The novel coronavirus has put zoonoses firmly at the top of the global health agenda, and the final day of science led with what can we do to mitigate zoonotic infection. The day included the Union/CDC late breaker session featuring the very latest science on tuberculosis, and COVID-19 in pregnant women, from onset in pregnancy to post-partum outcomes.
Read more about these highlights below.
Special Session 4: What can we do to mitigate zoonotic infection
More than 60 percent of emerging infectious diseases are zoonotic, so keeping animals in good health may be the first line of defence in helping keep outbreaks under control.
Amidst an outbreak it is often human vaccines that seem like the logical area of focus for control yet, ultimately, as this session explored, animal vaccines can be as effective and, in the case of rabies, more effective at slowing the spread.
Presentations focussed on as we become more adept at understanding how to contain and combat disease spread, recognition that prevention and mitigation starts with animals, is key.
This session included experiences of Zika in Brazil, SARS-CoV-2 in mink, experiences from the field, and, successful Zika community control programmes in an endemic area.
The Union/CDC late-breaker session on TB
The Union World Conference’s platform for the latest in breaking TB science, this session included a review of an artificial intelligence algorithm, trained and tested on a large scale dataset, to classify active TB from normal – and other abnormal – chest X-rays with high accuracy. Evidence was shared that this deep learning algorithm has the potential to be applied in TB screening programmes where a large amount of population need to be evaluated in a short period of time with limited radiologists.
A second presentation offered information about a tool designed to assess the willingness to prescribe TB preventative therapy (TPT) among healthcare workers in rural South Africa. This work is of particular significance given that TPT initiation rates have decreased among people living with HIV despite South Africa’s initial successful TPT roll out.
Another Union / CDC Late breaker presentation focussed on the results of the shorter treatment for minimal TB in children: the SHINE trial. SHINE was an open-label treatment shortening trial in children with minimal (non-severe and smear-negative), symptomatic drug-susceptible TB. One thousand, two hundred and four children in Africa and India were randomised to four-month versus six-month treatment, using World Health Organization-recommended paediatric fixed-dose formulations, and followed for 18 months.
Health and well-being post-TB
Emerging evidence suggests that patients formerly treated for TB are likely to be at increased risk of morbidity and mortality post-TB. The Comorbidities and all-cause mortality post-TB treatment: a retrospective cohort study of patients previously treated with second line TB drugs in Georgia study found that post-TB mortality rates were higher among TB survivors with pre-existing comorbidities, including hyperglycemia, hepatitis C virus, and human immunodeficiency virus (HIV) co-infection. Also in this session, the presentation ‘Systematic review and meta-analysis of the association between recurrent TB and HIV infection’ reviewed the frequency of recurrent TB and the risk of developing recurrent TB, exogenous reinfection and relapse, according to HIV status among literature since 1980.
COVID-19 in pregnant women. This symposium featured emerging research on the immunology of COVID-19 in pregnancy and the differences in clinical presentation and management – including treatment options, policies for safe pregnancy and potential research priorities.
Pathogenesis and immunology of COVID-19 in pregnant women. Findings from the Washington State COVID-19 in Pregnancy Collaborative included the pathogenesis and immunology of COVID-19 in pregnancy, and featured lessons learned from other emerging infectious diseases.
Pregnancy and postpartum outcomes of COVID-19 in New York City: a multicentre prospective cohort study. In this talk, the findings from this prospective cohort were discussed, including maternal presentation, obstetric and neonatal outcomes, and placental pathology associated with COVID-19 infection. Also discussed the evolution of maternal symptoms throughout the course of labour and the postpartum period, with implications for postpartum care.