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\"From the masters of storytelling-meets-science and co-authors of Quackery, Patient Zero tells the long and fascinating history of disease outbreaks-how they start, how they spread, the science that lets us understand them, and how we race to destroy them before they destroy us. Written in the authors' lively and accessible style, chapters include page-turning medical stories about a particular disease or virus-smallpox, Bubonic plague, polio, HIV-that combine \"Patient Zero\" narratives, or the human stories behind outbreaks, with historical examinations of missteps, milestones, scientific theories, and more. Learn the tragic stories of Patient Zeros throughout history, such as Mabalo Lokela, who contracted Ebola while on vacation in 1976, and the Lewis Baby on London's Broad Street, the first to catch cholera in an 1854 outbreak that led to a major medical breakthrough. Interspersed are origin stories of a different sort-how a rye fungus in 1951 turned a small village in France into a phantasmagoric scene reminiscent of Burning Man. Plus the uneasy history of human autopsy, how the HIV virus has been with us for at least a century, and more\"-- Provided by publisher.

It is now thirty years since the discovery of AIDS but its origins continue to puzzle doctors and scientists. Inspired by his own experiences working as an infectious diseases physician in Africa, Jacques Pepin looks back to the early twentieth-century events in Africa that triggered the emergence of HIV/AIDS and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how urbanization, prostitution, and large-scale colonial medical campaigns intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Léopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential new perspective on HIV/AIDS and on the lessons that must be learnt if we are to avoid provoking another pandemic in the future.

\"The COVID pandemic won't be our last because what makes us human also makes us vulnerable to pandemics; as this book explains, though, if we are the problem, then we're also the solution\"-- Provided by publisher.

In a double-blind, randomized, placebo-controlled trial in Zimbabwe, treatment of mothers with trimethoprim–sulfamethoxazole daily beginning as early as 14 weeks’ gestation did not significantly increase infant birth weight.

Background Patients with moderate-to-severe atopic dermatitis (AD) have increased infection risk, including skin infections and systemic infections. Immunomodulators (e.g., anti-tumor necrosis factors, anti-interleukin [anti-IL]-23, anti-IL-17, Janus kinase inhibitors) increase risk of infections. Dupilumab (a monoclonal antibody blocking the shared receptor component for IL-4 and IL-13) is approved for inadequately controlled moderate-to-severe AD and for moderate-to-severe eosinophilic or oral corticosteroid-dependent asthma. Objective The aim was to determine the impact of dupilumab on infection rates in patients with moderate-to-severe AD. Methods This analysis pooled data from seven randomized, placebo-controlled dupilumab trials in adults with moderate-to-severe AD. Exposure-adjusted analyses assessed infection rates. Results Of 2932 patients, 1091 received placebo, 1095 dupilumab 300 mg weekly, and 746 dupilumab 300 mg every 2 weeks. Treatment groups had similar infection rates overall per 100 patient-years (placebo, 155; dupilumab weekly, 150; dupilumab every 2 weeks, 156; dupilumab combined, 152), and similar non-skin infection rates. Serious/severe infections were reduced with dupilumab (risk ratio 0.43; p  < 0.05), as were bacterial and other non-herpetic skin infections (risk ratio 0.44; p  < 0.001). Although herpesviral infection rates overall were slightly higher with dupilumab than placebo, clinically important herpesviral infections (eczema herpeticum, herpes zoster) were less common with dupilumab (risk ratio 0.31; p  < 0.01). Systemic anti-infective medication use was lower with dupilumab. Conclusions Dupilumab is associated with reduced risk of serious/severe infections and non-herpetic skin infections and does not increase overall infection rates versus placebo in patients with moderate-to-severe AD. ClinicalTrials.gov Identifiers NCT01548404, NCT02210780, NCT01859988, NCT02277743, NCT02277769, NCT02260986, and NCT02755649.

\"Plagues upon the Earth is a history of human civilization and the germs that have shaped its course. At every stage in our species' past, micro-organisms have had macro-effects on the development of human societies. Kyle Harper proposes the first history of human disease to make full use of a radical new source of evidence: pathogen genomes as a biological archive and window into prehistoric times. We can now begin to reconstruct the natural history of human disease at the molecular level, tracing the biographies of the viruses, bacteria, and protozoa that have haunted our species. The story reveals, Harper will show, the continuing importance of the deep past in determining the patterns of global divergence today. Plagues upon the Earth puts the dynamic two-way relationship between humanity and its germs in the foreground. The takeover and transformation of the planet by Homo sapiens has been the most powerful force shaping the evolution of microbial pathogens, and in turn, pathogen evolution has been a decisive influence on the destiny of human societies. From humanity's dispersal out of Africa to the rise of agriculture and complex civilizations, from the great pandemics of the medieval world to the age of global expansion and industrialization, from the modern increase in life expectancy to the ongoing threats of microbial resistance and emerging pathogens like HIV and Ebola, disease evolution has been and remains a primary, powerful, and unpredictable factor in human history. This will be the story of how we made our germs, and how our germs made the world as we know it. Harper aims to cover the entire timespan of Homo sapiens and to set the history of our species in deep perspective. The pathogens that exist today are the heirs of millions of years of evolution. Similarly, the patterns of economic development, and the roots of global inequality, have distant origins. Thus, Harper aims to bring together two bodies of literature: the history of disease and the study of geography and social development. The book is global in coverage, insisting on the importance of understanding how the tropics and temperate zones, the Old World and the New World, differ and interact throughout the course of history. Viruses, bacteria, and protozoa - in all their peculiarity and specificity - have played an enormous part in shaping the different outcomes experienced by human societies. Plagues upon the Earth combines biology, geography, and economics to understand these differences but emphasizes the central importance of evolution as a source of constant change. The past is always present in the history of disease, and the future is always unpredictable. The story continues right up to our own world. The book closes with a reflection on antibiotic resistance as a form of evolution that continues the ancient molecular antagonism between pathogens and host immune systems, and the importance of seeing this struggle in a broader environmental framework. Freedom from infectious disease remains an unachieved goal for our species, which is more interconnected than ever. The biology of infectious disease has been one of the great forces shaping the patterns of global development, but only with a sense of history - of the interplay of change, conjunction, and chance - can we begin to understand the intertwined story of human societies and their germs\"-- Provided by publisher.

