Tag: Infectious disease

World AIDS Day: We have come a very long way but there is still much to do to protect those at risk

Professor Sarah Fidler

This festive period Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

While HIV is no longer the death sentence that it once was, lifelong treatment is still required and there is no cure – yet. Professor Sarah Fidler from the Department of Infectious Disease discusses how a new type of HIV treatment holds promise as a longer-lasting alternative to current complex drug regimens.


Despite extraordinary political and medical advances, HIV, the virus that causes AIDS, remains one of the world’s most serious public health challenges. Since its discovery in 1983 by researchers at the Pasteur Institute in France, 84 million people worldwide are estimated to have become HIV-positive and 40 million people have died from an HIV-related illness. Today, there are around 38 million people living with HIV globally, with 1.5 million new infections in 2021.

Advocacy and close collaboration between clinicians, scientists and the HIV-affected community has inspired and driven the research and drug development and access agenda. Without these close working relationships, the development of HIV treatments would have been markedly slower and many more lives would have been lost.

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How long is COVID-19 infectious? Opportunities and challenges in using real-world evidence

New York circa November 2020: Crowd of people walking on the street wearing masks during COVID-19 pandemic. Credit: blvdone / Shutterstock.com.

Providing the most comprehensive picture of COVID-19 infectiousness to date, recent research from Imperial College scientists offered new insights into how long people with COVID-19 are infectious for. Co-author, Dr Seran Hakki, outlines the challenges of collecting real-world evidence in the first-of-its-kind study.

In August, the ATACCC Study (The Assessment of Transmission and Contagiousness of COVID-19 in Contacts) published some of their findings in one of the world’s leading respiratory health journals, The Lancet Respiratory Medicine. Our study was the first to use real-life evidence from naturally acquired infection to assess the duration of COVID-19 infectiousness, its correlation with symptom onset, and how this affects the accuracy of lateral flow tests.

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How can we manufacture the safest possible challenge agents for human infection studies?

Pipettes in a scientific lab
Dr Emma Smith—HIC-Vac Network Manager—explains how specific guidelines for the provenance and manufacture of challenge agents could make human infection studies even safer.


Human infection studies, also known as human challenge studies, are clinical trials where volunteers are intentionally given a carefully considered dose of a pathogen—known as the challenge agent. These models can be used to study host-pathogen interactions and disease progression; identify and test the efficacy of promising vaccines and drugs in development; or be used as proof-of-concept studies for testing novel medications. In this controlled environment it is possible to study infections in ways that aren’t possible in traditional field studies.

One of the first steps towards establishing a challenge study is the selection, isolation, development and production of the challenge agent. However, unlike medicines, the regulation of challenge agent manufacture varies internationally; an area that the research community has identified as a potential weakness in the field. Although human challenge studies have an excellent safety record—a recent literature review identified just 24 Serious Adverse Events (SAE) and zero deaths or cases of permanent damage among 15,046 participants in 308 studies spanning 1980 to 2021— the lack of specific guidelines for the provenance and manufacture of challenge agents warrants attention.

HIC-Vac—an Imperial-led international network of researchers who are developing human infection challenge studies—has been working with the global charitable foundation Wellcome and the company hVIVO to address this unmet need. Our purpose was to promote volunteer safety whilst maximizing access to challenge agents and challenge models globally. (more…)

Could we have a simple solution to this huge HIV problem?

Test tube of blood with a label written "HIV TEST"

There are currently 38 million people infected with HIV worldwide with up to a million deaths each year.  During National HIV Testing Week, we hear from Dr. Catherine Kibirige  who has developed a highly sensitive HIV-1 test that can detect a single infected cell with high precision.


Meet Dr. Fred Nsubuga, he manages the Diagnostics Laboratory at Jinja District Hospital in Uganda.  His laboratory is not equipped for HIV-1 treatment monitoring, so, when patients come in who need a viral load test, he must collect, process and store their blood samples, batch them together, then send them on a truck to the national HIV testing laboratory in Kampala, the capital city, 44 miles away.  Despite the availability of this state-of-the art facility which boasts a Roche Cobas 8800™ high-throughput instrument with a good computer-based laboratory management system, it can take months for the results to get back to him.  Sometimes, they go missing.  

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What is the new coronavirus (2019-nCoV) and what do we know about the outbreak so far?

This post was last updated on 31 January 2020

What is the ‘Wuhan coronavirus (2019-nCoV)’ and what do we know about it so far?
Dr John Tregoning (JT) from Imperial’s Department of Infectious Disease spoke to the School of Public Health’s Prof Steven Riley (SR) about the coronavirus outbreak that recently began in Wuhan, China.


Who has been working on the outbreak epidemiology at Imperial College London?

SR: I work as part of the MRC Centre for Global Infectious Disease  Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics centre with Prof Neil Ferguson, Dr Natsuko Imai, Dr Ilaria Dorigatti, Dr Anne Cori Prof Christl Donnelly, Prof Azra Ghani and Dr Marc Baguelin.

So what is this new coronavirus?

