Isabella Eckerle Profile picture
Apr 8, 2022 10 tweets 9 min read Read on X
Our paper on infectious viral load in vaccinated & unvaccinated individuals infected with ancestral, #Delta or #Omicron #SARSCoV2 #COVID19 published today in
@NatureMedicine - what did we find? A 🧵1/
nature.com/articles/s4159…
We assessed infectious viral particles & RNA viral load from nasopharyngeal swabs of 565 #SARSCoV2 infected individuals in the first 5 days post symptom onset over several waves: 2020 ("pre-VOC", before the rise of #variants of concern), #Delta in 2021 & #Omicron in 2022. 2/
First of all, we found a rather low correlation between viral RNA copies and infectious viral titers & no correlation of infectious viral load with age or sex. Infectious viral load in unvaccinated individuals was higher when infected with #Delta than with pre-VOC #SARSCoV2 3/ Image
Next, we have investigated the effect of #vaccination (2 doses mRNA) on infectious viral load: In vaccinated individuals with a Delta breakthrough infection, infectious virus was almost 5-fold lower & was cleared more rapidly than in the unvaccinated with Delta 4/ ImageImage
For Omicron BA.1 infections, we have investigated infectious viral load for unvaccinated, 2x vaccinated & 3x vaccinated individuals. In 2x vaccinated individuals with a breakthrough infection, Omicron (while being highly contagious) had lower infectious viral load than Delta! 5/ Image
Next, effect of #vaccination (2x or 3x) on infectious viral load in #Omicron BA.1 infections: Individuals with 2x mRNA vaccine had comparable infectious viral load to unvaccinated. But with additional (booster) dose we saw a more than 5-fold reduction in infectious viral load! 6/ Image
Our data demonstrate that 1) measuring viral RNA (Ct values/copy numbers) are not the full story when it comes to viral load 2) it's important to asses infectious (culturable) virus to better understand viral shedding profiles 3) vaccination impacts infectious viral load 7/
Public health impact of our findings: vaccination can reduce infectious viral load, likely leading to lower onward transmission. These findings underscore the benefit of #vaccination on #SARSCoV2 circulation beyond individual protection from severe disease #SARSCoV2 #COVID19 8/
The work was a huge team effort of our hospital @Hopitaux_unige @FJacque1 @LaurentKaiser1 @GenecandC, the emerging virus team @UNIGEnews @unige_en @gcevd @MIMOL_UNIGE @KennethAdea, led by @OlhaVPuhach & Centre for Vaccinology @BenjaminMeyer85, funded by @snf_ch @nrp78_covid19 9/9
Note: we did not have information on prior infections in the individuals tested & we did also not assess the effect over different time points after having received the booster (Switzerland introduced boosters rather late). Hopefully we will be able to this in the future.

