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Chen X, Ma B, Yang Y, Zhang M, Xu F. Predicting the potentially exacerbation of severe viral pneumonia in hospital by MuLBSTA score joint CD4 + and CD8 +T cell counts: construction and verification of risk warning model. BMC Pulm Med 2024; 24:261. [PMID: 38811907 PMCID: PMC11137986 DOI: 10.1186/s12890-024-03073-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/22/2024] [Indexed: 05/31/2024] Open
Abstract
PURPOSE This study mainly focuses on the immune function and introduces CD4+, CD8+ T cells and their ratios based on the MuLBSTA score, a previous viral pneumonia mortality risk warning model, to construct an early warning model of severe viral pneumonia risk. METHODS A retrospective single-center observational study was operated from January 2021 to December 2022 at the People's Hospital of Liangjiang New Area, Chongqing, China. A total of 138 patients who met the criteria for viral pneumonia in hospital were selected and their data, including demographic data, comorbidities, laboratory results, CT scans, immunologic and pathogenic tests, treatment regimens, and clinical outcomes, were collected and statistically analyzed. RESULTS Forty-one patients (29.7%) developed severe or critical illness. A viral pneumonia severe risk warning model was successfully constructed, including eight parameters: age, bacterial coinfection, CD4+, CD4+/CD8+, multiple lung lobe infiltrations, smoking, hypertension, and hospital admission days. The risk score for severe illness in patients was set at 600 points. The model had good predictive performance (AUROC = 0.94397), better than the original MuLBSTA score (AUROC = 0.8241). CONCLUSION A warning system constructed based on immune function has a good warning effect on the risk of severe conversion in patients with viral pneumonia.
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Affiliation(s)
- Xi Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
- Department of Critical Care Medicine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401120, China
| | - Bei Ma
- Department of Critical Care Medicine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401120, China
| | - Yu Yang
- Department of Critical Care Medicine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401120, China
| | - Mu Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
| | - Fang Xu
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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2
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Zoepfl M, Dwivedi R, Kim SB, McVoy MA, Pomin VH. Antiviral activity of marine sulfated glycans against pathogenic human coronaviruses. Sci Rep 2023; 13:4804. [PMID: 36959228 PMCID: PMC10035982 DOI: 10.1038/s41598-023-31722-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/16/2023] [Indexed: 03/25/2023] Open
Abstract
Great interest exists towards the discovery and development of broad-spectrum antivirals. This occurs due to the frequent emergence of new viruses which can also eventually lead to pandemics. A reasonable and efficient strategy to develop new broad-spectrum antivirals relies on targeting a common molecular player of various viruses. Heparan sulfate is a sulfated glycosaminoglycan present on the surface of cells which plays a key role as co-receptor in many virus infections. In previous work, marine sulfated glycans (MSGs) were identified as having antiviral activities. Their mechanism of action relies primarily on competitive inhibition of virion binding to heparan sulfate, preventing virus attachment to the cell surface prior to entry. In the current work we used pseudotyped lentivirus particles to investigate in a comparative fashion the inhibitory properties of five structurally defined MSGs against SARS-CoV-1, SARS-CoV-2, MERS-CoV, and influenza A virus (IAV). MSGs include the disaccharide-repeating sulfated galactan from the red alga Botryocladia occidentalis, the tetrasaccharide-repeating sulfated fucans from the sea urchin Lytechinus variegatus and from the sea cucumber Isostichopus badionotus, and the two marine fucosylated chondroitin sulfates from the sea cucumbers I. badionotus and Pentacta pygmaea. Results indicate specificity of action against SARS-CoV-1 and SARS-CoV-2. Curiously, the MSGs showed decreased inhibitory potencies against MERS-CoV and negligible action against IAV. Among the five MSGs, the two sulfated fucans here studied deserve further attention since they have the lowest anticoagulant effects but still present potent and selective antiviral properties.
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Affiliation(s)
- Mary Zoepfl
- Department of Chemistry, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Rohini Dwivedi
- Department of BioMolecular Sciences, University of Mississippi, University, MS, 38677, USA
| | - Seon Beom Kim
- Department of BioMolecular Sciences, University of Mississippi, University, MS, 38677, USA
- Department of Food Science and Technology, College of Natural Resources and Life Science, Pusan National University, Miryang, 50463, Republic of Korea
| | - Michael A McVoy
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, 23298, USA.
| | - Vitor H Pomin
- Department of BioMolecular Sciences, University of Mississippi, University, MS, 38677, USA.
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3
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Chan-Zapata I, Borges-Argáez R, Ayora-Talavera G. Quinones as Promising Compounds against Respiratory Viruses: A Review. Molecules 2023; 28:molecules28041981. [PMID: 36838969 PMCID: PMC9967002 DOI: 10.3390/molecules28041981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Respiratory viruses represent a world public health problem, giving rise to annual seasonal epidemics and several pandemics caused by some of these viruses, including the COVID-19 pandemic caused by the novel SARS-CoV-2, which continues to date. Some antiviral drugs have been licensed for the treatment of influenza, but they cause side effects and lead to resistant viral strains. Likewise, aerosolized ribavirin is the only drug approved for the therapy of infections by the respiratory syncytial virus, but it possesses various limitations. On the other hand, no specific drugs are licensed to treat other viral respiratory diseases. In this sense, natural products and their derivatives have appeared as promising alternatives in searching for new compounds with antiviral activity. Besides their chemical properties, quinones have demonstrated interesting biological activities, including activity against respiratory viruses. This review summarizes the activity against respiratory viruses and their molecular targets by the different types of quinones (both natural and synthetic). Thus, the present work offers a general overview of the importance of quinones as an option for the future pharmacological treatment of viral respiratory infections, subject to additional studies that support their effectiveness and safety.
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Affiliation(s)
- Ivan Chan-Zapata
- Unidad de Biotecnología, Centro de Investigación Científica de Yucatán, Chuburná de Hidalgo, Merida 97205, Mexico
| | - Rocío Borges-Argáez
- Unidad de Biotecnología, Centro de Investigación Científica de Yucatán, Chuburná de Hidalgo, Merida 97205, Mexico
- Correspondence: ; Tel.: +52-99-99-42-83-30
| | - Guadalupe Ayora-Talavera
- Departamento de Virología, Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Paseo de Las Fuentes, Merida 97225, Mexico
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4
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Vanni T, Thomé BC, Sparrow E, Friede M, Fox CB, Beckmann AM, Huynh C, Mondini G, Silveira DH, Viscondi JYK, Braga PE, da Silva A, Salomão MDG, Piorelli RO, Santos JP, Gattás VL, Lucchesi MBB, de Oliveira MMM, Koike ME, Kallas EG, Campos LMA, Coelho EB, Siqueira MAM, Garcia CC, Miranda MD, Paiva TM, Timenetsky MDCST, Adami EA, Akamatsu MA, Ho PL, Precioso AR. Dose-sparing effect of two adjuvant formulations with a pandemic influenza A/H7N9 vaccine: A randomized, double-blind, placebo-controlled, phase 1 clinical trial. PLoS One 2022; 17:e0274943. [PMID: 36256646 PMCID: PMC9578608 DOI: 10.1371/journal.pone.0274943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
The emergence of potentially pandemic viruses has resulted in preparedness efforts to develop candidate vaccines and adjuvant formulations. We evaluated the dose-sparing effect and safety of two distinct squalene-based oil-in-water adjuvant emulsion formulations (IB160 and SE) with influenza A/H7N9 antigen. This phase I, randomized, double-blind, placebo-controlled, dose-finding trial (NCT03330899), enrolled 432 healthy volunteers aged 18 to 59. Participants were randomly allocated to 8 groups: 1A) IB160 + 15μg H7N9, 1B) IB160 + 7.5μg H7N9, 1C) IB160 + 3.75μg H7N9, 2A) SE + 15μg H7N9, 2B) SE + 7.5μg H7N9, 2C) SE + 3.75μg H7N9, 3) unadjuvanted vaccine 15μg H7N9 and 4) placebo. Immunogenicity was evaluated through haemagglutination inhibition (HI) and microneutralization (MN) tests. Safety was evaluated by monitoring local and systemic, solicited and unsolicited adverse events (AE) and reactions (AR) 7 and 28 days after each study injection, respectively, whereas serious adverse events (SAE) were monitored up to 194 days post-second dose. A greater increase in antibody geometric mean titers (GMT) was observed in groups receiving adjuvanted vaccines. Vaccinees receiving IB160-adjuvanted formulations showed the greatest response in group 1B, which induced an HI GMT increase of 4.7 times, HI titers ≥40 in 45.2% of participants (MN titers ≥40 in 80.8%). Vaccinees receiving SE-adjuvanted vaccines showed the greatest response in group 2A, with an HI GMT increase of 2.5 times, HI titers ≥40 in 22.9% of participants (MN titers ≥40 in 65.7%). Frequencies of AE and AR were similar among groups. Pain at the administration site and headache were the most frequent local and systemic solicited ARs. The vaccine candidates were safe and the adjuvanted formulations have a potential dose-sparing effect on immunogenicity against influenza A/H7N9. The magnitude of this effect could be further explored.