SR: It is a viral infection that was first discovered in the Chinese city of Wuhan in 2019 that has been associated with a number of cases of pneumonia – an infection of the tissue in the lungs. You might see it being called ‘2019-nCoV’, which stand for novel (or new) coronavirus. More information has been provided by the World Health Organisation. (more…)

Alive and ticking: Is Lyme disease on the rise in the UK?

Lyme disease UK

Justin Bieber’s recent Lyme disease diagnosis has brought the disease into the public eye. Professor Gareth Tudor-Williams explores whether there is a link between tick behaviour and a rise in reported cases.


It’s a fact that every time a high profile individual reveals that they have Lyme disease – the latest being singer Justin Bieber – there is an appreciable spike in internet searches, followed a short while later by an increase in the number of blood samples being sent for testing to the Public Health England national reference laboratory at Porton Down.

So this trend would suggest that the publicity about Lyme disease increases health-seeking behaviour in this country, which in turn leads to more cases being diagnosed.

All of which begs several questions. Is the incidence truly rising or are more people being diagnosed who would not previously have been tested? Are there significant numbers of people living in the UK with undiagnosed and therefore untreated infection?  What proportion of untreated infected individuals develop long-term health problems? (more…)

Working with HIV/AIDS patients was the highlight of my clinical career


Originally published on the Imperial College Healthcare NHS Trust blog, Professor Jonathan Weber, Dean of our Faculty of Medicine, shares the story of his career working with people affected by HIV/AIDS.


In April 1982, I was a young doctor with an interest in infectious diseases when my mentor, Professor Philip Marsden, mentioned a new disease he’d seen in New York, which was affecting young gay men and had all the hallmarks of a sexually transmitted infection. He suggested it would be interesting to look for this new disease in London and he thought St Mary’s Hospital might be a good starting point. So in August 1982, I joined Dr Willie Harris’ Praed St Clinic, looking at the immune system of gay men who visited the clinic, guided by immunologist Professor Tony Pinching and virologist Professor Don Jeffries.

Early observations

I was fortunate to be able to work on my research full-time from early 1983, thanks to a fellowship  from the Wellcome Trust; I had gathered a cohort of 400 gay men at the clinic and examined their immune systems. What my colleagues and I discovered was that all the men in the cohort had abnormal immune systems; they all had a low number of CD4+ T-lymphocytes and low CD4:CD8 T-cell ratios. They also had enlarged lymph nodes in their necks, armpits and groin, which is usually a sign that the body is trying to fight an infection. These observations led us to believe that all the patients in this cohort had an early manifestation of AIDS; it was a chilling insight into the scale of the unfolding AIDS epidemic. (more…)

HTLV-1: Time to care, time to take action

HTLV-1

Ahead of the WHO Global Consultation on HTLV-1, Professor Graham Taylor outlines three steps to prioritise the neglected cancer-causing virus.


“I couldn’t do anything for a week after I opened the letter and saw that I was infected with it. I saw H and thought I had HIV. I’d never heard of HTLV”.

It’s not the first time that I’ve heard this, but this was two days ago, almost 40 years since the report in 1980 of the discovery of the human T-cell lymphotropic virus (HTLV-1). Sadly Janet* is joined in her lack of awareness not only by almost the entire general public but also by most healthcare professionals.

This weekend saw World HTLV Day marked for the second year, with the slogan is: ‘It’s time to care’. This is in response to a general perception that there is a widespread indifference toward HTLV. Hopefully this will change soon. This week, I fly to Tokyo to participate in a WHO Global Consultation on HTLV-1 to address the public health impact and implications of this little-known virus. (more…)

The mystery of the typhoid toxin

Typhoid toxin

Dr Malick Gibani unravels the mystery behind the role of typhoid toxin in causing typhoid fever  – a disease that affects around 11 million people each year globally.


Salmonella Typhi is a fascinatingly complex bacterium. Whilst there are more than 2000 different (sero)types of Salmonella, there’s something special about Salmonella Typhi that sets it apart from the non-typhoidal Salmonella serovars. It causes different symptoms, the means of spread are different and the host it infects is different – specifically, Salmonella Typhi only causes disease in humans.

Understanding the mechanisms of how bacteria can cause disease is profoundly important for vaccine development. The Vi-antigen that forms the major component of injectable typhoid vaccines seems to have a key role in making the bacteria more virulent (hence the name). Vi-based vaccines have proven to be highly effective tools to prevent typhoid. (more…)

Nature wants you dead – here’s how vaccines work to help keep us all alive

 

Dr John Tregoning takes us on a tour of vaccination’s greatest successes, explaining how this incredible human achievement works to keep us all safer from disease – as long as we keep vaccinating ourselves and our families.


Nature wants you dead. Not just you, but your children and unborn children and everyone you have ever met.

It wants you to cough and sneeze and poop yourself into an early grave. If it can, it wants you your blood vessels to burst and pustules to explode all over your body. Put simply, Nature is trying to kill you.

And until relatively recently, it was really good at doing this. The average life expectancy of a human in 1900 was 31 years. I should already be dead.

But then science intervened with two critical innovations, clean water and vaccines, and changed everything. Clean water has had the biggest impact, but vaccines are a close second. (more…)