A 46-year-old man with relapsed B-cell acute lymphoblastic leukaemia following allogeneic sibling haematopoietic stem cell transplantation presented with neurological signs including limb weakness, imbalance, cognitive impairment, and seizures. His most recent treatment had been CD19 chimeric antigen receptor (CAR) T-cell therapy (3 × 106 cells per kg) 4 months previously. His underlying leukaemia remained at a level of low minimal residual disease according to molecular monitoring. The differential...
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We note some mischaracterisations in the Comment by Shabir A Mahdi and David Goldblatt1 on the Article by Beth Temple and colleagues.2 As an overarching framework, the data from Temple and colleagues cannot be used for predicting vaccine performance against most clinical outcomes, since the only accepted correlate of protection for pneumococcal conjugate vaccines (PCVs) is against invasive pneumococcal disease 1 month after three primary doses during infancy. For all other outcomes (carriage, mucosal...
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Bradford D Gessner and colleagues argue that our Comment1 contains mischaracterisations regarding the relative merits of the PCV10 and PCV13 vaccines.
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Mortality from pneumococcal, tuberculous, and culture-negative meningitis was high in this setting of high HIV prevalence. There is an urgent need for improved access to diagnostics, to better define aetiologies and develop novel diagnostic tools and treatment algorithms.
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In The Lancet Infectious Diseases, Mark W Tenforde and colleagues1 report the mortality findings of the 2004–15 Botswana national meningitis survey. This was a nationwide laboratory-based audit with linkage to the national HIV and death registries. Data from all patients with culture-confirmed pneumococcal and tuberculous meningitis, and all patients with culture-negative meningitis with CSF white cell count (WCC) above 20 cells per μL were included in their analyses, in addition to a random selection...
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We agree with Ulrich Heininger that when altering the primary infant vaccination schedule for the six-in-one diphtheria, tetanus, and pertussis-inactivated poliomyelitis-Haemophilus influenzae type b-hepatitis B (DTaP-IPV-Hib-HepB) vaccine from a dose at ages 2, 3, and 4 months to a reduced dose schedule (with doses at ages 3 and 5 months) in cases of timely maternal tetanus, diphtheria, and acellular pertussis (Tdap) vaccination during pregnancy in babies born full-term, one needs to take into account...
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I would like to correct a claim in the Comment by Eskild Petersen and colleagues1 on latent tuberculosis infection (LTBI) strategies. The authors state that “all high-income countries now have proactive latent tuberculosis infection screening and treatment programs for all new migrants and refugees”.1 However, the literature shows that this claim is incorrect.
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We read with great interest the Article by Daan Braug and colleagues1 on the results of the maternal pertussis vaccination trial and its effects on the immune response of infants in the Netherlands.
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The tuberculosis vaccine field has seen exciting new results over the past 12 months following decades of disappointing research. First, it was shown that, in adolescents uninfected with Mycobacterium tuberculosis in South Africa, re-vaccination with BCG (the vaccine recommended by WHO for use in neonates to prevent childhood tuberculosis) could protect against sustained M tuberculosis infection. An efficacy of 45·4% (95% CI 6·4–68·1; p=0·03) was shown against a secondary endpoint: sustained conversion...
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