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Affiliation(s)
| | | | | | | | - Christopher B. Fox
- Infectious Disease Research Institute, Seattle, WA, United States of America
| | - Anna Marie Beckmann
- Infectious Disease Research Institute, Seattle, WA, United States of America
| | - Chuong Huynh
- Biomedical Advanced Research and Development Authority, Washington, DC, United States of America
| | | | | | | | | | | | | | | | | | | | | | | | | | - Esper G. Kallas
- Clinics Hospital of the School of Medicine of University of São Paulo, São Paulo, Brazil
| | - Lucia M. A. Campos
- Child Institute of the Clinics Hospital of the School of Medicine of University of São Paulo, São Paulo, Brazil
| | - Eduardo B. Coelho
- Clinics Hospital of the Medical School of Ribeirão Preto of the University of São Paulo, Ribeirão Preto, Brazil
| | | | | | | | | | | | | | | | | | - Alexander R. Precioso
- Instituto Butantan, São Paulo, Brazil
- Child Institute of the Clinics Hospital of the School of Medicine of University of São Paulo, São Paulo, Brazil
- * E-mail:
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5
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Zhao GZ, Li B, Wang YF, Guo SQ, Du Y, Ma QX, Guo YH, Liu QQ. Reduning Injection versus Neuraminidase Inhibitors in the Treatment of Influenza: A Systematic Review and Meta-Analysis. Chin J Integr Med 2022; 28:1023-1031. [PMID: 35508864 PMCID: PMC9068505 DOI: 10.1007/s11655-022-3524-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 11/11/2022]
Abstract
Objective To perform a systematic review to assess the effectiveness and safety of Reduning Injection versus neuraminidase inhibitors in treatment of influenza. Methods The MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Bio-medical Literature and Retrieval System (Sinomed), China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP), Wanfang Data Knowledge Service Platform and ClinicalTrails.gov were systematically searched from inception dates to May 2021 for randomized controlled trials (RCTs) exploring Reduning Injection alone or in combination with neuraminidase inhibitors in patients with influenza. Statistical analysis was performed using RevMan 5.4 and Stata 15.1. The qualities of the involved studies were assessed by the risk of bias according to the Cochrane handbook. The evidence quality of each outcome was evaluated by GRADEpro GDT. Results Twelve trials with 1,460 patients were included. The included studies had a certain unclear or high risk of bias. Reduning Injection appeared to be more effective in shortening the fever clearance time (MD: −16.20 h, 95% CI: −19.40 to −12.99, 7 trials, 814 patients, I2=94%, very low certainty), fever alleviation time (MD: −4.09 h, 95% CI: −4.22 to −3.96, 3 trials, 366 patients, I2=0%, low certainty), cough alleviation time (MD: −21.34 h, 95% CI: −41.56 to −1.11, 2 trials, 228 patients, I2=89%, very low certainty), fatigue alleviation time (MD: −31.83 h, 95% CI: −36.88 to −26.77, 2 trials, 270 patients, I2=0%, low certainty), sore throat alleviation time (MD: −28.66 h, 95% CI: −32.23 to −25.10, 1 trial, 150 patients, low certainty), and improving the total effective rate (RR: 1.15, 95% CI: 1.06 to 1.25, 10 trials, 1,074 patients, I2=76%, very low certainty). Besides, Reduning Injection seemed generally safe. Conclusions This study provided low or very low evidence indicating Reduning Injection may be effective in the treatment of influenza and might be safe. Further rigorously designed studies are needed to confirm the effectiveness and safety of Reduning Injection and support it as a recommendation for influenza. Electronic Supplementary Material Supplementary material (Appendixes 1 and 2) are available in the online version of this article at DOI: 10.1007/s11655-022-3524-9.
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Affiliation(s)
- Guo-Zhen Zhao
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.,Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.,Beijing Evidence-Based Chinese Medicine Center, Beijing, 100010, China
| | - Bo Li
- Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.,Beijing Evidence-Based Chinese Medicine Center, Beijing, 100010, China.,Beijing Institute of Chinese Medicine, Beijing, 100010, China
| | - Ya-Fan Wang
- Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Shi-Qi Guo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yuan Du
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.,Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Qiu-Xiao Ma
- Department of Respiratory, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yu-Hong Guo
- Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Qing-Quan Liu
- Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China. .,Beijing Evidence-Based Chinese Medicine Center, Beijing, 100010, China. .,Beijing Institute of Chinese Medicine, Beijing, 100010, China.
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6
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Liu Q, Liu J. Clinical practice guideline on traditional Chinese medicine in the treatment of influenza (2021). JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2021. [DOI: 10.1016/j.jtcms.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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Yan L, Sun L, Guo C, Li L, Sun J, Huang X, Zhao P, Xie X, Hu J. Neutralizing antibody PR8-23 targets the footprint of the sialoglycan receptor binding site of H1N1 hemagglutinin. J Med Virol 2021; 93:3508-3515. [PMID: 33410516 DOI: 10.1002/jmv.26779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/21/2020] [Accepted: 01/05/2021] [Indexed: 11/05/2022]
Abstract
Influenza virus cause seasonal influenza epidemic and seriously sporadic influenza pandemic outbreaks. Hemagglutinin (HA) is an important target in the therapeutic treatment and diagnostic detection of the influenza virus. Variation in the sialic acid receptor binding site leads to strain-specific binding and results in different binding modes to the host receptors. Here, we evaluated the neutralizing activity and hemagglutination inhibition activity of a prepared murine anti-H1N1 monoclonal antibody PR8-23. Then we identified the epitope peptide of antibody PR8-23 by phage display technique from phage display peptide libraries. The identified epitope, 63-IAPLQLGKCNIA-74, containing two α-helix and two β-fold located at the footprint of the sialoglycan receptor on the RBS in the globular head domain of HA. It broads the growing arsenal of motifs for the amino acids on the globular head domain of HA in sialic acid receptor binding site and neutralizing antibody production.
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Affiliation(s)
- Liting Yan
- Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China
- Research Center of Cell Immunological Engineering and Technology of Shaanxi Province, Xi'an, China
| | - Lijun Sun
- Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China
- Research Center of Cell Immunological Engineering and Technology of Shaanxi Province, Xi'an, China
| | - Chunyan Guo
- Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China
- Research Center of Cell Immunological Engineering and Technology of Shaanxi Province, Xi'an, China
| | - Lanlan Li
- Department of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Jingying Sun
- Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China
- Research Center of Cell Immunological Engineering and Technology of Shaanxi Province, Xi'an, China
| | - Xiaoyan Huang
- Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China
- Research Center of Cell Immunological Engineering and Technology of Shaanxi Province, Xi'an, China
| | - Penghua Zhao
- Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China
- Research Center of Cell Immunological Engineering and Technology of Shaanxi Province, Xi'an, China
| | - Xin Xie
- College of Life Sciences, Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, China
- Department of Translational Medicine, Institute of Integrated Medical Information, Xi'an, China
| | - Jun Hu
- Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China
- Research Center of Cell Immunological Engineering and Technology of Shaanxi Province, Xi'an, China
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8
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Liu X, Peng X, Lin Z. Evodiamine Enhanced the Anti-Inflammation Effect of Clindamycin in the BEAS-2B Cells Infected with H5N1 and Pneumoniae D39 Through CREB-C/EBPβ Signaling Pathway. Viral Immunol 2021; 34:410-415. [PMID: 33945347 DOI: 10.1089/vim.2020.0319] [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: 11/13/2022] Open
Abstract
Pneumonia is a pulmonary disease among children. Evodiamine, a traditional Chinese medicine, is known for anti-inflammatory effect. This study aimed to investigate the impact of evodiamine on severe pneumonia-like cells and the underlying mechanism involved. H5N1 and pneumoniae D39 was used to induce severe pneumonia-like conditions in BEAS-2B cells. The cell viability in BEAS-2B cells after treatments with 0, 20, 40, 60, 80, and 100 μM evodiamine was examined using MTT assays. The protein concentrations of inflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1β, and Toll-like receptors (TLRs) were measured by enzyme-linked immunosorbent assay methods and the protein and mRNA changes in C/EBPβ/CREB were measured using Real Time-quantitative polymerase chain reaction and Western blot methods. Our results revealed that Evodiamine significantly decreased TNF-α, IL-6, and IL-1β in BEAS-2B cells. Moreover, evodiamine markedly reduced TLR2,3,4 protein expression and the phosphorylated protein of C/EBPβ and CREB. Besides, evodiamine combined with clindamycin exerted more significant effects than clindamycin alone. Taken together, our results demonstrated that evodiamine enhanced the anti-inflammation effect of clindamycin in the BEAS-2B cells infected with H5N1 and pneumoniae D39 through CREB-C/EBPβ signaling pathway.
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Affiliation(s)
- Xiaqing Liu
- Children's Respiratory Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaofang Peng
- Cell and Molecular Diagnosis Center, Sun Yat Sen Memorial Hospital, Sun Yat Sen University, Guangzhou, China
| | - Zhengfang Lin
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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9
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Liu WJ, Xiao H, Dai L, Liu D, Chen J, Qi X, Bi Y, Shi Y, Gao GF, Liu Y. Avian influenza A (H7N9) virus: from low pathogenic to highly pathogenic. Front Med 2021; 15:507-527. [PMID: 33860875 PMCID: PMC8190734 DOI: 10.1007/s11684-020-0814-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 07/08/2020] [Indexed: 12/13/2022]
Abstract
The avian influenza A (H7N9) virus is a zoonotic virus that is closely associated with live poultry markets. It has caused infections in humans in China since 2013. Five waves of the H7N9 influenza epidemic occurred in China between March 2013 and September 2017. H7N9 with low-pathogenicity dominated in the first four waves, whereas highly pathogenic H7N9 influenza emerged in poultry and spread to humans during the fifth wave, causing wide concern. Specialists and officials from China and other countries responded quickly, controlled the epidemic well thus far, and characterized the virus by using new technologies and surveillance tools that were made possible by their preparedness efforts. Here, we review the characteristics of the H7N9 viruses that were identified while controlling the spread of the disease. It was summarized and discussed from the perspectives of molecular epidemiology, clinical features, virulence and pathogenesis, receptor binding, T-cell responses, monoclonal antibody development, vaccine development, and disease burden. These data provide tools for minimizing the future threat of H7N9 and other emerging and re-emerging viruses, such as SARS-CoV-2.
