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Vaccination with Mycoplasma pneumoniae membrane lipoproteins induces IL-17A driven neutrophilia that mediates Vaccine-Enhanced Disease. NPJ Vaccines 2022; 7:86. [PMID: 35906257 PMCID: PMC9336141 DOI: 10.1038/s41541-022-00513-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
Bacterial lipoproteins are an often-underappreciated class of microbe-associated molecular patterns with potent immunomodulatory activity. We previously reported that vaccination of BALB/c mice with Mycoplasma pneumoniae (Mp) lipid-associated membrane proteins (LAMPs) resulted in lipoprotein-dependent vaccine enhanced disease after challenge with virulent Mp, though the immune responses underpinning this phenomenon remain poorly understood. Herein, we report that lipoprotein-induced VED in a mouse model is associated with elevated inflammatory cytokines TNF-α, IL-1β, IL-6, IL-17A, and KC in lung lavage fluid and with suppurative pneumonia marked by exuberant neutrophilia in the pulmonary parenchyma. Whole-lung-digest flow cytometry and RNAScope analysis identified multiple cellular sources for IL-17A, and the numbers of IL-17A producing cells were increased in LAMPs-vaccinated/Mp-challenged animals compared to controls. Specific IL-17A or neutrophil depletion reduced disease severity in our VED model—indicating that Mp lipoproteins induce VED in an IL-17A-dependent manner and through exuberant neutrophil recruitment. IL-17A neutralization reduced levels of TNF-α, IL-1β, IL-6, and KC, indicating that IL-17A preceded other inflammatory cytokines. Surprisingly, we found that IL-17A neutralization impaired bacterial clearance, while neutrophil depletion improved it—indicating that, while IL-17A appears to confer both maladaptive and protective responses, neutrophils play an entirely maladaptive role in VED. Given that lipoproteins are found in virtually all bacteria, the potential for lipoprotein-mediated maladaptive inflammatory responses should be taken into consideration when developing vaccines against bacterial pathogens.
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Niya MHK, Jeda AS, Tavakoli A, Sohani H, Tameshkel FS, Panahi M, Izadi M, Zamani F, Keyvani H. Molecular epidemiology of human respiratory syncytial virus (HRSV) in Iranian military trainees with acute respiratory symptoms in 2017. IRANIAN JOURNAL OF MICROBIOLOGY 2020; 12:495-502. [PMID: 33604006 PMCID: PMC7867691 DOI: 10.18502/ijm.v12i5.4612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection in many populations, including military recruits receiving basic training. Therefore, this study was set out to determine the molecular epidemiology, genotype and phylogenetic features of RSVs in patients with respiratory infection as a case study. Materials and Methods In this study, military barracks of Tehran, Iran, between January to March 2017 exposed to respiratory diseases were used for sampling. Throat swabs were taken, a reverse transcriptase-polymerase chain reaction (RTPCR) assay was performed to identify RSV and then the genotyping and phylogenetic analyses of RSVs in patients with a respiratory infection. Results Among 400 Iranian military trainees with respiratory symptoms, RSV infection was identified in 2.75% (11/400) using RT-PCR. Sequencing showed the incidence of type A (2.5%, n=10) to be much higher than type B (0.25%, n=1); Sore throat was the most common symptom among RSV patients. Phylogenetic analysis revealed that the majority of strains from the studied samples were more consistent with those from the Philippines and the US strains. Conclusion This study is the first to document RSV as a major cause of acute respiratory illness among military trainees in Iran. The prevalence of RSV is substantial in the cold season and the prevalence of genotype A is dominant in the country, leading to take essential steps in preparing a preventive vaccine against this viral infection.
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Affiliation(s)
- Mohammad Hadi Karbalaie Niya
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Medical Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Salimi Jeda
- Department of Medical Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Tavakoli
- Department of Medical Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Pediatric Infectious Diseases Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Hesam Sohani
- Department of Microbiology, Faculty of Biology, College of Sciences, University of Sciences and Research, Tehran, Iran
| | | | - Mahshid Panahi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Izadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Keyvani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Medical Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Collins ND, Adhikari A, Yang Y, Kuschner RA, Karasavvas N, Binn LN, Walls SD, Graf PCF, Myers CA, Jarman RG, Hang J. Live Oral Adenovirus Type 4 and Type 7 Vaccine Induces Durable Antibody Response. Vaccines (Basel) 2020; 8:vaccines8030411. [PMID: 32718082 PMCID: PMC7564809 DOI: 10.3390/vaccines8030411] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022] Open
Abstract
Human adenoviruses (AdV) are mostly associated with minimal pathology. However, more severe respiratory tract infections and acute respiratory diseases, most often caused by AdV-4 and AdV-7, have been reported. The only licensed vaccine in the United States, live oral AdV-4 and AdV-7 vaccine, is indicated for use in the military, nearly exclusively in recruit populations. The excellent safety profile and prominent antibody response of the vaccine is well established by placebo-controlled clinical trials, while, long-term immunity of vaccination has not been studied. Serum samples collected over 6 years from subjects co-administered live oral AdV-4 and AdV-7 vaccine in 2011 were evaluated to determine the duration of the antibody response. Group geometric mean titers (GMT) at 6 years post vaccination compared to previous years evaluated were not significantly different for either AdV-4 or AdV-7 vaccine components. There were no subjects that demonstrated waning neutralization antibody (NAb) titers against AdV-4 and less than 5% of subjects against AdV-7. Interestingly, there were subjects that had a four-fold increase in NAb titers against either AdV-4 or AdV-7, at various time points post vaccination, suggesting either homotypic or heterotypic re-exposure. This investigation provided strong evidence that the live oral AdV-4 and AdV-7 vaccine induced long-term immunity to protect from AdV-4 and AdV-7 infections.
