Major changes in grapevine wood microbiota are associated with the onset of esca, a devastating trunk disease.

Esca, a major grapevine trunk disease in old grapevines, is associated with the colonization of woody tissues by a broad range of plant pathogenic fungi. To identify which fungal and bacterial species are involved in the onset of this disease, we analysed the microbiota from woody tissues of young (10-year-old) grapevines at an early stage of esca. Using meta-barcoding, 515 fungal and 403 bacterial operational taxonomic units (OTUs) were identified in woody tissues. In situ hybridization showed that these fungi and bacteria co-inhabited in grapevine woody tissues. In non-necrotic woody tissues, fungal and bacterial microbiota varied according to organs and seasons but not diseased plant status. Phaeomoniella chlamydospora, involved in the Grapevine trunk disease, was the most abundant species in non-necrotic tissues from healthy plants, suggesting a possible non-pathogenic endophytic behaviour. Most diseased plants (70%) displayed cordons, with their central white-rot necrosis colonized essentially by two plant pathogenic fungi (Fomitiporia mediterranea: 60%-90% and P. chlamydospora: 5%-15%) and by a few bacterial taxa (Sphingomonas spp. and Mycobacterium spp.). The occurrence of a specific association of fungal and bacterial species in cordons from young grapevines expressing esca-foliar symptoms strongly suggests that that microbiota is involved in the onset of this complex disease.

Vaccine hesitancy : Report of a student study group.

In summer 2019 an extracurricular activity was started at the Medical University of Vienna (MUW) with the title: "Esoterism in Medicine", where different chapters were evaluated by students. Here we present the subheading "Vaccine Hesitancy". Three students formulated arguments from sceptic, hesitant or anti-vaccine groups and discussed the scientific literature to rebut it. Frequent objections were partly taken from the homepage of the German Robert-Koch-Institute, the home of the "Ständige Impfkommission". Other objections were taken from blogs and social media. The students' rebuttal was based on current scientific literature (preferentially pubmed), but also from other scientific sources like authorities.

The importance of precise documentation of vaccination by physicians and vaccine providers.

When reporting adverse events following immunisation, information about which vaccine was given, how it was administered, and if it was administered within the expiry date is often incomplete. To improve immunisation practice, a standardised uniform procedure is needed. Examples are given, where immunisations were given beyond the expiry date or were wrongly administered. These examples include proposals to avoid misleading documentation in the immunisation card.

Awareness and utilization of reporting pathways for adverse events following immunization: online survey among pediatricians in Russia and Germany.

OBJECTIVES: Vaccine safety surveillance is highly dependent on accurate reporting of adverse events following immunization (AEFI). An online survey was conducted to assess the utilization of AEFI reporting standards and pathways among pediatricians in Germany, and in Russia where pediatric specialization begins in medical school. METHODS: In May 2011, a 31-item online questionnaire was sent to members of the German Professional Association for Pediatricians (BVKJ) and the Union of Pediatricians of Russia (UPR), capturing information on vaccine safety training, awareness of AEFI reporting pathways, and use of standardized case definitions for the ascertainment of AEFI. A convenience sample of 1,632 completed online surveys was analyzed. RESULTS: Participating pediatricians reported spending approximately 50 min per 8-hour workday on vaccine safety consultations, but only 42 % (56 % UPR, 26 % BVKJ) have ever received any formal vaccine safety training. Two-thirds reported having observed AEFI in their practice, but only one-third utilized standardized case definitions for case ascertainment. Only 35 % of participants named accurate AEFI reporting pathways. Every second pediatrician would report AEFI to institutions that are not primarily in charge of vaccine safety surveillance; the remaining reports would either be lost or delayed. Pediatricians who had received formal vaccine safety training were significantly more likely to apply international safety standards and to report adequately, both at the p < 0.05 level. CONCLUSION: Pediatricians play a key role in the post-marketing surveillance of vaccine safety. The lack of training represents a missed opportunity. There may be a role for professional societies to improve vaccine safety training.

Standardization and simplification of vaccination records.

