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Lopez K, Harbison J, Irwin P, Erkapic A, Holub R, Blanco C, Paskewitz S, Clifton M, Bartholomay L. Extreme resistance to S-methoprene in field-collected Culex pipiens (Diptera: Culicidae) across the Chicago, IL region. Sci Rep 2024; 14:18001. [PMID: 39097646 PMCID: PMC11297970 DOI: 10.1038/s41598-024-69066-3] [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: 05/20/2024] [Accepted: 07/31/2024] [Indexed: 08/05/2024] Open
Abstract
Insect growth regulators, like S-methoprene, are heavily relied upon worldwide for larval mosquito chemical control due to their target specificity and long-lasting effects. In this study, susceptibility to S-methoprene was evaluated in Culex pipiens, a globally important vector species. Populations from 14 sites throughout the Chicago area with a long history of S-methoprene use and two sites with minimal use in Wisconsin were examined. Using a bioassay methodology and probit analyses, LC50 and LC90 values were calculated and compared to a susceptible laboratory strain to develop resistance ratios, then categorized for resistance intensity. The resistance ratios observed required the addition of another category, termed 'extreme' resistance, indicating resistance ratios greater than 100. 'Low' to 'extreme' levels of resistance to S-methoprene were detected throughout Illinois populations, with resistance ratios ranging from 2.33 to 1010.52. Resistance was not detected in populations where S-methoprene pressure has been very limited. These 'extreme' resistance ratios observed have never been documented in a wild vector species mosquito population. The relationships between historical S-methoprene use, resistance detected with laboratory bioassays, and the potential for field product failure remain unclear. However, the profound resistance detected here demonstrates a potential critical threat to protecting public health from mosquito-borne diseases.
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Affiliation(s)
- Kristina Lopez
- Department of Entomology, University of Wisconsin-Madison, Madison, WI, USA
- North Shore Mosquito Abatement District, Northfield, IL, USA
| | - Justin Harbison
- North Shore Mosquito Abatement District, Northfield, IL, USA
- Department of Public Health Sciences, Loyola University Chicago, Chicago, IL, USA
| | - Patrick Irwin
- Department of Entomology, University of Wisconsin-Madison, Madison, WI, USA
- Northwest Mosquito Abatement District, Wheeling, IL, USA
| | | | - Robert Holub
- Desplaines Valley Mosquito Abatement District, Lyons, IL, USA
| | | | - Susan Paskewitz
- Department of Entomology, University of Wisconsin-Madison, Madison, WI, USA
| | - Mark Clifton
- North Shore Mosquito Abatement District, Northfield, IL, USA.
| | - Lyric Bartholomay
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, USA.
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2
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Srichawla BS, Manan MR, Kipkorir V, Dhali A, Diebel S, Sawant T, Zia S, Carrion-Alvarez D, Suteja RC, Nurani K, Găman MA. Neuroinvasion of emerging and re-emerging arboviruses: A scoping review. SAGE Open Med 2024; 12:20503121241229847. [PMID: 38711470 PMCID: PMC11072077 DOI: 10.1177/20503121241229847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/16/2024] [Indexed: 05/08/2024] Open
Abstract
Background Arboviruses are RNA viruses and some have the potential to cause neuroinvasive disease and are a growing threat to global health. Objectives Our objective is to identify and map all aspects of arbovirus neuroinvasive disease, clarify key concepts, and identify gaps within our knowledge with appropriate future directions related to the improvement of global health. Methods Sources of Evidence: A scoping review of the literature was conducted using PubMed, Scopus, ScienceDirect, and Hinari. Eligibility Criteria: Original data including epidemiology, risk factors, neurological manifestations, neuro-diagnostics, management, and preventive measures related to neuroinvasive arbovirus infections was obtained. Sources of evidence not reporting on original data, non-English, and not in peer-reviewed journals were removed. Charting Methods: An initial pilot sample of 30 abstracts were reviewed by all authors and a Cohen's kappa of κ = 0.81 (near-perfect agreement) was obtained. Records were manually reviewed by two authors using the Rayyan QCRI software. Results A total of 171 records were included. A wide array of neurological manifestations can occur most frequently, including parkinsonism, encephalitis/encephalopathy, meningitis, flaccid myelitis, and Guillain-Barré syndrome. Magnetic resonance imaging of the brain often reveals subcortical lesions, sometimes with diffusion restriction consistent with acute ischemia. Vertical transmission of arbovirus is most often secondary to the Zika virus. Neurological manifestations of congenital Zika syndrome, include microcephaly, failure to thrive, intellectual disability, and seizures. Cerebrospinal fluid analysis often shows lymphocytic pleocytosis, elevated albumin, and protein consistent with blood-brain barrier dysfunction. Conclusions Arbovirus infection with neurological manifestations leads to increased morbidity and mortality. Risk factors for disease include living and traveling in an arbovirus endemic zone, age, pregnancy, and immunosuppressed status. The management of neuroinvasive arbovirus disease is largely supportive and focuses on specific neurological complications. There is a need for therapeutics and currently, management is based on disease prevention and limiting zoonosis.
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Affiliation(s)
- Bahadar S Srichawla
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Vincent Kipkorir
- Department of Human Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Arkadeep Dhali
- Department of Internal Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Sebastian Diebel
- Department of Family Medicine, Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Tirtha Sawant
- Department of Neurology, Spartan Health Sciences University, Spartan Drive St, Saint Lucia
| | - Subtain Zia
- Department of Infectious Diseases, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Richard C Suteja
- Faculty of Medicine, Udayana University, Kampus Bukit, Jl, Raya Kampus Unud Jimbaran, Kec, Kuta Sel, Kabupaten Badung, Bukit Jimbaran, Bali, Indonesia
| | - Khulud Nurani
- Department of Human Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, București, Romania
- Bucharest, Romania and Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, București, Romania
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3
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Simonin Y. Circulation of West Nile Virus and Usutu Virus in Europe: Overview and Challenges. Viruses 2024; 16:599. [PMID: 38675940 PMCID: PMC11055060 DOI: 10.3390/v16040599] [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: 03/20/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
West Nile Virus (WNV) and Usutu Virus (USUV) are both neurotropic mosquito-borne viruses belonging to the Flaviviridae family. These closely related viruses mainly follow an enzootic cycle involving mosquitoes as vectors and birds as amplifying hosts, but humans and other mammals can also be infected through mosquito bites. WNV was first identified in Uganda in 1937 and has since spread globally, notably in Europe, causing periodic outbreaks associated with severe cases of neuroinvasive diseases such as meningitis and encephalitis. USUV was initially isolated in 1959 in Swaziland and has also spread to Europe, primarily affecting birds and having a limited impact on human health. There has been a recent expansion of these viruses' geographic range in Europe, facilitated by factors such as climate change, leading to increased human exposure. While sharing similar biological traits, ecology, and epidemiology, there are significant distinctions in their pathogenicity and their impact on both human and animal health. While WNV has been more extensively studied and is a significant public health concern in many regions, USUV has recently been gaining attention due to its emergence in Europe and the diversity of its circulating lineages. Understanding the pathophysiology, ecology, and transmission dynamics of these viruses is important to the implementation of effective surveillance and control measures. This perspective provides a brief overview of the current situation of these two viruses in Europe and outlines the significant challenges that need to be addressed in the coming years.