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Affiliation(s)
- Natalie D. Collins
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
- Correspondence: ; Tel.: +1-301-319-3062
| | - Anima Adhikari
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Yu Yang
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Robert A. Kuschner
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Nicos Karasavvas
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Leonard N. Binn
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Shannon D. Walls
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Paul C. F. Graf
- Naval Health Research Center, San Diego, CA 92186, USA; (P.C.F.G.); (C.A.M.)
- U.S. Navy Medical Research Unit Six, Lima 07006, Peru
| | | | - Richard G. Jarman
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Jun Hang
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
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4
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Lago K, Telu K, Tribble D, Ganesan A, Kunz A, Geist C, Fraser J, Mitra I, Lalani T, Yun H, For The Infectious Disease Clinical Research Program TravMil Study Group. Impact of Doxycycline as Malaria Prophylaxis on Risk of Influenza-Like Illness among International Travelers. Am J Trop Med Hyg 2020; 102:821-826. [PMID: 32043448 PMCID: PMC7124920 DOI: 10.4269/ajtmh.19-0648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Travelers are often at risk for both influenza-like illness (ILI) and malaria. Doxycycline is active against pathogens causing ILI and is used for malaria prophylaxis. We evaluated the risk factors for ILI, and whether the choice of malaria prophylaxis was associated with ILI. TravMil is a prospective observational study enrolling subjects presenting to military travel clinics. Influenza-like illness was defined as subjective fever with either a sore throat or cough. Characteristics of trip and use of malaria prophylaxis were analyzed to determine association with development of ILI. Poisson regression models with robust error variance were used to estimate relative risk (RR) of ILI. A total of 3,227 trips were enrolled: 62.1% male, median age of 39 years (interquartile range [IQR] 27,59), median travel duration 19 days (IQR 12, 49); 32% traveled to Africa, 40% to Asia, and 27% to the Caribbean and Latin America. Military travel (46%) and vacation (40%) were most common reasons for travel. Among them, 20% took doxycycline, 50% other prophylaxis, and 30% took none; 8.7% developed ILI. Decreased RR of ILI was associated with doxycycline (RR 0.65 [0.43–0.99], P = 0.046) and military travel (RR 0.30 [0.21–0.43], P < 0.01). Increased risk of ILI was associated with female gender (RR 1.57 [1.24–1.98], P < 0.01), travel to Asia (RR 1.37 [1.08–1.75], P = 0.01), and cruises (RR 2.21 [1.73–2.83], P < 0.01). Use of doxycycline malaria prophylaxis is associated with a decreased risk of ILI. Possible reasons include anti-inflammatory or antimicrobial effects, or other unmeasured factors. With few strategies for decreasing ILI in travelers, these findings bear further investigation.
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Affiliation(s)
- Kathryn Lago
- Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Brooke Army Medical Center, Fort Sam Houston, Texas
| | - Kalyani Telu
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David Tribble
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Anuradha Ganesan
- Walter Reed National Military Medical Center, Bethesda, Maryland.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Anjali Kunz
- Landstuhl Regional Medical Center, Landstuhl, Germany.,Madigan Army Medical Center, Tacoma, Washington
| | - Charla Geist
- Landstuhl Regional Medical Center, Landstuhl, Germany.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
| | - Jamie Fraser
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Indrani Mitra
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Tahaniyat Lalani
- Naval Medical Center, Portsmouth, Virginia.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Heather Yun
- Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Brooke Army Medical Center, Fort Sam Houston, Texas
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Zemke JN, Sanchez JL, Pang J, Gray GC. The Double-Edged Sword of Military Response to Societal Disruptions: A Systematic Review of the Evidence for Military Personnel as Pathogen Transmitters. J Infect Dis 2020; 220:1873-1884. [PMID: 31519020 DOI: 10.1093/infdis/jiz400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/02/2019] [Indexed: 11/12/2022] Open
Abstract
Given their lack of immunity and increased exposure, military personnel have the potential to serve as carriers or reservoirs for infectious diseases into or out of the deployment areas, but, to our knowledge, the historical evidence for such transmission events has not previously been reviewed. Using PubMed, we performed a systematic review of published literature between 1955 and 2018, which documented evidence for military personnel transporting infectious pathogens into or out of deployment areas. Of the 439 articles screened, 67 were included for final qualitative and quantitative review. The data extracted from these articles described numerous instances in which thousands of military service members demonstrated potential or actual transmission and transportation of multiple diverse pathogens. These data underscore the immense importance preventive medical professionals play in mitigating such risk, how their public health efforts must be supported, and the importance of surveillance in protecting both military and civilian populations.