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More from @EckerleIsabella

Sep 16
This is a really cool paper that shows reduction of RNA viral load in #SARSCoV2 vaccinated individuals when infected across different vaccines in the early acute disease phase. We investigates the same question a while ago ... academic.oup.com/jid/advance-ar…
...in this paper, but in addition we have also assessed infectious viral particles by growing the virus. In both study designs, vaccination had an impact on viral load with lower viral RNA/infectious viral load after vaccination. nature.com/articles/s4159…
And: It was also observed in an epidemiological study that vaccination seems to reduce infectiousness! nature.com/articles/s4146…
Read 4 tweets
Aug 5
Wir werden in Zukunft in der #Schweiz keine Überwachung mehr für hospitalisierte Patienten mit #SARSCoV2 oder #Influenza haben. Schwer nachzuvollziehende Entscheidung des @BAG_OFSP_UFSP, insb. in Hinblick auf zukünftige Epidemien wie #Vogelgrippe #H5N1 bag.admin.ch/bag/de/home/da…
Dies ist insbesondere traurig, da die Schweiz seit 2018 ein exzellentes Netzwerk aus Spitälern aufgebaut hat, die in Echtzeit Daten von hospitalisierten Patienten mit Grippe gesammelt hat - ein System, um das uns viele Länder in der Pandemie mehr als beneidet haben!
In der Pandemie konnte das wertvolle Instrument, was in Genf für Grippe kreiert wurde, schnell auf #SARSCoV2 #COVID19 erweitert werden, und hat viele wichtige Daten für die öffentliche Gesundheit gesammelt, sowie für die Überwachung von SARS-CoV-2-Varianten durch Sequenzierung
Read 8 tweets
Jul 1
Es gibt zwei Ausbrüche, die global gerade ganz große Sorge hervorrufen sollte: #Vogelgrippe/#Influenza #H5N1 in Rindern, USA und #Mpox (#Affenpocken)-Ausbruch, DRC. Beides enormes Potential für die nächste Pandemie. Keins von beiden wäre auf globaler Ebene gut zu bewältigen.
Beide Viruszirkulationen, der eine (noch) im Tier, der andere gerade im Mensch angekommen, könnten mit sehr intensiver (nationaler & globaler) Anstrengung vielleicht noch ausgelöscht werden. Dies passiert aber nichtmal ansatzweise. H5N1 ist ja "nur" im Tier, Mpox scheint weit weg
M.E. das Problem bei der Einschätzung hier: Risiko wird so lange als gering für die allg. Bevölkerung gewertet werden, bis es zu spät ist. Es gibt kein mittleres Risiko. Wenn es breit & effektiv im Mensch ist, ist es zu spät für eine Eindämmung. Primäre Prävention: Nichts gelernt
Read 4 tweets
Jun 12
Increasing reports of #H5N1 on farms & other mammals is more than worrying. Yes we need to prepare, but most importantly we prevention: where’s the global push & pressure on the US to contain this while it’s still in animals (hopefully, as there’s also not enough human testing)
This virus will not burn out, it is thriving, it’s well suited to infect many species, thus it will spread further and become less a less controllable and at some point there will be a virus that is more adapted to humans. The window of opportunity is closing very quickly!
Containing contagious animals diseases is nothing new and there are decades of knowledge how it can be done. Test every farm, cull or at least isolate infected cows properly (I doubt isolation is possible though) & put infected farms under heightened surveillance & isolation.
Read 4 tweets
Apr 29
A good read on the current situation with Bird flu in US cows: is the milk supply safe #H5N1 nature.com/articles/d4158…
Three thoughts: "In fact, in some equipment set-ups, workers spray down milking machines with high-pressure hoses to clean them, which would aerosolize any infected milk, says Wasik." This sounds like an incredible bad idea in the current situation & a risk for the workers
"It’s possible that pasteurization would be less effective at killing relatively high viral concentrations in milk ... keeping milk from infected cows out of the commercial supply is extremely important." But exactly the latter is apparently not working it seems
Read 4 tweets
Apr 10
Es gibt einen weiteren Punkt, der hier vollkommen fehlt: Pelztierhaltung ist ein Risiko für neuartige Virusausbrüche, und diesen strenger zu regulieren ist eine einfache Möglichkeit, das Risiko für eine #Epidemie/#Pandemien zu verhindern. Beispiele: #SARSCoV2 & #H5N1 bei Nerzen
Internationale Wissenschaftler fordern bereits seit einiger Zeit, Pelztierhaltung, vor allem von Nerzen, aufzugeben, oder nur noch unter sehr strengen Biosicherheits-Auflagen zu betreiben (was wohl kaum möglich ist) pnas.org/doi/full/10.10…
Wenn der Tierschutz nicht als Argument reicht, dann sollte es der "Artenschutz" für unsere eigene Spezies sein, denn die Produktion dieses Modeproduktes stellt ein Risiko dar für eine zukünftige Pandemie! Leider, wie in vielen Bereichen, fehlt hier der #OneHealth Gedanke!
Read 5 tweets

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