Top News From IDSA 2010: Slideshow

The Infectious Diseases Society of America (IDSA) held its 48th Annual Meeting from October 21 to 24, 2010, in Vancouver, British Columbia, Canada.

Among this year's highlights:

• CD4 T cells from "elite controllers" resist infection by HIV,

• the herpes zoster vaccine reduced the incidence of shingles by 70% compared with placebo in adults in their 50s,

• young children with influenza are at risk for hospitalization if most household members are smokers, and

• maternal herpes suppression does not always prevent neonatal transmission.

The very small proportion of HIV-infected individuals known as "elite controllers," who — without treatment — have undetectable viral levels, have CD4 T cells that resist infection with the virus. Their CD4 cells have a 10- to 100-fold higher expression of p21, a host protein originally described as a product of a tumor suppressor gene. Modulating the intracellular level of p21 affects the level of HIV replication in the cell, announced Mathias Lichterfeld, MD, PhD, from Harvard Medical School and Massachusetts General Hospital in Boston.

Full news coverage: CD4 T Cells From "Elite Controllers" Resist Infection by HIV

In a clinical trial of 22,439 participants, the herpes zoster vaccine, currently FDA-approved for adults aged 60 years and older, reduced the incidence of herpes zoster by 70% compared with placebo in adults in their 50s. During 1 year of follow-up, there were 30 cases of shingles in the vaccinated group compared with 99 cases in the placebo group. Based on these results, Merck, manufacturer of Zostavax, has applied to the US Food and Drug Administration for expanded approval to include adults aged 50 to 59 years.

Full news coverage: Merck Herpes Zoster Vaccine Effective in Adults in 50s

If more than half of household members are smokers, a child's risk for hospitalization for influenza more than doubles. Having a mother younger than 26 years or a household income below the poverty level doubles the risk for a child being hospitalized with influenza, and risk is also nearly doubled if the child is not up to date on all vaccinations. If a child is not fully vaccinated against influenza, vaccination of any household member cuts the child's risk for hospitalization by 50%.

"Secondhand exposure to cigarette smoke has been suggested as a risk factor in previous studies, but this study is the largest to date examining the risk of childhood exposure to cigarette smoke and hospitalization specifically for influenza," said Nila Dharan, MD, from New York University School of Medicine in New York City.

Full news coverage: Secondhand Smoke Raises Risk for Hospitalization in Young Children With Influenza

Lindsey Baden, MD, from Harvard Medical School and Brigham and Women's Hospital in Boston, Massachusetts, and copanelists presented cases of invasive fungal infection that challenge the current Mycoses Study Group/European Organization for Research and Treatment of Cancer (MSG/EORTC) diagnostic algorithm. The audience graded the cases as proven, probable, or possible, and then discussed limitations and possible improvements to the algorithm.

The American Congress of Obstetricians and Gynecologists recommends antiviral treatment during the last 4 weeks of gestation for women with a history of recurrent genital herpes to reduce risk for transmission of the virus from mother to newborn. However, Swetha Pinninti, MD, from the University of Alabama at Birmingham, reported that "Maternal antiviral suppressive therapy during pregnancy does not prevent herpes disease in the newborn." As a result, newborns may present with herpes infection at 18 to 20 days of life, rather than at 7 to 12 days of life, and a pediatrician may not expect to see the disease so late, complicating the diagnosis and treatment.

Full news coverage: Maternal Herpes Suppression Does Not Always Prevent Neonatal Transmission

Poster sessions were well-attended at the IDSA 48th Annual Meeting.

Based on various models used to calculate risk reduction, Courtney Gidengil, MD, MPH, from the RAND Corporation and the Division of Infectious Diseases at Children's Hospital Boston, Massachusetts, reported that universal contact precautions with universal decolonization prevented the highest proportion of cases of methicillin-resistant Staphylococcus aureus colonization (54%) and infection (51%) compared with standard precautions alone.

Full news coverage: Contact Precautions, Decolonization Best for MRSA Prevention in ICU

Rapid HIV testing (RHT) programs in jails in Philadelphia, Pennsylvania; Baltimore, Maryland; and Washington, DC, identified 142 new diagnoses over 1 year that might have otherwise been missed. RHT involved local political support, use of electronic medical records to streamline testing, and general acceptance of RHT by detainees. As a result, newly diagnosed individuals were accommodated into existing HIV care services, reported Curt Beckwith, MD, from the Alpert Medical School of Brown University in Providence, Rhode Island.

