS infections are rare but serious, with high morbidity and mortality. Since March 2022, the National Institute for Public Health and the Environment (RIVM) reported a national increase in notifiable invasive GAS infections (NSTI, STSS and puerperal fever). Particularly NSTI has increased compared to the years before the SARS-CoV-2 pandemic. Remarkably, the proportion of children aged 0 to 5 years with invasive GAS-infections is higher in 2022 than in the previous years (12% compared to 4%). While seasonal peaks occur, the current elevation exceeds this variation. To promote early recognition and diagnosis of invasive GAS infections different clinical cases are presented.
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Affiliation(s)
| | | | | | - Laura M L Dix
- Erasmus MC - Sophia Kinderziekenhuis, Rotterdam: Afd. Medische Microbiologie
| | | | | | | | | | | | - Bart J M Vlaminckx
- St. Antonius Ziekenhuis, afd. Medische Microbiologie & Immunologie, Nieuwegein
| | - Caner Içli
- Albert Schweitzer ziekenhuis, Dordrecht. Afd. Orthopedie
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13
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van Iersel SCJL, Backer JA, van Gaalen RD, Andeweg SP, Munday JD, Wallinga J, van Hoek AJ, Maxwell A, Niessen A, Teirlinck A, Valk AW, van Benthem B, de Gier B, Boudewijns B, Verstraten C, Laarman C, Berry D, van Wees D, van Meijeren D, Klinkenberg D, Vos E, Geubbels E, Jongenotter F, Petit F, Dijkstra F, Broekhaar G, Willekens G, de Melker H, Veldhuijzen I, Polman J, Kassteele JVD, Heijne J, van Heereveld J, Kemmeren J, Bulsink K, Ainslie K, Wielders L, van Asten L, Jenniskens L, Soetens L, Mulder M, Schipper M, de Lange M, Middeldorp M, Kooijman M, de Dreu M, Knol M, Smorenburg N, Neppelenbroek N, van den Berg P, de Boer P, Bressane Lima PDO, van Gageldonk-Lafeber R, Wijburg S, McDonald S, Zadeh SA, de Bruijn S, Wierenga S, Hahne S, Lanooij S, van den Hof S, Keijser S, Smit T, Dalhuisen T, Faber T, Boere T. Empirical evidence of transmission over a school-household network for SARS-CoV-2; exploration of transmission pairs stratified by primary and secondary school. Epidemics 2023; 43:100675. [PMID: 36889158 PMCID: PMC9968452 DOI: 10.1016/j.epidem.2023.100675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Children play a key role in the transmission of many infectious diseases. They have many of their close social encounters at home or at school. We hypothesized that most of the transmission of respiratory infections among children occur in these two settings and that transmission patterns can be predicted by a bipartite network of schools and households. AIM AND METHODS To confirm transmission over a school-household network, SARS-CoV-2 transmission pairs in children aged 4-17 years were analyzed by study year and primary/secondary school. Cases with symptom onset between 1 March 2021 and 4 April 2021 identified by source and contact-tracing in the Netherlands were included. In this period, primary schools were open and secondary school students attended class at least once per week. Within pairs, spatial distance between the postcodes was calculated as the Euclidean distance. RESULTS A total of 4059 transmission pairs were identified; 51.9% between primary schoolers; 19.6% between primary and secondary schoolers; 28.5% between secondary schoolers. Most (68.5%) of the transmission for children in the same study year occurred at school. In contrast, most of the transmission of children from different study years (64.3%) and most primary-secondary transmission (81.7%) occurred at home. The average spatial distance between infections was 1.2 km (median 0.4) for primary school pairs, 1.6 km (median 0) for primary-secondary school pairs and 4.1 km (median 1.2) for secondary school pairs. CONCLUSION The results provide evidence of transmission on a bipartite school-household network. Schools play an important role in transmission within study years, and households play an important role in transmission between study years and between primary and secondary schools. Spatial distance between infections in a transmission pair reflects the smaller school catchment area of primary schools versus secondary schools. Many of these observed patterns likely hold for other respiratory pathogens.
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Affiliation(s)
- Senna C J L van Iersel
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Jantien A Backer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Rolina D van Gaalen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Stijn P Andeweg
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - James D Munday
- Centre for the Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacco Wallinga
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Albert Jan van Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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14
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Andeweg SP, de Gier B, Vennema H, van Walle I, van Maarseveen N, Kusters NE, de Melker HE, Hahné SJM, van den Hof S, Eggink D, Knol MJ. Higher risk of SARS-CoV-2 Omicron BA.4/5 infection than of BA.2 infection after previous BA.1 infection, the Netherlands, 2 May to 24 July 2022. Euro Surveill 2023; 28:2200724. [PMID: 36795499 PMCID: PMC9936591 DOI: 10.2807/1560-7917.es.2023.28.7.2200724] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BackgroundIn summer 2022, SARS-CoV-2 Omicron BA.5 became dominant in Europe. In vitro studies have shown a large reduction of antibody neutralisation for this variant.AimWe aimed to investigate differences in protection from previous infection and/or vaccination against infection with Omicron BA.4/5 vs BA.2.MethodsWe employed a case-only approach including positive PCR tests from community testing between 2 May and 24 July 2022 that were tested for S gene target failure (SGTF), which distinguishes BA.4/5 from BA.2 infection. Previous infections were categorised by variant using whole genome sequencing or SGTF. We estimated by logistic regression the association of SGTF with vaccination and/or previous infection, and of SGTF of the current infection with the variant of the previous infection, adjusting for testing week, age group and sex.ResultsThe percentage of registered previous SARS-CoV-2 infections was higher among 19,836 persons infected with Omicron BA.4/5 than among 7,052 persons infected with BA.2 (31.3% vs 20.0%). Adjusting for testing week, age group and sex, the adjusted odds ratio (aOR) was 1.4 (95% CI: 1.3-1.5). The distribution of vaccination status did not differ for BA.4/5 vs BA.2 infections (aOR = 1.1 for primary and booster vaccination). Among persons with a previous infection, those currently infected with BA4/5 had a shorter interval between infections, and the previous infection was more often caused by BA.1, compared with those currently infected with BA.2 (aOR = 1.9; 95% CI: 1.5-2.6).ConclusionOur results suggest immunity induced by BA.1 is less effective against BA.4/5 infection than against BA.2 infection.
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Affiliation(s)
- Stijn P Andeweg
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Brechje de Gier
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Harry Vennema
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ivo van Walle
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Noortje van Maarseveen
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands,Saltro Diagnostic Center for Primary Care, Utrecht, The Netherlands
| | - Nina E Kusters
- Saltro Diagnostic Center for Primary Care, Utrecht, The Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Susan JM Hahné
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Susan van den Hof
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Dirk Eggink
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, WHO COVID-19 reference laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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15
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Huiberts AJ, de Gier B, Hoeve CE, de Melker HE, Hahné SJM, den Hartog G, van de Wijgert JHHM, van den Hof S, Knol MJ. Effectiveness of bivalent mRNA booster vaccination against SARS-CoV-2 Omicron infection, the Netherlands, September to December 2022. Euro Surveill 2023; 28:2300087. [PMID: 36795500 PMCID: PMC9936593 DOI: 10.2807/1560-7917.es.2023.28.7.2300087] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
We used data of 32,542 prospective cohort study participants who previously received primary and one or two monovalent booster COVID-19 vaccinations. Between 26 September and 19 December 2022, relative effectiveness of bivalent original/Omicron BA.1 vaccination against self-reported Omicron SARS-CoV-2 infection was 31% in 18-59-year-olds and 14% in 60-85-year-olds. Protection of Omicron infection was higher than of bivalent vaccination without prior infection. Although bivalent booster vaccination increases protection against COVID-19 hospitalisations, we found limited added benefit in preventing SARS-CoV-2 infection.