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Affiliation(s)
- Juliana N Zemke
- Duke Global Health Institute, Duke University, Durham, North Carolina.,Division of Infectious Diseases, Duke University, Durham, North Carolina
| | - Jose L Sanchez
- Department of Defense, Defense Health Agency, Public Health Division, Armed Forces Health Surveillance Branch, Silver Spring, Maryland
| | - Junxiong Pang
- Duke Global Health Institute, Duke University, Durham, North Carolina.,Centre for Infectious Disease Epidemiology & Research, Saw Swee Hock School of Public Health, National University of Singapore
| | - Gregory C Gray
- Duke Global Health Institute, Duke University, Durham, North Carolina.,Division of Infectious Diseases, Duke University, Durham, North Carolina.,Emerging Infectious Disease Program, Duke-National University of Singapore Medical School, Singapore.,Global Health Research Center, Duke-Kunshan University, Kunshan, China
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6
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Yildiz M, Kara M, Sutcu M, Mese S, Demircili ME, Sivrikoz TS, Torun SH, Agacfidan A, Coban A, Unuvar E, Somer A. Evaluation of respiratory syncytial virus IgG antibody dynamics in mother-infant pairs cohort. Eur J Clin Microbiol Infect Dis 2020; 39:1279-1286. [PMID: 32060753 PMCID: PMC7223508 DOI: 10.1007/s10096-020-03841-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 02/05/2020] [Indexed: 11/24/2022]
Abstract
RSV is one of the most important agents of lower respiratory infections in childhood. In this study, anti-RSV antibody levels in mother-infant pairs and factors related to antibody transfer ratio were investigated. One hundred and twenty-seven women that had term babies and their babies and 84 mother-infant pairs of them who continued the study after 6 months were enrolled. Anti-RSV IgG antibodies of the mothers and infants were positive in 46.5% and 61.5%, respectively. At the sixth month, anti-RSV antibodies were negative in all infants. Median of the anti-RSV antibody levels of the mothers and infants at birth were 12.08 IU/ml (1.21-119.27) and 13.78 IU/ml (3.99-108.6), respectively. There was a significant correlation between anti-RSV antibody levels of mothers and infants at birth (p: 0.0001, r: 0.667) and anti-RSV antibody levels of infants at birth and at 6th month (p: 0.0001, r: 0.343). Median ratio of infant and mother antibody levels was 1.22 (0.14-6.05). Median ratio that was detected in appropriate for gestational age infants was significantly higher than in small for gestational age or large for gestational age infants. In this study, the significant positive correlation between maternal antibody levels and infants' antibody levels at birth suggests that maternal vaccination strategies may be logical. We showed that antibody transfer rate was highest in appropriate for gestational age infants. It should be kept in mind that maternal vaccination strategies may be less effective in small for gestational age and large for gestational age infants.
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Affiliation(s)
- Mehmet Yildiz
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Sutcu
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Mese
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Emin Demircili
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugba Sarac Sivrikoz
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Selda Hancerli Torun
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Agacfidan
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Asuman Coban
- Department of Pediatrics, Division of Neonatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emin Unuvar
- Department of Pediatrics, Faculty of Medicine, Okan University, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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7
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Wentz LM, Ward MD, Potter C, Oliver SJ, Jackson S, Izard RM, Greeves JP, Walsh NP. Increased Risk of Upper Respiratory Infection in Military Recruits Who Report Sleeping Less Than 6 h per night. Mil Med 2019; 183:e699-e704. [PMID: 29746692 DOI: 10.1093/milmed/usy090] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/10/2018] [Indexed: 12/19/2022] Open
Abstract
Introduction Professional sleep associations recommend 7-9 h of sleep per night for young adults. Habitually sleeping less than 6 h per night has been shown to increase susceptibility to common cold in otherwise healthy, adult civilians. However, no investigations have examined the importance of sleep duration on upper respiratory tract infection (URTI) and loss of training days in military recruits. The purpose of this study was to describe self-reported sleep duration in a large cohort of military recruits and to assess the relationship between reported sleep duration and incidence of URTI's. We hypothesized that recruits who reported sleeping less than the recommended 7-9 h per night during training suffered a greater incidence of URTI and, as a consequence, lost more training days compared with recruits who met sleep recommendations. Materials and Methods Participants included 651 British Army recruits aged 22 ± 3 yr who completed 13 wk of basic military training (67% males, 33% females). Participants