Content:
- Editorial
- Seroprevalence of tick-borne encephalitis in the adult population of the Czech Republic – Irena Hanovcová, Martina Malíková, Jan Smetana, Lucie Siráková, Petra Polcarová, Roman Chlíbek
- Attitudes of Army of the Czech Republic soldiers towards vaccination against covid-19 – Klára Lesňáková, Martina Malíková, Roman Chlíbek, Petra Polcarová, Jan Smetana
- Effect of prophylactic vaccination against HPV infection on the incidence of cervical precancers and cancers –Borek Sehnal, Jiří Sláma
- Vaccination of pregnant and breastfeeding women against covid-19 and other diseases – Roman Chlíbek
- Development in the field of vaccination against invasive meningococcal diseases in the Czech Republic – Jan Smetana
- Case study – invasive pneumococcal infection in a post-splenectomy patient – Barbora Hrstková, Lenka Petroušová
- Spike ferritin nanoparticle (SpFN) WRAIR’s COVID-19 vaccine and SARS-CoV-2 spike receptor–binding domain ferritin nanoparticle RFN vaccine from American Walter Reed Institute, during pandemic of SARS-CoV-2 – Vanda Boštíková
EDITORIAL
Vážení čtenáři, kolegové a kolegyně, covidová vlna nedávno prakticky odezněla a zdálo by se, že nás čekají relativně klidné prázdniny. Je však řada skutečností, které tento optimismus přinejmenším kalí.
Konflikt na Ukrajině na sebe strhuje veškerou pozornost, možná až příliš velkou u našich politiků, neboť se nezdá, že by se stejnou vervou řešili domácí závažné ekonomické problémy. Válka je nepochybně obrovskou katastrofou, která má dopady i do medicíny. Pomineme-li klasická válečná traumata, důležitou roli hrají i nechirurgické ztráty a prudce se zhoršující epidemiologická situace, rezultující v epidemie cholery či bacilární dyzenterie.
U nás očekáváme spíše další vývoj covidu-19. Již dnes vidíme mírný nárůst pozitivních záchytů při minimálním testování. Různé varianty omikronu jsou strašákem v různých zemích světa, ať je to BA.2, BA.2.12, BA.2.12.1, BA.4, nebo BA.5. A postupně se vynořují nové vlny onemocnění prakticky na všech kontinentech. Očkovací strategie je nejasná, neboť teoreticky se nabízející čtvrté dávky vakcín nemusí mít takový benefit, jaký bychom si všichni přáli. Zatím je zřejmé, že je dostatek vakcín Pfizer a Moderna, které jsou však na bázi původního kmenu Wuhan, jenž se poměrně výrazně liší od aktuálně cirkulujících variant viru, a míra protektivity je tak poměrně nízká. Nová dvojkombinovaná vakcína bude registrována zřejmě až na přelomu září a října a stát by se měl rozhodnout, jestli ji vůbec nakoupí.
Další pozoruhodnou událostí je záchyt a epidemické šíření opičích neštovic. K dnešnímu dni (13. 6.) je 1 480 případů s naprosto dominujícím přenosem v homo- a bisexuální komunitě. Věřme, že nedojde k masívnímu šíření v běžné populaci, protože i když průběh onemocnění není smrtící a obecně poměrně mírný, zavlečení do populace jistě není nezbytné.
Z příjemnějších zpráv bych doplnil informaci o konaném XIII. slovenském vakcinologickém kongresu, kde jsme se opět, po určité době, mohli střetnout takříkajíc „naživo“ a zavzpomínat na staré dobré časy.
Za redakční radu
prof. MUDr. Roman Prymula, CSc., Ph.D.
Seroprevalence of tick-borne encephalitis in the adult population of the Czech Republic
Summary:
Introduction: The Czech Republic has long been one of the countries with the highest incidence of tick-borne encephalitis (TBE) in Europe. In the period 2000–2010, it was one of the most affected countries in Europe, with 25% of all TBE cases reported to the European Centre of Disease Control and Prevention, followed by Latvia with 15% and Lithuania and Germany with 11%. Since 2015, there has been seen a further continuous increase in the incidence of TBE in the Czech Republic. Method and
Material: In the present study of seroprevalence, we monitored the presence of IgG antibodies against tick-borne encephalitis virus (TBEV) by ELISA in the serum of almost 3,000 individuals from three regions of the Czech Republic with different incidence of the disease and different rates of vaccination against TBE. The study also included a questionnaire survey, which focused on obtaining data on the frequency of their stay in nature, exposure to tick bites, tick-borne encephalitis and vaccination.