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Affiliation(s)
- Anne J Huiberts
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Christina E Hoeve
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Susan JM Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Gerco den Hartog
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands,Radboud Centre for Infectious Diseases, Radboudumc, Nijmegen, the Netherlands
| | - Janneke HHM van de Wijgert
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht (UMCU), Utrecht, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
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16
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de Gier B, Marchal N, de Beer-Schuurman I, Te Wierik M, Hooiveld M, de Melker HE, van Sorge NM. Increase in invasive group A streptococcal ( Streptococcus pyogenes) infections (iGAS) in young children in the Netherlands, 2022. Euro Surveill 2023; 28:2200941. [PMID: 36695447 PMCID: PMC9817208 DOI: 10.2807/1560-7917.es.2023.28.1.2200941] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/05/2023] [Indexed: 01/07/2023] Open
Abstract
In 2022, a sevenfold increase in the number of notifiable invasive Streptococcus pyogenes (iGAS) infections among children aged 0-5 years was observed in the Netherlands compared with pre-COVID-19 pandemic years. Of 42 cases in this age group, seven had preceding or coinciding varicella zoster infections, nine were fatal. This increase is not attributable to a specific emm type. Vigilance for clinical deterioration as iGAS sign is warranted in young children, especially those with varicella zoster infection.
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Affiliation(s)
- Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Niek Marchal
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ilse de Beer-Schuurman
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center location AMC, Amsterdam, the Netherlands
| | - Margreet Te Wierik
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Nina M van Sorge
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center location AMC, Amsterdam, the Netherlands
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC location University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
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17
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Van der Weijden FG, de Gier B, de Bruin MJ, Valkenburg C, Slot DE. SARS-CoV-2 TEST OUTCOMES AMONG DENTISTS AND DENTAL HYGIENISTS WITH COVID-19-LIKE COMPLAINTS - A RETROSPECTIVE ANALYSIS FROM THE NETHERLANDS. J Evid Based Dent Pract 2022; 22:101779. [PMID: 36494106 PMCID: PMC9484862 DOI: 10.1016/j.jebdp.2022.101779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/07/2022] [Accepted: 09/08/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This retrospective analysis aimed to evaluate, among individuals with COVID-19-like symptoms, the percentage of SARS-CoV-2 positive oral health care workers relative to health care workers in general and a non-close-contact occupation reference group in the Netherlands. MATERIALS AND METHODS Data was retrospectively analyzed based on data extracted from the CoronIT database. This contained mass testing data for those experiencing symptoms compatible with COVID-19 recorded from June 2020 up to February 2021. The total number of tests taken and the number of SARS-CoV-2 positive tests were assessed. Sub-analyses were performed for oral health care and health care workers based in professional working locations, long-term care facilities, hospitals, or elsewhere. RESULTS In total, data from 1,999,390 tests were obtained. Overall, 9.4% tested positive for SARS-CoV-2 in the three occupational groups. This was 9.2% for oral health care workers, 9.5% for health care workers, and 9.3% for the non-close-contact occupation reference group. For the three occupational groups the adjusted odds ratio with the month as covariate varied from 0.76 to 1.12. The odds ratio for oral health care workers compared to health care workers was 1 [95% CI:0.95;1.05] and 0.97 [95% CI:0.92;1.02] compared to the non-close-contact occupation reference group. Interpretation of the magnitude of the odds ratio indicates that the observed differences are none to very small. CONCLUSION During the pandemic oral health care providers were required to adhere to the COVID-19-specific amendments to the national infection control guidelines. Based on the data gathered, dentists and dental hygienists with COVID-19-like symptoms do not test SARS-CoV-2 positive more often than other health care workers or those with a non-close-contact occupation. This supports the assumption that working during the pandemic using the Dutch standard hygiene guideline supplemented with the COVID guideline for oral health care is adequately safe.
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Affiliation(s)
- Fridus G.A. Van der Weijden
- Committee member Guideline Oral Care Corona, Mondzorgalliantie, Utrecht, The Netherlands,Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Monique J.C. de Bruin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Cees Valkenburg
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Dagmar E. Slot
- Committee member Guideline Oral Care Corona, Mondzorgalliantie, Utrecht, The Netherlands,Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands,CORRESPONDING AUTHOR: D.E. Slot, Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands. Tel.: +(31)-20 5980 179
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18
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van Ewijk CE, Kooijman MN, Fanoy E, Raven SFH, Middeldorp M, Shah A, de Gier B, de Melker HE, Hahné SJM, Knol MJ. COVID-19 vaccine effectiveness against SARS-CoV-2 infection during the Delta period, a nationwide study adjusting for chance of exposure, the Netherlands, July to December 2021. Euro Surveill 2022; 27. [PMID: 36367011 PMCID: PMC9650707 DOI: 10.2807/1560-7917.es.2022.27.45.2200217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Differential SARS-CoV-2 exposure between vaccinated and unvaccinated individuals may confound vaccine effectiveness (VE) estimates. Aim We conducted a test-negative case–control study to determine VE against SARS-CoV-2 infection and the presence of confounding by SARS-CoV-2 exposure. Methods We included adults tested for SARS-CoV-2 at community facilities between 4 July and 8 December 2021 (circulation period of the Delta variant). The VE against SARS-CoV-2 infection after primary vaccination with an mRNA (Comirnaty or Spikevax) or vector-based vaccine (Vaxzevria or Janssen) was calculated using logistic regression adjusting for age, sex and calendar week (Model 1). We additionally adjusted for comorbidity and education level (Model 2) and SARS-CoV-2 exposure (number of close contacts, visiting busy locations, household size, face mask wearing, contact with SARS-CoV-2 case; Model 3). We stratified by age, vaccine type and time since vaccination. Results VE against infection (Model 3) was 64% (95% CI: 50–73), only slightly lower than in Models 1 (68%; 95% CI: 58–76) and 2 (67%; 95% CI: 56–75). Estimates stratified by age group, vaccine and time since vaccination remained similar: mRNA VE (Model 3) among people ≥ 50 years decreased significantly (p = 0.01) from 81% (95% CI: 66–91) at < 120 days to 61% (95% CI: 22–80) at ≥ 120 days after vaccination. It decreased from 83% to 59% in Model 1 and from 81% to 56% in Model 2. Conclusion SARS-CoV-2 exposure did not majorly confound the estimated COVID-19 VE against infection, suggesting that VE can be estimated accurately using routinely collected data without exposure information.
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Affiliation(s)
- Catharina E van Ewijk
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Marjolein N Kooijman
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Ewout Fanoy
- Department of Infectious Diseases, Public Health Service Amsterdam-Amstelland, Amsterdam, the Netherlands
| | - Stijn FH Raven
- Department of Infectious Diseases, Public Health Service Utrecht region, Utrecht, The Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Marit Middeldorp
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Anita Shah
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Susan JM Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
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19
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McDonald SA, van Wijhe M, de Gier B, Korthals Altes H, Vlaminckx BJM, Hahné S, Wallinga J. The dynamics of scarlet fever in The Netherlands, 1906-1920: a historical analysis. R Soc Open Sci 2022; 9:220030. [PMID: 36397968 PMCID: PMC9626260 DOI: 10.1098/rsos.220030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 10/13/2022] [Indexed: 06/09/2023]
Abstract
Background. Scarlet fever, an infectious disease caused by Streptococcus pyogenes, largely disappeared in developed countries during the twentieth century. In recent years, scarlet fever is on the rise again, and there is a need for a better understanding of possible factors driving transmission. Methods. Using historical case notification data from the three largest cities in The Netherlands (Amsterdam, Rotterdam and The Hague) from 1906 to 1920, we inferred the transmission rate for scarlet fever using time-series susceptible-infected-recovered (TSIR) methods. Through additive regression modelling, we investigated the contributions of meteorological variables and school term times to transmission rates. Results. Estimated transmission rates varied by city, and were highest overall for Rotterdam, the most densely populated city at that time. High temperature, seasonal precipitation levels and school term timing were associated with transmission rates, but the roles of these factors were limited and not consistent over all three cities. Conclusions. While weather factors alone can only explain a small portion of the variability in transmission rates, these results help understand the historical dynamics of scarlet fever infection in an era with less advanced sanitation and no antibiotic treatment and may offer insights into the driving factors associated with its recent resurgence.