were members of 21 platoons (11 male, 10 female) who commenced training across four seasons (19% winter, 20% spring, 29% summer, and 32% autumn). At the start and completion of training, participants completed a questionnaire asking the typical time they went to sleep and awoke. Incidence of physician-diagnosed URTI and lost training days due to URTI were retrieved from medical records. Results Self-reported sleep duration decreased from before to during training (8.5 ± 1.6 vs. 7.0 ± 0.8 h; p < 0.01). Prior to training, 13% of participants reported sleeping less than the recommended 7 h sleep per night; however, this increased to 38% during training (X2 = 3.8; p = 0.05). Overall, 49 participants (8%) were diagnosed by a physician with at least one URTI and 3 participants (<1%) were diagnosed with two URTI's. After controlling for sex, body mass index, season of recruitment, smoking, and alcohol, participants who reported sleeping less than 6 h per night during training were four times more likely to be diagnosed with URTI compared with participants who slept 7-9 h per night in a logistic regression model (OR 4.4; 95% CI, 1.5-12.9, p < 0.01). On average, each URTI resulted in 2.9 ± 1.5 lost training days. Participants who were diagnosed with URTI had more overall lost training days for any illness compared with participants who did not report a URTI during basic military training (3.3 ± 1.9 vs. 0.4 ± 1.3; p < 0.01). Conclusion In a large population of British Army recruits, these findings show that more than one third of participants failed to meet sleep duration recommendations during training. Furthermore, those who reported sleeping less than 6 h per night were four times more likely to be diagnosed with an URTI and lost more training days due to URTI. Since sleep restriction is considered a necessary element of military training, future studies should examine interventions to reduce any negative effects on immunity and host defense.
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Affiliation(s)
- Laurel M Wentz
- Beaver College of Health Sciences, 261 Locust Street, Appalachian State University, Boone, NC
| | - Mark D Ward
- College of Health and Behavioural Sciences, Holyhead Road, Bangor University, Bangor, Gwynedd, UK
| | - Claire Potter
- College of Health and Behavioural Sciences, Holyhead Road, Bangor University, Bangor, Gwynedd, UK
| | - Samuel J Oliver
- College of Health and Behavioural Sciences, Holyhead Road, Bangor University, Bangor, Gwynedd, UK
| | - Sarah Jackson
- Army Personnel and Research Capability, Army HQ, Marlborough Lines, Andover, Hampshire UK
| | - Rachel M Izard
- Occupational Medicine, HQ Army Recruiting and Training Division, Trenchard Lines, Upavon, Wiltshire, UK
| | - Julie P Greeves
- Army Personnel and Research Capability, Army HQ, Marlborough Lines, Andover, Hampshire UK
| | - Neil P Walsh
- College of Health and Behavioural Sciences, Holyhead Road, Bangor University, Bangor, Gwynedd, UK
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Tam CC, Offeddu V, Anderson KB, Weg AL, Macareo LR, Ellison DW, Rangsin R, Fernandez S, Gibbons RV, Yoon IK, Simasathien S. Association between semi-quantitative microbial load and respiratory symptoms among Thai military recruits: a prospective cohort study. BMC Infect Dis 2018; 18:462. [PMID: 30217168 PMCID: PMC6137728 DOI: 10.1186/s12879-018-3358-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/23/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Multiplex real-time polymerase chain reaction assays have improved diagnostic sensitivity for a wide range of pathogens. However, co-detection of multiple agents and bacterial colonization make it difficult to distinguish between asymptomatic infection or illness aetiology. We assessed whether semi-quantitative microbial load data can differentiate between symptomatic and asymptomatic states for common respiratory pathogens. METHODS We obtained throat and nasal swab samples from military trainees at two Thai Army barracks. Specimens were collected at the start and end of 10-week training periods (non-acute samples), and from individuals who developed upper respiratory tract infection during training (acute samples). We analysed the samples using a commercial multiplex respiratory panel comprising 33 bacterial, viral and fungal targets. We used random effects tobit models to compare cycle threshold (Ct) value distributions from non-acute and acute samples. RESULTS We analysed 341 non-acute and 145 acute swab samples from 274 participants. Haemophilus influenzae type B was the most commonly detected microbe (77.4% of non-acute and 64.8% of acute samples). In acute samples, nine specific microbe pairs were detected more frequently than expected by chance. Regression models indicated significantly lower microbial load in non-acute relative to acute samples for H. influenzae non-type B, Streptococcus pneumoniae and rhinovirus, although it was not possible to identify a Ct-value threshold indicating causal etiology for any of these organisms. CONCLUSIONS Semi-quantitative measures of microbial concentration did not reliably differentiate between illness and asymptomatic colonization, suggesting that clinical symptoms may not always be directly related to microbial load for common respiratory infections.
