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Tom Jefferson is a British epidemiologist, [1] based in Rome, Italy, [2] who works for the Cochrane Collaboration. Jefferson is an author and editor of the Cochrane Collaboration's acute respiratory infections group, as well as part of four other Cochrane groups. [3] He was also an advisor to the Italian National Agency for Regional Health Services. [ dead link ] [3]
In 1999, Jefferson was one of the founding members of the Brighton Collaboration along with Harald Heijbel, Ulrich Heininger, Robert Chen, and Elisabeth Loupi. [4] He has worked on Cochrane reviews examining the effectiveness of the anti-viral oseltamivir and the influenza vaccine. [5]
In 2009, Jefferson was hired by the governments of Britain and Australia to update a systematic review of oseltamivir. [5] Initially he had a great deal of trouble getting results of the original trials. [5] Previous researchers had published trials without seeing the underlying data and it appeared that some of the published papers used ghost writers. [5] As the company, Roche, that did the trials refused to provide data for independent analysis, their conclusions in 2009 were that benefits could not be shown. [5]
In 2011, Jefferson's team was provided 22,000 pages of data from the European Medicines Agency and Roche eventually provided 3,000 pages of data. [5] In 2012, Jefferson was the lead author of another Cochrane review of this data which concluded that oseltamivir did not reduce the number of hospitalizations caused by influenza. Jefferson said that this review also found no evidence that oseltamivir stopped complications from the disease. [6] The review is considered a landmark and is posted on the James Lind Library website [7] which illustrates the development of fair tests of healthcare.
Jefferson is the lead author of a suite of Cochrane reviews on antivirals, influenza vaccines and physical interventions to interrupt the spread of acute respiratory infections. The reviews are either kept up to date [8] or stabilized, meaning no new evidence is likely to become available. The earliest review date from 1996 and the latest is the fourth update of the physical interventions review (2020, currently undergoing its fifth update).
Jefferson has also reviewed the evidence of effects of editorial and grant giving peer review and co-written several reviews and topics on this subject. [9] Currently he is assessing the evidence of transmission of SARS-CoV-2 and other respiratory pathogens and is co-editor of the Substack publication website Trust The Evidence. [10] In his latest publication Jefferson and his fellows have concluded the presence of replication-competent SARS-CoV-2 on fomites, using evidence from viral culture studies. [11]
A list of his publications and contributions is available on his personal website. [1]
Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity of the condition is variable.
The common cold or the cold is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. Signs and symptoms may appear in as little as two days after exposure to the virus. These may include coughing, sore throat, runny nose, sneezing, headache, and fever. People usually recover in seven to ten days, but some symptoms may last up to three weeks. Occasionally, those with other health problems may develop pneumonia.
Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a fever may also be present.
Cochrane is a British international charitable organisation formed to synthesize medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers. It includes 53 review groups that are based at research institutions worldwide. Cochrane has over 37,000 volunteer experts from around the world.
Croup, also known as croupy cough, is a type of respiratory infection that is usually caused by a virus. The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms of "barking/brassy" cough, inspiratory stridor and a hoarse voice. Fever and runny nose may also be present. These symptoms may be mild, moderate, or severe. Often it starts or is worse at night and normally lasts one to two days.
Bronchiolitis is inflammation of the small airways also known as the bronchioles in the lungs. Acute bronchiolitis is caused by a viral infection, usually affecting children younger than two years of age. Symptoms may include fever, cough, runny nose or rhinorrhea, and wheezing. More severe cases may be associated with nasal flaring, grunting, or respiratory distress. If the child has not been able to feed properly due to the illness, signs of dehydration may be present.
Zanamivir is a medication used to treat and prevent influenza caused by influenza A and influenza B viruses. It is a neuraminidase inhibitor and was developed by the Australian biotech firm Biota Holdings. It was licensed to Glaxo in 1990 and approved in the US in 1999, only for use as a treatment for influenza. In 2006, it was approved for prevention of influenza A and B. Zanamivir was the first neuraminidase inhibitor commercially developed. It is marketed by GlaxoSmithKline under the trade name Relenza as a powder for oral inhalation.
