1
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Fanok S, Monis PT, Keegan AR, King BJ. The detection of Japanese encephalitis virus in municipal wastewater during an acute disease outbreak. J Appl Microbiol 2023; 134:lxad275. [PMID: 37977849 DOI: 10.1093/jambio/lxad275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023]
Abstract
AIM To demonstrate the capability of wastewater-based surveillance (WBS) as a tool for detecting potential cases of Japanese Encephalitis Virus (JEV) infection in the community. METHODS AND RESULTS In this study, we explore the potential of WBS to detect cases of JEV infection by leveraging from an established SARS-CoV-2 wastewater surveillance program. We describe the use of two reverse transcriptase quantitative polymerase chain reaction (RTqPCR) assays targeting JEV to screen archived samples from two wastewater treatment plants (WWTPs). JEV was detected in wastewater samples collected during a timeframe coinciding with a cluster of acute human encephalitis cases, alongside concurrent evidence of JEV detection in mosquito surveillance and the sentinel chicken programs within South Australia's Riverland and Murraylands regions. CONCLUSIONS Current surveillance measures for JEV encounter multiple constraints, which may miss the early stages of JEV circulation or fail to capture the full extent of transmission. The detection of JEV in wastewater during a disease outbreak highlights the potential WBS has as a complementary layer to existing monitoring efforts forming part of the One Health approach required for optimal disease response and control.
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Affiliation(s)
- Stella Fanok
- South Australian Water Corporation, Adelaide 5001, SA, Australia
| | - Paul T Monis
- South Australian Water Corporation, Adelaide 5001, SA, Australia
| | | | - Brendon J King
- South Australian Water Corporation, Adelaide 5001, SA, Australia
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2
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Diagnostic value of urine qRT-PCR for the diagnosis of West Nile virus neuroinvasive disease. Diagn Microbiol Infect Dis 2023. [PMID: 37390574 DOI: 10.1016/j.diagmicrobio.2023.115920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Short and low-level viremia and virorachia, antibody cross-reactivity, IgM persistence, and inaccessibility of neutralization test, make laboratory diagnosis of West Nile virus (WNV) infection difficult. Recent investigations imply that WNV is excreted in urine longer and at higher concentrations compared to blood. The detection of WNV nucleic acid in cerebrospinal fluid (CSF), serum, and urine samples collected from 41 patients with suspected WNV neuroinvasive disease, was done by real-time RT-PCR assay. CSF and serum samples were also serologically tested using anti-WNV IgM/IgG ELISA kits. WNV infection was confirmed in 46.3% of patients by positive WNV RNA results in serum and/or CSF samples. The WNV RNA testing of urine allowed confirmation of 31.7% more cases. No association between WNV RNA urine positivity and age, gender, or the day of sample collection was found. The urine qRT-PCR can be a valuable diagnostic test for confirmation of probable cases of WNV neuroinvasive disease.
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3
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Re-Introduction of West Nile Virus Lineage 1 in Senegal from Europe and Subsequent Circulation in Human and Mosquito Populations between 2012 and 2021. Viruses 2022; 14:v14122720. [PMID: 36560724 PMCID: PMC9785585 DOI: 10.3390/v14122720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
West Nile virus (WNV) is a virus of the Japanese encephalitis antigenic complex and belongs to the family Flaviviridae of the genus flavivirus. The virus can cause infection in humans which in most cases is asymptomatic, however symptomatic cases exist and the disease can be severe causing encephalitis and meningoencephalitis. The virus is maintained in an enzootic cycle involving mosquitoes and birds, humans and other mammals such as horses can be accidental hosts. A mosquito-based arbovirus surveillance system and the sentinel syndromic surveillance network (4S) have been in place since 1988 and 2015 respectively, to better understand the transmission dynamics of arboviruses including WNV in Senegal. Arthropod and human samples have been collected from the field and analysed at Institut Pasteur de Dakar using different methods including RT-PCR, ELISA, plaque reduction neutralization test and viral isolation. RT-PCR positive samples have been analysed by Next Generation Sequencing. From 2012 to 2021, 7912 samples have been analysed and WNV positive cases have been detected, 20 human cases (19 IgM and 1 RT-PCR positive cases) and 41 mosquito pools. Phylogenetic analyzes of the sequences of complete genomes obtained showed the circulation of lineage 1a, with all these recent strains from Senegal identical to each other and very close to strains isolated from horse in France in 2015, Italy and Spain. Our data showed lineage 1a endemicity in Senegal as previously described, with circulation of WNV in humans and mosquitoes. Phylogenetic analyzes carried out with the genome sequences obtained also revealed exchanges of WNV strains between Europe and Senegal which could be possible via migratory birds. The surveillance systems that have enabled the detection of WNV in humans and arthropods should be extended to animals in a one-health approach to better prepare for global health threats.