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Affiliation(s)
- Scott A. McDonald
- Centre for Infectious Disease Control, Netherlands National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Brechje de Gier
- Centre for Infectious Disease Control, Netherlands National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hester Korthals Altes
- Centre for Infectious Disease Control, Netherlands National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Susan Hahné
- Centre for Infectious Disease Control, Netherlands National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Jacco Wallinga
- Centre for Infectious Disease Control, Netherlands National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
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20
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Kissling E, Hooiveld M, Martínez-Baz I, Mazagatos C, William N, Vilcu AM, Kooijman MN, Ilić M, Domegan L, Machado A, de Lusignan S, Lazar M, Meijer A, Brytting M, Casado I, Larrauri A, Murray JLK, Behillil S, de Gier B, Mlinarić I, O’Donnell J, Rodrigues AP, Tsang R, Timnea O, de Lange M, Riess M, Castilla J, Pozo F, Hamilton M, Falchi A, Knol MJ, Kurečić Filipović S, Dunford L, Guiomar R, Cogdale J, Cherciu C, Jansen T, Enkirch T, Basile L, Connell J, Gomez V, Sandonis Martín V, Bacci S, Rose AMC, Pastore Celentano L, Valenciano M. Effectiveness of complete primary vaccination against COVID-19 at primary care and community level during predominant Delta circulation in Europe: multicentre analysis, I-MOVE-COVID-19 and ECDC networks, July to August 2021. Euro Surveill 2022; 27:2101104. [PMID: 35620997 PMCID: PMC9137272 DOI: 10.2807/1560-7917.es.2022.27.21.2101104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IntroductionIn July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe.AimUsing a multicentre test-negative study, we measured COVID-19 vaccine effectiveness (VE) against symptomatic infection.MethodsIndividuals with COVID-19 or acute respiratory symptoms at primary care/community level in 10 European countries were tested for SARS-CoV-2. We measured complete primary course overall VE by vaccine brand and by time since vaccination.ResultsOverall VE was 74% (95% CI: 69-79), 76% (95% CI: 71-80), 63% (95% CI: 48-75) and 63% (95% CI: 16-83) among those aged 30-44, 45-59, 60-74 and ≥ 75 years, respectively. VE among those aged 30-59 years was 78% (95% CI: 75-81), 66% (95% CI: 58-73), 91% (95% CI: 87-94) and 52% (95% CI: 40-61), for Comirnaty, Vaxzevria, Spikevax and COVID-19 Vaccine Janssen, respectively. VE among people 60 years and older was 67% (95% CI: 52-77), 65% (95% CI: 48-76) and 83% (95% CI: 64-92) for Comirnaty, Vaxzevria and Spikevax, respectively. Comirnaty VE among those aged 30-59 years was 87% (95% CI: 83-89) at 14-29 days and 65% (95% CI: 56-71%) at ≥ 90 days between vaccination and onset of symptoms.ConclusionsVE against symptomatic infection with the SARS-CoV-2 Delta variant varied among brands, ranging from 52% to 91%. While some waning of the vaccine effect may be present (sample size limited this analysis to only Comirnaty), protection was 65% at 90 days or more between vaccination and onset.
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Affiliation(s)
| | | | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Ana-Maria Vilcu
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Marjolein N Kooijman
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Maja Ilić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Mihaela Lazar
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Amparo Larrauri
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Sylvie Behillil
- Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, France,CNR des virus des infections respiratoires, Institut Pasteur, Paris, France
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Olivia Timnea
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | | | | - Mirjam J Knol
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Carmen Cherciu
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | | | | | - Luca Basile
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalunya, Spain
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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21
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Nawijn F, de Gier B, Brandwagt DAH, Groenwold RHH, Keizer J, Hietbrink F. Incidence and mortality of necrotizing fasciitis in The Netherlands: the impact of group A Streptococcus. BMC Infect Dis 2021; 21:1217. [PMID: 34872527 PMCID: PMC8650531 DOI: 10.1186/s12879-021-06928-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Little is known about the exact incidence of necrotizing soft tissue infections. The few incidences reported in international literature are not directly relatable to the Netherlands, or other European countries, due to geographic heterogeneity in causative micro-organisms involved. This resulted in the aim of this study to map the incidence, mortality rate and hospital course of necrotizing fasciitis infections in the Netherlands to gain insight in the incidence of necrotizing fasciitis in the Netherlands and the associated mortality and health care burden. METHODS This nationwide retrospective database study used three distinct data sources to map the incidence of necrotizing fasciitis in the Netherlands between 2014 and 2019, being data from the Dutch Hospital Data (DHD) foundation, data from Osiris-AIZ, which is a database of notifiable diseases managed by regional Public Health Services (GGD) and the National Institute for Public Health and the Environment (RIVM), and previously published studies on necrotizing fasciitis conducted in the Netherlands. RESULTS The incidence of necrotizing fasciitis in the Netherlands is estimated to be approximately 1.1 to 1.4 cases per 100,000 person years, which corresponds to 193-238 patients per year. Of all necrotizing fasciitis infections, 34 to 42% are caused by the group A Streptococcus. Annually, 56 patients die as a result of a necrotizing fasciitis infection (mortality of 23-29%) and 26 patients undergo an amputation for source control (11-14%). Patients stay a mean of 6 to 7 days at the intensive care unit and have a mean hospital length of stay of 24 to 30 days. CONCLUSION The combination of nationwide databases provides reliable insight in the epidemiology of low-incidence and heterogenic diseases. In the Netherlands, necrotizing fasciitis is a rare disease with group A Streptococcus being the most common causative micro-organism of necrotizing fasciitis. The prior Dutch cohort studies on necrotizing fasciitis report slightly higher sample mortality rates, compared to the population mortality. However, necrotizing fasciitis remain associated with substantial morbidity and mortality, risk at amputation and health care burden characterized by prolonged ICU and hospital stay.
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Affiliation(s)
- Femke Nawijn
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Utrecht, The Netherlands
| | - Diederik A H Brandwagt
- Department of Infectious Diseases, Public Health Service (GGD) Region Utrecht, Utrecht, The Netherlands
| | - Rolf H H Groenwold
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jort Keizer
- Department of Surgery, Sint Antonius Hospital, Utrecht, The Netherlands
| | - Falco Hietbrink
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
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22
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de Gier B, Andeweg S, Backer JA, Hahné SJ, van den Hof S, de Melker HE, Knol MJ. Vaccine effectiveness against SARS-CoV-2 transmission to household contacts during dominance of Delta variant (B.1.617.2), the Netherlands, August to September 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34738514 PMCID: PMC8569927 DOI: 10.2807/1560-7917.es.2021.26.44.2100977] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
We estimated SARS-CoV-2 vaccine effectiveness against onward transmission by comparing secondary attack rates among household members for vaccinated and unvaccinated index cases, based on source and contact tracing data collected when the Delta variant was dominant. Effectiveness of full vaccination of the index case against transmission to unvaccinated and fully vaccinated household contacts, respectively, was 63% (95% confidence interval (CI): 46–75) and 40% (95% CI: 20–54), in addition to the direct protection of vaccination of contacts against infection.
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Affiliation(s)
- Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Stijn Andeweg
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Jantien A Backer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | -
- The members of this group (in addition to the named authors) are listed under Investigators
| | - Susan Jm Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Susan van den Hof
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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23
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Horváth-Puhó E, Snoek L, van Kassel MN, Gonçalves BP, Chandna J, Procter SR, van de Beek D, de Gier B, van der Ende A, Sørensen HT, Lawn JE, Bijlsma MW. Every Country, Every Woman, Every Child; Group B Streptococcal Disease Worldwide Prematurity modifies the risk of long-term neurodevelopmental impairments after invasive Group B Streptococcus infections during infancy in Denmark and the Netherlands. Clin Infect Dis 2021; 74:S44-S53. [PMID: 34559200 PMCID: PMC8775650 DOI: 10.1093/cid/ciab774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Preterm birth and neonatal infections are both associated with mortality and long-term neurodevelopmental impairments (NDIs). We examined whether the effect of invasive group B Streptococcus disease (iGBS) on mortality and long-term NDI differs for preterm and term infants, and whether co-occurrence of iGBS and prematurity leads to worse outcome. Methods Nationwide cohort studies of children with a history of iGBS were conducted using Danish and Dutch medical databases. Comparison cohorts of children without iGBS were matched on birth year/month, sex, and gestational age. Effects of iGBS on all-cause mortality and NDI were analyzed using Cox proportional hazards and logistic regression. Effect modification by prematurity was evaluated on additive and multiplicative scales. Results We identified 487 preterm and 1642 term children with a history of iGBS and 21 172 matched comparators. Dutch preterm children exposed to iGBS had the highest mortality rate by 3 months of age (671/1000 [95% CI, 412–929/1000] person-years). Approximately 30% of this mortality rate could be due to the common effect of iGBS and prematurity. Preterm children with iGBS had the highest NDI risk (8.8% in Denmark, 9.0% in the Netherlands). Of this NDI risk 36% (Denmark) and 60% (the Netherlands) might be due to the combined effect of iGBS and prematurity. Conclusions Prematurity is associated with iGBS development. Our study shows that it also negatively impacts outcomes of children who survive iGBS. Preterm infants would benefit from additional approaches to prevent maternal GBS colonization, as this decreases risk of both preterm birth and iGBS.