Influenza vaccination is a commonly used intervention to prevent influenza infection in healthcare workers (HCWs) and onward transmission to other staff and patients. We undertook a systematic review to synthesize the latest evidence of the direct epidemiological and economic effectiveness of seasonal influenza vaccination among HCW. We conducted a systematic search of MEDLINE/PubMed, Scopus, and Cochrane Central Register of Controlled Trials from 1980 through January 2018. All studies comparing vaccinated and non-vaccinated (i.e. placebo or non-intervention) groups of HCWs were included. Research articles that focused on only patient-related outcomes or monovalent A(H1N1)pdm09 vaccines were excluded. Two reviewers independently selected articles and extracted data. Pooled-analyses were conducted on morbidity outcomes including laboratory-confirmed influenza, influenza-like illnesses (ILI), and absenteeism. Economic studies were summarized for the characteristics of methods and findings. Thirteen articles met eligibility criteria: three articles were randomized controlled studies and ten were cohort studies. Pooled results showed a significant effect on laboratory-confirmed influenza incidence but not ILI. While the overall incidence of absenteeism was not changed by vaccine, ILI absenteeism was significantly reduced. The duration of absenteeism was also shortened by vaccination. All published economic evaluations consistently found that the immunization of HCW was cost saving based on crude estimates of avoided absenteeism by vaccination. No studies, however, comprehensively evaluated both health outcomes and costs of vaccination programs to examine cost-effectiveness. Our findings reinforced the influenza vaccine effects in reducing infection incidence and length of absenteeism. A better understanding of the incidence of absenteeism and comprehensive economic program evaluations are required to ensure the best possible management of ill HCWs and the investment in HCW immunization in increasingly constrained financial environments. These steps are fundamental to establish sustainability and cost-effectiveness of vaccination programs and underpin HCW immunization policy.

In recent years, outbreaks of Ebola and Zika have provided vivid examples of how difficult it is to contain an infection once it strikes, and the panic that a rapidly spreading epidemic can ignite. But while we chase the diseases we are already aware of, new ones are constantly emerging, like the coronavirus that spread across the world in 2020. At the same time, antimicrobial resistance is harnessing infections that we once knew how to control, enabling them to thrive once more.

The use of azithromycin reduces maternal infection in women during unplanned cesarean delivery, but its effect on those with planned vaginal delivery is unknown. Data are needed on whether an intrapartum oral dose of azithromycin would reduce maternal and offspring sepsis or death. In this multicountry, placebo-controlled, randomized trial, we assigned women who were in labor at 28 weeks' gestation or more and who were planning a vaginal delivery to receive a single 2-g oral dose of azithromycin or placebo. The two primary outcomes were a composite of maternal sepsis or death and a composite of stillbirth or neonatal death or sepsis. During an interim analysis, the data and safety monitoring committee recommended stopping the trial for maternal benefit. A total of 29,278 women underwent randomization. The incidence of maternal sepsis or death was lower in the azithromycin group than in the placebo group (1.6% vs. 2.4%), with a relative risk of 0.67 (95% confidence interval [CI], 0.56 to 0.79; P<0.001), but the incidence of stillbirth or neonatal death or sepsis was similar (10.5% vs. 10.3%), with a relative risk of 1.02 (95% CI, 0.95 to 1.09; P = 0.56). The difference in the maternal primary outcome appeared to be driven mainly by the incidence of sepsis (1.5% in the azithromycin group and 2.3% in the placebo group), with a relative risk of 0.65 (95% CI, 0.55 to 0.77); the incidence of death from any cause was 0.1% in the two groups (relative risk, 1.23; 95% CI, 0.51 to 2.97). Neonatal sepsis occurred in 9.8% and 9.6% of the infants, respectively (relative risk, 1.03; 95% CI, 0.96 to 1.10). The incidence of stillbirth was 0.4% in the two groups (relative risk, 1.06; 95% CI, 0.74 to 1.53); neonatal death within 4 weeks after birth occurred in 1.5% in both groups (relative risk, 1.03; 95% CI, 0.86 to 1.24). Azithromycin was not associated with a higher incidence in adverse events. Among women planning a vaginal delivery, a single oral dose of azithromycin resulted in a significantly lower risk of maternal sepsis or death than placebo but had little effect on newborn sepsis or death. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and others; A-PLUS ClinicalTrials.gov number, NCT03871491.).