The majority of vaccines are administered during childhood. Vaccination records are important documents to be kept for a lifetime, but the documentation of immunization events is poorly standardized. At the point of care, paper records are often unavailable, making it impossible to obtain accurate vaccination histories. Vaccination records should include batch specifications to allow the tracking of licensed vaccines in cases of recall. The WHO have generated the International Certificate of Vaccination or Prophylaxis for the documentation of childhood and travel vaccinations as well as seasonal and booster immunizations. When moving vaccination records into the digital age, data standards and interoperability need to be considered. The ideal vaccination record should facilitate the interpretation of safety reports and promote a data continuum from pre-licensure trials to post-marketing surveillance. The current article describes which data elements are essential, and how vaccination documentation could be streamlined and simplified.

Safety reporting in developing country vaccine clinical trials-a systematic review.

With more vaccines becoming available worldwide, vaccine research is on the rise in developing countries. To gain a better understanding of safety reporting from vaccine clinical research in developing countries, we conducted a systematic review in Medline and Embase (1989-2011) of published randomized clinical trials (RCTs) reporting safety outcomes with ≥50% developing country participation (PROSPERO systematic review registration number: CRD42012002025). Developing country vaccine RCTs were analyzed with respect to the number of participants, age groups studied, inclusion of safety information, number of reported adverse events following immunization (AEFI), type and duration of safety follow-up, use of standardized AEFI case definitions, grading of AEFI severity, and the reporting of levels of diagnostic certainty for AEFI. The systematic search yielded a total number of 50 randomized vaccine clinical trials investigating 12 different vaccines, most commonly rotavirus and malaria vaccines. In these trials, 94,459 AEFI were reported from 446,908 participants receiving 735,920 vaccine doses. All 50 RCTs mentioned safety outcomes with 70% using definitions for at least one AEFI. The most commonly defined AEFI was fever (27), followed by local (16) and systemic reactions (14). Logistic regression analysis revealed a positive correlation between the implementation of a fever case definition and the reporting rate for fever as an AEFI (p=0.027). Overall, 16 different definitions for fever and 7 different definitions for erythema were applied. Predefined AEFI case definitions by the Brighton Collaboration were used in only two out of 50 RCTs. The search was limited to RCTs published in English or German and may be missing studies published locally. The reported systematic review suggests room for improvement with respect to the harmonization of safety reporting from developing country vaccine clinical trials and the implementation of standardized case definitions.

Evidence for an association between mannose-binding lectin 2 (MBL2) gene polymorphisms and pre-term birth.

PURPOSE: Human mannose-binding lectin, encoded by the MBL2 gene, is an important component of innate immunity and an important regulator of inflammatory processes. MBL2 gene polymorphisms are associated with an increased risk of neonatal infections and some data suggest a relation between the maternal MBL2 genotype and the risk of premature delivery. In this study, we evaluated whether there is an association between the fetal MBL2 genotype and prematurity. METHODS: A microarray-based on-chip PCR method was used to simultaneously detect five common MBL2 polymorphisms (codon 52, 54, 57; promoter -550, -221) in 204 DNA samples isolated from archival blood cards. MBL2 genotypes of infants born before the 36th week of pregnancy (N = 102) were compared to a control group of infants born at term after the 37th week (N = 102). RESULTS: The frequency of the codon 52 polymorphism was significantly higher in the pre-term group compared to the term group (10.8% versus 4.9%, P = 0.04), while the frequency of the codon 54 polymorphism was equal in both groups (11.3% versus 11.8%). Interestingly, carriers of genotypes (O/O) likely conferring deficient MBL plasma levels were more common in the group of premature birth (9.8% versus 2.9%, P = 0.05), while the promoter -550 C/C genotype was underrepresented in the pre-term birth group (24.5% versus 39.2%, P = 0.03). CONCLUSION: Our data add to the knowledge about genetic predisposition to prematurity and suggest that the fetal MBL2 genotype might be an additional genetic factor contributing to the risk of premature delivery.

[Rabies: epidemiology, pre- and postexposure immunization]. / Tollwut: Epidemiologie, prä- und postexpositionelle Immunisierung.