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Affiliation(s)
- William J Liu
- Shenzhen Key Laboratory of Pathogen and Immunity, Shenzhen Third People's Hospital, Shenzhen, 518114, China.
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Haixia Xiao
- Laboratory of Protein Engineering and Vaccines, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences (CAS), Tianjin, 300308, China
| | - Lianpan Dai
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Di Liu
- CAS Key Laboratory of Special Pathogens and Biosafety, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy Sciences, Beijing, 100049, China
- Center for Influenza Research and Early Warning, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jianjun Chen
- CAS Key Laboratory of Special Pathogens and Biosafety, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy Sciences, Beijing, 100049, China
- Center for Influenza Research and Early Warning, Chinese Academy of Sciences, Beijing, 100101, China
| | - Xiaopeng Qi
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yuhai Bi
- Shenzhen Key Laboratory of Pathogen and Immunity, Shenzhen Third People's Hospital, Shenzhen, 518114, China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy Sciences, Beijing, 100049, China
- Center for Influenza Research and Early Warning, Chinese Academy of Sciences, Beijing, 100101, China
| | - Yi Shi
- Shenzhen Key Laboratory of Pathogen and Immunity, Shenzhen Third People's Hospital, Shenzhen, 518114, China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy Sciences, Beijing, 100049, China
- Center for Influenza Research and Early Warning, Chinese Academy of Sciences, Beijing, 100101, China
| | - George F Gao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yingxia Liu
- Shenzhen Key Laboratory of Pathogen and Immunity, Shenzhen Third People's Hospital, Shenzhen, 518114, China.
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10
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Shi Y, Shi X, Liang J, Luo J, Ba J, Chen J, Wu B. Aggravated MRSA pneumonia secondary to influenza A virus infection is derived from decreased expression of IL-1β. J Med Virol 2020; 92:3047-3056. [PMID: 32697385 PMCID: PMC7692898 DOI: 10.1002/jmv.26329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/15/2020] [Indexed: 12/29/2022]
Abstract
Secondary methicillin-resistant Staphylococcus aureus (MRSA) infection is a cause of severe pneumonia with high mortality during influenza A virus (IAV) pandemics. Alveolar macrophages (AMs) mount cellular defenses against IAV and MRSA infection, which occurs via the nucleotide-binding domain-like receptor protein 3 (NLRP3) inflammasome. However, the activity and function of the NLRP3 inflammasome in MRSA pneumonia secondary to IAV infection remain unclear. To clarify this, we studied MRSA infection secondary to IAV both in vitro and in mouse model. The expression of the NLRP3 inflammasome was evaluated by quantitative reverse transcription polymerase chain reaction, immunofluorescence, Western blot, and enzyme-linked immunosorbent assay. The lung pathology and the rate of weight change were observed. We found that IAV infection for 1 week activated NLRP3 inflammasome. The enhanced expression of NLRP3, caspase-1, and cleaved caspase-1 was associated with MRSA infection secondary to IAV, but the expression of interleukin (IL)-1β decreased in superinfection with MRSA both in vitro and in vivo. The aggravated inflammatory pathology in MRSA pneumonia secondary to IAV infection was associated with decreased expression of IL-1β. And increased weight loss in MRSA pneumonia secondary to IAV infection was related to decreased concentration of IL-1β in serum. It infers that superinfection with MRSA reduces expression of IL-1β someway, and decreased expression of IL-1β impairs the host immunity and leads to aggravated pneumonia. These results contributed to our understanding of the detailed activity of the NLRP3 inflammasome, IL-1β, and their relationship with aggravation of MRSA pneumonia secondary to IAV infection. Immunotherapy targeting the IL-1β signaling pathway could be possible therapeutic strategy for secondary MRSA pneumonia.
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Affiliation(s)
- Yunfeng Shi
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Xiaohan Shi
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jingjing Liang
- Department of EmergencyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jinmei Luo
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Junhui Ba
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jianning Chen
- Department of PathologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Benquan Wu
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
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11
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Abideen AZ, Mohamad FB, Hassan MR. Mitigation strategies to fight the COVID-19 pandemic—present, future and beyond. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-04-2020-0109] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PurposeThe latest novel coronavirus disease 2019 (COVID-19) pandemic continues to have a significant social and financial impact globally. It is very essential to study, categorize and systematize published research on mitigation strategies adopted during previous pandemic scenario that could provide an insight into improving the current crisis. The goal of this paper is to systematize and identify gaps in previous research and suggest potential recommendations as a conceptual framework from a strategic point of view.Design/methodology/approachA systematic review of Scopus and Web of Science (WoS) core collection databases was performed based on strict keyword search selections followed by a bibliometric meta-analysis of the final dataset.FindingsThis study indicated that the traditional mitigation techniques adopted during past pandemics are in place but are not capable of managing the transmission capability and virulence of COVID-19. There is a greater need for rethinking and re-engineering short and long-term approaches to prevent, control and contain the current pandemic situation.Practical implicationsIntegrating various mitigation approaches shall assist in flattening the pandemic curve and help in the long run.Originality/valueArticles, conference proceedings, books, book chapters and other references from two extensive databases (Scopus and WoS) were purposively considered for this study. The search was confined to the selected keywords outlined in the methodology section of this paper.
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12
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Normal modes analysis and surface electrostatics of haemagglutinin proteins as fingerprints for high pathogenic type A influenza viruses. BMC Bioinformatics 2020; 21:354. [PMID: 32838732 PMCID: PMC7445075 DOI: 10.1186/s12859-020-03563-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Type A influenza viruses circulate and spread among wild birds and mostly consist of low pathogenic strains. However, fast genome variation timely results in the insurgence of high pathogenic strains, which when infecting poultry birds may cause a million deaths and strong commercial damage. More importantly, the host shift may concern these viruses and sustained human-to-human transmission may result in a dangerous pandemic outbreak. Therefore, fingerprints specific to either low or high pathogenic strains may represent a very important tool for global surveillance. Results We combined Normal Modes Analysis and surface electrostatic analysis of a mixed strain dataset of influenza A virus haemagglutinins from high and low pathogenic strains in order to infer specific fingerprints. Normal Modes Analysis sorted the strains in two different, homogeneous clusters; sorting was independent of clades and specific instead to high vs low pathogenicity. A deeper analysis of fluctuations and flexibility regions unveiled a special role for the 110-helix region. Specific sorting was confirmed by surface electrostatics analysis, which further allowed to focus on regions and mechanisms possibly crucial to the low-to-high transition. Conclusions Evidence from previous work demonstrated that changes in surface electrostatics are associated with the evolution and spreading of avian influenza A virus clades, and seemingly involved also in the avian to mammalian host shift. This work shows that a combination of electrostatics and Normal Modes Analysis can also identify fingerprints specific to high and low pathogenicity. The possibility to predict which specific mutations may result in a shift to high pathogenicity may help in surveillance and vaccine development.
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13
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Zou L, Dai L, Zhang Y, Fu W, Gao Y, Zhang Z, Zhang Z. Clinical Characteristics and Risk Factors for Disease Severity and Death in Patients With Coronavirus Disease 2019 in Wuhan, China. Front Med (Lausanne) 2020; 7:532. [PMID: 32903644 PMCID: PMC7438719 DOI: 10.3389/fmed.2020.00532] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/28/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: To describe the clinical manifestations and outcomes of COVID-19, and explore the risk factors of deterioration and death of the disease. Methods: In this retrospective study, we collected data from 121 COVID-19 cases confirmed by RT-PCR and next-generation sequencing in Renmin Hospital of Wuhan University from January 30, 2019, to March 23, 2020, and conducted statistical analysis. Results: A total of 121 patients were included in our study, the median age was 65 years (IQR, 55.0-71.5 years), and 54.5% cases were men. Among those cases, 52 (43.0%) cases progressed to severe, and 14 (11.6%) died. Overall, the most common manifestations were fever (78.5%) and respiratory symptoms (77.7%), while neurological symptoms were found in only 9.9% of the patients. 70.2% of all the cases had comorbidities, including hypertension (40.5%) and diabetes (20.7%). On admission, cases usually show elevated levels of neutrophils (27.3%), D-dimer (72.6%), Interleukin-6 (35.2%), Interleukin-10 (64.4%), high-sensitivity C-reactive protein (82.6%), and lactate dehydrogenase (62.0%), and decreased levels of lymphocytes (66.9%), CD3 cells (67.2%), and CD4 cells (63.0%). The proportional hazard Cox models showed that the risk factors for severity progression and death included comorbidities (HR: 4.53, 95% CI: 1.78-11.55 and HR: 7.81, 95% CI: 1.02-59.86), leukocytosis (HR: 1.13; 95% CI: 1.05-1.22 and HR: 1.25, 95% CI: 1.10-1.42), neutrophilia (HR: 1.15, 95% CI: 1.07-1.13 and HR: 1.28, 95% CI: 1.13-1.46, and elevated LDH (HR: 1.14, 95% CI: 1.12-1.15 and HR: 1.11, 95% CI: 1.10-1.12). Elevated D-dimer (HR: 1.02, 95% CI: 1.01-1.03), IL-6 (HR: 1.01, 95% CI: 1.00-1.02) and IL-10 levels (HR: 1.04, 95% CI: 1.01-1.07) were also risk factors for the progression of disease severity. Meanwhile, lymphopenia and wake immune responses [e.g., lower CD3, CD4, or CD19 counts (all HR < 1)] were associated with disease deterioration and death. Conclusions: Severe cases and death of COVID-19 are associated with older age, comorbidities, organ dysfunction, lymphopenia, high cytokines, and weak immune responses.