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Affiliation(s)
- Erzsébet Horváth-Puhó
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark
| | - Linde Snoek
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands
| | - Merel N van Kassel
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands
| | - Bronner P Gonçalves
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Jaya Chandna
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Simon R Procter
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Diederik van de Beek
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Arie van der Ende
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMC/RIVM, University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Amsterdam Infection and Immunity, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Merijn W Bijlsma
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands.,Amsterdam UMC, University of Amsterdam, Department of Pediatrics, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands
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24
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de Gier B, Andeweg S, Joosten R, Ter Schegget R, Smorenburg N, van de Kassteele J, Hahné SJ, van den Hof S, de Melker HE, Knol MJ. Vaccine effectiveness against SARS-CoV-2 transmission and infections among household and other close contacts of confirmed cases, the Netherlands, February to May 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34355689 PMCID: PMC8343550 DOI: 10.2807/1560-7917.es.2021.26.31.2100640] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Several studies report high effectiveness of COVID-19 vaccines against SARS-CoV-2 infection and severe disease, however an important knowledge gap is the vaccine effectiveness against transmission (VET). We present estimates of the VET to household and other close contacts in the Netherlands, from February to May 2021, using contact monitoring data. The secondary attack rate among household contacts was lower for fully vaccinated than unvaccinated index cases (11% vs 31%), with an adjusted VET of 71% (95% confidence interval: 63–77).
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Affiliation(s)
- Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Stijn Andeweg
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Rosa Joosten
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Naomi Smorenburg
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Jan van de Kassteele
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | -
- The members of the group are listed under Investigators
| | - Susan Jm Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Susan van den Hof
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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25
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de Gier B, Houben-van Herten M, Uiters E, Hahné SJM. Educational differences in acute infectious diseases in the Netherlands: results from a nationwide health survey. Eur J Public Health 2021; 30:270-275. [PMID: 31981359 DOI: 10.1093/eurpub/ckz230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is unclear to what extent socioeconomic inequalities exist in common infectious diseases in high-income countries. We aimed to explore educational differences in five common acute infectious diseases in adults in the Netherlands. METHODS As part of a year-round repeated cross-sectional health survey, adults aged 25 and older were asked if they had experienced acute upper or lower respiratory tract infections, acute otitis media, urinary tract infections or gastro-enteritis in the two previous months. If so, participants were asked whether they had consulted their general practitioner and if they had been unable to perform their normal daily activities. These outcomes were analyzed per highest attained level of education. RESULTS Data of 18 629 survey respondents were used in the analyses. People with a low educational level had lower odds of upper respiratory tract infections (OR 0.88, 95% CI 0.81-0.95), but higher odds of lower respiratory tract infections (OR 1.57, 95% CI 1.16-2.11). After adjustment for several covariates, the differences in upper respiratory tract infections remained statistically significant (aOR 0.84, 95% CI 0.77-0.91). The educational differences in lower respiratory tract infections were mitigated by adjusting for chronic diseases and health behaviours. For all infectious diseases, the likelihood of general practitioner consultation was highest for the lower educated group. Inability to work or perform normal daily activities due to an infectious disease was similar across all levels of education. CONCLUSION This study shows that educational differences in incidence and care seeking behaviours exist for common acute infectious diseases in the Netherlands.
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Affiliation(s)
- Brechje de Gier
- Department for Early Warning and Surveillance, Centre for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Ellen Uiters
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Susan J M Hahné
- Department for Early Warning and Surveillance, Centre for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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26
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Hahn BA, de Gier B, van Kassel MN, Bijlsma MW, van Leeuwen E, Wouters MGAJ, van der Ende A, van de Beek D, Wallinga J, Hahné SJM, Jan van Hoek A. Cost-effectiveness of maternal immunization against neonatal invasive Group B Streptococcus in the Netherlands. Vaccine 2021; 39:2876-2885. [PMID: 33895018 DOI: 10.1016/j.vaccine.2021.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Neonatal invasive Group B Streptococcus (GBS) infection causes considerable disease burden in the Netherlands. Intrapartum antibiotic prophylaxis (IAP) prevents early-onset disease (EOD), but has no effect on late-onset disease (LOD). A potential maternal GBS vaccine could prevent both EOD and LOD by conferring immunity in neonates. OBJECTIVE Explore under which circumstances maternal vaccination against GBS would be cost-effective as an addition to, or replacement for the current risk factor-based IAP prevention strategy in the Netherlands. METHODS We assessed the maximum cost-effective price per dose of a trivalent (serotypes Ia, Ib, and III) and hexavalent (additional serotypes II, IV, and V) GBS vaccine in addition to, or as a replacement for IAP. To project the prevented costs and disease burden, a decision tree model was developed to reflect neonatal GBS disease and long-term health outcomes among a cohort based on 169,836 live births in the Netherlands in 2017. RESULTS Under base-case conditions, maternal immunization with a trivalent vaccine would gain 186 QALYs and prevent more than €3.1 million in health care costs when implemented in addition to IAP. Immunization implemented as a replacement for IAP would gain 88 QALYs compared to the current prevention strategy, prevent €1.5 million in health care costs, and avoid potentially ~ 30,000 IAP administrations. The base-case results correspond to a maximum price of €58 per dose (vaccine + administration costs; using a threshold of €20,000/QALY). Expanding the serotype coverage to a hexavalent vaccine would only have a limited additional impact on the cost-effectiveness in the Netherlands. CONCLUSIONS A maternal GBS vaccine could be cost-effective when implemented in addition to the current risk factor-based IAP prevention strategy in the Netherlands. Discontinuation of IAP would save costs and prevent antibiotic use, however, is projected to lead to a lower health gain compared to vaccination in addition to IAP.
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Affiliation(s)
- Brett A Hahn
- Athena Institute, VU Amsterdam, the Netherlands; National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands.