Results: According to the data from the questionnaires, the average vaccination rate in the study group was 27.67% in 2015, the highest in the region with the highest long-term incidence of TBE in České Budějovice – 51.83%, in the Brno region – 34.02% and in the Hradec Králové region – 19.96%. The average seropositivity rate in the entire cohort was 27.74%, the highest in the 18–29- -year age group (35.29%) and decreased with increasing age up to the age group 50–59 years (22.69%), and remained at the same level in older age groups. Anti-TBEV antibodies were found in 88.18% of the vaccinated individuals and 4.42% of the unvaccinated individuals. Antibody levels were statistically significantly different between vaccinated and unvaccinated subjects and decreased with age in both groups. The highest seroprevalence was registered in the centre of České Budějovice, both among vaccinated persons (95.29%) and among unvaccinated persons (15.70%). In both other sampling centres, seropositivity was statistically significantly lower in both vaccinated and unvaccinated groups – 89.02% of vaccinated and 3.83% of unvaccinated persons in the Brno region and 83.21% of vaccinated and 2.93% of unvaccinated persons in the Hradec Králové region. There were no statistically significant differences between men and women. In the group of people who reported the administration of the last dose of the TBE vaccine 15 to 20 years ago, antibodies were still found in 73.68% of the people with an average concentration of 1 184 VIEU/ml.
Conclusion: TBE vaccination coverage in the Czech Republic is very low, averaging less than 30%, and varies considerably between regions. More than 50% of the vaccination coverage was found only in the region with the highest long-term incidence of TBE. In recent years, infected ticks with the TBE virus have been known to appear even in areas where they were previously absent. The increasing incidence of TBE in the country clearly shows that population protection is insufficient. In our study, we showed that serum anti-TBE antibodies persist in more than 85% of vaccinated people even 15 years after vaccination. It would be worth considering whether extending the intervals of booster doses administered 5 years after completion of core vaccination would contribute to a greater willingness of people to be vaccinated against TBE.
Keywords:
tick-borne viral encephalitis, seroprevalence, adults, Czech Republic
Irena Hanovcová,1 Martina Malíkova,1 Jan Smetana,1 Lucie Siráková,1 Petra Polcarová,2 Roman Chlíbek1
1Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové 2Sekce vojenského zdravotnictví Ministerstva obrany, Hradec Králové
Attitudes of Army of the Czech Republic soldiers towards vaccination against covid-19
Summary:
Introduction: Vaccination against covid-19 fundamentally helped alleviate the impact of the pandemic. The attitudes towards this vaccination differ especially in the lay public. A similar spectrum of opinions can be found in civilian surroundings even among professional soldiers. They undergo even more mandatory vaccinations against selected number of infectious diseases. The objective of the presented survey was to find out the relationship between professional soldiers and covid-19 vaccination and to analyze causes of refusal. Methodology: The Ministry of Defense conducted the survey in March and September 2021. It was sent in electronic form to authorized personnel of units and bases, who ensured successful filling by employees of that specific workplace. The March survey focused on finding out the interest of soldiers to get inoculated against covid-19. In September, the main point was to determine the total number of fully vaccinated soldiers and their attitude toward booster shots. In both months, the questions for unvaccinated soldiers focused on the frequently used reasons that led to the decision not to get vaccinated. Results: In the first phase, there were 23,886 soldiers, and the second phase consisted of 23,245 professional soldiers. All interviewed soldiers were over the age of 18 years with a different degree of education. 62 % of the respondents in the March phase exhibited interest in getting vaccinated against covid-19, while those refusing vaccination stated in 36 % fear of safety of vaccines, in 27 % mistrust in effectiveness, in 25 % relying on past infection, and in 12 % in general negative attitude against vaccination. In September, there were 79 % fully vaccinated soldiers. Unvaccinated individuals stated in 31 % fear of inoculation safety, in 27 % mistrust in sufficient effectiveness, in 27 % relying on past infection and in 15 % in general negative attitude against vaccination. In September, 61% of the professional soldiers interviewed with the complete primary vaccination course were interested in booster shots.
Conclusion: The survey results show that in current times there is a high vaccination rate and majority of interviewed was interested in a booster shot. Among unvaccinated individuals, the main causes of refusal are fear of vaccine safety and doubts about their efficiency.
Keywords:
SARS-CoV-2, covid-19, immunization, Army of the Czech Republic, booster shot, refusal of vaccination
Klára Lesňáková,1,2 Martina Malíková,1 Roman Chlíbek,1 Petra Polcarová,1 Jan Smetana1
1Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové
2Sekce vojenského zdravotnictví Ministerstva obrany, Hradec Králové
Effect of prophylactic vaccination against HPV infection on the incidence of cervical precancers and cancers
Summary:
Human papillomavirus (HPV) infection causes about 5% of all human cancers. Three prophylactic vaccines against HPV infection are currently available: the bivalent Cervarix, the quadrivalent Gardasil (formerly Silgard) and the nonavalent Gardasil 9. Extensive scientific data demonstrate their significant efficacy in preventing the development of persistent HPV infection and cervical precancers. In addition, early data also demonstrate a direct impact on reducing the incidence of invasive cervical cancer in vaccinated individuals. Furthermore, quadrivalent and nonavalent vaccines are highly effective in preventing condylomata. Efficacy is highest against lesions that are caused by vaccine genotypes, and the highest efficacy is achieved in the HPV naive population. The Czech Republic is among the countries with a national vaccination programme where HPV vaccination is covered by health insurance for girls and boys aged 13–14 years. Despite this, the declining trend in vaccination coverage of the target population is a persistent problem.