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Affiliation(s)
- Yannick Simonin
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, INSERM, EFS, 34000 Montpellier, France
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4
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Pavesi A, Tiecco G, Rossi L, Sforza A, Ciccarone A, Compostella F, Lovatti S, Tomasoni LR, Castelli F, Quiros-Roldan E. Inflammatory Response Associated with West Nile Neuroinvasive Disease: A Systematic Review. Viruses 2024; 16:383. [PMID: 38543749 PMCID: PMC10976239 DOI: 10.3390/v16030383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND West Nile virus (WNV) infection is a seasonal arbovirosis with the potential to cause severe neurological disease. Outcomes of the infection from WNV depend on viral factors (e.g., lineage) and host-intrinsic factors (e.g., age, sex, immunocompromising conditions). Immunity is essential to control the infection but may also prove detrimental to the host. Indeed, the persistence of high levels of pro-inflammatory cytokines and chemokines is associated with the development of blood-brain barrier (BBB) damage. Due to the importance of the inflammatory processes in the development of West Nile neuroinvasive disease (WNND), we reviewed the available literature on the subject. METHODS According to the 2020 updated PRISMA guidelines, all peer-reviewed articles regarding the inflammatory response associated with WNND were included. RESULTS One hundred and thirty-six articles were included in the data analysis and sorted into three groups (in vitro on-cell cultures, in vivo in animals, and in humans). The main cytokines found to be increased during WNND were IL-6 and TNF-α. We highlighted the generally small quantity and heterogeneity of information about the inflammatory patterns associated with WNND. CONCLUSIONS Further studies are needed to understand the pathogenesis of WNND and to investigate the extent and the way the host inflammatory response either helps in controlling the infection or in worsening the outcomes. This might prove useful both for the development of target therapies and for the development of molecular markers allowing early identification of patients displaying an inflammatory response that puts them at a higher risk of developing neuroinvasive disease and who might thus benefit from early antiviral therapies.
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Affiliation(s)
- Alessandro Pavesi
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Giorgio Tiecco
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Luca Rossi
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Anita Sforza
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Andrea Ciccarone
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Federico Compostella
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Sofia Lovatti
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Lina Rachele Tomasoni
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili di Brescia, 25123 Brescia, Italy;
| | - Francesco Castelli
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Eugenia Quiros-Roldan
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
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Maccarone MC, Coraci D, Ragazzo L, Munari M, Piccione F, Masiero S. Rehabilitation approaches in West Nile Virus survivors: a systematic review. Eur J Phys Rehabil Med 2024; 60:113-121. [PMID: 38059575 PMCID: PMC10938036 DOI: 10.23736/s1973-9087.23.07880-2] [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: 01/16/2023] [Revised: 09/05/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Periodic increases in West Nile virus (WNV) infections have been documented. Proper rehabilitative management is essential for these patients, who may experience limitations in daily activities even after the resolution of the acute infection. Since there are currently no globally accepted guidelines, our aim is to conduct a best-evidence synthesis on rehabilitative management for patients with neuroinvasive WNV. EVIDENCE ACQUISITION We screened the literature with two independent researchers conducting searches on PubMed, Embase, SCOPUS, and Google Scholar databases for WNV-related studies in the field of rehabilitation. Suitable studies were identified and selected through a rigorous process. The review includes original research articles published up to August 15, 2023. EVIDENCE SYNTHESIS Despite the potential for bias in the studies, the literature suggests that a comprehensive and interdisciplinary rehabilitation program, which includes physical therapy with neuromotor and respiratory interventions, occupational therapy, neurocognitive interventions, and speech therapy for dysphagia and communication issues, can lead to functional improvement in WNV patients. This program should be tailored to address each patient's specific challenges, and the duration of the rehabilitation program may vary depending on the individual patient's needs. CONCLUSIONS Even if additional research with larger cohorts and higher evidence levels is needed for a comprehensive understanding of WNV patient rehabilitation, an early and comprehensive rehabilitation approach addressing respiratory, neuromuscular, and cognitive aspects appears effective for WNV patient recovery.
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Affiliation(s)
- Maria C Maccarone
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy -
| | - Daniele Coraci
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
| | - Lisa Ragazzo
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
| | - Marina Munari
- Institute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy
| | - Francesco Piccione
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
| | - Stefano Masiero
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
- Institute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy
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6
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Ferraccioli F, Riccetti N, Fasano A, Mourelatos S, Kioutsioukis I, Stilianakis NI. Effects of climatic and environmental factors on mosquito population inferred from West Nile virus surveillance in Greece. Sci Rep 2023; 13:18803. [PMID: 37914706 PMCID: PMC10620416 DOI: 10.1038/s41598-023-45666-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023] Open
Abstract
Mosquito-borne diseases' impact on human health is among the most prominent of all communicable diseases. With limited pool of tools to contrast these diseases, public health focus remains preventing mosquito-human contacts. Applying a hierarchical spatio-temporal Bayesian model on West Nile virus (WNV) surveillance data from Greece, we aimed to investigate the impact of climatic and environmental factors on Culex mosquitoes' population. Our spatio-temporal analysis confirmed climatic factors as major drivers of WNV-transmitting-Culex mosquitoes population dynamics, with temperature and long periods of moderate-to-warm climate having the strongest positive effect on mosquito abundance. Conversely, rainfall, high humidity, and wind showed a negative impact. The results suggest the presence of statistically significant differences in the effect of regional and seasonal characteristics, highlighting the complex interplay between climatic, geographical and environmental factors in the dynamics of mosquito populations. This study may represent a relevant tool to inform public health policymakers in planning preventive measures.
