Report: Florida officials cut key data from vaccine study

 Dr. Joseph Ladapo speaks with reporters after the Florida Senate confirmed his appointment as the state's surgeon general on Feb. 23, 2022, in Tallahassee, Fla. An analysis that was the basis of a highly criticized recommendation from Florida’s surgeon general cautioning young men against getting the COVID-19 vaccine omitted information that showed catching the virus could increase the risk of a cardiac-related death much more than getting the shot. That's according to drafts of the analysis obtained by the Tampa Bay Times. (AP Photo/Brendan Farrington, File)

TAMPA, Fla. (AP) — An analysis that was the basis of a highly criticized recommendation from Florida’s surgeon general cautioning young men against getting the COVID-19 vaccine omitted information that showed catching the virus could increase the risk of a cardiac-related death much more than getting the mRNA shot, according to drafts of the analysis obtained by the Tampa Bay Times.

The nonbinding recommendation made by Florida Surgeon General Joseph Ladapo last fall ran counter to the advice provided by the federal Centers for Disease Control and Prevention. Ladapo, a Harvard-trained medical doctor who was appointed by Florida Gov. Ron DeSantis in 2021 to head the Florida Department of Health, has drawn intense scrutiny over his shared resistance with the Republican governor to COVID-19 mandates for vaccines and masks and other health policies endorsed by the federal government.

The early drafts of the analysis obtained by the Times through a records request showed that catching COVID-19 could increase the chances of a cardiac-related death much more than getting the vaccine, but that information was missing from the final version put out by the Florida Department of Health last October.

Ladapo said that the risk of men ages 18 to 39 having cardiac complications outweighed the benefits of getting the mRNA vaccine.

Matt Hitchings, an infectious disease epidemiologist and professor of biostatistics at the University of Florida, told the Times that it seems that sections of the analysis were omitted because they did not fit the narrative the surgeon general wanted to push.

“This is a grave violation of research integrity,” Hitchings said. “(The vaccine) has done a lot to advance the health of people of Florida and he’s encouraging people to mistrust it.”

In a statement on Twitter posted Saturday in response to the Times’ story, Ladapo said, “It’s not only unfortunate that COVID has corrupted scientists’ ability to think clearly about epidemiology but also sad that people rush to defend a vaccine that has shown increased cardiovascular risk in multiple studies.”

Last year, Ladapo released guidance recommending against vaccinations for healthy children, contradicting federal public health leaders whose advice says all kids should get the shots. In response, the American Academy of Pediatrics and its Florida chapter issued written statements reiterating support for vaccinating eligible children age 5 and older against COVID-19.

DeSantis, who is contemplating a run for the GOP presidential nomination, also has requested that a grand jury be convened to investigate any wrongdoing with respect to the COVID-19 vaccines. DeSantis’ request argues that pharmaceutical companies had a financial interest in creating a climate in which people believed that getting a coronavirus vaccine would ensure they couldn’t spread the virus to others.

The Florida Supreme Court agreed to the request last December.

Cambodia to deport 19 Japanese cybercrime scam suspects

April 7, 2023

PHNOM PENH, Cambodia (AP) — Nineteen Japanese men detained in Cambodia in January on suspicion of taking part in organized phone and online scams will be deported to their homeland, a Cambodian immigration police officer said Friday.

Arrangements for their return are being made by the Japanese Embassy in Cambodia, but so far no date has been set, Immigration Police spokesperson Gen. Keo Vanthan told The Associated Press.

Japanese public broadcaster NHK reported Friday that Tokyo police have obtained arrest warrants for the 19 Japanese on suspicion of running phone scams from Cambodia targeting people in Japan.

NHK said Cambodian authorities who searched the men’s hotel rooms “discovered a list of Japanese citizens believed to be targets in a fraud scheme.”

The 19 were taken into custody in the southern city of Sihanoukville on Jan. 24 and sent to the capital, Phnom Penh, where they were held after investigation by the interior ministry.

Keo Vanthan declined to provide further details about the detained Japanese or their alleged offenses.