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Affiliation(s)
- Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore. .,London School of Hygiene & Tropical Medicine, WC1E7HT, London, UK.
| | - Vittoria Offeddu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore
| | - Kathryn B Anderson
- University of Minnesota, Minneapolis, 55455, USA.,Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Alden L Weg
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Louis R Macareo
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Damon W Ellison
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Stefan Fernandez
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | | | - In-Kyu Yoon
- International Vaccine Institute, Seoul, 08826, South Korea
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9
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Lau YF, Koh WHV, Kan C, Dua PCA, Lim ASE, Liaw CWJ, Gao QH, Chng J, Lee VJ, Tan BH, Loh JP. Epidemiologic analysis of respiratory viral infections among Singapore military servicemen in 2016. BMC Infect Dis 2018. [PMID: 29529993 PMCID: PMC5848554 DOI: 10.1186/s12879-018-3040-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Respiratory illnesses have been identified as a significant factor leading to lost training time and morbidity among Singapore military recruits. A surveillance programme has been put in place to determine etiological agents responsible for febrile, as well as afebrile respiratory illnesses in a military camp. The goal of the study is to better understand the epidemiology of these diseases and identify potential countermeasures to protect military recruits against them. Methods From Jan 2016 - Jan 2017, a total of 2647 respiratory cases were enrolled into the surveillance programme. The cases were further stratified into Febrile Respiratory Illness (FRI, with body temperature > 37.5 °C) or Acute Respiratory Illness (ARI, with body temperature < 37.5 °C). Nasal washes were collected and tested by multiplex PCR to detect 26 different pathogens. Results One thousand ninety five cases (41% of total cases) met the criteria of FRI in which 932 cases (85% of FRI cases) were screened positive for at least one virus. The most common etiological agents for FRI mono-infection cases were Adenovirus E and Rhinovirus. Recruits infected with H3N2 influenza, Influenza B and Adenovirus E viruses were most likely presented as FRI cases. Notably, H3N2 influenza resulted in the greatest rise in body temperature. The remaining 1552 cases (59% of total cases) met the criteria of ARI in which 1198 cases (77% of ARI cases) were screened positive for at least one virus. The most common etiological agent for ARI mono-infection was Rhinovirus. The distribution pattern for dual infections was different for ARI and FRI cases. Maximum number of pathogens detected in a sample was five for both groups. Conclusion Previous studies on respiratory diseases in military focused largely on FRI cases. With the expanded surveillance to ARI cases, this study allows unbiased evaluation of the impact of respiratory disease pathogens among recruits in a military environment. The results show that several pathogens have a much bigger role in causing respiratory diseases in this cohort. Electronic supplementary material The online version of this article (10.1186/s12879-018-3040-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuk-Fai Lau
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore.
| | - Wee-Hong Victor Koh
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Clement Kan
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Poh-Choo Alethea Dua
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Ai-Sim Elizabeth Lim
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Chin-Wen Jasper Liaw
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Qiu-Han Gao
- Biodefence Centre, Ministry of Defence, Singapore, Singapore
| | - Jeremiah Chng
- Biodefence Centre, Ministry of Defence, Singapore, Singapore
| | - Vernon J Lee
- Biodefence Centre, Ministry of Defence, Singapore, Singapore
| | - Boon-Huan Tan
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Jin-Phang Loh
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
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10
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Huprikar NA, Deas SD, Skabelund AJ. Non-traumatic Pulmonary Emergencies in the Deployed Setting. CURRENT PULMONOLOGY REPORTS 2017; 6:138-145. [PMID: 32288987 PMCID: PMC7102247 DOI: 10.1007/s13665-017-0180-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Pulmonary disorders accounted for up to 8% of the over 70,000 medical evacuations conducted from Iraq and Afghanistan in the past 15 years. This review of non-traumatic pulmonary emergencies provides an overview of deployed military medical treatment capabilities and highlights pulmonary emergencies requiring aeromedical evacuation from theater. RECENT FINDINGS Recent studies have improved the epidemiologic evaluation of non-traumatic pulmonary disease, highlighted specific parenchymal diseases, and revealed infection pathologies unique to the deployed setting. Literature regarding possible chemical exposures in the current deployed environment remains limited. SUMMARY Respiratory disorders requiring medical evacuation represent a wide variety of diseases. Complications such as pulmonary emboli, infectious pathogens, and hazardous chemical exposures threaten the deployed warfighter. Adequate medical care requires an understanding of these potential environmental exposures. This review serves as a general overview of this topic; however, more research regarding epidemiologic and environmental exposures is required.