| | - Merel N van Kassel
- Amsterdam UMC, University of Amsterdam, Department of Neurology, the Netherlands
| | - Merijn W Bijlsma
- Amsterdam UMC, University of Amsterdam, Department of Neurology, the Netherlands
| | | | - Maurice G A J Wouters
- Amsterdam UMC, University of Amsterdam, Department of Neurology, the Netherlands; Amsterdam UMC, Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands
| | - Arie van der Ende
- Amsterdam UMC, Department of Medical Microbiology, Infection and Immunity, and Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam, the Netherlands
| | - Diederik van de Beek
- Amsterdam UMC, University of Amsterdam, Department of Neurology, the Netherlands
| | - Jacco Wallinga
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Susan J M Hahné
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Albert Jan van Hoek
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
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Horváth-Puhó E, van Kassel MN, Gonçalves BP, de Gier B, Procter SR, Paul P, van der Ende A, Søgaard KK, Hahné SJM, Chandna J, Schrag SJ, van de Beek D, Jit M, Sørensen HT, Bijlsma MW, Lawn JE. Mortality, neurodevelopmental impairments, and economic outcomes after invasive group B streptococcal disease in early infancy in Denmark and the Netherlands: a national matched cohort study. Lancet Child Adolesc Health 2021; 5:398-407. [PMID: 33894156 PMCID: PMC8131199 DOI: 10.1016/s2352-4642(21)00022-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 02/07/2023]
Abstract
Background Group B Streptococcus (GBS) disease is a leading cause of neonatal death, but its long-term effects have not been studied after early childhood. The aim of this study was to assess long-term mortality, neurodevelopmental impairments (NDIs), and economic outcomes after infant invasive GBS (iGBS) disease up to adolescence in Denmark and the Netherlands. Methods For this cohort study, children with iGBS disease were identified in Denmark and the Netherlands using national medical and administrative databases and culture results that confirmed their diagnoses. Exposed children were defined as having a history of iGBS disease (sepsis, meningitis, or pneumonia) by the age of 89 days. For each exposed child, ten unexposed children were randomly selected and matched by sex, year and month of birth, and gestational age. Mortality data were analysed with the use of Cox proportional hazards models. NDI data up to adolescence were captured from discharge diagnoses in the National Patient Registry (Denmark) and special educational support records (the Netherlands). Health care use and household income were also compared between the exposed and unexposed cohorts. Findings 2258 children—1561 in Denmark (born from Jan 1, 1997 to Dec 31, 2017) and 697 in the Netherlands (born from Jan 1, 2000 to Dec 31, 2017)—were identified to have iGBS disease and followed up for a median of 14 years (IQR 7–18) in Denmark and 9 years (6–11) in the Netherlands. 366 children had meningitis, 1763 had sepsis, and 129 had pneumonia (in Denmark only). These children were matched with 22 462 children with no history of iGBS disease. iGBS meningitis was associated with an increased mortality at age 5 years (adjusted hazard ratio 4·08 [95% CI 1·78–9·35] for Denmark and 6·73 [3·76–12·06] for the Netherlands). Any iGBS disease was associated with an increased risk of NDI at 10 years of age, both in Denmark (risk ratio 1·77 [95% CI 1·44–2·18]) and the Netherlands (2·28 [1·64–3·17]). A history of iGBS disease was associated with more frequent outpatient clinic visits (incidence rate ratio 1·93 [95% CI 1·79–2·09], p<0·0001) and hospital admissions (1·33 [1·27–1·38], p<0·0001) in children 5 years or younger. No differences in household income were observed between the exposed and unexposed cohorts. Interpretation iGBS disease, especially meningitis, was associated with increased mortality and a higher risk of NDIs in later childhood. This previously unquantified burden underlines the case for a maternal GBS vaccine, and the need to track and provide care for affected survivors of iGBS disease. Funding The Bill & Melinda Gates Foundation. Translations For the Dutch and Danish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
| | - Merel N van Kassel
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Bronner P Gonçalves
- Maternal, Adolescent, Reproductive & Child Health Centre and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Simon R Procter
- Maternal, Adolescent, Reproductive & Child Health Centre and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Proma Paul
- Maternal, Adolescent, Reproductive & Child Health Centre and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Arie van der Ende
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; The National Institute for Public Health and the Environment, University of Amsterdam, Amsterdam, Netherlands; Department of Medical Microbiology and Infection Prevention, Amsterdam Infection and Immunity, Amsterdam, Netherlands
| | - Kirstine K Søgaard
- Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark; Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark
| | - Susan J M Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jaya Chandna
- Maternal, Adolescent, Reproductive & Child Health Centre and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephanie J Schrag
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Mark Jit
- Maternal, Adolescent, Reproductive & Child Health Centre and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark
| | - Merijn W Bijlsma
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health Centre and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
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28
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van den Boogaard J, de Gier B, de Oliveira Bressane Lima P, Desai S, de Melker HE, Hahné SJM, Veldhuijzen IK. Immunogenicity, duration of protection, effectiveness and safety of rubella containing vaccines: A systematic literature review and meta-analysis. Vaccine 2021; 39:889-900. [PMID: 33454135 DOI: 10.1016/j.vaccine.2020.12.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Rubella containing vaccines (RCV) prevent rubella virus infection and subsequent congenital rubella syndrome (CRS). To update the evidence on immunogenicity, duration of protection, effectiveness and safety of RCV, we conducted a systematic literature review. METHODS We searched EMBASE and SCOPUS, using keywords for rubella vaccine in combination with immunogenicity (seroconversion and seropositivity), duration of protection, efficacy/effectiveness, and safety. Original research papers involving at least one dose of RCV (at any age), published between 1-1-2010 and 17-5-2019 were included. Where appropriate, meta-analyses were performed. Quality of included studies was assessed using GRADE methodology. RESULTS We included 36 papers (32 randomized controlled trials (RCTs) and 4 observational studies) on immunogenicity (RA27/3 strain) in children and adolescent girls, 14 papers (5 RCTs and 9 observational studies) on duration of protection, one paper on vaccine effectiveness (VE) (BRDII strain), and 74 studies on safety, including three on safety in pregnancy. Meta-analysis of immunogenicity data showed 99% seroconversion (95% CI: 98-99%) after a single dose of RCV in children, independent of co-administration with other vaccines. Seroconversion after RCV1 below 9 months of age (BRDII strain, at 8 months) was 93% (95% CI: 92-95%). For duration of protection, the included studies showed a seropositivity of 88%-100% measured 1-20 years after one or two RCV doses. The single study on VE of BRDII strain, reported 100% VE after one and two doses. Among 34,332 individuals participating in the RCTs, 140 severe adverse events (SAEs) were reported as possibly related to RCV. Among the case reports on SAEs, the association with RCV was confirmed in one report (on fulminant encephalitis). Among 3,000 pregnant women who were inadvertently vaccinated, no SAEs were reported. CONCLUSIONS One and two doses of RCV are highly immunogenic for a long period of time, effective in preventing rubella and CRS, and safe.
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Affiliation(s)
- Jossy van den Boogaard
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Priscila de Oliveira Bressane Lima
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Shalini Desai
- World Health Organization, Department of Immunization, Vaccines and Biologicals, Geneva, Switzerland
| | - Hester E de Melker
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Susan J M Hahné
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Irene K Veldhuijzen
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
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29
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van den Boogaard J, Hahné SJ, Te Wierik MJ, Knol MJ, Balasegaram S, de Gier B. Out-of-season increase of puerperal fever with group A Streptococcus infection: a case-control study, Netherlands, July to August 2018. ACTA ACUST UNITED AC 2021; 25. [PMID: 33034283 PMCID: PMC7545820 DOI: 10.2807/1560-7917.es.2020.25.40.1900589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We observed an increase in notifications of puerperal group A Streptococcus (GAS) infections in July and August 2018 throughout the Netherlands without evidence for common sources. General practitioners reported a simultaneous increase in impetigo. We hypothesised that the outbreak of puerperal GAS infections resulted from increased exposure via impetigo in the community.We conducted a case-control study to assess peripartum exposure to possible, non-invasive GAS infections using an online questionnaire. Confirmed cases were recruited through public health services while probable cases and controls were recruited through social media. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) with logistic regression analysis.We enrolled 22 confirmed and 23 probable cases, and 2,400 controls. Contact with persons with impetigo were reported by 8% of cases and 2% of controls (OR: 3.26, 95% CI: 0.98-10.88) and contact with possible GAS infections (impetigo, pharyngitis or scarlet fever) by 28% and 9%, respectively (OR: 4.12, 95% CI: 1.95-8.68). In multivariable analysis, contact with possible GAS infections remained an independent risk factor (aOR: 4.28, 95% CI: 2.02-9.09).We found an increased risk of puerperal fever after community contact with possible non-invasive GAS infections. Further study of this association is warranted.
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Affiliation(s)
- Jossy van den Boogaard
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Susan Jm Hahné
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Margreet Jm Te Wierik
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Mirjam J Knol
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Sooria Balasegaram
- Public Health England, London, United Kingdom.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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30
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de Gier B, de Oliveira Bressane Lima P, van Gaalen RD, de Boer PT, Alblas J, Ruijten M, van Gageldonk-Lafeber AB, Waegemaekers T, Schreijer A, van den Hof S, Hahné SJ. Occupation- and age-associated risk of SARS-CoV-2 test positivity, the Netherlands, June to October 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 33334396 PMCID: PMC7812419 DOI: 10.2807/1560-7917.es.2020.25.50.2001884] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
High coronavirus incidence has prompted the Netherlands to implement a second lockdown. To elucidate the epidemic's development preceding this second wave, we analysed weekly test positivity in public test locations by population subgroup between 1 June and 17 October 2020. Hospitality and public transport workers, driving instructors, hairdressers and aestheticians had higher test positivity compared with a reference group of individuals without a close-contact occupation. Workers in childcare, education and healthcare showed lower test positivity.