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4
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Fehér OE, Fehérvári P, Tolnai CH, Forgách P, Malik P, Jerzsele Á, Wagenhoffer Z, Szenci O, Korbacska-Kutasi O. Epidemiology and Clinical Manifestation of West Nile Virus Infections of Equines in Hungary, 2007-2020. Viruses 2022; 14:v14112551. [PMID: 36423160 PMCID: PMC9694158 DOI: 10.3390/v14112551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/06/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
West Nile virus (WNV) is an emerging pathogen in Hungary, causing severe outbreaks in equines and humans since 2007. The aim of our study was to provide a comprehensive report on the clinical signs of West Nile neuroinvasive disease (WNND) in horses in Hungary. Clinical details of 124 confirmed equine WNND cases were collected between 2007 and 2019. Data about the seasonal and geographical presentation, demographic data, clinical signs, treatment protocols, and disease progression were evaluated. Starting from an initial case originating from the area of possible virus introduction by migratory birds, the whole country became endemic with WNV over the subsequent 12 years. The transmission season did not expand significantly during the data collection period, but vaccination protocols should be always reviewed according to the recent observations. There was not any considerable relationship between the occurrence of WNND and age, breed, or gender. Ataxia was by far the most common neurologic sign related to the disease, but weakness, behavioral changes, and muscle fasciculation appeared frequently. Apart from recumbency combined with inappetence, no other clinical sign or treatment regime correlated with survival. The survival rate showed a moderate increase throughout the years, possibly due to the increased awareness of practitioners.
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Affiliation(s)
- Orsolya Eszter Fehér
- Institute for Animal Breeding, Nutrition and Laboratory Animal Science, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- Correspondence:
| | - Péter Fehérvári
- Department of Biomathematics and Informatics, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Csenge Hanna Tolnai
- University Equine Clinic, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Wien, Austria
| | - Petra Forgách
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Hungária Krt. 23-25, 1143 Budapest, Hungary
| | - Péter Malik
- National Food Chain Safety Office, Veterinary Diagnostic Directorate, Tábornok u. 2., 1143 Budapest, Hungary
| | - Ákos Jerzsele
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, István utca 2, 1078 Budapest, Hungary
| | - Zsombor Wagenhoffer
- Institute for Animal Breeding, Nutrition and Laboratory Animal Science, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
| | - Otto Szenci
- Department of Obstetrics and Food Animal Medicine Clinic, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
| | - Orsolya Korbacska-Kutasi
- Institute for Animal Breeding, Nutrition and Laboratory Animal Science, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- University Equine Clinic, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Wien, Austria
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5
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Grygorczuk S, Dunaj-Małyszko J, Czupryna P, Sulik A, Toczyłowski K, Siemieniako-Werszko A, Żebrowska A, Pancewicz S, Moniuszko-Malinowska A. The Detectability of the Viral RNA in Blood and Cerebrospinal Fluid of Patients with Tick-Borne Encephalitis. Int J Mol Sci 2022; 23:ijms23169332. [PMID: 36012596 PMCID: PMC9408829 DOI: 10.3390/ijms23169332] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/05/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The detection rate of viral RNA in tick-borne encephalitis (TBE) is low and variable between studies, and its diagnostic/prognostic potential is not well defined. We attempted to detect RNA of TBE virus (TBEV) in body fluids of TBE patients. Methods: We studied 98 adults and 12 children with TBEV infection, stratified by the disease phase and presentation. EDTA blood and cerebrospinal fluid (CSF) samples were obtained upon hospital admission. RNA was extracted from freshly obtained plasma, concentrated leukocyte-enriched CSF, and whole blood samples, and real time PCR was performed with a Rotor-Gene Q thermocycler. Results: TBEV RNA was detected in (1) plasma of one (of the two studied) adult patients with an abortive infection, (2) plasma of two (of the two studied) adults in the peripheral phase of TBE, and (3) plasma and blood of an adult in the neurologic phase of TBE presenting as meningoencephalomyelitis. No CSF samples were TBEV RNA-positive. Conclusions: The detection of TBEV RNA in blood might be diagnostic in the peripheral phase of TBE. The lack of TBEV RNA in the CSF cellular fraction speaks against TBEV influx into the central nervous system with infiltrating leukocytes and is consistent with a relatively low intrathecal viral burden.