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Affiliation(s)
- Li Zou
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijun Dai
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yangyang Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Gao
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhaohui Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhentao Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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14
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Xu PP, Tian RH, Luo S, Zu ZY, Fan B, Wang XM, Xu K, Wang JT, Zhu J, Shi JC, Chen F, Wan B, Yan ZH, Wang RP, Chen W, Fan WH, Zhang C, Lu MJ, Sun ZY, Zhou CS, Zhang LN, Xia F, Qi L, Zhang W, Zhong J, Liu XX, Zhang QR, Lu GM, Zhang LJ. Risk factors for adverse clinical outcomes with COVID-19 in China: a multicenter, retrospective, observational study. Am J Cancer Res 2020; 10:6372-6383. [PMID: 32483458 PMCID: PMC7255028 DOI: 10.7150/thno.46833] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/04/2020] [Indexed: 01/08/2023] Open
Abstract
Background: The risk factors for adverse events of Coronavirus Disease-19 (COVID-19) have not been well described. We aimed to explore the predictive value of clinical, laboratory and CT imaging characteristics on admission for short-term outcomes of COVID-19 patients. Methods: This multicenter, retrospective, observation study enrolled 703 laboratory-confirmed COVID-19 patients admitted to 16 tertiary hospitals from 8 provinces in China between January 10, 2020 and March 13, 2020. Demographic, clinical, laboratory data, CT imaging findings on admission and clinical outcomes were collected and compared. The primary endpoint was in-hospital death, the secondary endpoints were composite clinical adverse outcomes including in-hospital death, admission to intensive care unit (ICU) and requiring invasive mechanical ventilation support (IMV). Multivariable Cox regression, Kaplan-Meier plots and log-rank test were used to explore risk factors related to in-hospital death and in-hospital adverse outcomes. Results: Of 703 patients, 55 (8%) developed adverse outcomes (including 33 deceased), 648 (92%) discharged without any adverse outcome. Multivariable regression analysis showed risk factors associated with in-hospital death included ≥ 2 comorbidities (hazard ratio [HR], 6.734; 95% CI; 3.239-14.003, p < 0.001), leukocytosis (HR, 9.639; 95% CI, 4.572-20.321, p < 0.001), lymphopenia (HR, 4.579; 95% CI, 1.334-15.715, p = 0.016) and CT severity score > 14 (HR, 2.915; 95% CI, 1.376-6.177, p = 0.005) on admission, while older age (HR, 2.231; 95% CI, 1.124-4.427, p = 0.022), ≥ 2 comorbidities (HR, 4.778; 95% CI; 2.451-9.315, p < 0.001), leukocytosis (HR, 6.349; 95% CI; 3.330-12.108, p < 0.001), lymphopenia (HR, 3.014; 95% CI; 1.356-6.697, p = 0.007) and CT severity score > 14 (HR, 1.946; 95% CI; 1.095-3.459, p = 0.023) were associated with increased odds of composite adverse outcomes. Conclusion: The risk factors of older age, multiple comorbidities, leukocytosis, lymphopenia and higher CT severity score could help clinicians identify patients with potential adverse events.
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15
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Okello PE, Majwala RK, Kalani R, Kwesiga B, Kizito S, Kabwama SN, Bulage L, Ndegwa LK, Ochieng M, Harris JR, Hunsperger E, Kajumbula H, Kadobera D, Zhu BP, Chaves SS, Ario AR, Widdowson MA. Investigation of a Cluster of Severe Respiratory Disease Referred from Uganda to Kenya, February 2017. Health Secur 2020; 18:96-104. [PMID: 32324075 DOI: 10.1089/hs.2019.0107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
On February 22, 2017, Hospital X-Kampala and US CDC-Kenya reported to the Uganda Ministry of Health a respiratory illness in a 46-year-old expatriate of Company A. The patient, Mr. A, was evacuated from Uganda to Kenya and died. He had recently been exposed to dromedary camels (MERS-CoV) and wild birds with influenza A (H5N6). We investigated the cause of illness, transmission, and recommended control. We defined a suspected case of severe acute respiratory illness (SARI) as acute onset of fever (≥38°C) with sore throat or cough and at least one of the following: headache, lethargy, or difficulty in breathing. In addition, we looked at cases with onset between February 1 and March 31 in a person with a history of contact with Mr. A, his family, or other Company A employees. A confirmed case was defined as a suspected case with laboratory confirmation of the same pathogen detected in Mr. A. Influenza-like illness was defined as onset of fever (≥38°C) and cough or sore throat in a Uganda contact, and as fever (≥38°C) and cough lasting less than 10 days in a Kenya contact. We collected Mr. A's exposure and clinical history, searched for cases, and traced contacts. Specimens from the index case were tested for complete blood count, liver function tests, plasma chemistry, Influenza A(H1N1)pdm09, and MERS-CoV. Robust field epidemiology, laboratory capacity, and cross-border communication enabled investigation.
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Affiliation(s)
- Paul Edward Okello
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Robert Kaos Majwala
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Rosalia Kalani
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Benon Kwesiga
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Susan Kizito
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Steven N Kabwama
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Lilian Bulage
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Linus K Ndegwa
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Melvin Ochieng
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Julie R Harris
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Elizabeth Hunsperger
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Henry Kajumbula
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Daniel Kadobera
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Bao-Ping Zhu
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Sandra S Chaves
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Alex Riolexus Ario
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Marc-Alain Widdowson
- Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
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Dzieciatkowski T, Szarpak L, Filipiak KJ, Jaguszewski M, Ladny JR, Smereka J. COVID-19 challenge for modern medicine. Cardiol J 2020; 27:175-183. [PMID: 32286679 PMCID: PMC8016041 DOI: 10.5603/cj.a2020.0055] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 12/24/2022] Open
Abstract
Coronaviruses cause disease in animals and people around the world. Human coronaviruses (HCoV) are mainly known to cause infections of the upper and lower respiratory tract but the symptoms may also involve the nervous and digestive systems. Since the beginning of December 2019, there has been an epidemic of SARS-CoV-2, which was originally referred to as 2019-nCoV. The most common symptoms are fever and cough, fatigue, sputum production, dyspnea, myalgia, arthralgia or sore throat, headache, nausea, vomiting or diarrhea (30%). The best prevention is to avoid exposure. In addition, contact per-sons should be subjected to mandatory quarantine. COVID-19 patients should be treated in specialist centers. A significant number of patients with pneumonia require passive oxygen therapy. Non-invasive ventilation and high-flow nasal oxygen therapy can be applied in mild and moderate non-hypercapnia cases. A lung-saving ventilation strategy must be implemented in acute respiratory distress syndrome and mechanically ventilated patients. Extracorporeal membrane oxygenation is a highly specialized method, available only in selected centers and not applicable to a significant number of cases. Specific pharmacological treatment for COVID-19 is not currently available. Modern medicine is gearing up to fight the new coronavirus pandemic. The key is a holistic approach to the patient including, primar-ily, the use of personal protective equipment to reduce the risk of further virus transmission, as well as patient management, which consists in both quarantine and, in the absence of specific pharmacological therapy, symptomatic treatment.
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Affiliation(s)
- Tomasz Dzieciatkowski
- Chair and Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland, Warsaw
| | - Milosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Jerzy R Ladny
- Clinic of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
- Polish Society of Disaster Medicine, Warsaw, Poland
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Tahir MF, Abbas MA, Ghafoor T, Dil S, Shahid MA, Bullo MMH, Ain QU, Abbas Ranjha M, Khan MA, Naseem MT. Seroprevalence and risk factors of avian influenza H9 virus among poultry professionals in Rawalpindi, Pakistan. J Infect Public Health 2020; 13:414-417. [PMID: 32144018 DOI: 10.1016/j.jiph.2020.02.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/12/2018] [Accepted: 11/16/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Avian influenza H9 is endemic in commercial and backyard poultry in Pakistan and is a serious occupational health hazard to industry workers. This study aimed to determine the seroprevalence of avian influenza H9 infection in people working with poultry in Rawalpindi, Pakistan and assess the measures they took to protect themselves from infection. METHODS A cross-sectional study was conducted from December 2016 to May 2017 of 419 people working with poultry in Rawalpindi Division, including farm workers, vaccinators, field veterinarians, butchers and staff working in diagnostic laboratories. Potential participants were randomly approached and gave written consent to participate. Data were collected using a standardized questionnaire and serum samples were processed to detect H9 antibodies using the haemagglutination inhibition test. RESULTS Of the 419 participants, 406 (96.9%) were male. The mean age of the participants was 36.4 (SD 10.86) years. A total of 332 participants agreed to a blood test, 167 of whom were positive for A(H9) antibodies, giving an overall seroprevalence of 50.3%. Laboratory staff had the highest seroprevalence (100%) and veterinarians the lowest (38.5%). Vaccinators, butchers and farm workers had a seroprevalence of 83.3%, 52.4% and 45.5% respectively. Personals who used facemasks had significantly lower (P<0.002) seroprevalence (29.6%) than those who never used them (90.6%). Similarly, those who always used gloves and washed their hands with soap had a seroprevalence of 32.8% compared with 89.0% in those who never took these precautions. Of the participants who handled antigens, 92.3% were seropositive. CONCLUSION Laboratory staff and vaccinators are exposed to viral cultures and influenza vaccines respectively which may explain their high seroprevalence.
