The edition · Infectious Diseases
Rotavirus still causes a quarter of childhood diarrhoea in vaccinated low-income settings
Pooled surveillance after rotavirus vaccine rollout, a four-month TB regimen in early testing, a nasal pertussis vaccine, a rifampicin licence update, and how long skull-base surgery prophylaxis needs to run.
The edition in brief
A meta-analysis of 35,704 children under five with diarrhoea in lower-middle-income countries, after rotavirus vaccine introduction, found rotavirus in 24% and norovirus in 13%, with G3P[8] and norovirus GII.4 the commonest strains; heterogeneity was extreme. A phase 2b/c proof-of-concept trial in South Africa found four months of delamanid, bedaquiline and quabodepistat gave end-of-treatment culture conversion of 96% versus 100% with six months of standard therapy in drug-susceptible pulmonary TB, meeting a 12% non-inferiority margin; relapse data are not yet reported. BPZE1, a live intranasal pertussis vaccine, induced nasal IgA in children aged 6–17 without interfering with Tdap responses, a step towards blocking carriage rather than only disease. FDA recorded a supplement to an abbreviated application for rifampicin from Fresenius Kabi on 29 September, an administrative licence change rather than a safety signal. A meta-analysis of 7,981 patients undergoing endoscopic endonasal skull-base surgery found postoperative meningitis in 1.4%, with no association between prophylaxis duration and meningitis; intraoperative CSF leak was the factor linked to infection.
Rotavirus and norovirus remain common in childhood diarrhoea after vaccine introduction
Rotavirus and norovirus still cause about one in five childhood diarrhoeal episodes in vaccinated low-income settings; rehydration remains the treatment.
A four-month rifampicin-free TB regimen matched culture conversion in a small trial
Quabodepistat with bedaquiline and delamanid is promising, but end-of-treatment culture is not cure; standard regimens stand.
A nasal live pertussis vaccine raised mucosal IgA in schoolchildren without blunting Tdap
BPZE1 induced mucosal immunity safely in schoolchildren, but whether it prevents infection is untested.
FDA records a licence supplement for a generic rifampicin
This is an administrative supplement to a generic rifampicin licence, not a safety finding.
Stop surgical prophylaxis at the end of the operation for most clean procedures
Most surgical prophylaxis should end within 24 hours; write the stop time when you prescribe.
Skull-base surgery: longer antibiotic prophylaxis was not linked to less meningitis
Consider short prophylaxis after endoscopic skull-base surgery; longer courses were not linked to fewer meningitis cases.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for infectious diseases, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free