Oseltamivir, sold under the brand name Tamiflu among others, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. They recommend it to prevent infection in those at high risk, but not the general population. The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection. It is taken by mouth, either as a pill or liquid.
Lower respiratory tract infection (LRTI) is a term often used as a synonym for pneumonia but can also be applied to other types of infection including lung abscess and acute bronchitis. Symptoms include shortness of breath, weakness, fever, coughing and fatigue. A routine chest X-ray is not always necessary for people who have symptoms of a lower respiratory tract infection.
Viral pneumonia is a pneumonia caused by a virus. Pneumonia is an infection that causes inflammation in one or both of the lungs. The pulmonary alveoli fill with fluid or pus making it difficult to breathe. Pneumonia can be caused by bacteria, viruses, fungi or parasites. Viruses are the most common cause of pneumonia in children, while in adults bacteria are a more common cause.
Neuraminidase inhibitors (NAIs) are a class of drugs which block the neuraminidase enzyme. They are a commonly used antiviral drug type against influenza. Viral neuraminidases are essential for influenza reproduction, facilitating viral budding from the host cell. Oseltamivir (Tamiflu), zanamivir (Relenza), laninamivir (Inavir), and peramivir belong to this class. Unlike the M2 inhibitors, which work only against the influenza A virus, NAIs act against both influenza A and influenza B.
Respiratory tract infections (RTIs) are infectious diseases involving the lower or upper respiratory tract. An infection of this type usually is further classified as an upper respiratory tract infection or a lower respiratory tract infection. Lower respiratory infections, such as pneumonia, tend to be far more severe than upper respiratory infections, such as the common cold.
Immunization during pregnancy is the administration of a vaccine to a pregnant individual. This may be done either to protect the individual from disease or to induce an antibody response, such that the antibodies cross the placenta and provide passive immunity to the infant after birth. In many countries, including the US, Canada, UK, Australia and New Zealand, vaccination against influenza, COVID-19 and whooping cough is routinely offered during pregnancy.
Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptoms begin one to four days after exposure to the virus and last for about two to eight days. Diarrhea and vomiting can occur, particularly in children. Influenza may progress to pneumonia from the virus or a subsequent bacterial infection. Other complications include acute respiratory distress syndrome, meningitis, encephalitis, and worsening of pre-existing health problems such as asthma and cardiovascular disease.
Peter Christian Gøtzsche is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark. He is a co-founder of the Cochrane Collaboration and has written numerous reviews for the organization. His membership in Cochrane was terminated by its Governing Board of Trustees on 25 September 2018. During the COVID-19 pandemic, Gøtzsche was criticised for spreading disinformation about COVID-19 vaccines.
The Centre for Evidence-Based Medicine (CEBM), based in the Nuffield Department of Primary Care Health Sciences at the University of Oxford, is an academic-led centre dedicated to the practice, teaching, and dissemination of high quality evidence-based medicine to improve healthcare in everyday clinical practice. CEBM was founded by David Sackett in 1995. It was subsequently directed by Brian Haynes and Paul Glasziou. Since 2010 it has been led by Professor Carl Heneghan, a clinical epidemiologist and general practitioner.
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. The disease spread worldwide, resulting in the COVID-19 pandemic.
The treatment and management of COVID-19 combines both supportive care, which includes treatment to relieve symptoms, fluid therapy, oxygen support as needed, and a growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; however, for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important. Some people may experience persistent symptoms or disability after recovery from the infection, known as long COVID, but there is still limited information on the best management and rehabilitation for this condition.
Viral interference, also known as superinfection resistance, is the inhibition of viral reproduction caused by previous exposure of cells to another virus. The exact mechanism for viral interference is unknown. Factors that have been implicated are the generation of interferons by infected cells, and the occupation or down-modulation of cellular receptors.
Elizabeth A. Spencer is a British epidemiologist and researcher at the Centre for Evidence-Based Medicine (CEBM), University of Oxford, whose research focuses on systematic reviews, multimorbidity, and evidence synthesis.