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Affiliation(s)
- Muhammad Farooq Tahir
- Poultry Research Institute, Rawalpindi, Punjab, Pakistan; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan.
| | | | - Tamkeen Ghafoor
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan
| | - Saima Dil
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Livestock and Dairy Development Department, Punjab, Pakistan
| | - Muhammad Akbar Shahid
- Department of Pathobiology, Faculty of Veterinary Science, Bahauddin Zakariya University, Multan, Pakistan
| | - Mir Muhammad Hassan Bullo
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Federal General Hospital, Islamabad, Pakistan
| | - Qurat Ul Ain
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Veterinary Research Institute, Quetta, Balochistan, Pakistan
| | | | - Mumtaz Ali Khan
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; National Institute of Health, Islamabad, Pakistan
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18
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Experimental pathology of two highly pathogenic H5N1 viruses isolated from crows in BALB/c mice. Microb Pathog 2020; 141:103984. [PMID: 31972269 DOI: 10.1016/j.micpath.2020.103984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/28/2019] [Accepted: 01/15/2020] [Indexed: 12/27/2022]
Abstract
In this study, we assessed the pathogenicity of two H5N1 viruses isolated from crows in mice. Eighteen 6-8 weeks BALB/c mice each were intranasally inoculated with 106 EID50/ml of H5N1 viruses A/crow/India/03CA04/2015 (H9N2-PB2 reassortant H5N1) and A/crow/India/02CA01/2012 (Non-reassortant H5N1). The infected mice showed dullness, weight loss and ruffled fur coat. Histopathological examination of lungs showed severe congestion, haemorrhage, thrombus, fibrinous exudate in perivascular area, interstitial septal thickening, bronchiolitis and alveolitis leading to severe pneumonic changes and these lesions were less pronounced in reassortant virus infected mice. Viral replication was demonstrated in nasal mucosa, lungs, trachea and brain in both the groups. Brain, lung, nasal mucosa and trachea showed significantly higher viral RNA copies and presence of antigen in immunohistochemistry in both the groups. This study concludes that both the crow viruses caused morbidity and mortality in mice and the viruses were phenotypically highly virulent in mice. The H5N1 viruses isolated from synanthropes pose a serious public health concern and should be monitored continuously for their human spill-over.
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Guo L, Wei D, Zhang X, Wu Y, Li Q, Zhou M, Qu J. Clinical Features Predicting Mortality Risk in Patients With Viral Pneumonia: The MuLBSTA Score. Front Microbiol 2019; 10:2752. [PMID: 31849894 PMCID: PMC6901688 DOI: 10.3389/fmicb.2019.02752] [Citation(s) in RCA: 278] [Impact Index Per Article: 55.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022] Open
Abstract
Objective The aim of this study was to further clarify clinical characteristics and predict mortality risk among patients with viral pneumonia. Methods A total of 528 patients with viral pneumonia at RuiJin hospital in Shanghai from May 2015 to May 2019 were recruited. Multiplex real-time RT-PCR was used to detect respiratory viruses. Demographic information, comorbidities, routine laboratory examinations, immunological indexes, etiological detections, radiological images and treatment were collected on admission. Results 76 (14.4%) patients died within 90 days in hospital. A predictive MuLBSTA score was calculated on the basis of a multivariate logistic regression model in order to predict mortality with a weighted score that included multilobular infiltrates (OR = 5.20, 95% CI 1.41–12.52, p = 0.010; 5 points), lymphocyte ≤ 0.8∗109/L (OR = 4.53, 95% CI 2.55–8.05, p < 0.001; 4 points), bacterial coinfection (OR = 3.71, 95% CI 2.11–6.51, p < 0.001; 4 points), acute-smoker (OR = 3.19, 95% CI 1.34–6.26, p = 0.001; 3 points), quit-smoker (OR = 2.18, 95% CI 0.99–4.82, p = 0.054; 2 points), hypertension (OR = 2.39, 95% CI 1.55–4.26, p = 0.003; 2 points) and age ≥60 years (OR = 2.14, 95% CI 1.04–4.39, p = 0.038; 2 points). 12 points was used as a cut-off value for mortality risk stratification. This model showed sensitivity of 0.776, specificity of 0.778 and a better predictive ability than CURB-65 (AUROC = 0.773 vs. 0.717, p < 0.001). Conclusion Here, we designed an easy-to-use clinically predictive tool for assessing 90-day mortality risk of viral pneumonia. It can accurately stratify hospitalized patients with viral pneumonia into relevant risk categories and could provide guidance to make further clinical decisions.
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Affiliation(s)
- Lingxi Guo
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Wei
- Research Laboratory of Clinical Virology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Infectious Diseases, Institute of Infectious and Respiratory Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinxin Zhang
- Research Laboratory of Clinical Virology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Infectious Diseases, Institute of Infectious and Respiratory Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Clinical Research Center, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yurong Wu
- Department of Respiratory Medicine, The Third People's Hospital of Zhengzhou, Henan, China
| | - Qingyun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieming Qu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Li G, Zhou L, Zhang C, Shi Y, Dong D, Bai M, Wang R, Zhang C. Insulin-Like Growth Factor 1 Regulates Acute Inflammatory Lung Injury Mediated by Influenza Virus Infection. Front Microbiol 2019; 10:2541. [PMID: 31849847 PMCID: PMC6887893 DOI: 10.3389/fmicb.2019.02541] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/21/2019] [Indexed: 12/28/2022] Open
Abstract
The acute inflammatory lung injury is an important cause of death due to influenza A virus (IAV) infection. Insulin-like growth factor 1 (IGF1) played an important role in the regulation of inflammation in the immune system. To investigate the role of IGF1 in IAV-mediated acute inflammatory lung injury, the expression of IGF1 and inflammatory cytokines was tested after IAV A/Puerto Rico/8/1934 (H1N1; abbreviated as PR8) infection in A549 cells. Then, a BALB/c mouse model of PR8 infection was established. On days 3, 5, 7, and 9 post-infection, the mice lung tissue was collected to detect the expression changes in IGF1 mRNA and protein. The mice were divided into four groups: (1) PBS (abbreviation of phosphate buffered saline); (2) PR8 + PBS; (3) PR8 + IGF1; and (4) PR8 + PPP (abbreviation of picropodophyllin, the IGF1 receptor inhibitor). The body weight and survival rate of the mice were monitored daily, and the clinical symptoms of the mice were recorded. On day 5 post-infection, the mice were sacrificed to obtain the serum and lung tissues. The expression of inflammatory cytokines in the serum was detected by enzyme linked immunosorbent assay; lung injury was observed by hematoxylin-eosin staining; the viral proliferation in the lung was detected by real-time quantitative PCR; and the protein expression of the main molecules in the phosphatidylinositol-3-kinases/protein kinase B (PI3K/AKT) and mitogen-activated protein kinase (MAPK) signaling pathways was detected by Western blot. It was found that IGF1 expression is upregulated in A549 cells and BALB/c mice infected with PR8, whereas IGF1 regulated the expression of inflammatory cytokines induced by PR8 infection. Overexpression of IGF1 aggravated the IAV-mediated inflammatory response, whereas the inhibition of IGF1 receptor reduced such inflammatory response. The phosphorylation of IGF1 receptor triggered the PI3K/AKT and MAPK signaling pathways to induce an inflammatory response after IAV infection. Therefore, IGF1 plays an important immune function in IAV-mediated acute inflammatory lung injury. IGF1 may provide a therapeutic target for humans in response to an influenza outbreak, and inhibition of IGF1 or IGF1 receptor may represent a novel approach to influenza treatment.
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Affiliation(s)
- Guiping Li
- Center for Hygienic Assessment and Research, Center for Disease Control and Prevention of Chinese PLA, Beijing, China
- College of Life Science, Huaibei Normal University, Huaibei, China
| | - Lijuan Zhou
- Center for Hygienic Assessment and Research, Center for Disease Control and Prevention of Chinese PLA, Beijing, China
- College of Life Science, Huaibei Normal University, Huaibei, China
| | - Can Zhang
- Center for Hygienic Assessment and Research, Center for Disease Control and Prevention of Chinese PLA, Beijing, China
| | - Yun Shi
- Center for Hygienic Assessment and Research, Center for Disease Control and Prevention of Chinese PLA, Beijing, China
| | - Derong Dong
- Center for Hygienic Assessment and Research, Center for Disease Control and Prevention of Chinese PLA, Beijing, China
| | - Miao Bai
- Center for Hygienic Assessment and Research, Center for Disease Control and Prevention of Chinese PLA, Beijing, China
| | - Rong Wang
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
| | - Chuanfu Zhang
- Center for Hygienic Assessment and Research, Center for Disease Control and Prevention of Chinese PLA, Beijing, China
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21
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Sodhi CP, Nguyen J, Yamaguchi Y, Werts AD, Lu P, Ladd MR, Fulton WB, Kovler ML, Wang S, Prindle T, Zhang Y, Lazartigues ED, Holtzman MJ, Alcorn JF, Hackam DJ, Jia H. A Dynamic Variation of Pulmonary ACE2 Is Required to Modulate Neutrophilic Inflammation in Response to Pseudomonas aeruginosa Lung Infection in Mice. THE JOURNAL OF IMMUNOLOGY 2019; 203:3000-3012. [PMID: 31645418 DOI: 10.4049/jimmunol.1900579] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/26/2019] [Indexed: 12/15/2022]
Abstract
Angiotensin-converting enzyme 2 (ACE2) is a potent negative regulator capable of restraining overactivation of the renin-angiotensin system, which contributes to exuberant inflammation after bacterial infection. However, the mechanism through which ACE2 modulates this inflammatory response is not well understood. Accumulating evidence indicates that infectious insults perturb ACE2 activity, allowing for uncontrolled inflammation. In the current study, we demonstrate that pulmonary ACE2 levels are dynamically varied during bacterial lung infection, and the fluctuation is critical in determining the severity of bacterial pneumonia. Specifically, we found that a pre-existing and persistent deficiency of active ACE2 led to excessive neutrophil accumulation in mouse lungs subjected to bacterial infection, resulting in a hyperinflammatory response and lung damage. In contrast, pre-existing and persistent increased ACE2 activity reduces neutrophil infiltration and compromises host defense, leading to overwhelming bacterial infection. Further, we found that the interruption of pulmonary ACE2 restitution in the model of bacterial lung infection delays the recovery process from neutrophilic lung inflammation. We observed the beneficial effects of recombinant ACE2 when administered to bacterially infected mouse lungs following an initial inflammatory response. In seeking to elucidate the mechanisms involved, we discovered that ACE2 inhibits neutrophil infiltration and lung inflammation by limiting IL-17 signaling by reducing the activity of the STAT3 pathway. The results suggest that the alteration of active ACE2 is not only a consequence of bacterial lung infection but also a critical component of host defense through modulation of the innate immune response to bacterial lung infection by regulating neutrophil influx.