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Affiliation(s)
- Sambor Grygorczuk
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
| | - Justyna Dunaj-Małyszko
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
| | - Piotr Czupryna
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
- Correspondence:
| | - Artur Sulik
- Department of the Pediatric Infectious Diseases of the Medical University in Białystok, Ul. Jerzego Waszyngtona 17, 15-274 Białystok, Poland
| | - Kacper Toczyłowski
- Department of the Pediatric Infectious Diseases of the Medical University in Białystok, Ul. Jerzego Waszyngtona 17, 15-274 Białystok, Poland
| | | | - Agnieszka Żebrowska
- Regional Centre of Transfusion Medicine in Białystok, Ul. Marii Skłodowskiej-Curie 23, 15-950 Białystok, Poland
| | - Sławomir Pancewicz
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
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6
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The value of West Nile virus RNA detection by real-time RT-PCR in urine samples from patients with neuroinvasive forms. Arch Microbiol 2022; 204:238. [DOI: 10.1007/s00203-022-02829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 03/08/2022] [Indexed: 11/26/2022]
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7
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Yagci-Caglayik D, Kayaaslan B, Yapar D, Kocagul-Celikbas A, Ozkaya-Parlakay A, Emek M, Baykam N, Tezer H, Korukluoglu G, Ozkul A. Monitoring Crimean-Congo haemorrhagic fever virus RNA shedding in body secretions and serological status in hospitalised patients, Turkey, 2015. ACTA ACUST UNITED AC 2020; 25. [PMID: 32183931 PMCID: PMC7078823 DOI: 10.2807/1560-7917.es.2020.25.10.1900284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
IntroductionCrimean-Congo haemorrhagic fever (CCHF) is a tick-borne disease in Africa, Asia, the Balkan peninsula, the south-east of Europe and the Middle East, with mortality rates of 3-30%. Transmission can also occur through contact with infected animals or humans.AimThis observational, prospective case series aimed to investigate detectable viral genomic RNA in whole-body fluids and antibody dynamics in consecutive daily samples of patients diagnosed with CCHF until discharge from hospital.MethodsWe tested 18 patients and 824 swabs and sera with RT-PCR and 125 serum samples serologically.ResultsThe longest duration until clearance of viral RNA was 18 days from serum collection and 18, 15, 13, 19 and 17 days, respectively, from nasal, oral, genital (urethral or vaginal) and faecal swab, and urine. In seven patients, viral load decreased in serum at the same time as it increased in urine or persisted at the same logarithmic values. Despite clearance in serum, viral RNA was detected in faeces and genital swabs in two and three patients, respectively. Viral clearance from body fluids occurred earlier than from serum in eight patients on ribavirin treatment. The shortest seroconversion time was 3 days after symptom onset for IgM and IgG. Seroconversion of IgG occurred until Day 14 of symptoms.ConclusionWe report persistence of viral RNA in urine, faeces and genital swabs despite serum clearance. This may indicate a need for extending isolation precautions, re-evaluating discharge criteria and transmission risk after discharge, and considering oral swabs as a less invasive diagnostic alternative.
