Topics in Infection 2017
This year ‘Topics in Infection’ celebrated its 43rd annual meeting. Organised in association with Public Health England and Barts and the London School of Medicine and Dentistry, the meeting focused on many infectious diseases, including the current 'hot topics' Ebola, Zika, dengue and antimicrobial resistance (AMR). Participants were treated to an array of talks, with content ranging from cutting edge molecular science to the latest information and methodologies for scientists and clinical practitioners alike. Here are a few highlights:
The 2014-2016 West African Ebola virus outbreak caused over 11 000 deaths and had a significant detrimental effect on the region’s fragile public health services and economies. However, Prof. Miles Carroll explained how the size and length of the outbreak had provided an opportunity to apply deep sequencing technologies to understand the mutation rate of the virus. Professor Carroll’s research group applied molecular modelling to build an epidemiological map and used sequencing technologies, smaller than a mobile phone, to provide vital real-time sequence information on outbreak response. This is important in helping to terminate chains of transmission.
Antimicrobial resistance is considered by many to be one of the major health challenges of our time. Dr Adam Roberts, UCL spoke about his group’s search for the source of antibiotic resistance genes, looking at human-associated bacteria that reside in our mouths. His group found bacteria in the mouth resistant to many different classes of antibiotics and antiseptics, including those conferring resistance to the "drugs of last resort" such as tigecycline. They found that many of the AMR genes would normally be associated with metabolic activities in their natural hosts. Therefore, vigilance is needed regarding the emergence of genes that have been re-purposed following horizontal gene transfer to pathogenic bacteria.
Treatment is now curative for hepatitis C in the majority of patients and eradication plans have recently been set out by the World Health Organization. Dr Emma Thomson explained that to achieve this, several implementation barriers need to be overcome: increase the numbers of patients we diagnose; develop infrastructure for diagnosis and treatment in low and middle income countries (LMICs); and bring the cost of treatment down. Studies to identify circulating strains in under-sampled parts of the world are necessary and vigilance for the emergence of resistance is essential. By overcoming these barriers, eradication of hepatitis C infection is achievable in the near future.
In pregnancy, vaccination can protect the mother, foetus and infant from infection. Tetanus vaccination in pregnancy has been a fundamental part of efforts to eradicate maternal and neonatal tetanus in LMIC countries for more than 30 years. Dr Chrissie Jones spoke about maternal vaccination needs, including influenza vaccination and the pertussis (whooping cough) vaccination, both of which have been successful. Vaccines targeting group B streptococcus (GBS), respiratory syncytial virus (RSV) and cytomegalovirus (CMV) are now priorities for vaccine development. RSV vaccine studies in 2017 hold promise for reducing global infant morbidity and mortality.
During 2016, changes to International Health Regulations, concern about global vaccine stockpiles and unprecedented urban outbreaks, posed challenges to yellow fever health strategists and health advisors. Hilary Simons explained the complications of these challenges and the pressure to maintain global yellow fever vaccine stock levels for routine use and emergency response, including the large outbreak in Angola and the Democratic Republic of the Congo - the first large outbreak for decades. Yellow fever continues to be a challenge as outbreaks are dynamic, vaccine supply can be fragile and International Health Regulations are subject to change. Health professionals need to stay current and understand the bigger global picture in order to provide timely and accurate advice for travellers.
As well as showcasing some spectacular work on such a range of diseases, this was a fantastic opportunity for professionals working on infectious diseases to meet, network and socialise. For many it is an annual event on their calendar, with at least one participant who has been attending this event for 30 years! A huge thank you to all of those who made this such a successful event and we look forward to seeing you next year.