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Affiliation(s)
- Chhinder P Sodhi
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Jenny Nguyen
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
| | - Yukihiro Yamaguchi
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Adam D Werts
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Peng Lu
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Mitchell R Ladd
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - William B Fulton
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Mark L Kovler
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Sanxia Wang
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Thomas Prindle
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Yong Zhang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110
| | - Eric D Lazartigues
- Department of Pharmacology and Experimental Therapeutics, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112.,Southeast Louisiana Veterans Health Care System, New Orleans, LA 70119; and
| | - Michael J Holtzman
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110
| | - John F Alcorn
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15224
| | - David J Hackam
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Hongpeng Jia
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205;
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22
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Yan L, Wang H, Sun L, Liu Y, Sun J, Zhao X, Li Y, Xie X, Hu J. An epitope on the stem region of hemagglutinin of H1N1 influenza A virus recognized by neutralizing monoclonal antibody. Biochem Biophys Res Commun 2019; 518:319-324. [DOI: 10.1016/j.bbrc.2019.08.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/09/2019] [Indexed: 11/26/2022]
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23
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Abstract
RATIONALE H7N9 infection causes acute respiratory distress syndrome with high mortality. The use of glucocorticoids in the acute phase lessened inflammatory responses. Some case reports suggested that secondary organizing pneumonia (SOP) could occur at the recovery stage of the influenza virus infection, and the treatment with glucocorticoid was effective. However, the reports of organizing pneumonia after H7N9 infection are lacking. This study reported a patient with H7N9 virus infection who presented a suspected SOP during the recovery stage. PATIENT CONCERN A 68-year-old woman who was diagnosed with H7N9 viral pneumonia. After standard antiviral treatment, venous-venous extracorporeal membranous oxygenation (VV-ECMO) and other supportive treatment, the antigen in the alveolar lavage fluid turned negative, and the shadow in the lung was partially absorbed. However, the imaging manifestations were deteriorated at 3 weeks after disease onset, presented as exudation and consolidation shadow distributed under the pleura and along the bronchial vascular bundles. The oxygenation could not be improved. Repeated sputum, alveolar lavage fluid, and blood pathogen examinations showed negative results. Broad-spectrum anti-infective treatment was ineffective. However, the autoantibodies (ANA, anti-SSA/Ro60, anti-SSA/Ro52) were detected. DIAGNOSIS SOP was considered. INTERVENTIONS Glucocorticoid treatment begun at week 4 from the disease onset. The regimen was methylprednisolone at an initial dose of 40 mg twice a day for 1 week, tapering within 70 days until total withdrawal. OUTCOMES The oxygenation was rapidly improved after initiation of methylprednisolone. The shadow in the lung gradually resolved, and the patient was discharged after improvement of the disease condition. The clinical disease course, imaging findings, and treatment effects in the previous cases of SOP after influenza virus infection were similar to those in this case, suggesting the occurrence of SOP after H7N9 virus infection. LESSONS Organizing pneumonia might occur during the recovery stage of influenza virus infection. When the clinical symptoms do not improve and the shadow in the lung shows no obvious absorption after elimination of the H7N9 influenza virus, or the clinical symptoms are aggravated again after improvement, the probability of transforming into the organizing pneumonia should be taken into consideration.
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Affiliation(s)
| | | | | | - Jiahao Su
- Department of Neurosurgery, Zhongshan City People's Hospital, Zhongshan, China
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24
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Abstract
Influenza pandemics with different extent occur every year in the world. It can cause high morbidity and mortality, arouse fear panic in public, and attract extensive attention worldwide. This paper reviews the research progress in epidemiological characteristics, detection methods, pathogenesis, treatment and prophylactic measures of influenza in China. It will be helpful for us to understand the current situation of influenza.
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25
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He J, Li Z, Huang W, Guan W, Ma H, Yang ZF, Wang X. Efficacy and safety of Chou-Ling-Dan granules in the treatment of seasonal influenza via combining Western and traditional Chinese medicine: protocol for a multicentre, randomised controlled clinical trial. BMJ Open 2019; 9:e024800. [PMID: 30944133 PMCID: PMC6500347 DOI: 10.1136/bmjopen-2018-024800] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 01/17/2019] [Accepted: 01/28/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Chou-Ling-Dan (CLD) (Laggerapterodonta) granules are an ethnic herbal medicine from Yunnan province of China. CLD granules have been used for the treatment of inflammatory conditions and feverish diseases in China, including seasonal influenza, but few evidence-based medicine (EBM) clinical studies have been conducted to assess its efficacy and safety in the treatment of influenza. Here, we performed an EBM clinical trial combining Western Chinese medicine and traditional Chinese medicine (TCM) evaluation systems to evaluate the efficacy and safety of CLD granules in the treatment of seasonal influenza. METHODS AND ANALYSIS The study is designed as a multicentre, randomised, double-blinded, double-simulation, oseltamivir-controlled and placebo-controlled, parallel-design clinical trial. Eligible subjects (n=318) will be allocated after satisfying the criteria (Western medicine). Subjects will be randomised to receive CLD granules, oseltamivir, or a placebo for 5 days of treatment and with follow-up after treatment to record symptoms and signs and to collect pharyngeal/throat swabs and serum samples for detecting the virus and antibodies. At the same time, the syndrome differentiation criteria of TCM, such as tongue body, furred tongue and type of pulse, will be recorded as determined by doctors of both Western and Chinese medicine. Participants will be instructed to comply with the protocol and to keep a daily record of symptoms. The primary and secondary outcomes and safety indicators will be used to evaluate the efficacy and safety of CLD granules in the treatment of seasonal influenza based on both Western Chinese medicine and TCM evaluation systems. ETHICS AND DISSEMINATION The CLD granules clinical trial will be conducted in accordance with the Declaration of Helsinki and Good Clinical Practice and has been approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University. All participants must provide written informed consent. The results obtained will be disseminated at international medical conferences and in peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT02662426; Pre-results.
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Affiliation(s)
- Jiayang He
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Tropical Medicine Institute, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhengtu Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wanyi Huang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenda Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China
| | - Zi feng Yang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xinhua Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China
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26
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Cho HM, Doan TP, Ha TKQ, Kim HW, Lee BW, Pham HTT, Cho TO, Oh WK. Dereplication by High-Performance Liquid Chromatography (HPLC) with Quadrupole-Time-of-Flight Mass Spectroscopy (qTOF-MS) and Antiviral Activities of Phlorotannins from Ecklonia cava. Mar Drugs 2019; 17:E149. [PMID: 30836593 PMCID: PMC6471242 DOI: 10.3390/md17030149] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 01/13/2023] Open
Abstract
Ecklonia cava is edible seaweed that is found in Asian countries, such as Japan and Korea; and, its major components include fucoidan and phlorotannins. Phlorotannins that are isolated from E. cava are well-known to have an antioxidant effect and strong antiviral activity against porcine epidemic diarrhea virus (PEDV), which has a high mortality rate in piglets. In this study, the bioactive components were determined based on two different approaches: (i) bio-guided isolation using the antiviral activity against the H1N1 viral strain, which is a representative influenza virus that originates from swine and (ii) high-resolution mass spectrometry-based dereplication, including relative mass defects (RMDs) and HPLC-qTOFMS fragmentation analysis. The EC70 fraction showed the strongest antiviral activity and contained thirteen phlorotannins, which were predicted by dereplication. Ten compounds were directly isolated from E. cava extract and then identified. Moreover, the dereplication method allowed for the discovery of two new phlorotannins. The structures of these two isolated compounds were elucidated using NMR techniques and HPLC-qTOFMS fragmentation analysis. In addition, molecular modelling was applied to determine the absolute configurations of the two new compounds. The antiviral activities of seven major phlorotannins in active fraction were evaluated against two influenza A viral strains (H1N1 and H9N2). Six of the compounds showed moderate to strong effects on both of the viruses and phlorofucofuroeckol A (12), which showed an EC50 value of 13.48 ± 1.93 μM, is a potential active antiviral component of E. cava.
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Affiliation(s)
- Hyo Moon Cho
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Thi Phuong Doan
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Thi Kim Quy Ha
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Hyun Woo Kim
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Ba Wool Lee
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Ha Thanh Tung Pham
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Tae Oh Cho
- Marine Bio Research Center, Department of Life Science, Chosun University, Gwangju 501-759, Korea.
| | - Won Keun Oh
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, Korea.