In the mid-nineties rabies was eliminated from Austria by mass vaccination of foxes. This has eventually led to a decrease in knowledge about epidemiology, prophylaxis and post-exposure treatment of this deadly disease. In addition, there has been considerable scientific progress in the field of rabies vaccination during the last decade. International travel led to more then twice the amount of people from Austria travelling to rabies endemic countries than ten years ago. Frequent travelling to the new EU member states, amongst them rabies endemic countries, further increased the risk of being exposed to this disease. Formerly mainly emergency units in hospitals had to deal with post-exposure rabies prophylaxis. Now that mostly travellers are exposed, any family physician or travel medicine specialist should be able to provide adequate information and treatment. It seems therefore necessary to refresh actual recommendations and guidelines for rabies vaccination, epidemiology and pos-texposure treatment in order to facilitate the management of suspect cases by physicians in Austria.

[Adjuvants and additives in vaccines--medical relevance]. / Hilfs- und Zusatzstoffe von Impfstoffen -- Medizinische Relevanz.

Side effects of vaccinations can have different causes. Substances admixed to vaccines may produce allergic or toxic reactions. The significance and importance of causal associations is discussed in this paper. A table is added listing the most important substances in vaccines, such as inactivating substances, preservatives, stabilizers, adjuvants, and residual substances derived from production processes. Among possible allergic reactions, type I reactions, as the most undesirable ones, should be avoided. In this respect, vaccines against yellow fever are the most important ones. With respect to antibiotics, it should be stressed that penicillin and cephalosporins are not contained in any of the vaccines. The significance of side effects caused by ethylmercury as a preservative (thiomersal) is extensively discussed in the literature. Allergy against this substance is common among the population, manifested as type IV reactions following superficial antigen administration. It has been shown that deep intramuscular injection of thiomersal-containing vaccines may be administered even to persons who are allergic to this substance without risk of side effects. Regarding toxic side effects after application of thiomersal, several studies have disproved a causal relation between thiomersal exposure and developmental disorders. Nevertheless, the general recommendation is to use thiomersal-free vaccines, unless no other preparations are available. In these cases risk of morbidity and mortality from the vaccine-preventable diseases outweigh by far any theoretical risk from ethylmercury.

Microarray-based detection of mannose-binding lectin 2 (MBL2) polymorphisms in a routine clinical setting.

The assessment of allelic variants in the human mannose-binding lectin 2 (MBL2) gene is of great clinical importance in newborns or immune-suppressed patients at high risk for a variety of infections. Here, we present a study on the genotyping accuracy of a DNA microarray-based on-chip PCR method suited for the detection of five different polymorphisms in the MBL2 gene. We tested 153 genomic DNA samples, prepared from archival blood spots on Guthrie cards, for the presence of allelic variants in the human MBL2 gene by the on-chip PCR method and compared the obtained results of three variants to standard DNA capillary sequencing. The genotyping power of the described assay was readily comparable to DNA sequencing (453/459 correct genotype calls in 153 DNA samples; 98.7% accuracy), mainly due to intrinsic technical benefits of microarrays such as high number of test replicates and automated data analysis. This study demonstrates, for the first time, the accuracy and reliability of a microarray-based on-chip PCR genotyping assay for measuring allelic variants in a routine clinical setting.

Mannose-binding lectin: comparison of two assays for the quantification of MBL in the serum of pediatric patients.

Individuals with mannose-binding lectin (MBL)-deficiency are at an increased risk from infections with mannose-bearing microorganisms. We have investigated two quantitative research assays for measuring MBL protein in serum for routine diagnosis. The evaluation of 817 serum samples with a nephelometric assay revealed two deficiencies, a number far below the postulated 5-10% of the population. Reevaluation of 102 serum samples with an MBL-ELISA detected low levels in 27 cases (26.4%) and clear deficiencies in 21 samples (20.4%). In our hands, the MBL-ELISA permitted the detection of decreased levels of MBL in serum, as occurs in individuals with homozygous or heterozygous MBL gene mutations; in contrast, the nephelometric assay appeared to be unsuitable for the detection of MBL deficiencies. We support the routine measurement of MBL in serum, especially in children with frequent infections.