April 20, 2020
MULTIPLE BRANDS OF BAD TESTS (WASHINGTON POST)
Serious problems are being reported with a new generation of tests flooding U.S. markets. The Food and Drug Administration allowed more than 90 brands of unvetted antibody tests to be sold to hospitals and acknowledges that some of them may be inaccurate or fraudulent. The tests are supposed to identify people who have been exposed to the virus, but health experts fear they may be giving false results. “Having many inaccurate tests is worse than having no tests at all,” the director of infectious disease programs at the Association of Public Health Laboratories told The Post.
CLAIM: Smithfield Foods was sold recently to China. The hogs will still be raised in the U.S., but slaughtered and packaged for sale in China before being sent back here.
THE FACTS: Smithfield Foods does not import any products from China to the U.S. Social media users began resharing the false claim following the closure of a Smithfield Foods pork processing plant in South Dakota on Sunday due to hundreds of employees testing positive for the coronavirus. The false claim has been circulating online since 2014. Smithfield Foods was sold to Chinese pork giant WH Group in 2013. Jenna Wollin, a spokeswoman for Smithfield Foods, told The Associated Press in an email that the claims circulating online were false. “No Smithfield products come from animals raised, processed, or packaged in China,” she said. “All our U.S. products are made in one of our nearly 50 facilities across America. These products are produced in compliance with the strict standards and regulations of the U.S. Department of Agriculture (USDA), U.S. Food and Drug Administration (FDA), and other federal and state authorities.” Posts with the false claim, which were shared hundreds of times, told social media users to “read this before buying meat.”
(Work in progress, sent by JHopkins) 1. Introduction
Most pathogens enter the human body at mucosal surfaces lining the oral, nasal, rectal, or vaginal orifices and first infect cells at these ports of entry. Systemic disease ensues when the microbes or their toxins break down epithelial barriers and spread via the bloodstream. This mode of infection suggests that the most attractive routes for immunization could be at the mucosal surfaces first encountered, but most vaccines continue to be administered via intramuscular or subcutaneous injection. Mucosal vaccination induces pathogen-specific mucosal immune responses that can stop infection before it spreads to distal sites, but traditional intra- muscular and subcutaneous injections often do not provide this type of protection, especially in infants . As an alternative, the oral route of delivery is acceptable for medicines across all global cultures, with a high rate of patient compliance. The oral cavity itself has potential sites for mucosal immunization (e.g., sublingual) and is also the gateway to the mucosal lining of the gastrointestinal tract. However, only a few vaccines targeting the intestinal mucosa are administered orally because of the challenges of over- coming stomach acid and enzymatic degradation, which typically require large buffer volumes or an enteric coating for protection until the antigen reaches the intestine.
Advantages of oral vaccination include its needle-free format, which prevents needlestick injury and eliminates sharps waste. Oral vaccines can be administered by health workers with minimal training, and needle-free vaccination reduces vaccine hesitancy due to needle phobia, especially for the pediatric population. However, most current products are either in liquid form (cholera and rotavirus vaccines) that require an administration device or are presented as capsules (typhoid fever vaccine) too difficult for children to swallow.
To address disadvantages of current oral vaccines, we have developed a promising novel dosage form, the freeze-dried fast- dissolving tablet (FDT). Freeze-drying is the gold standard method for manufacture of vaccines—both oral and injectable—and our FDTs have the potential to be manufactured in current facilities with minimal changes to production. These tablets dissolve quickly, allowing adults to take them directly without added liquid, and require only 1.5–2 mL of fluid (less than a teaspoon) for administration to children (Fig. 1). FDTs could be administered by all levels of health workers—and possibly by patients themselves—which would accelerate vaccination rates in the event of a disease outbreak. Below we briefly discuss ongoing research on oral vaccines that target the intestinal mucosa, and then describe the techniques used in producing our FDTs, along with the resulting properties that could bring new advantages to oral vaccine production and administration. ….
The Promise and Peril of Antibody Testing for COVID-19 JAMA. Published online April 17, 2020. doi:10.1001/jama.2020.6170
Unlike polymerase chain reaction (PCR) tests—also referred to as molecular or nucleic acid–based tests—antibody tests aren’t intended to identify active SARS-CoV-2 infections. Instead of detecting viral genetic material in throat or nasal swabs, antibody tests reveal markers of immune response—the IgM and IgG antibodies that for most people show up in blood more than a week after they start to feel sick, when symptoms may already be waning.
Serologic antibody tests not only can confirm suspected cases after the fact, they can also reveal who was infected and didn’t know it. Up to a quarter of people with SARS-CoV-2 infection may unwittingly spread the virus because they have mild or no symptoms.
In their first therapeutic application, serology tests are being used to screen donor blood for antibodies to SARS-CoV-2(Covid-19) Plasma containing the antibodies from recovered patients is then transfused to gravely ill patients in an experimental treatment known as convalescent plasma. Early results from a small number of Chinese patients, published in JAMA in late March, were promising.
But experts strongly underscored that antibody testing generally should not be used to diagnose active cases.
(J.Harris: This is the type of test that Christus Good Shepherd is offering soon in East Texas. It is still not known if positivity for the antibody confers immunity nor how long the antibody will persist in the tested person’s blood. But the test is quick, cheap, and may be very helpful. Health care personnel who are positive might have less chance of reacquiring Covid-19 virus infection again and could perhaps safer work with infected patients. Read this article for yourself. It contains useful information about other types of tests and vaccine possibilities)
EPI UPDATE The WHO COVID-19 Situation Report for April 19 FROM JOHNS HOPKINS, COUNTS FROM AROUND THE WORLD
Experience in Spain
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