However, police in Sihanoukville, which in the past few years has become notorious for crimes such as online and phone scams, said in January that they opened the case after being informed on a crime-fighting hotline that about 20 Japanese men were being held there and extorted for money.

They found a group of 19 Japanese men staying in a hotel in Sihanoukville, but the men denied to police that they were being held against their will or extorted. They said they were visiting Cambodia legally and had been seeking work but were not involved in any crimes or wrongdoing.

Sihanoukville police, however, sent them to Phnom Penh for further investigation.

Cybercrime scams became a major issue in Cambodia last year, with numerous accounts of people from various Asian countries and further afield being lured into taking jobs in Cambodia. However, they found themselves trapped in virtual slavery and often forced to participate in scams targeting people over the internet.

The scam networks, which often have links to transnational organized crime, are set up in countries with weak law enforcement and attract educated young workers with promises of high earnings. The workers are then subject to isolation and the threat of violence unless they succeed in cheating victims reached by phone into transferring payments into overseas bank accounts.

Such activities appear to have declined recently in Sihanoukville but persist in other places, including in Myanmar near the border with Thailand. In many cases, these operations are controlled by Chinese organized crime groups.

Moving towards 3 degrees of warming – the phasing out of coal is too slow

Peer-Reviewed Publication

CHALMERS UNIVERSITY OF TECHNOLOGY

 

IMAGE: ALEH CHERP, PROFESSOR AT THE INTERNATIONAL INSTITUTE FOR INDUSTRIAL ENVIRONMENTAL ECONOMICS, LUND UNIVERSITY. view more 

CREDIT: CENTRAL EUROPEAN UNIVERSITY.

The use of coal power is not decreasing fast enough. The Paris Agreement’s target of a maximum of 2 degrees of warming appear to be missed, and the world is moving towards a temperature increase of 2.5–3 degrees. At the same time it is feasible to avoid higher warming. This is shown by researchers from Chalmers University of Technology and Lund University, Sweden, in a new study.

“More and more countries are promising that they will phase out coal from their energy systems, which is positive. But unfortunately, their commitments are not strong enough. If we are to have a realistic chance of meeting the 2-degree target, the phasing out of coal needs to happen faster”, says Aleh Cherp, professor at the International Institute for Industrial Environmental Economics at Lund University.

China and India need to begin phasing out their coal use 

Phasing out coal is necessary to keep the world’s temperature increase below 2 degrees, compared to pre-industrial levels. In a study by the research programme Mistra Electrification, a group of researchers have analysed 72 countries’ pledged commitments to phase out their coal use by 2022–2050.

In the best-case scenario, the researchers show that it is possible that the temperature increase will stay at 2 degrees. But that assumes, among other things, that both China and India begin phasing out their coal use within five years. Furthermore, their phase-out needs to be as rapid as it has been in the UK, which is the fastest that ever happened in a large country, and faster than Germany has promised. This may create inequities which will need to be addressed by international policies.

Global warming of up to 3 degrees is likely

The research group has also developed scenarios that they consider to be the most realistic. These scenarios indicate that Earth is moving towards a global warming of 2.5–3 degrees.

“The countries’ commitments are not sufficient, not even among the most ambitious countries. In addition, Russia’s invasion of Ukraine may prevent some countries from phasing out coal as they promised”, says Jessica Jewell, Associate Professor at the Division of Physical Resource Theory at Chalmers University of Technology.

The study shows that the 72 countries’ commitments to phase out coal power are similar to each other and in line with historical data for how quickly coal power was phased out in the past.

More about the study

Read the full article in Environmental Research Letters: Phasing out coal for 2 °C target requires worldwide replication of most ambitious national plans despite security and fairness concerns. The authors of the article are: Aleh Cherp, Lund University and Jessica Jewell, Vadim Vinichenko, Marta Vetier and Lola Nacke, Chalmers University of Technology. 

Jessica Jewell, Associate Professor at the Division of Physical Resource theory, Chalmers University of Technology.