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Affiliation(s)
- Federico Ferraccioli
- European Commission, Joint Research Centre (JRC), Via E. Fermi 2749, 21027, Ispra, VA, Italy
- Department of Statistical Sciences, University of Padova, Via C. Battisti 241, 35121, Padua, PD, Italy
| | - Nicola Riccetti
- European Commission, Joint Research Centre (JRC), Via E. Fermi 2749, 21027, Ispra, VA, Italy
| | - Augusto Fasano
- European Commission, Joint Research Centre (JRC), Via E. Fermi 2749, 21027, Ispra, VA, Italy
- Department of Statistics, Catholic University of the Sacred Heart, Largo A. Gemelli, 20123, Milan, MI, Italy
| | | | | | - Nikolaos I Stilianakis
- European Commission, Joint Research Centre (JRC), Via E. Fermi 2749, 21027, Ispra, VA, Italy
- Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Waldstraße 6, 91054, Erlangen, Germany
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7
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Holcomb KM, Staples JE, Nett RJ, Beard CB, Petersen LR, Benjamin SG, Green BW, Jones H, Johansson MA. Multi-Model Prediction of West Nile Virus Neuroinvasive Disease With Machine Learning for Identification of Important Regional Climatic Drivers. GEOHEALTH 2023; 7:e2023GH000906. [PMID: 38023388 PMCID: PMC10654557 DOI: 10.1029/2023gh000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/15/2023] [Accepted: 10/21/2023] [Indexed: 12/01/2023]
Abstract
West Nile virus (WNV) is the leading cause of mosquito-borne illness in the continental United States (CONUS). Spatial heterogeneity in historical incidence, environmental factors, and complex ecology make prediction of spatiotemporal variation in WNV transmission challenging. Machine learning provides promising tools for identification of important variables in such situations. To predict annual WNV neuroinvasive disease (WNND) cases in CONUS (2015-2021), we fitted 10 probabilistic models with variation in complexity from naïve to machine learning algorithm and an ensemble. We made predictions in each of nine climate regions on a hexagonal grid and evaluated each model's predictive accuracy. Using the machine learning models (random forest and neural network), we identified the relative importance and variation in ranking of predictors (historical WNND cases, climate anomalies, human demographics, and land use) across regions. We found that historical WNND cases and population density were among the most important factors while anomalies in temperature and precipitation often had relatively low importance. While the relative performance of each model varied across climatic regions, the magnitude of difference between models was small. All models except the naïve model had non-significant differences in performance relative to the baseline model (negative binomial model fit per hexagon). No model, including the ensemble or more complex machine learning models, outperformed models based on historical case counts on the hexagon or region level; these models are good forecasting benchmarks. Further work is needed to assess if predictive capacity can be improved beyond that of these historical baselines.
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Affiliation(s)
- Karen M. Holcomb
- Global Systems LaboratoryNational Oceanic and Atmospheric AdministrationBoulderCOUSA
- Now at Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionFort CollinsCOUSA
| | - J. Erin Staples
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionFort CollinsCOUSA
| | - Randall J. Nett
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionFort CollinsCOUSA
| | - Charles B. Beard
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionFort CollinsCOUSA
| | - Lyle R. Petersen
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionFort CollinsCOUSA
| | - Stanley G. Benjamin
- Global Systems LaboratoryNational Oceanic and Atmospheric AdministrationBoulderCOUSA
- Cooperative Institute for Research in Environmental SciencesUniversity of Colorado BoulderBoulderCOUSA
| | - Benjamin W. Green
- Global Systems LaboratoryNational Oceanic and Atmospheric AdministrationBoulderCOUSA
- Cooperative Institute for Research in Environmental SciencesUniversity of Colorado BoulderBoulderCOUSA
| | - Hunter Jones
- Climate Prediction OfficeNational Oceanic and Atmospheric AdministrationSilver SpringMDUSA
| | - Michael A. Johansson
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionSan JuanPRUSA
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8
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Holcomb KM, Nguyen C, Komar N, Foy BD, Panella NA, Baskett ML, Barker CM. Predicted reduction in transmission from deployment of ivermectin-treated birdfeeders for local control of West Nile virus. Epidemics 2023; 44:100697. [PMID: 37348378 PMCID: PMC10529638 DOI: 10.1016/j.epidem.2023.100697] [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: 05/04/2022] [Revised: 05/01/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023] Open
Abstract
Ivermectin (IVM)-treated birds provide the potential for targeted control of Culex mosquitoes to reduce West Nile virus (WNV) transmission. Ingestion of IVM increases mosquito mortality, which could reduce WNV transmission from birds to humans and in enzootic maintenance cycles affecting predominantly bird-feeding mosquitoes and from birds to humans. This strategy might also provide an alternative method for WNV control that is less hampered by insecticide resistance and the logistics of large-scale pesticide applications. Through a combination of field studies and modeling, we assessed the feasibility and impact of deploying IVM-treated birdfeed in residential neighborhoods to reduce WNV transmission. We first tracked 105 birds using radio telemetry and radio frequency identification to monitor their feeder usage and locations of nocturnal roosts in relation to five feeder sites in a neighborhood in Fort Collins, Colorado. Using these results, we then modified a compartmental model of WNV transmission to account for the impact of IVM on mosquito mortality and spatial movement of birds and mosquitoes on the neighborhood level. We found that, while the number of treated lots in a neighborhood strongly influenced the total transmission potential, the arrangement of treated lots in a neighborhood had little effect. Increasing the proportion of treated birds, regardless of the WNV competency status, resulted in a larger reduction in infection dynamics than only treating competent birds. Taken together, model results indicate that deployment of IVM-treated feeders could reduce local transmission throughout the WNV season, including reducing the enzootic transmission prior to the onset of human infections, with high spatial coverage and rates of IVM-induced mortality in mosquitoes. To improve predictions, more work is needed to refine estimates of daily mosquito movement in urban areas and rates of IVM-induced mortality. Our results can guide future field trials of this control strategy.
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Affiliation(s)
- Karen M Holcomb
- Davis Arbovirus Research and Training Laboratory, Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, United States.
| | - Chilinh Nguyen
- Center for Vector-Borne Infectious Diseases, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, United States; Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Nicholas Komar
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Brian D Foy
- Center for Vector-Borne Infectious Diseases, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, United States
| | - Nicholas A Panella
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Marissa L Baskett
- Department of Environmental Science and Policy, University of California, Davis, CA, United States
| | - Christopher M Barker
- Davis Arbovirus Research and Training Laboratory, Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, United States.