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27
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Naguib MM, Harder T. Endemic situation of multiple avian influenza strains in poultry in Egypt: A continuing nightmare. Zoonoses Public Health 2019; 65:908-910. [PMID: 30369095 DOI: 10.1111/zph.12486] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mahmoud M Naguib
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Infectious Medicine, Uppsala University, Uppsala, Sweden.,National Laboratory for Veterinary Quality Control on Poultry Production, Animal Health Research Institute, Giza, Egypt
| | - Timm Harder
- Friedrich-Loeffler-Institut, Federal Research Institute for AnimalHealth, GreifswaldInsel-Riems, Germany
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28
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Zhang J, Su R, Jian X, An H, Jiang R, Mok CKP. The D253N Mutation in the Polymerase Basic 2 Gene in Avian Influenza (H9N2) Virus Contributes to the Pathogenesis of the Virus in Mammalian Hosts. Virol Sin 2018; 33:531-537. [PMID: 30569291 DOI: 10.1007/s12250-018-0072-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/13/2018] [Indexed: 12/12/2022] Open
Abstract
Mutations in the polymerase basic 2 (PB2) gene of avian influenza viruses are important signatures for their adaptation to mammalian hosts. Various adaptive mutations have been identified around the 627 and nuclear localization sequence (NLS) domains of PB2 protein, and these mutations contribute to the replicative ability of avian influenza viruses. However, few studies have focused on adaptive mutations in other regions of PB2. In this study, we investigated the functional roles of the D253N mutation in PB2 in an H9N2 virus. This mutation was found to affect an amino acid residue in the middle domain of the PB2 protein. The virus with the D253N mutation showed higher polymerase activity and transiently increased viral replication in human cells. However, the mutant did not show significant differences in viral replication in the respiratory tract of mice upon infection. Our results supported that the D253N mutation in the middle domain of PB2, similar to mutations at the 627 and NLS domains, specifically contributed to the replication of avian influenza viruses in human cells.
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Affiliation(s)
- Jinfeng Zhang
- Laboratory Medicine Center, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, 528200, China
| | - Rong Su
- Laboratory Medicine Center, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, 528200, China
| | - Xiaoyun Jian
- Department of Respiratory Medicine, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, 528200, China
| | - Hongliang An
- Laboratory Medicine Center, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, 528200, China
| | - Ronbing Jiang
- Laboratory Medicine Center, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, 528200, China
| | - Chris Ka Pun Mok
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China. .,HKU-Pasteur Research Pole, School of Public Health, HKU Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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29
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Tahir MF, Abbas MA, Ghafoor T, Dil S, Shahid MA, Bullo MMH, Ain QU, Ranjha MA, Khan MA, Naseem MT. Seroprevalence and risk factors of avian influenza H9 virus among poultry professionals in Rawalpindi, Pakistan. J Infect Public Health 2018; 12:482-485. [PMID: 30578143 DOI: 10.1016/j.jiph.2018.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/12/2018] [Accepted: 11/16/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Avian influenza H9 is endemic in commercial and backyard poultry in Pakistan and is a serious occupational health hazard to industry workers. This study aimed to determine the seroprevalence of avian influenza H9 infection in people working with poultry in Rawalpindi, Pakistan and assess the measures they took to protect themselves from infection. METHODS A cross-sectional study was conducted from December 2016 to May 2017 of 419 people working with poultry in Rawalpindi Division, including farm workers, vaccinators, field veterinarians, butchers and staff working in diagnostic laboratories. Potential participants were randomly approached and gave written consent to participate. Data were collected using a standardized questionnaire and serum samples were processed to detect H9 antibodies using the haemagglutination inhibition test. RESULTS Of the 419 participants, 406 (96.9%) were male. The mean age of the participants was 36.4 (SD 10.86) years. A total of 332 participants agreed to a blood test, 167 of whom were positive for A(H9) antibodies, giving an overall seroprevalence of 50.3%. Laboratory staff had the highest seroprevalence (100%) and veterinarians the lowest (38.5%). Vaccinators, butchers and farm workers had a seroprevalence of 83.3%, 52.4% and 45.5% respectively. Personals who used facemasks had significantly lower (P<0.002) seroprevalence (29.6%) than those who never used them (90.6%). Similarly, those who always used gloves and washed their hands with soap had a seroprevalence of 32.8% compared with 89.0% in those who never took these precautions. Of the participants who handled antigens, 92.3% were seropositive. CONCLUSION Laboratory staff and vaccinators are exposed to viral cultures and influenza vaccines respectively which may explain their high seroprevalence.
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Affiliation(s)
- Muhammad F Tahir
- Poultry Research Institute, Rawalpindi, Punjab, Pakistan; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan.
| | | | - Tamkeen Ghafoor
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan
| | - Saima Dil
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Livestock and Dairy Development Department, Punjab, Pakistan
| | - Muhammad A Shahid
- Department of Pathobiology, Faculty of Veterinary Science, Bahauddin Zakariya University, Multan, Pakistan
| | - Mir M H Bullo
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Federal General Hospital, Islamabad, Pakistan
| | - Qurat Ul Ain
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Veterinary Research Institute, Quetta, Balochistan, Pakistan
| | | | - Mumtaz A Khan
- Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; National Institute of Health, Islamabad, Pakistan
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30
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Abstract
In several lately published studies, the association between single-nucleotide polymorphism (SNP, rs12252) of IFITM3 and the risk of influenza is inconsistent. To further understand the association between the SNP of IFITM3 and the risk of influenza, we searched related studies in five databases including PubMed published earlier than 9 November 2017. Ten sets of data from nine studies were included and data were analysed by Revman 5.0 and Stata 12.0 in our updated meta-analysis, which represented 1365 patients and 5425 no-influenza controls from four different ethnicities. Here strong association between rs12252 and influenza was found in all four genetic models. The significant differences in the allelic model (C vs. T: odds ratio (OR) = 1.35, 95% confidence interval (CI) (1.03–1.79), P = 0.03) and homozygote model (CC vs. TT: OR = 10.63, 95% CI (3.39–33.33), P < 0.00001) in the Caucasian subgroup were discovered, which is very novel and striking. Also novel discoveries were found in the allelic model (C vs. T: OR = 1.37, 95% CI (1.08–1.73), P = 0.009), dominant model (CC + CT vs. TT: OR = 1.48, 95% CI (1.08–2.02), P = 0.01) and homozygote model (CC vs. TT: OR = 2.84, 95% CI (1.36–5.92), P = 0.005) when we compared patients with mild influenza with healthy individuals. Our meta-analysis suggests that single-nucleotide T to C polymorphism of IFITM3 associated with increasingly risk of severe and mild influenza in both Asian and Caucasian populations.
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31
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Xu L, Jiang X, Zhu Y, Duan Y, Huang T, Huang Z, Liu C, Xu B, Xie Z. A Multiplex Asymmetric Reverse Transcription-PCR Assay Combined With an Electrochemical DNA Sensor for Simultaneously Detecting and Subtyping Influenza A Viruses. Front Microbiol 2018; 9:1405. [PMID: 30013525 PMCID: PMC6036258 DOI: 10.3389/fmicb.2018.01405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/07/2018] [Indexed: 12/21/2022] Open
Abstract
The reliable and rapid detection of viral pathogens that cause respiratory infections provide physicians several advantages in treating patients and managing outbreaks. The Luminex respiratory virus panel (RVP) assay has been shown to be comparable to or superior to culture/direct fluorescent-antibody assays (DFAs) and nucleic acid tests that are used to diagnose respiratory viral infections. We developed a multiplex asymmetric reverse transcription (RT)-PCR assay that can simultaneously differentiate all influenza A virus epidemic subtypes. The amplified products were hybridized with an electrochemical DNA sensor, and the results were automatically acquired. The limits of detection (LoDs) of both the Luminex RVP assay and the multiplex RT-PCR-electrochemical DNA sensor were 101 TCID50 for H1N1 virus and 102 TCID50 for H3N2 virus. The specificity assessment of the multiplex RT-PCR-electrochemical DNA sensor showed no cross-reactivity among different influenza A subtypes or with other non-influenza respiratory viruses. In total, 3098 respiratory tract specimens collected from padiatric patients diagnosed with pneumonia were tested. More than half (43, 53.75%) of the specimens positive for influenza A viruses could not be further subtyped using the Luminex RVP assay. Among the remaining 15 specimens that were not subtyped, not degraded, and in sufficient amounts for the multiplex RT-PCR-electrochemical DNA sensor test, all (100%) were H3N2 positive. Therefore, the sensitivity of the Luminex RVP assay for influenza A virus was 46.25%, whereas the sensitivity of the multiplex RT-PCR-electrochemical DNA sensor for the clinical H1N1 and H3N2 specimens was 100%. The sensitivities of the multiplex RT-PCR-electrochemical DNA sensor for the avian H5N1, H5N6, H9N2, and H10N8 viruses were 100%, whereas that for H7N9 virus was 85.19%. We conclude that the multiplex RT-PCR-electrochemical DNA sensor is a reliable method for the rapid and accurate detection of highly variable influenza A viruses in respiratory infections with greater detection sensitivity than that of the Luminex xTAG assay. The high mutation rate of influenza A viruses, particularly H3N2 during the 2014 to 2016 epidemic seasons, has a strong impact on diagnosis. A study involving more positive specimens from all influenza A virus epidemic subtypes is required to fully assess the performance of the assay.