For further information, please contact:
Aleh Cherp, Professor at the International Institute for Industrial Environmental Economics, Lund University, aleh.cherp@iiiee.lu.se +46 46 222 02 53

Jessica Jewell, Associate Professor at the Division of Physical Resource theory, Chalmers University of Technology, jewell@chalmers.se +46 31 772 61 06

About Mistra Electrification

The Mistra Electrification research program aims to accelerate the transition to a sustainable and efficient energy system. The program will produce knowledge, with a focus on electrification and sector coupling, to enable a fair transition. The main financier is the research foundation Mistra. The program is hosted by the research company Energiforsk, which leads the program together with Chalmers University of Technology. Read more at www.mistraelectrification.com

Captions

Aleh Cherp, Professor at the International Institute for Industrial Environmental Economics, Lund University. Photo: Central European University.

Jessica Jewell, Associate Professor at the Division of Physical Resource theory, Chalmers University of Technology. Photo: Chalmers.

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JOURNAL

Environmental Research Letters

DOI

10.1088/1748-9326/acadf6 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Phasing out coal for 2 °C target requires worldwide replication of most ambitious national plans despite security and fairness concerns

Limiting warming to 2°C may avoid 80% of heat-related deaths in Middle East and North Africa

Peer-Reviewed Publication

LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE

Over 80% of predicted heat-related deaths in the Middle East and North Africa (MENA) by the end of the century could be prevented if global warming is limited to 2°C, according to a modelling study published in The Lancet Planetary Health.

Under high-emissions scenarios, approximately 123 people per 100,000 in MENA are predicted to die annually from heat-related causes by the end of the century — approximately 60-fold greater than current figures and much higher than predictions under similar scenarios worldwide.

However, if global warming is instead limited to 2°C, over 80% of these deaths could be avoided, highlighting the urgent need for better adaption policies and a switch to renewable technologies.

The findings come as the world prepares for COP28 in Dubai in November.

MENA is one of the most climate-vulnerable regions of the world, with maximum temperatures predicted to rise to almost 50°C by the end of the century, potentially making some areas unliveable. 

However, despite this vulnerability, the impact of heat stress in this region, which is worsening due to climate change, remains underexplored.

In the current study, an international team of researchers, including from the London School of Hygiene & Tropical Medicine (LSHTM), modelled current (2001 to 2020) and future (2021 to 2100) trends in heat-related mortality in 19 countries in the MENA region. In their analyses, the team considered variations in the levels of potential greenhouse gas emissions over time and different socioeconomic scenarios.

Under high emissions scenarios (defined by the Intergovernmental Panel on Climate Change Shared Socioeconomic Pathways (SSP) 5-8.5), most of the MENA region will experience substantial levels of warming by the 2060s.

Indeed, under SSP5-8.5, annual heat-related deaths will rise from approximately two per 100,000 currently to 123 per 100,000 by the period between 2081 and 2100. Although current heat-related deaths in MENA are relatively low compared to other regions (two per 100,000 compared to 17 per 100,000 in Western Europe or 10 per 100,000 in Australasia, for example), this rise is expected to be much higher than other regions of the world under similar climate change scenarios. The UK, for example, is expected to see a rise from current figures of three per 100,000 to nine per 100,000 by the 2080s.

Iran is expected to have the highest annual death rate in MENA under SSP5-8.5 (423 per 100,000), with other countries such as Palestine, Iraq and Israel also predicted to have high rates (186, 169 and 163 per 100,000, respectively). Smaller Gulf states, such as Qatar and the United Arab Emirates, will see the greatest relative increases in heat-related deaths.

However, for the MENA region as a whole, if global warming can be limited to 2°C as defined by SSP1-2.6, the team estimate that over 80% of the total 123 annual predicted heat-related deaths per 100,000 people could be avoided.

With COP28 on the horizon, the authors conclude that there is an even greater urgency for stronger mitigation and adaptation policies to be agreed upon, both at the conference and beyond, if MENA is to avoid the worst possible impacts of future warming.  

Reliance on traditional heat-adaption solutions such as air-conditioning will not be enough, they warn. Air-conditioning, for example, is used to a relatively high extent in countries where rates of heat-related mortality are higher than the regional average, such as in Israel and Cyprus. 