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9
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Mingo-Casas P, Sanchez-Céspedes J, Blázquez AB, Casas J, Balsera-Manzanero M, Herrero L, Vázquez A, Pachón J, Aguilar-Guisado M, Cisneros JM, Saiz JC, Martín-Acebes MA. Lipid signatures of West Nile virus infection unveil alterations of sphingolipid metabolism providing novel biomarkers. Emerg Microbes Infect 2023:2231556. [PMID: 37377355 DOI: 10.1080/22221751.2023.2231556] [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: 06/29/2023]
Abstract
West Nile virus (WNV) is a neurotropic flavivirus transmitted by the bites of infected mosquitoes. Severe forms of West Nile disease (WND) can curse with meningitis, encephalitis or acute flaccid paralysis. A better understanding of the physiopathology associated with disease progression is mandatory to find biomarkers and effective therapies. In this scenario, blood derivatives (plasma and serum) constitute the more commonly used biofluids due to its ease of collection and high value for diagnostic purposes. Therefore, the potential impact of this virus in the circulating lipidome was addressed combining the analysis of samples from experimentally infected mice and naturally WND patients. Our results unveil dynamic alterations in the lipidome that define specific metabolic fingerprints of different infection stages. Concomitant with neuroinvasion in mice, the lipid landscape was dominated by a metabolic reprograming that resulted in significant elevations of circulating sphingolipids (ceramides, dihydroceramides and dihydrosphingomyelins), phosphatidylethanolamines and triacylglycerols. Remarkably, patients suffering from WND also displayed an elevation of ceramides, dihydroceramides, lactosylceramides and monoacylglycerols in their sera. The dysregulation of sphingolipid metabolism by WNV may provide new therapeutic opportunities and supports the potential of certain lipids as novel peripheral biomarkers of WND progression.
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Affiliation(s)
- Patricia Mingo-Casas
- Department of Biotechnology, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), Madrid, Spain
| | - Javier Sanchez-Céspedes
- Department of Infectious Diseases, Microbiology and Parasitology, Virgen del Rocío University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana-Belén Blázquez
- Department of Biotechnology, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), Madrid, Spain
| | - Josefina Casas
- Department of Biological Chemistry, Institute for Advanced Chemistry of Catalonia (IQAC-CSIC), Barcelona, Spain
- Liver and Digestive Diseases Networking Biomedical Research Centre (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - María Balsera-Manzanero
- Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain
| | - Lura Herrero
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Vázquez
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jerónimo Pachón
- Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain
- Department of Medicine, School of Medicine, University of Seville, Seville, Spain
| | - Manuela Aguilar-Guisado
- Department of Infectious Diseases, Microbiology and Parasitology, Virgen del Rocío University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - José Miguel Cisneros
- Department of Infectious Diseases, Microbiology and Parasitology, Virgen del Rocío University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan-Carlos Saiz
- Department of Biotechnology, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), Madrid, Spain
| | - Miguel A Martín-Acebes
- Department of Biotechnology, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), Madrid, Spain
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Schwarz ER, Long MT. Comparison of West Nile Virus Disease in Humans and Horses: Exploiting Similarities for Enhancing Syndromic Surveillance. Viruses 2023; 15:1230. [PMID: 37376530 DOI: 10.3390/v15061230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
West Nile virus (WNV) neuroinvasive disease threatens the health and well-being of horses and humans worldwide. Disease in horses and humans is remarkably similar. The occurrence of WNV disease in these mammalian hosts has geographic overlap with shared macroscale and microscale drivers of risk. Importantly, intrahost virus dynamics, the evolution of the antibody response, and clinicopathology are similar. The goal of this review is to provide a comparison of WNV infection in humans and horses and to identify similarities that can be exploited to enhance surveillance methods for the early detection of WNV neuroinvasive disease.
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Affiliation(s)
- Erika R Schwarz
- Montana Veterinary Diagnostic Laboratory, MT Department of Livestock, Bozeman, MT 59718, USA
| | - Maureen T Long
- Department of Comparative, Diagnostic, & Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA
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Chotiwan N, Rosendal E, Willekens SMA, Schexnaydre E, Nilsson E, Lindqvist R, Hahn M, Mihai IS, Morini F, Zhang J, Ebel GD, Carlson LA, Henriksson J, Ahlgren U, Marcellino D, Överby AK. Type I interferon shapes brain distribution and tropism of tick-borne flavivirus. Nat Commun 2023; 14:2007. [PMID: 37037810 PMCID: PMC10086010 DOI: 10.1038/s41467-023-37698-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023] Open
Abstract
Viral tropism within the brain and the role(s) of vertebrate immune response to neurotropic flaviviruses infection is largely understudied. We combine multimodal imaging (cm-nm scale) with single nuclei RNA-sequencing to study Langat virus in wildtype and interferon alpha/beta receptor knockout (Ifnar-/-) mice to visualize viral pathogenesis and define molecular mechanisms. Whole brain viral infection is imaged by Optical Projection Tomography coregistered to ex vivo MRI. Infection is limited to grey matter of sensory systems in wildtype mice, but extends into white matter, meninges and choroid plexus in Ifnar-/- mice. Cells in wildtype display strong type I and II IFN responses, likely due to Ifnb expressing astrocytes, infiltration of macrophages and Ifng-expressing CD8+ NK cells, whereas in Ifnar-/-, the absence of this response contributes to a shift in cellular tropism towards non-activated resident microglia. Multimodal imaging-transcriptomics exemplifies a powerful way to characterize mechanisms of viral pathogenesis and tropism.
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Affiliation(s)
- Nunya Chotiwan
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden.
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden.
