Publications by authors named "Ray Borrow"

Article Synopsis
  • Factor H-Binding Protein (fHbp) is essential for the effectiveness of MenB-fHbp vaccines, as its expression on bacteria is crucial for inducing a strong immune response.* -
  • A study analyzing 451 invasive group B meningococcal strains found that 92% expressed fHbp above a critical threshold, indicating they could potentially be targeted by the vaccine.* -
  • While regions like England, Wales, and Italy showed high fHbp expression, Spain had more lower-expressing strains, suggesting variations in vaccine coverage and the need for improved predictive methods based on genetic factors.*
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In Western Europe, many countries have robust and well-established surveillance systems and case reporting mechanisms. IMD incidence across Western Europe is low with a predominance of meningococcal serogroup B (MenB). Case confirmation and antimicrobial susceptibility testing is often standardised in this region, with many countries also having robust vaccination programmes in place.

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Article Synopsis
  • Genome-wide association studies (GWAS) have effectively identified disease-related genetic markers and antimicrobial resistance factors in bacterial pathogens, using a new phenotype-to-genotype approach to analyze multiple traits simultaneously.
  • Researchers examined 163 specific bacterial isolates for 11 traits, revealing significant differences in eight traits between disease subgroups and candidate genes linked to survival advantages.
  • The study highlights the importance of integrating high-throughput phenotypic testing with genomic analysis, successfully identifying key genetic determinants that contribute to the behavior and pathogenicity of bacterial pathogens.
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Introduction: Following the CHAMPION-NMOSD trial, the FDA recently granted approval for ravulizumab, a humanized monoclonal antibody against complement C5 protein in AQP-4 seropositive neuromyelitis optica spectrum disorder (NMOSD). Similar to eculizumab, ravulizumab offers near-complete prevention of NMOSD relapses, but has a longer half-life, providing decreased infusion frequency and increased convenience for patients. While targeting the complement pathway has clear advantages, patients are at risk for infection with encapsulated organisms, in particular .

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Article Synopsis
  • The study aimed to compare the immune responses of preterm infants receiving a meningococcal B vaccine using either a 2+1 or a 3+1 vaccination schedule while also evaluating the side effects of routine vaccinations.
  • The research was conducted in an open-label, phase IV study format across six hospitals in the UK, enrolling 129 preterm infants born before 35 weeks gestation.
  • Results indicated that while both vaccination schedules were effective, the 3+1 schedule led to a significantly higher antibody response against a specific strain compared to the 2+1 schedule, but also resulted in more fever episodes after vaccination.
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The 4-component meningococcal serogroup B (MenB) vaccine, 4CMenB, the first broadly protective, protein-based MenB vaccine to be licensed, is now registered in more than 50 countries worldwide. Real-world evidence (RWE) from the last decade confirms its effectiveness and impact, with infant immunization programs showing vaccine effectiveness of 71-95% against invasive MenB disease and cross-protection against non-B serogroups, including a 69% decrease in serogroup W cases in 4CMenB-eligible cohorts in England. RWE from different countries also demonstrates the potential for additional moderate protection against gonorrhea in adolescents.

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Article Synopsis
  • Invasive meningococcal disease (IMD) is a serious illness caused by the bacterium Neisseria meningitidis, often leading to meningitis or septicemia.
  • There are six main serogroups (A, B, C, W, X, Y) responsible for the majority of cases, which can spread through respiratory droplets and secretions from infected individuals or carriers.
  • Vaccination is available to prevent IMD, and giving antibiotics to close contacts of infected people is vital to stop further infections.
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Article Synopsis
  • - Rotavirus is a major cause of severe diarrhea and mortality in children under five, and vaccination is crucial for reducing its impact, especially in South America where nine out of twelve countries have implemented the vaccine with over 90% coverage in 2022.
  • - The introduction of the rotavirus vaccine has significantly decreased hospitalization and death rates from diarrheal diseases in children, with notable improvements in countries like Brazil (59% fewer hospitalizations) and Peru (46% in infants), indicating a reduction in rotavirus-related deaths by 15-50% across the region.
  • - While the vaccine has proven effective, evidence suggests that immunity may diminish after the first year, making continuous monitoring of vaccination outcomes and disease prevalence essential to ensure ongoing protection
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Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen were published by the British Committee for Standards in Haematology in 1996 and updated in 2002 and 2011. With advances in vaccinations and changes in patterns of infection, the guidelines required updating. Key aspects included in this guideline are the identification of patients at risk of infection, patient education and information and immunisation schedules.

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Background: Prepandemic sentinel surveillance focused on improved management of winter pressures, with influenza-like illness (ILI) being the key clinical indicator. The World Health Organization (WHO) global standards for influenza surveillance include monitoring acute respiratory infection (ARI) and ILI. The WHO's mosaic framework recommends that the surveillance strategies of countries include the virological monitoring of respiratory viruses with pandemic potential such as influenza.

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The meningococcal group B vaccine, 4CMenB, is a broad-spectrum, recombinant protein vaccine that is licensed for protection against meningococcal group B disease in children and adults. Over the past decade, several observational studies supported by laboratory studies have reported protection by 4CMenB against gonorrhoea, a sexually transmitted infection caused by Neisseria gonorrhoeae. Gonorrhoea is a major global public health problem, with rising numbers of diagnoses and increasing resistance to multiple antibiotics.

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Introduction: The epidemiology of invasive meningococcal disease (IMD), a rare but potentially fatal illness, is typically described as unpredictable and subject to sporadic outbreaks.