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Affiliation(s)
- Nikhil A. Huprikar
- Pulmonary/Critical Care Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Fort Sam Houston, San Antonio, TX 78234 USA
| | - Steven D. Deas
- Pulmonary/Critical Care Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Fort Sam Houston, San Antonio, TX 78234 USA
| | - Andrew J. Skabelund
- Pulmonary/Critical Care Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Fort Sam Houston, San Antonio, TX 78234 USA
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11
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Moretti E, Figura N, Campagna MS, Iacoponi F, Gonnelli S, Collodel G. Infectious Burden and Semen Parameters. Urology 2016; 100:90-96. [PMID: 27793655 DOI: 10.1016/j.urology.2016.10.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/28/2016] [Accepted: 10/18/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the relationship between chronic infections detected in serum and semen quality. The pathogen burden is a concept consisting in the observation that, in patients with heart disease, damaging effects of the coronary arteries increase concomitantly with the number of agents responsible for chronic infections to which patients mounted a serological response. Previous observations that Helicobacter pylori infection may reduce the semen quality prompted us to perform the present study. METHODS Blood and semen samples were collected from 73 selected men, enrolled from January 2014 to January 2015. Semen characteristics were evaluated by light and transmission electron microscopy. Transmission electron microscopy data were quantified with a mathematical formula providing numerical scores, such as fertility index (FI, number of sperm free from ultrastructural defects) and the percentages of sperm apoptosis, immaturity, and necrosis. Serum samples were examined by enzyme-linked immunosorbent assay for the presence of immunoglobulin G to the most common agents of chronic infections such as H. pylori (HP), Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), and cytomegalovirus (CMV). RESULTS The prevalence of infections was as follows: HP 43.8%, CP 46.6%, MP 72.6%, EBV 95.9%, HSV-1 74.0%, and CMV 46.6%. Concomitantly with the increased number of pathogens against which the patients mounted a significant antibody response, sperm concentration (P <.05), sperm motility (P <.001), and fertility index (P <.001) were significantly reduced and the percentage of necrotic sperm was increased (P <.01). CONCLUSION The higher the number of pathogens stimulating an immunoglobulin G systemic response, the lower was the semen quality.
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Affiliation(s)
- Elena Moretti
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
| | - Natale Figura
- Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Maria Stella Campagna
- Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Francesca Iacoponi
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy
| | - Stefano Gonnelli
- Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Giulia Collodel
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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12
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Newman ENC, Johnstone P, Bridge H, Wright D, Jameson L, Bosworth A, Hatch R, Hayward-Karlsson J, Osborne J, Bailey MS, Green A, Ross D, Brooks T, Hewson R. Seroconversion for infectious pathogens among UK military personnel deployed to Afghanistan, 2008-2011. Emerg Infect Dis 2016; 20:2015-22. [PMID: 25418685 PMCID: PMC4257834 DOI: 10.3201/eid2012.131830] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Military personnel are at high risk of contracting vector-borne and zoonotic infections, particularly during overseas deployments, when they may be exposed to endemic or emerging infections not prevalent in their native countries. We conducted seroprevalence testing of 467 UK military personnel deployed to Helmand Province, Afghanistan, during 2008-2011 and found that up to 3.1% showed seroconversion for infection with Rickettsia spp., Coxiella burnetii, sandfly fever virus, or hantavirus; none showed seroconversion for infection with Crimean-Congo hemorrhagic fever virus. Most seroconversions occurred in personnel who did not report illness, except for those with hantavirus (70% symptomatic). These results indicate that many exposures to infectious pathogens, and potentially infections resulting from those exposures, may go unreported. Our findings reinforce the need for continued surveillance of military personnel and for education of health care providers to help recognize and prevent illnesses and transmission of pathogens during and after overseas deployments.
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13
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Parrott GL, Kinjo T, Fujita J. A Compendium for Mycoplasma pneumoniae. Front Microbiol 2016; 7:513. [PMID: 27148202 PMCID: PMC4828434 DOI: 10.3389/fmicb.2016.00513] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/29/2016] [Indexed: 12/11/2022] Open
Abstract
Historically, atypical pneumonia was a term used to describe an unusual presentation of pneumonia. Currently, it is used to describe the multitude of symptoms juxtaposing the classic symptoms found in cases of pneumococcal pneumonia. Specifically, atypical pneumonia is a syndrome resulting from a relatively common group of pathogens including Chlamydophila sp., and Mycoplasma pneumoniae. The incidence of M. pneumoniae pneumonia in adults is less than the burden experienced by children. Transmission rates among families indicate children may act as a reservoir and maintain contagiousness over a long period of time ranging from months to years. In adults, M. pneumoniae typically produces a mild, “walking” pneumonia and is considered to be one of the causes of persistent cough in patients. M. pneumoniae has also been shown to trigger the exacerbation of other lung diseases. It has been repeatedly detected in patients with bronchitis, asthma, chronic obstructive pulmonary disorder, and cystic fibrosis. Recent advances in technology allow for the rapid diagnosis of M. pneumoniae through the use of polymerase chain reaction or rapid antigen tests. With this, more effort has been afforded to identify the causative etiologic agent in all cases of pneumonia. However, previous practices, including the overprescribing of macrolide treatment in China and Japan, have created increased incidence of macrolide-resistant M. pneumoniae. Reports from these countries indicate that >85% of M. pneumoniae pneumonia pediatric cases are macrolide-resistant. Despite its extensively studied past, the smallest bacterial species still inspires some of the largest questions. The developments in microbiology, diagnostic features and techniques, epidemiology, treatment and vaccines, and upper respiratory conditions associated with M. pneumoniae in adult populations are included within this review.