As population growth in MENA will be a substantial driver of predicted heat-related deaths, demographic policies and healthy ageing will also be vital if MENA is to successfully adapt to a changing climate.

Shakoor Hajat, lead author and Professor of Global Environmental Health at LSHTM, said: “Global warming will need to be limited to 2°C to avoid the catastrophic health impacts estimated in our study. Even with stronger action, countries in the region need to develop ways other than air-conditioning to protect their citizens from the dangers of extreme heat.

“Strengthening health systems and better coordination between MENA countries will be key in tackling the health impacts of climate change in the region. With COP28 coming up, discussions are needed to consider how countries in the region can better work together to improve resilience in the face of climate change.”

 

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JOURNAL

The Lancet Planetary Health

ARTICLE TITLE

Current and future trends in heat-related mortality in the MENA region: a health impact assessment with bias-adjusted statistically downscaled CMIP6 (SSP-based) data and Bayesian inference

ARTICLE PUBLICATION DATE

3-Apr-2023

Antibiotic consumption and resistance ‘two-way street’ between animals and humans

Peer-Reviewed Publication

LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE

Scientists have demonstrated for the first time that, globally, the association between antibiotic consumption and antimicrobial resistance (AMR) between human and animals goes both ways.

The findings, published in The Lancet Planetary Health, reveal that using antibiotics in animals is associated with AMR in humans and using antibiotics in humans is associated with AMR in animals.

The study highlights the urgent need for an integrated, cross-domain strategy to tackle the spread of AMR, focusing on social development, poverty reduction and enforcing tighter rules on the use of antibiotics.

Kasim Allel, lead author and Associate Research Fellow in Infectious Disease Epidemiology at the London School of Hygiene & Tropical Medicine (LSHTM) said: “AMR is a ‘wicked problem’ as conflicting priorities exist amongst an intricate web of stakeholders.

“A robust, cross-disciplinary and-species approach for AMR surveillance and control, which is not limited to a human-centred perspective, should be embraced among decision-makers and local governments for better planetary health.”

AMR is a major threat to global health, with resistant bacteria responsible for 1.27 million deaths in 2019.

Incorrect use of antibiotics (which include antibiotics, antivirals and antifungals) is a key driver of the spread of AMR. Rising demands for animal-based food and products, as well as intricate and interlinked socioeconomic and environmental factors, are also highly influential.

In this study, an international team of researchers, including from LSHTM, investigated links between the global consumption of antibiotics and rates of AMR in humans and food-producing animals around 2018. The authors also considered the influence of socioeconomic, health and environmental risk factors. 

As predicted, overall, greater consumption of antibiotics in animals is associated with an increased rate of AMR in food-producing animals, with higher rates of human consumption of antibiotics increasing the risk of AMR in humans.

However, the paper also uniquely revealed a global bi-directional relationship between humans and animals. Namely, greater consumption of antibiotics by animals is associated with an increased risk of AMR in human pathogens (defined as critical priority by the World Health Organization), while greater human consumption of antibiotics increases the risk of AMR in animals.

Despite recording low levels of antibiotic consumption, low- and middle-income countries, notably in Asia (such as Bangladesh, China and India), had the highest rates of AMR in food-producing animals, suggesting that antibiotic consumption may be a secondary risk factor to the spread of AMR in certain areas of the world.

Socioeconomic factors, such as income inequality or death rates due to unsafe hygiene practices or heart problems, also increased rates of AMR in humans.

Consistent with previous research, these findings highlight that factors that typically reflect lower socioeconomic status are associated with an increased likelihood of AMR in humans. The authors argue that this further emphasises the importance of strong governance and anti-corruption within a ‘One-Health’ context, which emphasises the interdependency between animals, humans and the environment.  

The team conclude that reducing antibiotic consumption alone will not be enough to fight the global spread of AMR. Instead, they state that integrated control methods focused on reducing poverty and supporting social development will be needed to prevent the transmission of resistance between humans and animals.

