1- Monday Infectious Disease News – 1st November 

1 – Delta ‘Plus’ Covid variant may be more transmissible

• A new mutated form of coronavirus that some are calling “Delta Plus” may spread more easily than regular Delta, UK experts now say.
• The UK Health Security Agency (UKHSA) has moved it up into the “variant under investigation” category, to reflect this possible risk.
• There is no evidence yet that it causes worse illness.
• And scientists are confident that existing vaccines should still work well to protect people.
• Although regular Delta still accounts for most Covid infections in the UK, cases of “Delta Plus” or AY.4.2 have been increasing.
• Latest official data suggests 6% of Covid cases are of this type.

Source: BBC

2 – The delta variant has a mutation that’s worrying experts: Here’s what we know so far

• A newly-discovered mutation of the delta variant is under investigation in the U.K.
• There are worries that it could make the virus yet more transmissible, and could possibly undermine Covid-19 vaccines further.
• Still, there are many unknowns surrounding this new descendent of the delta variant and it has not been dubbed a “variant of concern” yet.
• A large part of the world remains unvaccinated (only 2.8% of people in low-income countries have received at least one dose of a Covid vaccine, according to Our World in Data) while developed countries are seeing more and more “breakthrough” cases as immunity to Covid wanes around six months after being fully vaccinated.
• A more infectious variant could undermine vaccine efficacy even further, although there is no indicated that is the case yet with the AY.4.2 subtype.

Source: CNBC

3 – Association of Age With SARS-CoV-2 Antibody Response

• Accumulating evidence suggests that children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to manifest mild symptoms and are at a lower risk of developing severe respiratory disease compared with adults.
• It remains unknown how the immune response in children differs from that of adolescents and adults.
• This study aims to investigate the association of age with the quantity and quality of SARS-CoV-2 antibody responses.
• The results of this study suggest that SARS-CoV-2 viral specific antibody response profiles are distinct in different age groups.
• Age-targeted strategies for disease screening and management as well as vaccine development may be warranted.

Source: JAMA Network

4- Association Between Removal of a Warning Against Cephalosporin Use in Patients With Penicillin Allergy and Antibiotic Prescribing

• Electronic health records (EHRs) often include default alerts that can influence physician selection of antibiotics, which in turn may be associated with a suboptimal choice of agents and increased antibiotic resistance.
• This study aims to examine whether removal of a default alert in the EHR to avoid cephalosporin use in patients with penicillin allergies is associated with changes in cephalosporin dispensing or administration in these patients.
• In this cohort study, removal of a warning in the electronic health record to avoid cephalosporin use in patients with penicillin allergies was associated with increased administration and dispensing of cephalosporin.
• This simple and rapidly implementable system-level intervention may be useful for improvement in antibiotic stewardship.

Source: JAMA Network

5 – Assessment of Allergic and Anaphylactic Reactions to mRNA COVID-19 Vaccines With Confirmatory Testing in a US Regional Health System

• As of May 2021, more than 32 million cases of COVID-19 have been confirmed in the United States, resulting in more than 615 000 deaths.
• Anaphylactic reactions associated with the Food and Drug Administration (FDA)–authorized mRNA COVID-19 vaccines have been reported.
• This study aims to characterize the immunologic mechanisms underlying allergic reactions to these vaccines.
• Based on this case series, women and those with a history of allergic reactions appear at have an elevated risk of mRNA vaccine allergy.
• Immunological testing suggests non–IgE-mediated immune responses to PEG may be responsible in most individuals.

Source: JAMA Network

6 – Prevalence of Allergic Reactions After Pfizer-BioNTech COVID-19 Vaccination Among Adults With High Allergy Risk

• Allergic reactions among some individuals who received the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine discourage patients with allergic conditions from receiving this vaccine and physicians from recommending the vaccine.
• This study aims to describe the assessment and immunization of highly allergic individuals with the BNT162b2 vaccine.
• The rate of allergic reactions to BNT162b2 vaccine, is higher among patients with allergies, particularly among a subgroup with a history of high-risk allergies.
• This study suggests that most patients with a history of allergic diseases and, particularly, highly allergic patients can be safely immunized by using an algorithm that can be implemented in different medical facilities and includes a referral center, a risk assessment questionnaire, and a setting for immunization under medical supervision of highly allergic patients.
• Further studies are required to define more specific risk factors for allergic reactions to the BNT162b2 vaccine.

Source: JAMA Network

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