Keywords:
HPV, vaccination, prophylactic HPV vaccine, efficacy, precancer lesion, cervical carcinoma
Borek Sehnal,1,2 Jiří Sláma3
¹Onkogynekologické centrum, Gynekologicko-porodnická klinika 1. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Bulovka
2Nemocnice Neratovice
3Gynekologicko-porodnická klinika 1. lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice
Vaccination of pregnant and breastfeeding women
Summary:
Infectious disease in a woman during pregnancy can threaten not only the mother, but also the fetus and the entire course of pregnancy. A significantly higher risk of death, including fetal death, severe course of infection, risk of preterm delivery, and need for acute caesarean section in pregnant women compared to the general population has been confirmed in the case of covid-19. Similar experiences have been reported from previous coronavirus pandemics. Vaccination of pregnant women is becoming an increasingly important protective measure. By a number of professional societies, based on evidence-based medicine, vaccination during pregnancy is being delivered. The most common recommendations are for vaccination against covid-19, influenza and whooping cough. With the advent of a new generation of mRNA vaccines, a number of clinical and population-based studies have already been conducted demonstrating sufficient immunogenicity, safety and efficacy of vaccination in pregnant and breastfeeding women. The transfer of maternal antibodies after vaccination to the fetus and the passage of antibodies into breast milk have been confirmed. Thus, vaccination provides protection not only to the vaccinated mother but also to her newborn. The correct timing of vaccination also plays a role. The results of studies have not yet confirmed a significant safety risk of vaccination during pregnancy. Vaccination of pregnant and breastfeeding women should therefore become an integral part of routine vaccination practice.
Keywords:
gravidity, vaccination, covid-19, influenza, whooping cough, safety, efficacy
Roman Chlíbek
Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové
Development in the field of vaccination against invasive meningococcal diseases in the Czech Republic
Summary:
Invasive meningococcal diseases are high-risk diseases due to high mortality and long-term consequences. Vaccination protects against the disease. Two groups of vaccines are available, group B meningococcal vaccines and group A, C, W and Y meningococcal vaccines. To ensure the widest possible level of protection, the combined use of both types of vaccines is recommended.
The use of vaccination is affected not only by the recommendation of vaccination, but also its reimbursement. In the Czech Republic, full reimbursement of meningococcal vaccines has been introduced since 1 January 2022 for defined age groups, children and adolescents. Vaccination against invasive meningococcal diseases caused by group B meningococcus is currently covered if vaccination is started before the age of 12 months or since the age of 14 years to the age of 15 years, and groups A, C, W and Y if the vaccination is given as a single dose since the completion of the first year of age to the completion of the second year of age or since the completion of the 14th to the completion of the 15th year of age. Vaccination is also reimbursed if it is performed after the stated deadlines, if the administration of one or more doses of vaccines has been delayed due to the health condition of the vaccinee. Vaccination against invasive meningococcal diseases in people with a defined health risk also reimbursed.
Keywords:
invasive meningococcal diseases, epidemiology, vaccination, reimbursement
Jan Smetana
Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové
Case study – invasive pneumococcal infection in a post-splenectomy patient
Summary:
This case study reviews the symptoms and treatment of a 39-year-old post-splenectomy male patient who underwent pneumococcal sepsis accompanied by meningitis which eventually lead to partial hearing loss. Patients after splenectomy are often prone to invasive pneumococcal infections with either lethal or permanently damaging consequences. Such patients are prescribed 13-valent conjucate vaccine combined with 23-valent polysaccharide vaccine.
Keywords:
Streptococcus pneumoniae, meningitis, splenectomy, hypacusis, vaccination
Barbora Hrstková, Lenka Petroušová
Klinika infekčního lékařství, FN Ostrava
Spike ferritin nanoparticle (SpFN) WRAIR’s COVID-19 vaccine and SARS-CoV-2 spike receptor–binding domain ferritin nanoparticle RFN vaccine from American Walter Reed Institute during pandemic of SARS-CoV-2
Summary:
In general, it can only be stated that new or emerging diseases are dangerous diseases and have high potential for spreading. Their common denominator is high mortality, dangerous spread in the population and limited treatment options. Today, there is a real possibility of introducing these diseases from the areas of their occurrence due to massive tourism, population migration and foreign workers. Another possibile way of their spread may be abuse in the form of bioterrorism, i.e. the use of an infectious agent as a biological weapon.
The World Health Organization (WHO) continuously monitors and quantifies dangerous events in several well-defined categories (e.g. nuclear hazards, chemical hazards, natural disasters), however, annual as well as long-term statistics lead infectious diseases worldwide, which, due to epidemics and pandemics, account for more than 80% of the overall picture.
The current SARS-CoV-2 pandemic is unprecedented. This is also because it is the first pandemic in human history, during which we are able to develop both drugs and vaccines against the biological agent.
Keywords:
pandemic, SARS-CoV-2, infectiuos diseases, yellow fever, Watker Reed, american military research, candidate vaccines
Vanda Boštíková
Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové