02 / 2022

Content:

• Editorial
• History and changes of the anti-vaccination movement – Vanda Boštíková, Václav Moravec
• HPV vaccination in pregnancy – Borek Sehnal, Jiří Sláma, Jiří Vojtěch
• The role of vaccines in the prevention and treatment of head and neck cancer – Stanislav Batko
• SARS-CoV-2 diagnosis using RT-PCR –Barbora Macúchová, Vanda Boštíková, Hana Bílková Fránková
• Use of biofilms for vaccine design and preparation – 21st century technology – Vanda Boštíková, Michaela Hympánová, Hana Straková, Jan Marek

Editorial

Vážení čtenáři, kolegové a kolegyně, na dveře nám klepe neodbytně podzim a teploty nám klesají do chladnějších pásem. To nás bude nutit k těsnějším kontaktům, v letošním roce možná těsnějším než jindy, neboť redukce topení nás bude nutit zahřívat se vzájemně. Na to se již těší naše oblíbené mikroorganismy, a tak můžeme očekávat z tohoto hlediska opět zajímavou podzimní a zimní sezónu.

Covid-19 nezmizel v propadlišti dějin, jak jsme si všichni přáli, ale stále je tu s námi a bohužel o sobě dává vědět. V posledních dnech vidíme očekávané nárůsty pozitivních záchytů, ale i narůstající počty hospitalizovaných. Naštěstí počet závažných průběhů onemocnění příliš nestoupá. Protože nálada ve společnosti nepřeje plošnému používání roušek nebo respirátorů, dá se po dvou mírných sezónách očekávat i výrazný nástup chřipky. Zde nás čeká tradiční souboj o zvýšení proočkovanosti, která je u nás dlouhodobě hluboko pod 10 %, tedy násobně níže než v některých západních zemích. Také nás trochu děsil výskyt opičích neštovic. Celosvětově již máme 69 tisíc případů, naštěstí se však počáteční prudký nárůst zastavil a epidemie již výrazně klesá. To znamená, že přijímaná opatření mají výrazný dopad.

V uplynulých dnech jsme absolvovali tradiční výroční konferenci – Hradecké vakcinologické dny. Konal se již 17. ročník a s výjimkou doby covidové se uskutečnila každý rok. Konference se zúčastnilo na 350 delegátů, zároveň jsme přivítali i ministra zdravotnictví prof. Vlastimila Válka a hlavní hygieničku MUDr. Pavlu Svrčinovou. Měli jsme možnost diskutovat řadu sdělení s přímým dopadem do současné praxe. V diskuzích dominovala témata přeočkování u meningokokových onemocnění, úhrada vícevalentních vakcín proti pneumokokům, přeočkování u diptherie a polia a celá řada dalších. Do programu se vrátila i oblíbená sekce otázek a odpovědí.

S přáním klidného podzimu za redakční radu prof. MUDr. Roman Prymula, CSc., Ph.D.

(články)

History and changes of the anti-vaccination movement

Summary:

Although the term “antivax” is a modern term, opposition to vaccination has been around for a long time. The first steps by vaccine rejectionists were recorded when the English physician Edward Jenner introduced the smallpox vaccine and the vaccination campaign led to the only successful eradication of the highly dangerous, life-threatening viral disease to date. It is well known that vaccination is the safest method of preventing many infectious diseases worldwide. Unfortunately, people who oppose vaccination represent a significant proportion of the world’s population. The anti-vaccination movements not only have a negative impact on collective vaccination, for example on the decline in vaccination coverage, but are now also influencing decision-making processes. In the light of the growing number of anti-vaccine groups, this phenomenon should not be underestimated and treated as a mere reaction against vaccines, but should be studied in detail in a transdisciplinary manner in order to counter it as effectively as possible.

Keywords:

infectious diseases, vaccination, vaccines, antivaccine movement, misinformation, Edward Jenner, smallpox

Vanda Boštíková,¹ Václav Moravec²

¹Katedra epidemiologie, Fakulta vojenského zdravotnictví, Univerzita obrany, Hradec Králové

²Katedra žurnalistiky, Fakulta sociálních věd, Univerzita Karlova, Praha

HPV vaccination in pregnancy

Summary:

Human papillomavirus (HPV) infection is the most common sexually transmitted infection. Persistent HPV infection has been repeatedly associated with the development of anogenital and oropharyngeal cancers and genital warts. The prevalence of HPV infection appears to be twice as high in pregnant persons compared to non-pregnant persons. In addition, various studies suggest a negative effect of HPV infection on the course and complications of pregnancy. To date, millions of doses of HPV vaccine have been administered worldwide. Unintentional administration of the HPV vaccine during pregnancy occurs most often in fertile young women, who are often unaware of their pregnancy at the time. The HPV vaccine has not been approved for pregnant persons and is therefore not recommended. If unintentionally administered during pregnancy, it is recommended to delay the remaining doses of the vaccine until after delivery. On the other hand, according to current scientific evidence, there is no link between HPV vaccination before or during pregnancy and adverse pregnancy outcomes. No increased incidence of fetal birth defects has been observed after vaccination and termination of pregnancy is not warranted in this case.

