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Krogsgaard LW, Helmuth IG, Bech BH, Plana-Ripoll O, Lützen TH, Vestergaard HT, Bjerre KD, Thomsen RW, Mølbak K, Rytter D. Are unexplained adverse health events following HPV vaccination associated with infectious mononucleosis? - A Danish nationwide matched case-control study. Vaccine 2020; 38:5678-5684. [PMID: 32624249 DOI: 10.1016/j.vaccine.2020.06.057] [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: 02/03/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND In Denmark, the acceptance of the HPV vaccination program has been threatened by reports of suspected adverse events. Epstein Barr Virus (EBV) infection is associated with symptoms of long-lasting tiredness and may be misinterpreted as HPV vaccine adverse events. The main aim of this study was to examine if EBV infection around time of HPV vaccination was a risk factor for later suspected vaccine adverse events. METHODS The study was a nationwide register-based matched case-control study. Cases were females vaccinated against HPV in the period 2011 throughout 2017 with suspected adverse events. For each case, five HPV vaccinated females without suspected adverse events were selected. Information about EBV infection was obtained from the Danish Microbiology Database and assessed for three time periods: (1) before first HPV vaccination, (2) around time of HPV vaccination, and (3) any time during the study period 2010-2017. Multiple logistic regression was used to estimate the association between EBV and suspected adverse events. RESULTS We identified 1217 cases, matched to 6085 controls. A higher proportion of cases (38; 3.1%) than controls (31; 0.5%) were tested for EBV around time of HPV vaccination and cases had elevated odds for testing both EBV positive (OR 4.52, 95% CI 2.68-7.63) and EBV negative (OR 20.99, 95% CI 5.81-75.79). Only five females were classified with acute/recent EVB infection in this period. CONCLUSION Misinterpretation of EBV infection late symptoms is not a leading explanation for Danish females experiencing suspected adverse events after HPV vaccination. Although EBV cannot be excluded as an explanatory factor for a very small proportion of suspected adverse events, the findings are more likely explained by protopathic bias, i.e. the fact that a larger proportion of females suspecting adverse events are tested for EBV.
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Affiliation(s)
- Lene Wulff Krogsgaard
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark.
| | - Ida Glode Helmuth
- Department of Infectious Diseases Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
| | - Bodil Hammer Bech
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark.
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark.
| | - Tina Hovgaard Lützen
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark.
| | | | - Karsten Dalsgaard Bjerre
- Division of Infectious Disease Preparedness, Data Analysis and Integration, Statens Serum Institut, Copenhagen, Denmark.
| | | | - Kåre Mølbak
- Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark; Department of Veterinary and Animal Sciences, University of Copenhagen, Denmark.
| | - Dorte Rytter
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark.
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Vestergaard HT, Thomsen MK, Nielsen L, Panum I. [Diagnostics of congenital cytomegalovirus in Denmark]. Ugeskr Laeger 2018; 180:V03180221. [PMID: 30547875] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Congenital cytomegalovirus (cCMV) is the most common infectious cause of congenital malformations in Denmark. The disease is not notifiable, and there are no national data. A regional Danish prospective study from the 1970s found a cCMV incidence of 0.4%. We propose three algorithms for microbiological diagnosing: 1) Testing of pregnant women should only be -applied, when symptoms compatible with CMV infection are present, and no other diagnoses are found. 2) In children less than three weeks of age urine is the -preferred sample. 3) Retrospectively, cCMV may be diagnosed on dried blood spots, if the mother is CMV IgG-positive.
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Vestergaard HT, Harritshøj LH, Midgley SE, Ullum H, Kampmann P. Transfusion transmission of hepatitis A virus with fecal shedding in a previously hepatitis A vaccinated recipient. J Infect Chemother 2018; 24:766-768. [PMID: 29490881 DOI: 10.1016/j.jiac.2018.01.020] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 11/28/2022]
Abstract
We describe a rare case of hepatitis A virus (HAV) replication in feces despite presence of hepatitis A antibodies in an acute myeloid leukemia (AML) patient after transfusion with HAV contaminated platelets. The patient has been vaccinated against HAV years before the AML diagnosis. Transient infection and reshedding should thus be considered in antibody-positive hematological patients. Transfusion associated HAV transmission is rare, and little evidence exists on the clinical consequences and possible effect of treatment with immunoglobulin. Further reporting on fecal shedding despite antibodies are needed, as HAV antibody levels are used as course of action for post-exposure prophylaxis and infection control.
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Affiliation(s)
| | - Lene Holm Harritshøj
- Department of Clinical Immunology, Blood Bank, Rigshospitalet, Copenhagen, Denmark
| | | | - Henrik Ullum
- Department of Clinical Immunology, Blood Bank, Rigshospitalet, Copenhagen, Denmark
| | - Peter Kampmann
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
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Vestergaard HT, Joergensen CS, Ott P, Frische A. HEPATITIS E – Reaction or unspecific reaction? J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gillesberg Lassen S, Soborg B, Midgley SE, Steens A, Vold L, Stene-Johansen K, Rimhanen-Finne R, Kontio M, Löfdahl M, Sundqvist L, Edelstein M, Jensen T, Vestergaard HT, Fischer TK, Mølbak K, Ethelberg S. Ongoing multi-strain food-borne hepatitis A outbreak with frozen berries as suspected vehicle: four Nordic countries affected, October 2012 to April 2013. Euro Surveill 2013; 18:20467. [PMID: 23647625] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- S Gillesberg Lassen
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
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Gillesberg Lassen S, Soborg B, Midgley SE, Steens A, Vold L, Stene-Johansen K, Rimhanen-Finne R, Kontio M, Löfdahl M, Sundqvist L, Edelstein M, Jensen T, Vestergaard HT, Fischer TK, Mølbak K, Ethelberg S. Ongoing multi-strain food-borne hepatitis A outbreak with frozen berries as suspected vehicle: four Nordic countries affected, October 2012 to April 2013. Euro Surveill 2013. [DOI: 10.2807/ese.18.17.20467-en] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- S Gillesberg Lassen
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - B Soborg
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - S E Midgley
- Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | - A Steens
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - L Vold
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - K Stene-Johansen
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - R Rimhanen-Finne
- Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
| | - M Kontio
- Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
| | - M Löfdahl
- Department of Preparedness, Swedish Institute for Communicable Disease Control, Stockholm, Sweden
| | - L Sundqvist
- Department of Preparedness, Swedish Institute for Communicable Disease Control, Stockholm, Sweden
| | - M Edelstein
- Department of Epidemiology and Biostatistics, Swedish Institute for Communicable Disease Control, Stockholm, Sweden
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - T Jensen
- The Danish Veterinary and Food Administration, Copenhagen, Denmark
| | - H T Vestergaard
- Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | - T K Fischer
- Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | - K Mølbak
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - S Ethelberg
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
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