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Affiliation(s)
- Dilek Yagci-Caglayik
- Ankara University Faculty of Veterinary Medicine, Department of Virology, Ankara, Turkey.,Public Health General Directorate of Turkey, Virology Laboratory, Ankara, Turkey.,Marmara University Pendik Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Bircan Kayaaslan
- Yıldırım Beyazıt University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Derya Yapar
- Hitit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Aysel Kocagul-Celikbas
- Hitit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Aslinur Ozkaya-Parlakay
- Health Sciences University, Ankara Children's Hematology Oncology Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Mestan Emek
- Akdeniz University Faculty of Medicine, Department of Public Health, Antalya, Turkey
| | - Nurcan Baykam
- Hitit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Hasan Tezer
- Gazi University Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Gulay Korukluoglu
- Public Health General Directorate of Turkey, Virology Laboratory, Ankara, Turkey
| | - Aykut Ozkul
- Ankara University, Biotechnology Institute, Ankara, Turkey.,Ankara University Faculty of Veterinary Medicine, Department of Virology, Ankara, Turkey
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8
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Nagy A, Mezei E, Nagy O, Bakonyi T, Csonka N, Kaposi M, Koroknai A, Szomor K, Rigó Z, Molnár Z, Dánielisz Á, Takács M. Extraordinary increase in West Nile virus cases and first confirmed human Usutu virus infection in Hungary, 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 31311619 PMCID: PMC6636212 DOI: 10.2807/1560-7917.es.2019.24.28.1900038] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BackgroundDuring the 2018 WNV transmission season, similarly to other endemic areas in Europe, a large number of human West Nile virus (WNV) infections were reported in Hungary.AimsWe summarise the epidemiological and laboratory findings of the 2018 transmission season and expand experiences in flavivirus differential diagnostics.MethodsEvery patient with clinical suspicion of acute WNV infection was in parallel tested for WNV, tick-borne encephalitis virus and Usutu virus (USUV) by serological methods. Sera, whole blood and urine samples were also tested for the presence of viral nucleic acid.ResultsUntil the end of December 2018, 215 locally acquired and 10 imported human WNV infections were notified in Hungary. All reported cases were symptomatic; most of them exhibited neurological symptoms. In a large proportion of tested individuals, whole blood was the most appropriate sample type for viral nucleic acid detection, but because whole blood samples were not always available, testing of urine samples also extended diagnostic possibilities. In addition, the first human USUV infection was confirmed in 2018 in a patient with aseptic meningitis. Serological cross-reactions with WNV in different serological assays were experienced, but subsequent molecular biological testing and sequence analysis identified Europe lineage 2 USUV infection.ConclusionCareful interpretation and simultaneous application of different laboratory methods are necessary to avoid misdiagnosis of human USUV cases. Expansion of the laboratory-confirmed case definition criteria for detection of viral RNA in any clinical specimens to include urine samples could increase diagnostic sensitivity.
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Affiliation(s)
- Anna Nagy
- These authors contributed equally to this work.,National Reference Laboratory for Viral Zoonoses; National Public Health Center, Budapest, Hungary
| | - Eszter Mezei
- Department of Communicable Diseases Epidemiology and Infection Control; National Public Health Center, Budapest, Hungary.,These authors contributed equally to this work
| | - Orsolya Nagy
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary.,National Reference Laboratory for Viral Zoonoses; National Public Health Center, Budapest, Hungary
| | - Tamás Bakonyi
- Viral Zoonoses, Emerging and Vector-borne Infections Group, Institute of Virology, University of Veterinary Medicine, Vienna, Austria.,Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Budapest, Hungary
| | - Nikolett Csonka
- National Reference Laboratory for Viral Zoonoses; National Public Health Center, Budapest, Hungary
| | - Magdolna Kaposi
- National Reference Laboratory for Viral Zoonoses; National Public Health Center, Budapest, Hungary
| | - Anita Koroknai
- National Reference Laboratory for Viral Zoonoses; National Public Health Center, Budapest, Hungary
| | - Katalin Szomor
- National Reference Laboratory for Viral Exanthematous Diseases; National Public Health Center, Budapest, Hungary
| | - Zita Rigó
- National Reference Laboratory for Viral Exanthematous Diseases; National Public Health Center, Budapest, Hungary
| | - Zsuzsanna Molnár
- Department of Communicable Diseases Epidemiology and Infection Control; National Public Health Center, Budapest, Hungary
| | - Ágnes Dánielisz
- Department of Communicable Diseases Epidemiology and Infection Control; National Public Health Center, Budapest, Hungary
| | - Mária Takács
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary.,National Reference Laboratory for Viral Zoonoses; National Public Health Center, Budapest, Hungary
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9
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Nagy O, Nagy A, Tóth S, Pályi B, Vargáné Koroknai A, Takács M. Imported Zika virus infections in Hungary between 2016 and 2018. Acta Microbiol Immunol Hung 2019; 66:423-442. [PMID: 31658836 DOI: 10.1556/030.66.2019.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zika virus is a mosquito-borne flavivirus with significant public health concern due to its association with neurological symptoms and intrauterine malformations. Although it is endemic in tropical and subtropical areas, sexual transmission raises the possibility of autochthonous spreading elsewhere. We describe the first laboratory diagnosed imported Zika-infections of Hungary, to highlight the challenges of microbiological identification of the pathogen, caused by serological cross-reactivity and short viremia. Serological examination was carried out using indirect immunofluorescent assay and enzyme-linked immunosorbent assay. Plaque-reduction neutralization test was used for verification purposes. A wide range of clinical specimens: serum, whole-blood, urine, saliva, and semen were analyzed by molecular methods, and sequencing was applied in case of PCR positive results to identify the virus strain. Zika-infected patients with previous vaccination against flaviviruses or possible flavivirus infection in the past showed high serological cross-reactivity, and even cross-neutralizing antibodies were observed. Zika virus RNA could be detected in urine specimen in case of two patients, and in EDTA-anticoagulated whole-blood sample of one patient. The detected strains belong to the Asian lineage of the virus. We presume that serological investigation of imported Zika virus could be altered by infections, vaccination of endemic flaviviruses in Hungary and vice versa.