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Affiliation(s)
- Lili Xu
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiwen Jiang
- DAAN Gene Co., Ltd., Sun Yat-sen University, Guangzhou, China.,The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
| | - Yun Zhu
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yali Duan
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Taosheng Huang
- DAAN Gene Co., Ltd., Sun Yat-sen University, Guangzhou, China.,The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
| | - Zhiwen Huang
- DAAN Gene Co., Ltd., Sun Yat-sen University, Guangzhou, China.,The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
| | - Chunyan Liu
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Baoping Xu
- National Clinical Research Center for Respiratory Diseases, Department of Respiratory, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhengde Xie
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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32
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Pandemic Avian Influenza and Intra/Interhaemagglutinin Subtype Electrostatic Variation among Viruses Isolated from Avian, Mammalian, and Human Hosts. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3870508. [PMID: 29888260 PMCID: PMC5985083 DOI: 10.1155/2018/3870508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/12/2018] [Accepted: 03/14/2018] [Indexed: 11/18/2022]
Abstract
Host jump can result in deadly pandemic events when avian influenza A viruses broaden their host specificity and become able to infect mammals, including humans. Haemagglutinin—the major capsid protein in influenza A viruses—is subjected to high rate mutations, of which several occur at its “head”: the receptor-binding domain that mediates specific binding to host cell receptors. Such surface-changing mutations may lead to antigenically novel influenza A viruses hence in pandemics by host jump and in vaccine escape by antigenic drift. Changes in haemagglutinin surface electrostatics have been recently associated with antigenic drift and with clades evolution and spreading in H5N1 and H9N2 viruses. We performed a comparative analysis of haemagglutinin surface electrostatics to investigate clustering and eventual fingerprints among representative pandemic (H5 and H7) and nonpandemic (H4 and H6) avian influenza viral subtypes. We observed preferential sorting of viruses isolated from mammalian/human hosts among these electrostatic clusters of a subtype; however, sorting was not “100% specific” to the different clusters. Therefore, electrostatic fingerprints can help in understanding, but they cannot explain alone the host jumping mechanism.
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Natural Reassortants of Potentially Zoonotic Avian Influenza Viruses H5N1 and H9N2 from Egypt Display Distinct Pathogenic Phenotypes in Experimentally Infected Chickens and Ferrets. J Virol 2017; 91:JVI.01300-17. [PMID: 28931674 DOI: 10.1128/jvi.01300-17] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/11/2017] [Indexed: 12/22/2022] Open
Abstract
The cocirculation of zoonotic highly pathogenic avian influenza virus (HPAIV) of subtype H5N1 and avian influenza virus (AIV) of subtype H9N2 among poultry in Egypt for at least 6 years should render that country a hypothetical hot spot for the emergence of reassortant, phenotypically altered viruses, yet no reassortants have been detected in Egypt. The present investigations proved that reassortants of the Egyptian H5N1 clade 2.2.1.2 virus and H9N2 virus of the G1-B lineage can be generated by coamplification in embryonated chicken eggs. Reassortants were restricted to the H5N1 subtype and acquired between two and all six of the internal segments of the H9N2 virus. Five selected plaque-purified reassortant clones expressed a broad phenotypic spectrum both in vitro and in vivo Two groups of reassortants were characterized to have retarded growth characteristics in vitro compared to the H5N1 parent virus. One clone provoked reduced mortality in inoculated chickens, although the characteristics of a highly pathogenic phenotype were retained. Enhanced zoonotic properties were not predicted for any of these clones, and this prediction was confirmed by ferret inoculation experiments: neither the H5N1 parent virus nor two selected clones induced severe clinical symptoms or were transmitted to sentinel ferrets by contact. While the emergence of reassortants of Egyptian HPAIV of subtype H5N1 with internal gene segments of cocirculating H9N2 viruses is possible in principle, the spread of such viruses is expected to be governed by their fitness to outcompete the parental viruses in the field. The eventual spread of attenuated phenotypes, however, would negatively impact syndrome surveillance on poultry farms and might foster enzootic virus circulation.IMPORTANCE Despite almost 6 years of the continuous cocirculation of highly pathogenic avian influenza virus H5N1 and avian influenza virus H9N2 in poultry in Egypt, no reassortants of the two subtypes have been reported. Here, the principal compatibility of the two subtypes is shown by forcing the reassortment between copassaged H5N1 und H9N2 viruses in embryonated chicken eggs. The resulting reassortant viruses displayed a wide range of pathogenicity including attenuated phenotypes in chickens, but did not show enhanced zoonotic propensities in the ferret model.
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Synergistic effect of PB2 283M and 526R contributes to enhanced virulence of H5N8 influenza viruses in mice. Vet Res 2017; 48:67. [PMID: 29070059 PMCID: PMC5657129 DOI: 10.1186/s13567-017-0471-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 10/09/2017] [Indexed: 12/14/2022] Open
Abstract
Highly pathogenic avian influenza (HPAI) H5N8 virus has caused considerable economic losses to poultry industry and poses a great threat to public health. Our previous study revealed two genetically similar HPAI H5N8 viruses displaying completely different virulence in mice. However, the molecular basis for viral pathogenicity to mammals remains unknown. Herein, we generated a series of reassortants between the two viruses and evaluated their virulence in mice. We demonstrated that 283M in PB2 is a new mammalian virulence marker for H5 viruses and that synergistic effect of amino acid residues 283M and 526R in PB2 is responsible for high virulence of the HPAI H5N8 virus. Analysis of available PB2 sequences showed that PB2 283M is highly conserved among influenza A viruses, while PB2 526R presents in most of human H3N2 and H5N1 isolates. Further study confirmed that the residues 283M and 526R had similar impacts on an HPAI H5N1 virus, suggesting that influenza viruses with both residues may replicate well in mammalian hosts. Together, these results present new insights for synergistic effect of 283M and 526R in PB2 of H5 HPAI virus on virulence to mammalian host, furthering our understanding of the pathogenesis of influenza A virus.
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SELECTED EPIDEMICS & EMERGING PATHOGENS - RESPIRATORY ILLNESSES - AN OVERVIEW. Dis Mon 2017; 63:246-248. [PMID: 29737280 PMCID: PMC7126048 DOI: 10.1016/j.disamonth.2017.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Farrukee R, Hurt AC. Antiviral Drugs for the Treatment and Prevention of Influenza. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2017. [DOI: 10.1007/s40506-017-0129-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Xu Y, Liu L. Curcumin alleviates macrophage activation and lung inflammation induced by influenza virus infection through inhibiting the NF-κB signaling pathway. Influenza Other Respir Viruses 2017. [PMID: 28646616 PMCID: PMC5596526 DOI: 10.1111/irv.12459] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Influenza A viruses (IAV) result in severe public health problems with worldwide each year. Overresponse of immune system to IAV infection leads to complications, and ultimately causing morbidity and mortality. OBJECTIVE Curcumin has been reported to have anti-inflammatory ability. However, its molecular mechanism in immune responses remains unclear. METHODS We detected the pro-inflammatory cytokine secretion and nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB)-related protein expression in human macrophages or mice infected by IAV with or without curcumin treatment. RESULTS We found that the IAV infection caused a dramatic enhancement of pro-inflammatory cytokine productions of human macrophages and mice immune cells. However, curcumin treatment after IAV infection downregulated these cytokines production in a dose-dependent manner. Moreover, the NF-κB has been activated in human macrophages after IAV infection, while administration of curcumin inhibited NF-κB signaling pathway via promoting the expression of nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor, alpha (IκBα), and inhibiting the translocation of p65 from cytoplasm to nucleus. CONCLUSIONS In summary, IAV infection could result in the inflammatory responses of immune cells, especially macrophages. Curcumin has the therapeutic potentials to relieve these inflammatory responses through inhibiting the NF-κB signaling pathway.
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Affiliation(s)
- Yiming Xu
- Department of Respiration Medicine, The Affiliated Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, China
| | - Ling Liu
- Department of Respiration Medicine, The Affiliated Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, China
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Epidemiological, clinical, and virologic features of two family clusters of avian influenza A (H7N9) virus infections in Southeast China. Sci Rep 2017; 7:1512. [PMID: 28473725 PMCID: PMC5431426 DOI: 10.1038/s41598-017-01761-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 04/19/2017] [Indexed: 01/08/2023] Open
Abstract
This study aimed to investigate the epidemiological, clinical, and virologic characteristics of avian influenza A (H7N9) confirmed cases from two family clusters in Southeast China. Epidemiological data of the H7N9 confirmed cases and their close contacts were obtained through interviews and reviews of medical records. Of the four patients in these two family clusters, two cases had mild symptoms, one had severe symptoms, and one died. Three of the four patients had a history of exposure to live poultry or contaminated environments. The complete genome sequences of the H7N9 viruses from the same family cluster were highly homologous, and the four isolated viruses from the two family clusters exhibited the virologic features of the H7N9 virus, in terms of transmissibility, pathogenicity, host adaptation, and antiviral drug resistance. In addition, our findings indicated that the A/Fujian/18/2015 viral strain contained an additional hemagglutinin G225D substitution, which preferentially binds α2,6-linked sialic acids. The results of this study demonstrate that one family cluster was infected through common exposure to live poultry or contaminated environments, and the other was more likely to be infected through the human-to-human route.
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Hong KH. Viral Infections in Workers in Hospital and Research Laboratory Settings. ANNALS OF CLINICAL MICROBIOLOGY 2017. [DOI: 10.5145/acm.2017.20.2.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ki Ho Hong
- Department of Laboratory Medicine, Seoul Medical Center, Seoul, Korea
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