Keywords:

human papillomavirus, HPV vaccination, pregnancy, pregnancy complications, obstetric outcomes

Borek Sehnal,¹ Jiří Sláma,² Jiří Vojtěch²

¹Gynekologicko-porodnická klinika, Fakultní nemocnice Bulovka a 1. lékařská fakulta Univerzity Karlovy, Praha

²Gynekologicko-porodnická klinika 1. lékařské fakulty a Všeobecné fakultní nemocnice v Praze

The role of vaccines in the prevention and treatment of head and neck cancer

Summary:

Head and neck tumors significantly contribute to the overall cancer incidence and mortality. Recently, notable rise of the HPV associated tumors has been observed in this heterogeneous group, mainly represented by oropharyngeal carcinomas. Currently, 70–90% of all oropharyngeal carcinomas are HPV positive. Treatment algorithms involve surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy, nevertheless overall mortality from this malignancy still exceeds 40%. Investigation of the role of HPV bivalent and quadrivalent vaccination has demonstrated the ability to induce the production of neutralizing antibodies. Furthermore, studies which compared the incidence of HPV positivity in oral specimens found that vaccination led to a significant decrease in the prevalence of HPV positivity, corresponding to a 72–88% vaccination efficacy. In June 2020, the indication for Gardasil vaccine was expanded to include prevention of oropharyngeal carcinomas and recommended for both sexes in the age range 9–45 years.

Keywords:

head and neck cancer, oropharyngeal cancer, HPV, vaccination

Stanislav Batko

Onkologická klinika FN Motol a 2. lékařské fakulty Univerzity Karlovy,

Fakulta vojenského zdravotnictví, Univerzita Obrany, Hradec Králové

SARS-CoV-2 diagnosis using RT-PCR

Summary:

The highly infectious disease COVID-19 caused by rapidly evolving variants and sub-variants of the novel SARS-CoV-2 is a grand challenge for microbiological laboratories as well as the whole world pandemic situation that has been going on for three years. During very short period all the laboratories were pushed to change their routine to be able to process increased number of clinical samples and also change the entire diagnostics to suit the new situation in healthcare. The golden standard of clinical diagnostic detection of SARS-CoV-2 are RT-PCR tests, which are very sensitive and specific. It is the molecular biological diagnostics that, when properly set up and used, can bring the situation under control together with antiepidemic measures. Nevertheless, it is important to count with a couple of important factors from a sample collection to the final analysis of the results in laboratory diagnostics. The following text is based on the experience of Czech molecular biology laboratory, where the samples are processed from the very beginning after collection of samples to their evaluation of results and transmission of the resulting data back to clinical workplaces.

Keywords:

COVID-19, SARS-CoV-2, coronaviruses, pandemic, molecular diagnostic, microbiology, PCR, viral disease, infectious diseases

Barbora Macúchová,^1,2 Vanda Boštíková,¹ Hana Bílková Fránková²

¹Fakulta vojenského zdravotnictví, Univerzita obrany, Hradec Králové

²Laboratoř klinické mikrobiologie, Laboratoře Agel, Ostrava-Vítkovice

Use of biofilms for vaccine design and preparation – 21st century technology

Summary:

Biofilms can produce bacteria, as well as yeast, fungi or protozoa, or small multicellular organisms that produce a mucous polysaccharide shell around them. The biofilm cells adhere to each other or are firmly attached to the surface. This “envelope” then allows the cells to transport nutrients, communicate with each other, creates a stable environment and provides protection against toxins, radiation as well as antimicrobials. In addition to polysaccharides, nucleic acids, lipids or enzymes, it can contain a various of inorganic substances. It follows that the biofilm is able to adhere to various surfaces. Biofilms produced in both human and animal play a very important role in the pathogenesis of a significant number of infectious diseases. It is often the cause of very serious, chronic and often resistant infections. Innovations in the development of vaccines using antigens isolated from biofilms represent a very promising approach to the prevention of infectious diseases and may increase the protective effects of existing vaccines.

Keywords:

vaccines, vaccination, biofilm, matrix, infectious diseases, bacteria, viruses, immune sytem, reverse vaccinology

Vanda Boštíková,¹ Michaela Hympánová,^{1, 2} Hana Straková,^{1, 2} Jan Marek^{1, 2}

¹Katedra epidemiologie, Fakulta vojenského zdravotnictví, Univerzita obrany

²Centrum biomedicínského výzkumu, Fakultní nemocnice Hradec Králové