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Affiliation(s)
- Orsolya Nagy
- 1 Department of Virology, National Public Health Center, Budapest, Hungary
- 2 Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Anna Nagy
- 1 Department of Virology, National Public Health Center, Budapest, Hungary
| | - Szilvia Tóth
- 3 Central Hospital of Southern Pest – National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Bernadett Pályi
- 1 Department of Virology, National Public Health Center, Budapest, Hungary
| | | | - Mária Takács
- 1 Department of Virology, National Public Health Center, Budapest, Hungary
- 2 Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
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10
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Bharucha T, Sengvilaipaseuth O, Seephonelee M, Vongsouvath M, Vongsouvath M, Rattanavong S, Piorkowski G, Lecuit M, Gorman C, Pommier JD, Garson JA, Newton PN, de Lamballerie X, Dubot-Pérès A. Viral RNA Degradation Makes Urine a Challenging Specimen for Detection of Japanese Encephalitis Virus in Patients With Suspected CNS Infection. Open Forum Infect Dis 2019; 6:ofz048. [PMID: 30882014 PMCID: PMC6411208 DOI: 10.1093/ofid/ofz048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/23/2019] [Accepted: 01/31/2019] [Indexed: 11/14/2022] Open
Abstract
Background Japanese encephalitis virus (JEV) is a leading cause of central nervous system (CNS) infections in Asia and results in significant morbidity and mortality. JEV RNA is rarely detected in serum or cerebrospinal fluid (CSF), and diagnosis of JEV infection is usually based on serological tests that are frequently difficult to interpret. Unlike serum or CSF, urine is relatively easy to obtain, but, to date, there has been minimal work on the feasibility of testing urine for JEV RNA. Methods We investigated the use of lysis buffer and a Microsep device to optimize urine storage for detection of JEV RNA by reverse transcription real-time polymerase chain reaction (RT-qPCR). The best of the studied methods was then evaluated in consecutive patients admitted to the hospital with suspected CNS infections in Laos. Results We demonstrated degradation of JEV RNA in urine after even short storage periods at 4°C or –80°C. Although there was no advantage in using a Microsep concentration device alone, immediate addition of lysis buffer to fresh urine improved the detection of JEV RNA at the limit of detection. Conclusions In 2 studies of 41 patients with acute encephalitis syndrome, 11 (27%) were positive for JEV IgM in CSF and/or serum, and 2 (4.9%) were JEV RT-qPCR positive from throat swabs. JEV RNA was not detected in any of these patients’ urine samples. However, lysis buffer was only used during a prospective study, that is, for only 17/41 (41%) patient urine samples. Our findings suggest a need for larger studies testing urine for JEV RNA, with urine collected at different times from symptom onset, and using lysis buffer, which stabilizes RNA, for storage.