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Affiliation(s)
- Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Rolina D van Gaalen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Pieter T de Boer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Jeroen Alblas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Arianne B van Gageldonk-Lafeber
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Toos Waegemaekers
- Public Health Service Gelderland Midden, Arnhem, the Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Anja Schreijer
- National Consultation on Infectious Disease Control (LOI), Public Health Service (GGD) Amsterdam, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Susan Jm Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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31
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Rümke LW, de Gier B, Vestjens SMT, van der Ende A, van Sorge NM, Vlaminckx BJM, Witteveen S, van Santen M, Schouls LM, Kuijper EJ. Dominance of M1 UK clade among Dutch M1 Streptococcus pyogenes. Lancet Infect Dis 2020; 20:539-540. [PMID: 32359464 DOI: 10.1016/s1473-3099(20)30278-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/30/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Lidewij W Rümke
- Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven 3720 BA, Netherlands.
| | - Stefan M T Vestjens
- Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Arie van der Ende
- Netherlands Reference Laboratory for Bacterial Meningitis, Center of Infection and Immunity Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Nina M van Sorge
- Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Bart J M Vlaminckx
- Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Sandra Witteveen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven 3720 BA, Netherlands
| | - Marga van Santen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven 3720 BA, Netherlands
| | - Leo M Schouls
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven 3720 BA, Netherlands
| | - Ed J Kuijper
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven 3720 BA, Netherlands
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32
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van Lier A, de Gier B, McDonald SA, Mangen MJJ, van Wijhe M, Sanders EAM, Kretzschmar ME, van Vliet H, de Melker HE. Disease burden of varicella versus other vaccine-preventable diseases before introduction of vaccination into the national immunisation programme in the Netherlands. ACTA ACUST UNITED AC 2020; 24. [PMID: 31064637 PMCID: PMC6505181 DOI: 10.2807/1560-7917.es.2019.24.18.1800363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction Estimating burden of disease (BoD) is an essential first step in the decision-making process on introducing new vaccines into national immunisation programmes (NIPs). For varicella, a common vaccine-preventable disease, BoD in the Netherlands was unknown. Aim To assess national varicella BoD and compare it to BoD of other vaccine-preventable diseases before their introduction in the NIP. Methods In this health estimates reporting study, BoD was expressed in disability-adjusted life years (DALYs) using methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project. As no parameters/disease model for varicella (including herpes zoster) were available in the BCoDE toolkit, incidence, disease progression model and parameters were derived from seroprevalence, healthcare registries and published data. For most other diseases, BoD was estimated with existing BCoDE-parameters, adapted to the Netherlands if needed. Results In 2017, the estimated BoD of varicella in the Netherlands was 1,800 (95% uncertainty interval (UI): 1,800–1,900) DALYs. Herpes zoster mainly contributed to this BoD (1,600 DALYs; 91%), which was generally lower than the BoD of most current NIP diseases in the year before their introduction into the NIP. However, BoD for varicella was higher than for rotavirus gastroenteritis (1,100; 95%UI: 440–2,200 DALYs) and meningococcal B disease (620; 95%UI: 490–770 DALYs), two other potential NIP candidates. Conclusions When considering the introduction of a new vaccine in the NIP, BoD is usually estimated in isolation. The current approach assesses BoD in relation to other vaccine-preventable diseases’ BoD, which may help national advisory committees on immunisation and policymakers to set vaccination priorities.
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Affiliation(s)
- Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Scott A McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Marie-Josée J Mangen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Maarten van Wijhe
- Department of Science and Environment, Roskilde University, Roskilde, Denmark.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Elisabeth A M Sanders
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina's Children Hospital, University Medical Center Utrecht (UMCU), Utrecht, Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Mirjam E Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Hans van Vliet
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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33
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Sondén K, Rolling T, Wångdahl A, Ydring E, Vygen-Bonnet S, Kobbe R, Douhan J, Hammar U, Duijster J, de Gier B, Freedman J, Gysin N, Stark K, Stevens F, Vestergaard LS, Tegnell A, Färnert A. Malaria in Eritrean migrants newly arrived in seven European countries, 2011 to 2016. ACTA ACUST UNITED AC 2020; 24. [PMID: 30722809 PMCID: PMC6386211 DOI: 10.2807/1560-7917.es.2019.24.5.1800139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Global migration has resulted in a large number of asylum applications in Europe. In 2014, clusters of Plasmodium vivax cases were reported among newly arrived Eritreans. This study aimed to assess malaria among Eritrean migrants in Europe from 2011 to 2016. We reviewed European migration numbers and malaria surveillance data for seven countries (Denmark, Germany, Netherlands, Norway, Sweden, Switzerland and the United Kingdom) which received 44,050 (94.3%) of 46,730 Eritreans seeking asylum in Europe in 2014. The overall number of malaria cases, predominantly P. vivax, increased significantly in 2014 compared to previous years, with the largest increases in Germany (44 P. vivax cases in 2013 vs 294 in 2014, p < 0.001) and Sweden (18 in 2013 vs 205 in 2014, p < 0.001). Overall, malaria incidence in Eritreans increased from 1-5 to 25 cases per 1,000, and was highest in male teenagers (50 cases/1,000). In conclusion, an exceptional increase of malaria cases occurred in Europe in 2014 and 2015, due to rising numbers of Eritreans with high incidence of P. vivax arriving in Europe. Our results demonstrate potential for rapid changes in imported malaria patterns, highlighting the need for improved awareness, surveillance efforts and timely healthcare in migrants.
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Affiliation(s)
- Klara Sondén
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Thierry Rolling
- Clinical Research Department, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.,Division of Infectious Diseases, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Wångdahl
- Department of Infectious Diseases, Västmanland Hospital, Västerås, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Elsie Ydring
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | - Robert Kobbe
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johan Douhan
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ulf Hammar
- Unit of Biostatistics, Department of Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Janneke Duijster
- Department for Early Warning and Surveillance Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Brechje de Gier
- Department for Early Warning and Surveillance Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Nicole Gysin
- Federal Office of Public Health, Bern, Switzerland
| | | | | | | | | | - Anna Färnert
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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34
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de Gier B, Nic Lochlainn LM, de Melker HE, Hahné SJM. Measles vaccination in infants younger than 9 months. Lancet Infect Dis 2020; 20:403. [PMID: 32222201 DOI: 10.1016/s1473-3099(20)30135-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Affiliation(s)
- Brechje de Gier
- National Institute for Public Health and the Environment, Bilthoven 3720, Netherlands
| | - Laura M Nic Lochlainn
- National Institute for Public Health and the Environment, Bilthoven 3720, Netherlands
| | - Hester E de Melker
- National Institute for Public Health and the Environment, Bilthoven 3720, Netherlands
| | - Susan J M Hahné
- National Institute for Public Health and the Environment, Bilthoven 3720, Netherlands.
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de Gier B, Vlaminckx BJM, Woudt SHS, van Sorge NM, van Asten L. Associations between common respiratory viruses and invasive group A streptococcal infection: A time-series analysis. Influenza Other Respir Viruses 2019; 13:453-458. [PMID: 31237087 PMCID: PMC6692538 DOI: 10.1111/irv.12658] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 01/11/2023] Open
Abstract
Background Invasive infections by group A Streptococcus (iGAS, Streptococcus pyogenes) have a winter seasonality which largely coincides with the season for influenza and other respiratory viruses. Influenza superinfections with GAS have been described to occur regularly and to show a severe clinical picture with high mortality. We aimed to study the extent to which influenza A and B viruses (IAV and IBV), respiratory syncytial virus (RSV) and rhinovirus circulation contribute to iGAS incidence and severity. Methods Time‐series regression models were built to explore the temporal associations between weekly laboratory counts of IAV, IBV, RSV and rhinovirus as independent variables and weekly counts of GAS disease notifications or laboratory GAS cultures as dependent variables. Results The weekly number of IAV detections showed a significant temporal association with the number of notifications of streptococcal toxic shock syndrome (STSS), a severe complication of iGAS. Depending on the season, up to 40% of all notified STSS cases was attributable to IAV circulation. Besides STSS, none of the other iGAS manifestations were associated with a respiratory virus. Conclusions Our study found an ecological temporal association between IAV and STSS, the most severe complication of iGAS. Future studies are needed to confirm this association and assess the possible preventability of STSS by influenza vaccination, especially in the age group 60 years and older.