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, 10540, Thailand.
| | - Ebba Rosendal
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
| | - Stefanie M A Willekens
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
- Umeå Centre for Molecular Medicine (UCMM), Umeå University, 90187, Umeå, Sweden
| | - Erin Schexnaydre
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, 90187, Umeå, Sweden
- Department of Medical Biochemistry and Biophysics, Umeå University, 90187, Umeå, Sweden
- Umeå Centre for Microbial Research, Umeå University, 90187, Umeå, Sweden
| | - Emma Nilsson
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
| | - Richard Lindqvist
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
| | - Max Hahn
- Umeå Centre for Molecular Medicine (UCMM), Umeå University, 90187, Umeå, Sweden
| | - Ionut Sebastian Mihai
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
- Department of Department of Molecular biology, Umeå University, 90187, Umeå, Sweden
- Företagsforskarskolan, Umeå University, 90187, Umeå, Sweden
| | - Federico Morini
- Umeå Centre for Molecular Medicine (UCMM), Umeå University, 90187, Umeå, Sweden
| | - Jianguo Zhang
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, 90187, Umeå, Sweden
- Department of Medical Biochemistry and Biophysics, Umeå University, 90187, Umeå, Sweden
- Umeå Centre for Microbial Research, Umeå University, 90187, Umeå, Sweden
| | - Gregory D Ebel
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Lars-Anders Carlson
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, 90187, Umeå, Sweden
- Department of Medical Biochemistry and Biophysics, Umeå University, 90187, Umeå, Sweden
- Umeå Centre for Microbial Research, Umeå University, 90187, Umeå, Sweden
| | - Johan Henriksson
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden
- Umeå Centre for Microbial Research, Umeå University, 90187, Umeå, Sweden
- Department of Department of Molecular biology, Umeå University, 90187, Umeå, Sweden
| | - Ulf Ahlgren
- Umeå Centre for Molecular Medicine (UCMM), Umeå University, 90187, Umeå, Sweden
| | - Daniel Marcellino
- Department of Integrative Medical Biology, Umeå University, 90187, Umeå, Sweden
| | - Anna K Överby
- Department of Clinical Microbiology, Umeå University, 90185, Umeå, Sweden.
- The Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187, Umeå, Sweden.
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12
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Vernon SD, Hartle M, Sullivan K, Bell J, Abbaszadeh S, Unutmaz D, Bateman L. Post-exertional malaise among people with long COVID compared to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Work 2023; 74:1179-1186. [PMID: 36911963 DOI: 10.3233/wor-220581] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Long COVID describes a condition with symptoms that linger for months to years following acute COVID-19. Many of these Long COVID symptoms are like those experienced by patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). OBJECTIVE We wanted to determine if people with Long COVID experienced post-exertional malaise (PEM), the hallmark symptom of ME/CFS, and if so, how it compared to PEM experienced by patients with ME/CFS. METHODS A questionnaire that asked about the domains of PEM including triggers, experience, recovery, and prevention was administered to 80 people seeking care for Long COVID at Bateman Horne Center. Their responses were compared to responses about PEM given by 151 patients with ME/CFS using chi-square tests of independence. RESULTS All but one Long COVID respondent reported having PEM. There were many significant differences in the types of PEM triggers, symptoms experienced during PEM, and ways to recover and prevent PEM between Long COVID and ME/CFS. Similarities between Long COVID and ME/CFS included low and medium physical and cognitive exertion to trigger PEM, symptoms of fatigue, pain, immune reaction, neurologic, orthostatic intolerance, and gastrointestinal symptoms during PEM, rest to recover from PEM, and pacing to prevent PEM. CONCLUSION People with Long COVID experience PEM. There were significant differences in PEM experienced by people with Long COVID compared to patients with ME/CFS. This may be due to the newness of Long COVID, not knowing what exertional intolerance is or how to manage it.
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Affiliation(s)
| | | | - Karen Sullivan
- The Bateman Horne Center of Excellence, Salt Lake City, UT, USA
| | - Jennifer Bell
- The Bateman Horne Center of Excellence, Salt Lake City, UT, USA
| | | | - Derya Unutmaz
- Jackson Laboratory for Genomic Medicine, Farmington, CT, USA.,University of Connecticut School of Medicine, Farmington, CT, USA
| | - Lucinda Bateman
- The Bateman Horne Center of Excellence, Salt Lake City, UT, USA
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13
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Arthropod-Borne Flaviviruses in Pregnancy. Microorganisms 2023; 11:microorganisms11020433. [PMID: 36838398 PMCID: PMC9959669 DOI: 10.3390/microorganisms11020433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Flaviviruses are a diverse group of enveloped RNA viruses that cause significant clinical manifestations in the pregnancy and postpartum periods. This review highlights the epidemiology, pathophysiology, clinical features, diagnosis, and prevention of the key arthropod-borne flaviviruses of concern in pregnancy and the neonatal period-Zika, Dengue, Japanese encephalitis, West Nile, and Yellow fever viruses. Increased disease severity during pregnancy, risk of congenital malformations, and manifestations of postnatal infection vary widely amongst this virus family and may be quite marked. Laboratory confirmation of infection is complex, especially due to the reliance on serology for which flavivirus cross-reactivity challenges diagnostic specificity. As such, a thorough clinical history including relevant geographic exposures and prior vaccinations is paramount for accurate diagnosis. Novel vaccines are eagerly anticipated to ameliorate the impact of these flaviviruses, particularly neuroinvasive disease manifestations and congenital infection, with consideration of vaccine safety in pregnant women and children pivotal. Moving forward, the geographical spread of flaviviruses, as for other zoonoses, will be heavily influenced by climate change due to the potential expansion of vector and reservoir host habitats. Ongoing 'One Health' engagement across the human-animal-environment interface is critical to detect and responding to emergent flavivirus epidemics.
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14
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Rocamonde B, Hasan U, Mathieu C, Dutartre H. Viral-induced neuroinflammation: Different mechanisms converging to similar exacerbated glial responses. Front Neurosci 2023; 17:1108212. [PMID: 36937670 PMCID: PMC10017484 DOI: 10.3389/fnins.2023.1108212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
There is increasing evidence that viral infections are the source/origin of various types of encephalitis, encephalomyelitis, and other neurological and cognitive disorders. While the involvement of certain viruses, such as the Nipah virus and measles virus, is known, the mechanisms of neural invasion and the factors that trigger intense immune reactions are not fully understood. Based on recent publications, this review discusses the role of the immune response, interactions between viruses and glial cells, and cytokine mediators in the development of inflammatory diseases in the central nervous system. It also highlights the significant gaps in knowledge regarding these mechanisms.