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Affiliation(s)
- Tehmina Bharucha
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R.,Division of Infection and Immunity, University College London, London, UK
| | - Onanong Sengvilaipaseuth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Malee Seephonelee
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Malavanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Sayaphet Rattanavong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Géraldine Piorkowski
- Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Marc Lecuit
- Biology of Infection Unit, Inserm U1117, Institut Pasteur, Paris, France.,Division of Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Paris Descartes University, Paris, France
| | - Christopher Gorman
- Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Jean-David Pommier
- Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Jeremy A Garson
- Division of Infection and Immunity, University College London, London, UK.,Transfusion Microbiology, NHS Blood and Transplant, London, UK
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R.,Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Churchill Hospital, Oxford, UK
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Audrey Dubot-Pérès
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R.,Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Churchill Hospital, Oxford, UK.,Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
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11
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Niedrig M, Patel P, El Wahed AA, Schädler R, Yactayo S. Find the right sample: A study on the versatility of saliva and urine samples for the diagnosis of emerging viruses. BMC Infect Dis 2018; 18:707. [PMID: 30594124 PMCID: PMC6311079 DOI: 10.1186/s12879-018-3611-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/10/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The emergence of different viral infections during the last decades like dengue, West Nile, SARS, chikungunya, MERS-CoV, Ebola, Zika and Yellow Fever raised some questions on quickness and reliability of laboratory diagnostic tests for verification of suspected cases. Since sampling of blood requires medically trained personal and comprises some risks for the patient as well as for the health care personal, the sampling by non-invasive methods (e.g. saliva and/ or urine) might be a very valuable alternative for investigating a diseased patient. MAIN BODY To analyse the usefulness of alternative non-invasive samples for the diagnosis of emerging infectious viral diseases, a literature search was performed on PubMed for alternative sampling for these viral infections. In total, 711 papers of potential relevance were found, of which we have included 128 in this review. CONCLUSIONS Considering the experience using non-invasive sampling for the diagnostic of emerging viral diseases, it seems important to perform an investigation using alternative samples for routine diagnostics. Moreover, during an outbreak situation, evaluation of appropriate sampling and further processing for laboratory analysis on various diagnostic platforms are very crucial. This will help to achieve optimal diagnostic results for a good and reliable case identification.
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Affiliation(s)
| | | | - Ahmed Abd El Wahed
- Division of Microbiology and Animal Hygiene, University of Goettingen, Goettingen, Germany
| | | | - Sergio Yactayo
- Control of Epidemic Diseases (CED), World Health Organization, Geneva, Switzerland
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12
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Ziyaeyan M, Behzadi MA, Leyva-Grado VH, Azizi K, Pouladfar G, Dorzaban H, Ziyaeyan A, Salek S, Jaber Hashemi A, Jamalidoust M. Widespread circulation of West Nile virus, but not Zika virus in southern Iran. PLoS Negl Trop Dis 2018; 12:e0007022. [PMID: 30557321 PMCID: PMC6312345 DOI: 10.1371/journal.pntd.0007022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 12/31/2018] [Accepted: 11/26/2018] [Indexed: 12/20/2022] Open
Abstract
West Nile virus (WNV) and Zika virus (ZIKV) are mosquito-borne viral infections. Over the past few decades, WNV has been associated with several outbreaks involving high numbers of neuroinvasive diseases among humans. The recent re-emergence of ZIKV has been associated with congenital malformation and also with Guillain-Barre syndrome in adults. The geographic range of arthropod-borne viruses has been rapidly increasing in recent years. The objectives of this study were to determine the presence of IgG specific antibodies and the genome of WNV and ZIKV in human samples, as well as WNV and ZIKV genomes in wild-caught mosquitoes in urban and rural areas of the Hormozgan province, in southern Iran. A total of 494 serum samples were tested for the presence of WNV and ZIKV IgG antibodies using ELISA assays. One hundred and two (20.6%) samples were reactive for WNV IgG antibodies. All serum samples were negative for ZIKV IgG antibodies. Using the multivariable logistic analysis, age (45+ vs. 1-25; OR = 3.4, 95% C.I.: 1.8-6.3), occupation (mostly outdoor vs. mostly indoor; OR = 2.4, 95% C.I.: 1.1-5.2), and skin type(type I/II vs. type III/IV and type V/VI; OR = 4.3, 95% C.I.: 1.7-10.8 and OR = 2.7, 95% C.I.: 1.3-5.5 respectively, skin types based on Fitzpatrick scale) showed significant association with WNV seroreactivity. We collected 2,015 mosquitoes in 136 pools belonging to 5 genera and 14 species. Three pools of Culex pipiens complex were positive for WNV RNA using real-time reverse transcription polymerase chain reaction (rtRT-PCR). ZIKV RNA was not detected in any of the pools. All WNV ELISA reactive serum samples were negative for WNV RNA. In conclusion, we provided evidence of the establishment of WNV in southern Iran and no proof of ZIKV in serum samples or in mosquito vectors. The establishment of an organized arbovirus surveillance system and active case finding strategies seems to be necessary.