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Affiliation(s)
- Brechje de Gier
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bart J M Vlaminckx
- Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Sjoukje H S Woudt
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Nina M van Sorge
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Liselotte van Asten
- Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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de Gier B, van Kassel MN, Sanders EAM, van de Beek D, Hahné SJM, van der Ende A, Bijlsma MW. Disease burden of neonatal invasive Group B Streptococcus infection in the Netherlands. PLoS One 2019; 14:e0216749. [PMID: 31071191 PMCID: PMC6508726 DOI: 10.1371/journal.pone.0216749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Group B Streptococcus (GBS) is the leading cause of neonatal sepsis and meningitis worldwide. We aimed to estimate the current burden of neonatal invasive GBS disease in the Netherlands, as a first step in providing an evidence base for policy makers on the potential benefits of a future maternal GBS vaccine. METHODS Surveillance of neonatal invasive GBS occurs at the National Reference Laboratory for Bacterial Meningitis, where culture isolates from cerebrospinal fluid and blood are sent by diagnostic laboratories. From the number of cultures we estimated the incidence of neonatal (age 0-90 days) GBS meningitis and sepsis. We constructed a disease progression model informed by literature and expert consultation to estimate the disease burden of neonatal invasive GBS infection. As many neonates with a probable GBS sepsis are never confirmed by blood culture, we further estimated the disease burden of unconfirmed cases of probable GBS sepsis in sensitivity analyses. RESULTS An estimated 97 cases and 6.5 deaths occurred in the Netherlands in 2017 due to culture positive neonatal invasive GBS infection. This incidence comprised 15 cases of meningitis and 42 cases of sepsis per 100.000 births, with an estimated mortality of 3.8 per 100.000 live births. A disease burden of 780 disability-adjusted life years (DALY) (95% CI 650-910) or 460 DALY per 100.000 live births was attributed to neonatal invasive GBS infection. In the sensitivity analysis including probable neonatal GBS sepsis the disease burden increased to 71 cases and 550 DALY (95% CI 460-650) per 100.000 live births. CONCLUSION In conclusion, neonatal invasive GBS infection currently causes a substantial disease burden in the Netherlands. However, important evidence gaps are yet to be filled. Furthermore, cases of GBS sepsis lacking a positive blood culture may contribute considerably to this burden potentially preventable by a future GBS vaccine.
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Affiliation(s)
- Brechje de Gier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- * E-mail:
| | - Merel N. van Kassel
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Elisabeth A. M. Sanders
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Susan J. M. Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Arie van der Ende
- Department of Medical Microbiology and the Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Merijn W. Bijlsma
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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de Gier B, Pita-Rodríguez GM, Campos-Ponce M, van de Bor M, Chamnan C, Junco-Díaz R, Doak CM, Fiorentino M, Kuong K, Angel-Núñez F, Parker ME, Perignon M, Rojas-Rivero L, Berger J, Polman K, Wieringa FT. Soil-transmitted helminth infections and intestinal and systemic inflammation in schoolchildren. Acta Trop 2018; 182:124-127. [PMID: 29486173 DOI: 10.1016/j.actatropica.2018.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 09/26/2017] [Accepted: 02/23/2018] [Indexed: 01/16/2023]
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de Gier B, Suryapranata FST, Croughs M, van Genderen PJJ, Keuter M, Visser LG, van Vugt M, Sonder GJB. Increase in imported malaria in the Netherlands in asylum seekers and VFR travellers. Malar J 2017; 16:60. [PMID: 28148300 PMCID: PMC5288937 DOI: 10.1186/s12936-017-1711-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/25/2017] [Indexed: 01/12/2023] Open
Abstract
Background Malaria is a notifiable disease in the Netherlands, a non-endemic country. Imported malaria infections occur regularly among travellers, migrants and visitors. Surveillance data were analysed from 2008 to 2015. Trends in amounts of notifications among risk groups were analysed using Poisson regression. For asylum seekers, yearly incidence was calculated per region of origin, using national asylum request statistics as denominator data. For tourists, denominator data were used from travel statistics to estimate incidence per travel region up to 2012. Results A modest increase in overall imported malaria notifications occurred in 2008–2015 (from 222 in 2008 to 344 in 2015). Notably, in 2014 and 2015 sharp increases were seen in malaria among travellers visiting friends and relatives (VFR), and in asylum seekers. Of all Plasmodium falciparum infections, most (1254/1337; 93.8%) were imported from Africa; 1037/1337 (77.6%) were imported from Central and West Africa. Malaria in VFR was mostly caused by P. falciparum infection after visiting Ghana (22%) or Nigeria (19%). Malaria in asylum seekers was mostly caused by Plasmodium vivax infection from the Horn of Africa. The large number of notifications in asylum seekers resulted from both an increase in number of asylum seekers and a striking increase of malaria incidence in this group. Incidence of malaria in asylum seekers from the Horn of Africa ranged between 0.02 and 0.3% in 2008–2013, but rose to 1.6% in 2014 and 1.3% in 2015. In 2008–2012, incidence in tourists visiting Central and West Africa dropped markedly. Conclusions Imported malaria is on the rise again in the Netherlands, most notably since 2013. This is mostly due to immigration of asylum seekers from the Horn of Africa. The predominance of P. vivax infection among asylum seekers warrants vigilance in health workers when a migrant presents with fever, as relapses of this type of malaria can occur long after arrival in the Netherlands. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1711-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brechje de Gier
- Department for Early Warning and Surveillance, Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Franciska S T Suryapranata
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. .,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.
| | - Mieke Croughs
- Department of Environment, Public Health Service (GGD) Hart voor Brabant, Ringbaan West 227, 5037 PC, Tilburg, The Netherlands.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Perry J J van Genderen
- Institute for Tropical Diseases, Harbour Hospital Rotterdam, Haringvliet 72, 3011 TG, Rotterdam, The Netherlands
| | - Monique Keuter
- Nijmegen Institute for International Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Centre, C5P46, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Michele van Vugt
- Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Gerard J B Sonder
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands.,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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de Gier B, Nga TT, Winichagoon P, Dijkhuizen MA, Khan NC, van de Bor M, Ponce MC, Polman K, Wieringa FT. Species-Specific Associations Between Soil-Transmitted Helminths and Micronutrients in Vietnamese Schoolchildren. Am J Trop Med Hyg 2016; 95:77-82. [PMID: 27246448 DOI: 10.4269/ajtmh.15-0533] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 03/06/2016] [Indexed: 11/07/2022] Open
Abstract
Soil-transmitted helminth (STH) infections and micronutrient deficiencies are closely related and often coexist among low-income populations. We studied the association between infections with specific STH species and micronutrient status in rural Vietnamese schoolchildren. Children (N = 510) aged 6-9 years were recruited from two primary schools. STH infections were determined in stool samples. Hemoglobin, ferritin, retinol, and zinc were measured in blood samples, as well as C-reactive protein to control for inflammation. Iodine excretion was measured in urine. Associations of single and multiple infections with Ascaris lumbricoides, Trichuris trichiura, and hookworm with micronutrient status (hemoglobin, plasma ferritin, retinol, zinc, and urinary iodine) were estimated by multiple regression analysis. Ascaris infections showed a specific and intensity-dependent negative association with vitamin A. Trichuris and hookworm infections were associated with lower hemoglobin concentration, but not with plasma ferritin. Trichuris-infected children had zinc deficiency less often than uninfected children. In conclusion, our study shows species-specific associations between STH infections and micronutrient status in children. The different life cycles of STH species might have specific effects on the absorption or loss of specific micronutrients. Tailor-made combinations of deworming and nutritional interventions may be needed to improve child health and nutrition.