They also emphasise the importance of strengthening surveillance efforts, especially in low-and middle-income countries, and ensuring that livestock surveillance for AMR in particular, mirrors surveillance in humans.

Laith Yakob, senior author and Taught Programme co-Director of the Faculty of Infectious and Tropical Diseases at LSHTM said: “This bidirectionality in antibiotic consumption and resistance among humans and livestock uncovered by our analysis offers novel opportunities for mitigating resistance. For example, it highlights the potential for targeting single One-Health components with interventions but having system-wide impacts.

“Designing interventions around this holistic picture of resistance will be essential in tackling what has rapidly become one of the biggest threats to global health.

“Going forward, we recommend tighter country policies and regulations on antibiotic use and prescription among animals and humans, as well as improved governance, transparency and accountability, particularly among countries with the highest disease burdens.”

 

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JOURNAL

The Lancet Planetary Health

ARTICLE TITLE

Global antimicrobial-resistance drivers: an ecological country-level study at the human–animal interface

When SEC is challenged, CEOs notice

MU research shows that success of regulatory enforcement impacts corporate managers’ communication during private meetings.

Peer-Reviewed Publication

UNIVERSITY OF MISSOURI-COLUMBIA

 

IMAGE: HOYOUN KYUNG view more 

CREDIT: UNIVERSITY OF MISSOURI

COLUMBIA, Mo. — ­­­­­­­­­­­­­­­­­­­­­In 2005, Siebel Systems, Inc., a California software company, challenged an enforcement action taken by the Security and Exchange Commission (SEC) that found the business had violated the Regulation Fair Disclosure (Reg FD) — a regulation implemented to prevent businesses from giving key analysts and investors insider information. The Siebel case went to the federal court marking the only court case under Reg FD, and it was eventually dismissed by the judge.

Now, new research at the University of Missouri shows the impact of that landmark decision and how future decisions involving the SEC could have a profound impact on the way chief executive officers (CEOs) and chief financial officers (CFOs) communicate with investors and analysts, including the amount of information they share in a private setting. Ultimately, Hoyoun Kyung, an assistant professor in the Trulaske College of Business, and his team of coauthors found the court’s ruling sent the message to CEOs and CFOs that they could be more relaxed in their private interactions with analysts and investors and potentially share more information than they shared with the public.

That attitude prevailed among CEOs and CFOs until 2009 when the SEC filed another Reg FD violation, this time against American Commercial Lines. Eventually, the SEC settled out of court with the company, but the case was enough to reestablish the Reg FD as a law that businesses need to respect.

In his study, Kyung found that the effectiveness of the Reg FD depends on the perception of the SEC’s ability to enforce the regulation.

“It doesn’t matter that the regulation is there, if you can’t enforce it, the market is going to take advantage,” Kyung said. “In 2009, after businesses saw the SEC’s resumption of Reg FD enforcement, they started behaving more cautiously in their private meetings.”

Every quarter, publicly traded businesses must report their gains and losses to the public. However, the reporting process doesn’t necessarily end there. Businesses also can meet privately with potential investors and analysts with the legal stipulation that they only share the same information they do with the public. The issue is CEOs and CFOs are sometimes tempted to build stronger relationships with these potential investors and analysts because they often have more resources than members of the general public to influence the success of the business. At times, that motivating factor can lead to businesses feeling the need to share exclusive insider information with the private investors and analysts.

In 2005, the SEC accused Siebel Systems of using body language to tip off private investors to an upswing in business after reporting losses and a negative outlook to the public. But after Siebel Systems challenged the punishment, the judicial system disagreed with the SEC’s determination. The court then ruled that the SEC was being too aggressive for punishing the software company over body language.

Kyung, who is also an accountancy alumni faculty scholar, analyzed changes in stock market responses to analyst earnings forecasts and stock recommendations before and after the Siebel court case, comparing the information to content of analyst reports. He noticed a significant increase in the analyst output informativeness indicating increased information sharing by managers to analysts in private meetings. He then surveyed securities lawyers who were working with businesses around the time of the 2005 court case and asked them what was happening to create this change. He discovered that after the court case, CEOs and CFOs were often acting more relaxed in their body language when talking to the analysts. This sent the message that when a CFO or CEO acts either excited or deflated about the outlook of the business, they were more likely to tip off the analyst or private investor through their demeaner.

That began to change in 2009 after the SEC filed a Reg FD action against American Commercial Lines. In that case, a CFO for the company sent an email to analysts stating the company’s earnings would likely be less than what was publicly forecasted a few days earlier. Ultimately, the SEC decided the company cooperated enough with its investigation to not impose a punishment.

Kyung said his research can be used to help people anticipate business and market reactions after landmark regulatory rulings.

In 2021, the SEC accused AT&T of leaking details about its smartphones to investor relations executives. AT&T challenged the decision in circuit court. The judge rejected AT&T’s plea for dismissal but didn’t rule in favor of the SEC either due to lack of proven intent. Ultimately, AT&T agreed to pay more than $6 million in a settlement, the biggest payout for this type of regulatory punishment ever.

“We don’t know what the outcome of the AT&T v. SEC trial would’ve been, but it’s possible that if this judge were to side with AT&T, we might see a similar impact to the 2005 decision,” Kyung said. “It’s likely that at some point, someone can challenge the SEC again, and this research can help people understand how businesses will respond.”  

“Managers’ private communications with analysts: The effect of SEC v. Siebel Systems Inc.” was published in Contemporary Accounting Research.

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JOURNAL

Contemporary Accounting Research

DOI

10.1111/1911-3846.12858 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Managers’ Private Communications with Analysts: The Effect of SEC v. Siebel Systems Inc.

Diversifying crop fields reduces pest abundance, study finds

Peer-Reviewed Publication

UNIVERSITY OF FLORIDA

Intercropping – the practice of planting mixtures of crops – can be an effective pest management tool worldwide, a new University of Florida study shows.

The analysis compiled results from 44 field studies across six continents and focused on four crop types – cabbage, squash, cotton and onion – planted on their own and mixed with a companion plant species. In these studies, scientists recorded 272 total occurrences of 35 different species of plant-eating insects on crops, representing one of the most comprehensive evaluations of intercropping effectiveness across the globe.

“Overall, intercropping proved to be very effective against pests, but it did vary based on the pest and their feed preferences,” said Philip Hahn, assistant professor in the UF/IFAS entomology and nematology department, who led the study. “It also depended on crop type, with cabbage and squashes showing the strongest resistance, while resistance was less strong for onions and cotton.”

There are a few common methods of intercropping. Sometimes non-cash crops are arranged in borders surrounding the field to repel or intercept pests before they damage the cash crop. Companion plants can also be planted within the field to disrupt pests from locating the main crops. A common combination is known as the Three Sisters: corn, squash and beans. Another of this study’s findings was that interspersed planting schemes, like the Three Sisters, make it more difficult for the pests to locate their preferred host plant and were more effective than border plantings.

“In the studies we examined, we found intercropping was more effective for generalist pests that feed on a variety of crops,” Hahn said. “Specialist pests that target one type of crop were less affected.” Specialist pests usually have a long history of co-evolution with the plants they target and therefore may be less influenced by the presence of a neighboring companion plant.

Researchers have long been interested in studying the value of intercropping systems, providing an abundance of previously published data. Hahn included studies from those earlier analyses, plus more recent studies, which allowed for a comprehensive evaluation of the conditions that best promote the benefits of intercropping.

While variability proved to be a common thread across studies, Hahn noted that a geographical pattern arose, however weakly.

“We did find a stronger benefit for pest suppression at lower latitudes – so, in tropical systems versus northern temperate systems,” Hahn said. “There are lots of reasons we could have found that pattern, of course; the tropics are places where there tend to be more species of insects year-round. It was surprising that the pattern was not as strong as I would have expected.”

This analysis will likely inform future investigations, Hahn said, as neighboring plant selections could be the key to success in intercropping systems. The new research provides recommendations for piecing together the most effective companion plantings, while also highlighting pairs that seem to be less effective.

“There are a few combinations that seem to be particularly effective at reducing pest abundance,” Hahn said. “Overall, for growers interested in organic methods, intercropping seems to be a very effective tool.”

The study was funded by the National Science Foundation and co-authored by Joseph Cammarano, a University of Florida graduate student. It is available now at doi.org/10.1111/1365-2664.14382.

 

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JOURNAL

Journal of Applied Ecology

DOI

10.1111/1365-2664.14382 

ARTICLE TITLE

Environmental context and herbivore traits mediate the strength of associational effects in a meta-analysis of crop diversity

Disruption from war in Ukraine pushes highly contagious infectious diseases to alarming levels

Reports and Proceedings

EUROPEAN SOCIETY OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES

• Analysis of official Ukraine health data reveals a perfect storm of rising infectious diseases cases and falling levels of childhood vaccination and case detection in the frontline eastern region of Kharkiv.
• Between January and September 2022, new cases of rubella were 23 times higher among children living in the Kharkiv region than average rates across Ukraine, while shigellosis (diarrhoeal disease) and viral meningitis incidence was around 6 times higher, and whooping cough 5 times greater.
• But registration of infectious disease cases halved in Kharkiv hospital suggesting these figures most likely are an underestimate of the true situation.
• Routine childhood vaccination coverage also fell to less than 50% across the region.
• Findings highlight the urgent need to strengthen medical support in the regions of Ukraine where active hostilities are taking place, researchers say.

 

**Note: the release below is a special early release from the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, 15-18 April). Please credit the congress if you use this story**

Embargo: 2301H UK time Wednesday 5 April  

 

**Note – the press release is available in Spanish and Portuguese, see links below**

 

New research being presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Copenhagen, Denmark (15-18 April), reveals an extremely worrying picture of rising infectious diseases cases and falling levels of childhood vaccination and case detection in the eastern region of Ukraine in the city of Kharkiv and Kharkiv region, the scene of some of the most intense combat in 2022.

 

The research by Maryna Railian and Tetyana Chumachenko from Kharkiv National Medical University (KhNMU), Ukraine, examines how fierce fighting in the Kharkiv region, which was under attack from the first minutes of the Russian invasion of Ukraine, and continues to be under rocket and artillery fire, significantly disrupted access to medical care, routine vaccinations, and the response to infectious disease outbreaks.

 

They analysed official data from the State Institution Kharkiv Oblast Center for Disease Control and Prevention of the Ministry of Health to assesses infectious disease incidence and vaccination coverage for the population in the Kharkiv region across 9 months of 2022.

 

Between January and September, 124,170 infectious disease cases were registered in the Kharkiv region—40% less than during the same period before the war in 2021 (207,038 infectious disease cases).

 

Official data also suggests that the total percentage of the population exposed to infectious diseases decreased by 1.7 times compared to the same period in 2021. And the proportion of children affected by infectious diseases fell from 29% in 2021 to 23% in 2022.

 

Nevertheless, new cases of shigellosis, a highly contagious diarrhoeal disease, were 3 times higher in the Kharkiv region than average rates across Ukraine. Similarly, new cases of rubella (German measles) were 11 times higher than the Ukraine average, whooping cough 5 times higher and viral meningitis 2 times higher (for number of cases, see figure in notes to editors).

 

Additionally, new cases of viral hepatitis A in the region exceeded the country average by 2.4%, viral hepatitis B by 87%, and chronic viral hepatitis B and C combined by 72%.

 

“During this period, only severe forms of infections and diseases with a pronounced clinical picture were recorded,” explains Railian. “These data underscore the unfavourable epidemic situation that arose during the hostilities and partial occupation of the Kharkiv region. Mild cases were not registered or isolated and continued to be sources of infection, exacerbating the spread of diseases.”

 

Similar patterns were seen in children, with shigellosis and viral meningitis incidence around 6 times higher in the Kharkiv region compared to the Ukraine average, rubella incidence 23 times higher, and new cases of whooping cough 5 times greater than the country average.