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Affiliation(s)
- Brenda Rocamonde
- Centre International de Recherche en Infectiologie, Équipe d’Oncogenèse Rétrovirale, INSERM U1111 - Université Claude Bernard Lyon 1, CNRS, UMR 5308, École Normale Supérieure de Lyon, Université Lyon, Lyon, France
- Equipe Labellisée par la Fondation pour la Recherche Médicale, Labex Ecofect, Lyon, France
- *Correspondence: Brenda Rocamonde,
| | - Uzma Hasan
- Centre International de Recherche en Infectiologie, Team Enveloped Viruses, Vectors and Immunotherapy INSERM U1111 - Université Claude Bernard Lyon 1, CNRS, UMR 5308, École Normale Supérieure de Lyon, Université Lyon, Lyon, France
- The Lyon Immunotherapy for Cancer Laboratory (LICL), Centre de Recherche en Cancérologie de Lyon (CRCL, UMR INSERM 1052 – CNRS 5286) Centre Léon Bérard, Lyon, France
| | - Cyrille Mathieu
- Centre International de Recherche en Infectiologie Équipe Neuro-Invasion, Tropism and Viral Encephalitis, INSERM U1111 - Université Claude Bernard Lyon 1, CNRS, UMR 5308, École Normale Supérieure de Lyon, Université Lyon, Lyon, France
- Cyrille Mathieu,
| | - Hélène Dutartre
- Centre International de Recherche en Infectiologie, Équipe d’Oncogenèse Rétrovirale, INSERM U1111 - Université Claude Bernard Lyon 1, CNRS, UMR 5308, École Normale Supérieure de Lyon, Université Lyon, Lyon, France
- Equipe Labellisée par la Fondation pour la Recherche Médicale, Labex Ecofect, Lyon, France
- Hélène Dutartre,
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15
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Chauhan L, Matthews E, Piquet AL, Henao-Martinez A, Franco-Paredes C, Tyler KL, Beckham D, Pastula DM. Nervous System Manifestations of Arboviral Infections. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:107-118. [PMID: 36124288 PMCID: PMC9476420 DOI: 10.1007/s40475-022-00262-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 01/11/2023]
Abstract
Purpose of Review Complex environmental factors and human intervention influence the spread of arthropod vectors and the cycle of transmission of arboviruses. The spectrum of clinical manifestations is diverse, ranging from serious presentations like viral hemorrhagic fever (e.g., dengue, yellow fever, rift valley fever) or shock syndromes (e.g., dengue virus) to organ-specific illness like meningoencephalitis. Recent Findings A spectrum of clinical neurologic syndromes with potential acute devastating consequences or long-term sequelae may result from some arboviral infections. Summary In this review, we describe some of the most frequent and emerging neuro-invasive arboviral infections, spectrum of neurologic disorders including encephalitis, meningitis, myelitis or poliomyelitis, acute demyelinating encephalomyelitis, Guillain-Barré syndrome, and ocular syndromes.
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Affiliation(s)
- Lakshmi Chauhan
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045 USA
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado, Anschutz Medical Center, Aurora, CO USA
| | - Elizabeth Matthews
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado, Anschutz Medical Center, Aurora, CO USA
| | - Amanda L. Piquet
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado, Anschutz Medical Center, Aurora, CO USA
| | - Andrés Henao-Martinez
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Carlos Franco-Paredes
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045 USA
- Hospital Infantil de México, Federico Gómez, México City, México
| | - Kenneth L. Tyler
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045 USA
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado, Anschutz Medical Center, Aurora, CO USA
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Center, Aurora, CO USA
| | - David Beckham
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045 USA
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado, Anschutz Medical Center, Aurora, CO USA
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Center, Aurora, CO USA
| | - Daniel M. Pastula
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado, Anschutz Medical Center, Aurora, CO USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO USA
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16
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Abstract
Japanese Encephalitis Virus (JEV)/West Nile Virus (WNV)-induced encephalitis, although observed in selective cases, is associated with fatal consequences ranging from decline in cognitive abilities among recovered patients to coma/death. Loss of neuronal cells following viral infection-induced neuronal death imposes significant challenge to the central nervous system (CNS) homeostasis eventually resulting in loss of CNS tissue integrity and poor disease outcome in patients. In our present study, we aim to evaluate the role played by miRNA in modulating neuronal death upon neurotropic flaviviral infections. Infection of neuronal cell line resulted in upregulation of miR-451a abundance. Upon its upregulation, miR-451a has been demonstrated to target 3′-UTR of 14-3-3ζ transcript culminating into downregulation of 14-3-3ζ at the protein level. In response to 14-3-3ζ protein depletion in the cytosol upon flavivirus infection, increased phosphorylation of JNK protein has been shown to take place thus paving way for the cell to undergo apoptosis. Reversal of virus-induced miR-451a-upregulation helped abrogate neuronal apoptosis which is accompanied by a restoration of 14-3-3ζ protein and phosphorylated-JNK abundance to its normal level. Our findings hence provide a possible therapeutic target for preventing JEV/WNV-induced neuronal apoptosis thus improving disease outcome in flaviviral infection-associated encephalitis. IMPORTANCE Neuronal infection by JEV/WNV culminates into neuronal cell death thus contributing to signs and symptoms exhibited by patients that suffer from and that have recovered from JEV/WNV-induced encephalitis. In the present study we have evaluated the role of miRNA in promoting flavivirus-induced neuronal apoptosis. miR-451a has been demonstrated to promote neuronal cell death by targeting 14-3-3ζ protein function. The function of miR-451a in modulating neuronal physiology toward self-destruction has been shown to be independent of its effect upon the virus infection life cycle. The 14-3-3ζ transcript upon being targeted by miR-451a promotes JNK phosphorylation hence culminating into neuronal death by activation of apoptotic machinery. Inhibition of miR-451a upon neuronal infection by JEV/WNV helped reduce apoptotic machinery activation hence providing us with possible future therapeutic strategy in ameliorating flavivirus-induced neurological manifestations and overall disease burden in terms of morbidity.
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17
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Krett JD, Beckham JD, Tyler KL, Piquet AL, Chauhan L, Wallace CJ, Pastula DM, Kapadia RK. Neurology of Acute Viral Infections. Neurohospitalist 2022; 12:632-646. [PMID: 36147750 PMCID: PMC9485684 DOI: 10.1177/19418744221104778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As specialists in acute neurology, neurohospitalists are often called upon to diagnose and manage acute viral infections affecting the nervous system. In this broad review covering the neurology of several acute viral infections, our aim is to provide key diagnostic and therapeutic pearls of practical use to the busy neurohospitalist. We will review acute presentations, diagnosis, and treatment of human herpesviruses, arboviruses, enteroviruses, and some vaccine-preventable viruses. The neurological effects of coronaviruses, including COVID-19, are not covered in this review.