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Affiliation(s)
- Mazyar Ziyaeyan
- Department of Clinical Virology, Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran
| | - Mohammad Amin Behzadi
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Victor Hugo Leyva-Grado
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Kourosh Azizi
- Department of Medical Entomology and Vector Control, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Pouladfar
- Department of Infectious Diseases, Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran
| | - Hedayat Dorzaban
- Department of Medical Entomology and Vector Control, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sanaz Salek
- Department of Clinical Virology, Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran
| | - Aghyl Jaber Hashemi
- Department of Medical Entomology and Vector Control, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Jamalidoust
- Department of Clinical Virology, Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran
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13
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Integrated analysis of human-animal-vector surveillance: West Nile virus infections in Austria, 2015-2016. Emerg Microbes Infect 2018. [PMID: 29535293 PMCID: PMC5849732 DOI: 10.1038/s41426-018-0021-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The results of integrated human and veterinary surveillance for West Nile virus (WNV) infections in Austria during the transmission seasons 2015 and 2016 are shown. Altogether WNV nucleic acid was detected in 21 humans, horses, wild birds and mosquito pools. In detail: in four human clinical cases [two cases of West Nile fever (WNF) and two cases of West Nile neuroinvasive disease (WNND)]; eight blood donors [among 145,541 tested donations], of which three remained asymptomatic and five subsequently developed mild WNF; two horses with WNND, of which one recovered and one had to be euthanized; two wild birds [one goshawk and one falcon, both succumbed to WNND]; and five Culex pipiens mosquito pools. Compared to previous years the number of infections increased remarkably. All infections were recorded in the city of Vienna and neighboring regions of Lower Austria. Sixteen coding-complete WNV sequences were established which were closely related to each other and to other Austrian, Czech and Italian viruses, all belonging to the Central/Southern European cluster of WNV sublineage 2d. However, several genetically slightly different WNV strains seem to co-circulate in the same area, as demonstrated by phylogenetic analysis. Based on detailed sequence analysis, all newly discovered Austrian WNV strains had the potential to cause neurological disease, but no correlation was found between severity of disease and the analyzed genetic virulence/neuroinvasiveness markers. Results of integrated human-animal-vector surveillance presented in this paper provide a comprehensive description of WNV activity in the region and will facilitate proactive public health measures to prevent or mitigate potential outbreaks.
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14
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Nagy A, Nagy O, Tarcsai K, Farkas Á, Takács M. First detection of tick-borne encephalitis virus RNA in clinical specimens of acutely ill patients in Hungary. Ticks Tick Borne Dis 2018; 9:485-489. [DOI: 10.1016/j.ttbdis.2017.12.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/27/2017] [Accepted: 12/27/2017] [Indexed: 12/30/2022]
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15
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Khan E, Barr KL, Farooqi JQ, Prakoso D, Abbas A, Khan ZY, Ashi S, Imtiaz K, Aziz Z, Malik F, Lednicky JA, Long MT. Human West Nile Virus Disease Outbreak in Pakistan, 2015-2016. Front Public Health 2018. [PMID: 29535994 PMCID: PMC5835076 DOI: 10.3389/fpubh.2018.00020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Like most of the world, Pakistan has seen an increase in mosquito-transmitted diseases in recent years. The magnitude and distribution of these diseases are poorly understood as Pakistan does not have a nation-wide system for reporting disease. A cross-sectional study to determine which flaviviruses were causing of arboviral disease in Pakistan was instituted. West Nile virus (WNV) is a cause of seasonal fever with neurotropic findings in countries that share borders with Pakistan. Here, we describe the active and persistent circulation of WNV in humans in the southern region of Pakistan. This is the first report of WNV causing neurological disease in human patients in this country. Of 997 enrolled patients presenting with clinical features suggestive of arboviral disease, 105 were positive for WNV IgM antibodies, and 71 of these patients possessed WNV-specific neutralizing antibodies. Cross-reactivity of WNV IgM antibodies with Japanese encephalitis virus (JEV) occurred in 75 of these 105 patients. WNV co-infections with Dengue viruses were not a contributing factor for the severity of disease. Nor did prior exposure to dengue virus contribute to incidence of neurological involvement in WNV-infected patients. Patients with WNV infections were more likely to present with altered mental status, seizures, and reduced Glasgow Coma scores when compared with JEV-infected patients. Human WNV cases and vector numbers exhibited a temporal correlation with climate.