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Affiliation(s)
- Gretchen L Parrott
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
| | - Takeshi Kinjo
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
| | - Jiro Fujita
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
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14
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Chlamydial Antibiotic Resistance and Treatment Failure in Veterinary and Human Medicine. CURRENT CLINICAL MICROBIOLOGY REPORTS 2016; 3:10-18. [PMID: 27218014 PMCID: PMC4845085 DOI: 10.1007/s40588-016-0028-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Chlamydiaceae are widespread pathogens of both humans and animals. Chlamydia trachomatis infection causes blinding trachoma and reproductive complications in humans. Chlamydia pneumoniae causes human respiratory tract infections and atypical pneumonia. Chlamydia suis infection is associated with conjunctivitis, diarrhea, and failure to gain weight in domestic swine. Chlamydial infections in humans and domesticated animals are generally controlled by antibiotic treatment—particularly macrolides (usually azithromycin) and tetracyclines (tetracycline and doxycycline). Tetracycline-containing feed has also been used to limit infections and promote growth in livestock populations, although its use has decreased because of growing concerns about antimicrobial resistance development. Because Sandoz and Rockey published an elegant review of chlamydial anti-microbial resistance in 2010, we will review the following: (i) antibiotic resistance in C. suis, (ii) recent evidence for acquired resistance in human chlamydial infections, and (iii) recent non-genetic mechanisms of antibiotic resistance that may contribute to treatment failure.
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15
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Monteiro GS, Fleck JD, Kluge M, Rech NK, Soliman MC, Staggemeier R, Rodrigues MT, Barros MP, Heinzelmann LS, Spilki FR. Adenoviruses of canine and human origins in stool samples from free-living pampas foxes (Lycalopex gymnocercus) and crab-eating foxes (Cerdocyon thous) in São Francisco de Paula, Rio dos Sinos basin. BRAZ J BIOL 2015; 75:11-6. [PMID: 26270208 DOI: 10.1590/1519-6984.0313] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/05/2013] [Indexed: 11/22/2022] Open
Abstract
The spread of enteric viruses of domestic animals and human beings to wild species can be facilitated by the resistance of these viruses on the environment and their ability to be transmitted by water and contaminated food. The health status of the populations of pampas foxes Lycalopex gymnocercus) and crab-eating foxes (Cerdocyon thous) is largely unknown and the landscapes occupied by these animals in southern Brazil have been threatened by human occupation and expansion of agriculture. In this work, the search of genomes of human and canine adenoviruses in feces from these wild carnivores was used to track the dissemination of domestic animals and human pathogens to the free-living populations in a wildlife reserve located in southern Brazil. This was performed by virus-specific differential real-time polymerase chain reactions (qPCR) on stool specimens, avoiding capture and additional stress to the animals. Genus-specific conventional reverse-transcriptase PCR (RT-PCR) was complementarily performed aiming the detection of enteroviruses (EV) and rotaviruses (RV) on these same samples. HAdV genomes were found on 14 out of the 17 (82.35%) stool samples analysed, whereas CAV was found co-infecting 5 of these samples. RV genomes were detected on 7 of the 17 samples (41.18%) and all samples were negative for EV. The results point to the dispersion of HAdV and RV at a high rate to these species of South American wild carnivores, which can be an effect of growing anthropisation of the habitat of these animals.
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Affiliation(s)
- G S Monteiro
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - J D Fleck
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - M Kluge
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - N K Rech
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - M C Soliman
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - R Staggemeier
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - M T Rodrigues
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - M P Barros
- Laboratório de Zoologia, Universidade Feevale, Novo Hamburgo, RS, BR
| | - L S Heinzelmann
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
| | - F R Spilki
- Laboratório de Microbiologia Molecular, Universidade Feevale, Novo Hamburgo, RS, BR
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16
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Sanchez JL, Cooper MJ, Myers CA, Cummings JF, Vest KG, Russell KL, Sanchez JL, Hiser MJ, Gaydos CA. Respiratory Infections in the U.S. Military: Recent Experience and Control. Clin Microbiol Rev 2015; 28:743-800. [PMID: 26085551 PMCID: PMC4475643 DOI: 10.1128/cmr.00039-14] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This comprehensive review outlines the impact of military-relevant respiratory infections, with special attention to recruit training environments, influenza pandemics in 1918 to 1919 and 2009 to 2010, and peacetime operations and conflicts in the past 25 years. Outbreaks and epidemiologic investigations of viral and bacterial infections among high-risk groups are presented, including (i) experience by recruits at training centers, (ii) impact on advanced trainees in special settings, (iii) morbidity sustained by shipboard personnel at sea, and (iv) experience of deployed personnel. Utilizing a pathogen-by-pathogen approach, we examine (i) epidemiology, (ii) impact in terms of morbidity and operational readiness, (iii) clinical presentation and outbreak potential, (iv) diagnostic modalities, (v) treatment approaches, and (vi) vaccine and other control measures. We also outline military-specific initiatives in (i) surveillance, (ii) vaccine development and policy, (iii) novel influenza and coronavirus diagnostic test development and surveillance methods, (iv) influenza virus transmission and severity prediction modeling efforts, and (v) evaluation and implementation of nonvaccine, nonpharmacologic interventions.