Full news coverage: 3 Cities Show Value of Rapid HIV Testing in Jails

Conference delegates walk through the lobby of the Vancouver Convention Centre during the 48th annual IDSA conference. Nearly 4800 delegates attended this year's meeting — a record-breaking number.

Influenza vaccination rates among healthcare workers were 54% in 2003 and 30% in 2004, rose to 97.6% in 2005, and were maintained at rates higher than 98% during the subsequent 4 years, reported Robert Rakita, MD, from the University of Washington at Seattle.

Infants with neonatal herpes simplex virus central nervous system involvement had better neurodevelopment at 1 year if they received 6 months of oral acyclovir after an initial course of intravenous acyclovir immediately compared with infants who received delayed oral acyclovir treatment, reported David Kimberlin, MD, from the University of Alabama at Birmingham. "For babies with skin/eye/mouth disease...we also found that the antiviral suppression kept it from coming back on the skin as well."

Full news coverage: Prolonged Oral Acyclovir Improves Neurodevelopment of Infants With CNS Herpes Simplex

Physicians, scientists, and other healthcare professionals involved in research, patient care, public health and education in the field of infectious diseases gathered at IDSA 48th Annual Meeting to hear the latest news. The IDSA's 49th Annual Meeting will be held October 20 to 23, 2011, in Boston, Massachusetts.

Last year's H1N1 influenza vaccine was safe for pregnant women and was well tolerated. There was no difference in reported adverse effects between unvaccinated women and women who received the H1N1 vaccine alone or with the seasonal influenza vaccine, except for arm soreness, a postlicensure safety profile of the H1N1 vaccine reported by Stephanie Irving, MHS, from the Marshfield Clinic Research Foundation in Wisconsin, showed. Results were similar to prelicensure studies. Hospitalization rates and death from influenza for pregnant women were higher than in the general population during the 2009 H1N1 pandemic. The US Advisory Committee on Immunization Practices made pregnant women a high priority for H1N1 vaccination.

Full news coverage: H1N1 Influenza Vaccine Safe for Pregnant Women

Twelve months after the intake visit, undocumented Hispanics infected with HIV had a higher increase in CD4 counts and a higher proportion reaching an HIV RNA viral load target of fewer than 400 copies/mL than documented Hispanics, blacks, and whites, reported Thomas Giordano, MD, MPH, from Baylor College of Medicine in Houston, Texas. All 4 groups had similar retention in care. A multivariate analysis revealed that blacks had a significantly lower odds ratio for retention in care and for achieving a viral load of fewer than 400 copies/mL.

Full news coverage: Undocumented Hispanics With HIV Present Late But Do Well With Treatment

Ahi tuna imported from Southeast Asia proved to be the unlikely source of a Salmonella outbreak in Hawaii. Sarah Park, MD, from the Disease Outbreak Control Division of the Hawaii Department of Health, in Honolulu, cautioned that such an outbreak could stretch out for months and can recur when contaminated frozen fish is defrosted and consumed. "Essentially, this outbreak highlights the critical gap in the security of imported food products," she said. "Increased globalization of our food commerce to meet demand means that controlling potential hazards for contamination at the source is a public health imperative...demand through global outsourcing, therefore, must be balanced against ensuring our food security."

Full news coverage: Unusual Outbreak of Salmonella in Imported Ahi Tuna

Photographs by Jeff Vinnick of Vancouver, British Columbia, Canada

Martha Kerr, Conference News Editor, Medscape Medical News, East Haddam, Connecticut
Martha Kerr has disclosed no relevant financial relationships.

Jane Hwang, Senior Editor/Photo, Medscape, New York City
Jane Hwang has disclosed no relevant financial relationships.

Daniel M. Keller, PhD, Freelance Journalist, Philadelphia, Pennsylvania
Daniel Keller has disclosed no relevant financial relationships.

Top News From IDSA 2010: Slideshow

For More Information

More Conference Slideshows

For more information, see the following resources:

More Conference Slideshows