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Affiliation(s)
- Brechje de Gier
- Section Health and Life Sciences, Athena Institute, Vrije Universiteit (VU University), Amsterdam, The Netherlands
| | | | | | | | | | - Margot van de Bor
- Section Health and Life Sciences, Athena Institute, Vrije Universiteit (VU University), Amsterdam, The Netherlands
| | - Maiza Campos Ponce
- Section Infectious Diseases, Department of Health Sciences, Vrije Universiteit (VU University), Amsterdam, The Netherlands
| | - Katja Polman
- Section Infectious Diseases, Department of Health Sciences, Vrije Universiteit (VU University), Amsterdam, The Netherlands. Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Frank T Wieringa
- UMR-204 NutriPass IRD-UM-SupAgro, Institut de Recherche pour le Développement, Montpellier, France.
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de Gier B, Mpabanzi L, Vereecken K, van der Werff SD, D'Haese PC, Fiorentino M, Khov K, Perignon M, Chamnan C, Berger J, Parker ME, Díaz RJ, Núñez FA, Rivero LR, Gorbea MB, Doak CM, Ponce MC, Wieringa FT, Polman K. Height, zinc and soil-transmitted helminth infections in schoolchildren: a study in Cuba and Cambodia. Nutrients 2015; 7:3000-10. [PMID: 25903454 PMCID: PMC4425185 DOI: 10.3390/nu7043000] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 11/23/2022] Open
Abstract
Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children, plasma zinc was associated with height for age (aB-0.033, p = 0.029), but STH infection was not. Only in Cambodia, STH infection showed an association with zinc concentration (aB-0.233, p = 0.051). Factors influencing child growth differ between populations and may depend on prevalences of STH species and zinc deficiency. Further research is needed to elucidate these relationships and their underlying mechanisms.
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Affiliation(s)
- Brechje de Gier
- Department of Health Sciences, VU University Amsterdam, Amsterdam 1081HV, The Netherlands.
| | - Liliane Mpabanzi
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp 2000, Belgium.
| | - Kim Vereecken
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp 2000, Belgium.
| | | | - Patrick C D'Haese
- Laboratory of Pathophysiology, University of Antwerp, Wilrijk, B-2610, Belgium.
| | - Marion Fiorentino
- Institut de Recherche pour le Développement, UMR-204 NutriPass IRD-UM-SupAgro, Montpellier 34394, France.
| | - Kuong Khov
- Department of Fisheries Post-Harvest Technologies and Quality Control, Fisheries Administration, Phnom Penh 12301, Cambodia.
| | - Marlene Perignon
- Institut de Recherche pour le Développement, UMR-204 NutriPass IRD-UM-SupAgro, Montpellier 34394, France.
| | - Chhoun Chamnan
- Department of Fisheries Post-Harvest Technologies and Quality Control, Fisheries Administration, Phnom Penh 12301, Cambodia.
| | - Jacques Berger
- Institut de Recherche pour le Développement, UMR-204 NutriPass IRD-UM-SupAgro, Montpellier 34394, France.
| | | | - Raquel Junco Díaz
- National Institute of Hygiene, Epidemiology and Microbiology, Havana 10300, Cuba.
| | | | | | - Mariano Bonet Gorbea
- National Institute of Hygiene, Epidemiology and Microbiology, Havana 10300, Cuba.
| | - Colleen M Doak
- Department of Health Sciences, VU University Amsterdam, Amsterdam 1081HV, The Netherlands.
| | - Maiza Campos Ponce
- Department of Health Sciences, VU University Amsterdam, Amsterdam 1081HV, The Netherlands.
| | - Frank T Wieringa
- Institut de Recherche pour le Développement, UMR-204 NutriPass IRD-UM-SupAgro, Montpellier 34394, France.
| | - Katja Polman
- Department of Health Sciences, VU University Amsterdam, Amsterdam 1081HV, The Netherlands.
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp 2000, Belgium.
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de Gier B, Campos Ponce M, van de Bor M, Doak CM, Polman K. Helminth infections and micronutrients in school-age children: a systematic review and meta-analysis. Am J Clin Nutr 2014; 99:1499-509. [PMID: 24740209 DOI: 10.3945/ajcn.113.069955] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. OBJECTIVE We aimed to systematically review current evidence on the relation of helminth infections with micronutrient status in school-age children worldwide. DESIGN We included both observational studies and randomized controlled trials (RCTs). We applied a random-effects meta-analysis to estimate 1) cross-sectional associations between helminths and micronutrient status, 2) effects of anthelminthic treatment on micronutrient status, and 3) effects of micronutrient supplementation on helminth infection and reinfection. RESULTS Meta-analyses of observational studies showed an association between helminth infections and serum retinol [standardized mean difference (SMD): -0.30; 95% CI: -0.48, -0.13] but not serum ferritin (SMD: 0.00; 95% CI: -0.7, 0.7). Conversely, meta-analyses of anthelminthic treatment RCTs showed a positive effect on ferritin (SMD: 0.16; 95% CI: 0.09, 0.22) but not retinol (SMD: 0.04; 95% CI: -0.06, 0.14). The number of studies on micronutrients other than ferritin and retinol was not sufficient for pooling. Meta-analyses of micronutrient-supplementation RCTs showed only a modest protective effect for multimicronutrient interventions on helminth infection and reinfection rates (OR: 0.77; 95% CI: 0.61, 0.97). CONCLUSIONS In this review, we show evidence of distinct associations between helminth infections and micronutrients in school-age children. More studies are needed on micronutrients other than iron and vitamin A and on possible helminth species-specific effects. A thorough comprehension of the interplay between helminth infections and micronutrients will help guide integrated and sustainable intervention strategies in affected children worldwide.
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Affiliation(s)
- Brechje de Gier
- From the Department of Health Sciences (MCP, CMD, and KP) and Section of Health and Life Sciences (BdG and MvdB), VU University Amsterdam, Amsterdam, Netherlands, and the Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (KP)
| | - Maiza Campos Ponce
- From the Department of Health Sciences (MCP, CMD, and KP) and Section of Health and Life Sciences (BdG and MvdB), VU University Amsterdam, Amsterdam, Netherlands, and the Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (KP)
| | - Margot van de Bor
- From the Department of Health Sciences (MCP, CMD, and KP) and Section of Health and Life Sciences (BdG and MvdB), VU University Amsterdam, Amsterdam, Netherlands, and the Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (KP)
| | - Colleen M Doak
- From the Department of Health Sciences (MCP, CMD, and KP) and Section of Health and Life Sciences (BdG and MvdB), VU University Amsterdam, Amsterdam, Netherlands, and the Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (KP)
| | - Katja Polman
- From the Department of Health Sciences (MCP, CMD, and KP) and Section of Health and Life Sciences (BdG and MvdB), VU University Amsterdam, Amsterdam, Netherlands, and the Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (KP)
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Wammes LJ, Hamid F, Wiria AE, de Gier B, Sartono E, Maizels RM, Luty AJF, Fillié Y, Brice GT, Supali T, Smits HH, Yazdanbakhsh M. Regulatory T cells in human geohelminth infection suppress immune responses to BCG and Plasmodium falciparum. Eur J Immunol 2010; 40:437-42. [PMID: 20063313 DOI: 10.1002/eji.200939699] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chronic helminth infections induce T-cell hyporesponsiveness, which may affect immune responses to other pathogens or to vaccines. This study investigates the influence of Treg activity on proliferation and cytokine responses to BCG and Plasmodium falciparum-parasitized RBC in Indonesian schoolchildren. Geohelminth-infected children's in vitro T-cell proliferation to either BCG or pRBC was reduced compared to that of uninfected children. Although the frequency of CD4(+)CD25(hi)FOXP3(+) T cells was similar regardless of infection status, the suppressive activity differed between geohelminth-infected and geohelminth-uninfected groups: Ag-specific proliferative responses increased upon CD4(+)CD25(hi) T-cell depletion in geohelminth-infected subjects only. In addition, IFN-gamma production in response to both BCG and parasitized RBC was increased after removal of CD4(+)CD25(hi) T cells. These data demonstrate that geohelminth-associated Treg influence immune responses to bystander Ag of mycobacteria and plasmodia. Geohelminth-induced immune modulation may have important consequences for co-endemic infections and vaccine trials.
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Affiliation(s)
- Linda J Wammes
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
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