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Affiliation(s)
- Erum Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Kelli L Barr
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Joveria Qais Farooqi
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Dhani Prakoso
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Alizeh Abbas
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Zain Yar Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Shanze Ashi
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Kehkashan Imtiaz
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Z Aziz
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Faisal Malik
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - John A Lednicky
- Department of Environmental and Global Health, Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Maureen T Long
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
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16
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Murray KO, Kolodziej S, Ronca SE, Gorchakov R, Navarro P, Nolan MS, Podoll A, Finkel K, Mandayam S. Visualization of West Nile Virus in Urine Sediment using Electron Microscopy and Immunogold up to Nine Years Postinfection. Am J Trop Med Hyg 2017; 97:1913-1919. [PMID: 29141749 DOI: 10.4269/ajtmh.17-0405] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
West Nile virus (WNV) is an important emerging flavivirus in North America. Experimental studies in animals infer the development of persistent infection in the kidneys. In humans, recent studies suggest the possibility of persistent renal infection and chronic kidney disease. Considering the discrepancies between published studies on viral RNA detection in urine of convalescing WNV-positive patients, we explored the use of electron microscopy (EM) with anti-WNV E protein antibody immunogold labeling to detect virus in the urine sediment from a subset of study participants in the Houston WNV cohort. In 42% of evaluated study participants had visible sediment present in urine after centrifugation; viral particles consistent with the size and morphology of WNV were successfully detected using EM in the urine sediment up to 9 years postinfection. The anti-WNV immunogold labeling bound to virus envelope in the sediment allowed for enhanced detection when compared with PCR and provide a new technique for understanding kidney disease in WNV patients. These results provide further evidence of persistent infection in at least a subset of individuals infected with WNV. These findings present a novel tool to diagnose persistent WNV infection and its possible link with progressive renal pathology.
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Affiliation(s)
- Kristy O Murray
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Pediatric Tropical Medicine, National School of Tropical Medicine, Houston, Texas
| | - Steven Kolodziej
- The University of Texas Health Science Center, Medical School, Houston, Texas
| | - Shannon E Ronca
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Pediatric Tropical Medicine, National School of Tropical Medicine, Houston, Texas
| | - Rodion Gorchakov
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Pediatric Tropical Medicine, National School of Tropical Medicine, Houston, Texas
| | - Patricia Navarro
- The University of Texas Health Science Center, Medical School, Houston, Texas
| | - Melissa S Nolan
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Pediatric Tropical Medicine, National School of Tropical Medicine, Houston, Texas
| | - Amber Podoll
- The University of Texas Health Science Center, Medical School, Houston, Texas
| | - Kevin Finkel
- The University of Texas Health Science Center, Medical School, Houston, Texas
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17
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Huang GKL, Tio SY, Caly L, Nicholson S, Thevarajan I, Papadakis G, Catton M, Tong SYC, Druce J. Prolonged Detection of Japanese Encephalitis Virus in Urine and Whole Blood in a Returned Short-term Traveler. Open Forum Infect Dis 2017; 4:ofx203. [PMID: 29226169 PMCID: PMC5714136 DOI: 10.1093/ofid/ofx203] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 09/20/2017] [Indexed: 11/14/2022] Open
Abstract
We describe a fatal case of Japanese encephalitis virus infection following short-term travel to Thailand. Viral RNA was detected in urine and whole blood out to 26 and 28 days, respectively, after the onset of symptoms. Live virus was isolated from a urine specimen from day 14.
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Affiliation(s)
- G Khai Lin Huang
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Shio Yen Tio
- Victorian Infectious Disease Service, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Leon Caly
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Suellen Nicholson
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Irani Thevarajan
- Victorian Infectious Disease Service, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Georgina Papadakis
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Mike Catton
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Steven Y C Tong
- Victorian Infectious Disease Service, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia.,Menzies School of Health Research, Darwin, Australia
| | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital, and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
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18
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Urine as Sample Type for Molecular Diagnosis of Natural Yellow Fever Virus Infections. J Clin Microbiol 2017; 55:3294-3296. [PMID: 28855304 DOI: 10.1128/jcm.01113-17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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