 

“The shockingly high incidence of highly contagious infectious diseases in the Kharkiv region compared to Ukraine as a whole reflects the appalling living conditions across the region where water supply interruptions were common and residents were unable to buy even basic healthy foods,” says Railian. “The widespread damage and destruction to infrastructure and atrocious living conditions meant much of the population had to be relocated for their safety.”

 

The analysis also found that the ongoing crisis has had dramatic effects on routine childhood vaccination coverage across the Kharkiv region, putting the most vulnerable at increased risk of severe illness and death. Between January and September 2022, the rate of polio vaccination fell to 40%, hepatitis B to just 37%, tuberculosis to 43%, measles, mumps and rubella to 50%, and diphtheria, whooping cough and tetanus to 46% (and only 24% in the adult population).

 

However, the authors caution that given the lack of disease surveillance and public health infrastructure available for diagnosis, the true burden of infectious disease remains unknown.

Worryingly, the authors say that this might be just the tip of the iceberg. “The upsurge in measles and other vaccine-preventable infectious diseases could soon become uncontrollable. The stark reality is that in the absence of surveillance, diagnostic, and preventive measures, these figures most likely represent an underestimate of the true situation,” says Railian.

 

Infectious disease case detection has halved

 

Further analyses examining the impact of the war on infectious disease surveillance capacity in Kharkiv Hospital, reveals that the case detection rate is only half of that prior to the war. Between January and October 2021, 2,306 infectious disease cases were registered, this declined to 1,056 reports during the same period in 2022, with just 31 cases registered from March to August 2022.

 

The hospital in the capital city of the Kharkiv region provides medical care to almost 17,000 adults in 25 medical specialties.

 

Worse still, infectious illness in the hospital wasn’t registered in full, with almost two-thirds of cases left without laboratory results between January and October in 2022, and three-quarters of cases not given a final diagnosis.

 

“Because of the hostilities, medical staff could not get to work and large numbers of workers responsible for registration of cases left the country,” explains Railian. “Our findings underscore the urgent need to strengthen medical support in the regions of Ukraine where active hostilities are taking place. We must prioritise field vaccination teams in populated areas and health education campaigns to highlight the growing threats of infectious diseases.”

 

For interviews with the report authors, please contact Maryna Railian, Kharkiv National Medical University (KhNMU), Kharkiv, Ukraine E) railyan77@gmail.com  T) +380 509 340 323

 

Alternative contact in the ECCMID Press Room: Tony Kirby T) + 44(0)7834 385827 E) tony@tonykirby.com

 

Notes to editors:

The authors declare no conflicts of interest.

The study was funded by the Ministry of Health of Ukraine in the framework of the research project 0123U100184 on the topic “Analysis of the impact of war and its consequences on the epidemic process of widespread infections on the basis of information technologies”.

This press release is based on abstracts 3400 and 3406 at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) annual meeting. The material has been peer reviewed by the congress selection committee. There is no full paper available at this stage and, as this is an early release from ECCMID, the poster is not yet available. The work has not yet been submitted to a medical journal for publication.

 

Adult infections	Kharkiv region		Ukraine
	January – September 2022		January – September 2022
	Absolute number	per 100,000 population	Absolute number	per 100,000 population
shigellosis	34	1.3	176	0.42
rubella (German measles)	3	0.11	6	0.014
whooping cough	5	0.19	17	0.04
viral meningitis	1	0.15	30	0.072
viral hepatitis A	11	0.42	171	0.41
viral hepatitis B	44	1.68	371	0.90
Chronic viral hepatitis	348	13.29	3,194	7.71

 

 

This press release is based on abstracts 3400 and 3406 at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) annual meeting. The material has been peer reviewed by the congress selection committee. A full paper has been submitted to a medical journal and is currently under review but not available at this stage and, as this is an early release from ECCMID, the posters are not yet available.

For press release in Spanish, click here

For press release in Portuguese, click here

Twitter (for when embargo lifts): @escmid #ECCMID2023

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ARTICLE PUBLICATION DATE

5-Apr-2023