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Affiliation(s)
- Jose L Sanchez
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Michael J Cooper
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | | | - James F Cummings
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kelly G Vest
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Joyce L Sanchez
- Mayo Clinic, Division of General Internal Medicine, Rochester, Minnesota, USA
| | - Michelle J Hiser
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA Oak Ridge Institute for Science and Education, Postgraduate Research Participation Program, U.S. Army Public Health Command, Aberdeen Proving Ground, Aberdeen, Maryland, USA
| | - Charlotte A Gaydos
- International STD, Respiratory, and Biothreat Research Laboratory, Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
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17
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Korzeniewski K, Nitsch-Osuch A, Konior M, Lass A. Respiratory tract infections in the military environment. Respir Physiol Neurobiol 2014; 209:76-80. [PMID: 25278277 PMCID: PMC7172564 DOI: 10.1016/j.resp.2014.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 11/08/2022]
Abstract
Soldiers in combat zones are at risk of contracting respiratory infections. Troops deployed to the harsh environment have high rates of respiratory symptoms. Over 40% of soldiers’ respiratory illnesses have been due to unknown causative agents. Limited diagnostic capabilities make it difficult to estimate the number of cases.
Military personnel fighting in contemporary battlefields as well as those participating in combat training are at risk of contracting respiratory infections. Epidemiological studies have demonstrated that soldiers deployed to the harsh environment have higher rates of newly reported respiratory symptoms than non-deployers. Acute respiratory diseases are the principle reason for outpatient treatment and hospitalization among military personnel, with an incidence exceeding that of the adult civilian population by up to three-fold. Adenoviruses, influenza A and B viruses, Streptococcus pneumoniae, Streptococcus pyogenes, coronaviruses and rhinoviruses have been identified as the main causes of acute respiratory infections among the military population. Although infective pathogens have been extensively studied, a significant proportion of illnesses (over 40%) have been due to unknown causative agents. Other health hazards, which can lead to respiratory illnesses among troops, are extreme air temperatures, desert dust, emissions from burn pits, industrial pollutants, and airborne contaminants originating from degraded soil. Limited diagnostic capabilities, especially inside the area of operations, make it difficult to accurately estimate the exact number of respiratory diseases in the military environment. The aim of the study was to discuss the occurrence of respiratory tract infections in army personnel, existing risk factors and preventive measures.
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Affiliation(s)
- Krzysztof Korzeniewski
- Military Institute of Medicine, Department of Epidemiology and Tropical Medicine, Gdynia, Poland.
| | - Aneta Nitsch-Osuch
- Warsaw Medical University, Department of Family Medicine, Warsaw, Poland
| | - Monika Konior
- Military Institute of Medicine, Department of Epidemiology and Tropical Medicine, Gdynia, Poland
| | - Anna Lass
- Medical University of Gdańsk, Department of Tropical Parasitology, Gdynia, Poland
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18
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Park WJ. Seroprevalence of respiratory syncytial virus IgG among healthy young adults in basic training for the Republic of Korea Air Force. J Korean Med Sci 2014; 29:1325-7. [PMID: 25246755 PMCID: PMC4168190 DOI: 10.3346/jkms.2014.29.9.1325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 06/13/2014] [Indexed: 11/20/2022] Open
Abstract
This investigation enrolled 570 healthy young males gathered from all over the country for military service at the Republic of Korea Air Force boot camp. It confirmed RSV IgG seroprevalence by utilizing the enzyme immunoassay method just prior to undergoing basic training. The mean age of this study was 20.25 ± 1.34 yr old. The results of their immunoassay seroprofiles showed that 561 men (98.4%) were positive, 2 (0.4%) were negative and 7 (1.2%) were equivocal belonging to the grey zone. It was confirmed that RSV is a common respiratory virus and RSV infection was encountered by almost all people before reaching adulthood in Korea. Nine basic trainees belonging to the RSV IgG negative and equivocal grey zone categories were prospectively observed for any particular vulnerability to respiratory infection during the training period of two months. However, these nine men completed their basic training without developing any specific respiratory illness.
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Affiliation(s)
- Won-Ju Park
- Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
- Department of Occupational and Environmental Medicine, Aerospace Medical Research Center, Republic of Korea Air Force, Cheongwon, Korea
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20
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Environmental Exposure and Health of Operation Enduring Freedom/Operation Iraqi Freedom Veterans. J Occup Environ Med 2012; 54:665-9. [DOI: 10.1097/jom.0b013e318255ba1b] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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