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Affiliation(s)
- Jonathan D Krett
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - J David Beckham
- Department of Neurology and Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado Neurosciences Center, Aurora, CO, USA
- Departments of Immunology & Microbiology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Kenneth L Tyler
- Department of Neurology and Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado Neurosciences Center, Aurora, CO, USA
- Departments of Immunology & Microbiology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Amanda L Piquet
- Department of Neurology and Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado Neurosciences Center, Aurora, CO, USA
| | - Lakshmi Chauhan
- Department of Neurology and Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado Neurosciences Center, Aurora, CO, USA
| | - Carla J Wallace
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Daniel M Pastula
- Department of Neurology and Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado Neurosciences Center, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Ronak K Kapadia
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
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18
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Comorbid conditions as risk factors for West Nile neuroinvasive disease in Ontario, Canada: a population-based cohort study. Epidemiol Infect 2022; 150:e103. [PMID: 35543409 PMCID: PMC9171902 DOI: 10.1017/s0950268822000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
West Nile neuroinvasive disease (WNND) is a severe neurological illness that can result from West Nile virus (WNV) infection, with long-term disability and death being common outcomes. Although WNV arrived in North America over two decades ago, risk factors for WNND are still being explored. The objective of this study was to identify WNND comorbid risk factors in the Ontario population using a retrospective, population-based cohort design. Incident WNV infections from laboratory records between 1 January 2002 – 31 December 2012 were individually-linked to health administrative databases to ascertain WNND outcomes and comorbid risk factors. WNND incidence was compared among individuals with and without comorbidities using risk ratios (RR) calculated with log binomial regression. Three hundred and forty-five individuals developed WNND (18.3%) out of 1884 WNV infections. West Nile encephalitis was driving most associations with comorbidities. Immunocompromised (aRR 2.61 [95% CI 1.23–4.53]) and male sex (aRR 1.32 [95% CI 1.00–1.76]) were risk factors for encephalitis, in addition to age, for which each 1-year increase was associated with a 2% (aRR 1.02 [95% CI 1.02–1.03]) relative increase in risk. Our results suggest that individuals living with comorbidities are at higher risk for WNND, in particular encephalitis, following WNV infection.
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19
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Evaluation of the effectiveness of the California mosquito-borne virus surveillance & response plan, 2009–2018. PLoS Negl Trop Dis 2022; 16:e0010375. [PMID: 35533207 PMCID: PMC9119623 DOI: 10.1371/journal.pntd.0010375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/19/2022] [Accepted: 03/30/2022] [Indexed: 11/19/2022] Open
Abstract
Local vector control and public health agencies in California use the California Mosquito-Borne Virus Surveillance and Response Plan to monitor and evaluate West Nile virus (WNV) activity and guide responses to reduce the burden of WNV disease. All available data from environmental surveillance, such as the abundance and WNV infection rates in Culex tarsalis and the Culex pipiens complex mosquitoes, the numbers of dead birds, seroconversions in sentinel chickens, and ambient air temperatures, are fed into a formula to estimate the risk level and associated risk of human infections. In many other areas of the US, the vector index, based only on vector mosquito abundance and infection rates, is used by vector control programs to estimate the risk of human WNV transmission. We built models to determine the association between risk level and the number of reported symptomatic human disease cases with onset in the following three weeks to identify the essential components of the risk level and to compare California’s risk estimates to vector index. Risk level calculations based on Cx. tarsalis and Cx. pipiens complex levels were significantly associated with increased human risk, particularly when accounting for vector control area and population, and were better predictors than using vector index. Including all potential environmental components created an effective tool to estimate the risk of WNV transmission to humans in California.
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20
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Holcomb KM, Nguyen C, Foy BD, Ahn M, Cramer K, Lonstrup ET, Mete A, Tell LA, Barker CM. Effects of ivermectin treatment of backyard chickens on mosquito dynamics and West Nile virus transmission. PLoS Negl Trop Dis 2022; 16:e0010260. [PMID: 35333866 PMCID: PMC9012369 DOI: 10.1371/journal.pntd.0010260] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 04/15/2022] [Accepted: 02/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Vector control strategies typically rely on pesticides to target mosquitoes involved in enzootic and zoonotic transmission of West Nile virus (WNV). Nevertheless, increasing insecticide resistance and a desire to reduce pesticide usage provide the impetus for developing alternative strategies. Ivermectin (IVM), an antiparasitic drug which is widely used in human and veterinary medicine, is a potential alternative for targeted control because Culex mosquitoes experience increased mortality following ingestion of IVM in bloodmeals. Methodology/Principal findings We conducted a randomized field trial to investigate the impact of treating backyard chicken flocks with IVM in urban neighborhoods across Davis, California on mosquito populations and WNV transmission dynamics. We observed a significant reduction in WNV seroconversions in treated vs. untreated chickens, suggesting a reduction in WNV transmission intensity around treated flocks. We also detected a reduction in parity rates of Cx. tarsalis near treated vs. untreated flocks and increased mortality in wild mosquitoes following a bloodmeal on treated chickens (IVM serum concentration > 5ng/mL) vs. chickens with IVM serum concentrations < 5 ng/mL. However, we did not find a significant difference in abundance or infection prevalence in mosquitoes between treatment groups associated with the reductions in seroconversions. Mosquito immigration from surrounding larval habitat, relatively low WNV activity in the study area, and variable IVM serum concentrations likely contributed to uncertainty about the impact. Conclusions/Significance Taken together, our results point to a reduction in WNV transmission due to the impact of IVM on Culex mosquito populations and support the ongoing investigation of oral administration of IVM to wild birds for local control of WNV transmission, although further work is needed to optimize dosing and understand effects on entomological endpoints. Current mosquito control strategies aimed to prevent pathogen transmission to humans have limited ability to target mosquitoes involved in amplification and spillover transmission of pathogens like West Nile virus (WNV). Additionally, growing prevalence of insecticide resistance in mosquito populations limit the efficacy of these insecticide-based control strategies. Ivermectin (IVM) provides an alternative avenue for control by increasing the mortality of mosquitoes that ingest this drug in bloodmeals. Therefore, IVM treatment of avian species that account for the majority of mosquito bloodmeals during the WNV transmission season could be an effective control strategy. Building on pilot studies indicating the efficacy and feasibility of IVM-deployment for WNV control, we performed a randomized field trial to investigate the impact of IVM-treatment of backyard chickens on local population dynamics of Culex mosquitoes and WNV transmission. We were able to link changes in mosquito populations to reduction in WNV transmission, as measured by chicken seroconversions, through IVM-induced mortality in mosquitoes. However, further work is needed to identify the impact of treatment on mosquito abundance and infection prevalence to fully attribute observed changes to IVM administration. Overall, our results support IVM treatment as a potentially effective alternative to insecticide-based vector control strategies and one that can be used to target WNV transmission on the local scale.