Areas Covered: Meningococcal epidemiology and vaccine use during the last ~ 200 years are examined within the context of meningococcal characterization and classification to guide future IMD prevention efforts.

Expert Opinion: Historical and contemporary data highlight the dynamic nature of meningococcal epidemiology, with continued emergence of hyperinvasive clones and affected regions.

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Introduction: Outer membrane vesicles (OMVs) of in the group B-directed vaccine MenB-4C (Bexsero) protect against infections with . The immunological basis for protection remains unclear. OMV vaccines generate human antibodies to and lipooligosaccharide (LOS/endotoxin), but the structural specificity of these LOS antibodies is not defined.

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SARS-CoV-2 infections in children are generally asymptomatic or mild and rarely progress to severe disease and hospitalization. Why this is so remains unclear. Here we explore the potential for protection due to pre-existing cross-reactive seasonal coronavirus antibodies and compare the rate of antibody decline for nucleocapsid and spike protein in serum and oral fluid against SARS-CoV-2 within the pediatric population.

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Article Synopsis
  • * The follow-up study measured the immune responses of 40 participants at 1.5 and 2.5 years after vaccination, focusing on serum bactericidal antibody (SBA) levels against various MenB strains and other serogroups.
  • * Results showed that while antibody levels declined over time, a significant percentage (68.8% for MenB and up to 87.5% for MenA, W, and Y) maintained protective antibody levels, with MenC showing a quicker decline.
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This review details recent findings from the Global Meningococcal Initiative's (GMI) recent meeting on the surveillance and control strategies for invasive meningococcal disease in the Middle East. The nature of case reporting and notification varies across the region, with many countries using bacterial meningitis as an IMD case definition in lieu of meningitis and septicaemia. This may overlook a significant burden associated with IMD leading to underreporting or misreporting of the disease.

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Background: Diphtheria is rare in England because of an effective national immunisation schedule that includes 5 doses of a diphtheria-containing vaccine at 2, 3, 4 months, preschool and adolescent boosters. However, in recent years there has been a notable increase in cases due to Corynebacterium ulcerans among older adults and evidence of endemic transmission of C. diphtheriae (normally associated with travel to endemic countries).

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Objective: Few data outside of individual case reports are available on non-meningococcal, non-gonococcal species of Neisseria as causative agents of invasive disease. This review collates disease, organism and patient information from case reports on the topic.

Methods: A literature search was performed examining articles describing diseases caused by non-meningococcal and non-gonococcal Neisseria.

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Background: An increase in acute severe hepatitis of unknown aetiology in previously healthy children in the UK in March, 2022, triggered global case-finding. We aimed to describe UK epidemiological investigations of cases and their possible causes.

Methods: We actively surveilled unexplained paediatric acute hepatitis (transaminase >500 international units per litre) in children younger than 16 years presenting since Jan 1, 2022, through notifications from paediatricians, microbiologists, and paediatric liver units; we collected demographic, clinical, and exposure information.

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Article Synopsis
  • The COVID-19 pandemic caused a significant decline in invasive meningococcal disease (IMD) cases in England, with a 73% reduction following restrictions introduced in March 2020.
  • Prior to the pandemic, MenB was the most common strain, making up over half of IMD cases, but after restrictions were lifted in 2021, a notable resurgence was seen particularly among teenagers and young adults.
  • Despite the increase in MenB cases in the winter of 2022/23, the incidence in young children eligible for MenB vaccination remained lower than pre-pandemic levels, while MenACWY cases stayed low due to ongoing vaccination efforts.
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Introduction: serogroup B (NmB) antigens are inherently diverse with variable expression among strains. Prediction of meningococcal B (MenB) vaccine effectiveness therefore requires an assay suitable for use against large panels of epidemiologically representative disease-causing NmB strains. Traditional serum bactericidal antibody assay using exogenous human complement (hSBA) is limited to the quantification of MenB vaccine immunogenicity on a small number of indicator strains.

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Affordable, polyvalent meningococcal vaccines are needed for use in emergency reactive immunization campaigns. A phase IV randomized, observer-blind, controlled study compared the safety and immunogenicity of a quadrivalent meningococcal polysaccharide vaccine (MPV-4, MPV ACYW135) and quadrivalent meningococcal ACWY conjugate vaccine (MCV-4, Menactra®). Healthy, 2- to 10-year-old children in Bamako, Mali, were randomized 1:1 to receive one dose of MPV-4 or MCV-4.

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Background: Travel to international mass gatherings such as the Hajj pilgrimage increases the risk of Neisseria meningitidis transmission and meningococcal disease. We investigated carriage and acquisition of N. meningitidis among travelers to Hajj and determined circulating serogroups, sequence types and antibiotic susceptibility among isolates.

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Background: People living with HIV have been shown to have an increased risk of invasive meningococcal disease. In some countries, meningococcal vaccines are now routinely recommended to all people living with HIV, but no study has yet assessed the immunogenicity and safety of a meningococcal serogroup B vaccine or the co-administration of a MenB and MenACWY vaccine in people living with HIV.

Methods: This phase IV open-label clinical trial investigated the immunogenicity and safety of two doses of a four-component recombinant protein-based MenB vaccine (4CMenB) and a quadrivalent conjugate polysaccharide MenACWY vaccine (MenACWY-CRM197) given 1 month apart in a population of people living with HIV.

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Background: Antibodies are a measure of immunity after primary infection, which may help protect against further SARS-CoV-2 infections. They may also provide some cross-protection against SARS-CoV-2 variants. There are limited data on antibody persistence and, especially, cross-reactivity against different SARS-CoV-2 variants after primary infection in children.

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