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Affiliation(s)
- Karen M. Holcomb
- Davis Arbovirus Research and Training Laboratory, Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Chilinh Nguyen
- Center for Vector-borne Infectious Diseases, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Brian D. Foy
- Center for Vector-borne Infectious Diseases, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Michelle Ahn
- Davis Arbovirus Research and Training Laboratory, Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Kurt Cramer
- Davis Arbovirus Research and Training Laboratory, Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Emma T. Lonstrup
- Davis Arbovirus Research and Training Laboratory, Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Asli Mete
- California Animal Health and Food Safety Lab, Department of Pathology, Microbiology & Immunology, University of California, Davis, California, United States of America
| | - Lisa A. Tell
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Christopher M. Barker
- Davis Arbovirus Research and Training Laboratory, Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
- * E-mail:
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21
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Almeida GM, Souza JP, Mendes ND, Pontelli MC, Pinheiro NR, Nogueira GO, Cardoso RS, Paiva IM, Ferrari GD, Veras FP, Cunha FQ, Horta-Junior JAC, Alberici LC, Cunha TM, Podolsky-Gondim GG, Neder L, Arruda E, Sebollela A. Neural Infection by Oropouche Virus in Adult Human Brain Slices Induces an Inflammatory and Toxic Response. Front Neurosci 2021; 15:674576. [PMID: 34887719 PMCID: PMC8651276 DOI: 10.3389/fnins.2021.674576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/28/2021] [Indexed: 12/22/2022] Open
Abstract
Oropouche virus (OROV) is an emerging arbovirus in South and Central Americas with high spreading potential. OROV infection has been associated with neurological complications and OROV genomic RNA has been detected in cerebrospinal fluid from patients, suggesting its neuroinvasive potential. Motivated by these findings, neurotropism and neuropathogenesis of OROV have been investigated in vivo in murine models, which do not fully recapitulate the complexity of the human brain. Here we have used slice cultures from adult human brains to investigate whether OROV is capable of infecting mature human neural cells in a context of preserved neural connections and brain cytoarchitecture. Our results demonstrate that human neural cells can be infected ex vivo by OROV and support the production of infectious viral particles. Moreover, OROV infection led to the release of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-α) and diminished cell viability 48 h post-infection, indicating that OROV triggers an inflammatory response and tissue damage. Although OROV-positive neurons were observed, microglia were the most abundant central nervous system (CNS) cell type infected by OROV, suggesting that they play an important role in the response to CNS infection by OROV in the adult human brain. Importantly, we found no OROV-infected astrocytes. To the best of our knowledge, this is the first direct demonstration of OROV infection in human brain cells. Combined with previous data from murine models and case reports of OROV genome detection in cerebrospinal fluid from patients, our data shed light on OROV neuropathogenesis and help raising awareness about acute and possibly chronic consequences of OROV infection in the human brain.
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Affiliation(s)
- Glaucia M. Almeida
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Center for Virus Research, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Juliano P. Souza
- Center for Virus Research, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Niele D. Mendes
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Marjorie C. Pontelli
- Center for Virus Research, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Nathalia R. Pinheiro
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Giovanna O. Nogueira
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo S. Cardoso
- Center for Virus Research, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Isadora M. Paiva
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Center for Research in Inflammatory Diseases (CRID), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gustavo D. Ferrari
- Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Flávio P. Veras
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Center for Research in Inflammatory Diseases (CRID), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Fernando Q. Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Center for Research in Inflammatory Diseases (CRID), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jose A. C. Horta-Junior
- Department of Structural and Functional Biology (Anatomy), Institute of Biosciences, São Paulo State University, Botucatu, Brazil
| | - Luciane C. Alberici
- Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Thiago M. Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Center for Research in Inflammatory Diseases (CRID), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Guilherme G. Podolsky-Gondim
- Division of Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luciano Neder
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Eurico Arruda
- Center for Virus Research, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Adriano Sebollela
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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22
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Bravar G, Luchesa Smith A, Siddiqui A, Lim M. Acute Myelopathy in Childhood. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1055. [PMID: 34828768 PMCID: PMC8618498 DOI: 10.3390/children8111055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/04/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022]
Abstract
Acute myelopathy presenting in childhood can be clinically classified based on the location of injury (with resulting spinal syndrome) or the cause (broadly traumatic or non-traumatic). Types of nontraumatic myelopathy include ischaemic, infectious, inflammatory, nutritional, and metabolic causes, some of which may be part of a systemic illness such as systemic lupus erythematosus or a demyelinating disease such as multiple sclerosis. Nonaccidental injury is an important consideration in cases of traumatic myelopathy, which may often be associated with other injuries. Assessment should include neuroimaging of the brain and spinal cord, with further investigations targeted based on the most likely differential diagnoses; for example, a child with suspected demyelinating disease may require specialist cerebrospinal fluid and serological testing. Management also will differ based on the cause of the myelopathy, with several of these treatments more efficacious with earlier initiation, necessitating prompt recognition, diagnosis, and treatment of children presenting with symptoms of a myelopathy. Important components of holistic care may include physiotherapy and occupational therapy, with multidisciplinary team involvement as required (for example psychological support or specialist bowel and bladder teams).
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Affiliation(s)
- Giulia Bravar
- Department of Paediatrics, Hospital Santa Maria della Misericordia, 33100 Udine, Italy;
| | | | - Ata Siddiqui
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London SE1 7EH, UK;
- Department of Neuroradiology, King’s College Hospital, London SE5 9RS, UK
| | - Ming Lim
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London SE1 7EH, UK;
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE5 9NU, UK
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23
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Snyder RE, Cooksey GS, Kramer V, Jain S, Vugia DJ. West Nile Virus-Associated Hospitalizations, California, 2004-2017. Clin Infect Dis 2021; 73:441-447. [PMID: 32525967 DOI: 10.1093/cid/ciaa749] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND West Nile virus (WNV) is the most commonly reported mosquito-borne disease in the USA. California reports more WNV disease than any other state. METHODS We identified WNV-associated hospitalizations from 2004 through 2017 in California and estimated hospitalization incidence using Patient Discharge Data. We described demographic, geographic, and clinical characteristics of WNV hospitalizations; identified risk factors for in-hospital death; and tabulated hospitalization charges. RESULTS From 2004 through 2017, 3109 Californians were hospitalized with WNV (median, 214 patients/year; range, 72-449). The majority were male (1983; 63.8%) and aged ≥60 years (1766; 56.8%). The highest median annual hospitalization rate (0.88 hospitalizations/100 000 persons) was in the Central Valley, followed by southern California (0.59 hospitalizations/100 000 persons). Most patients (2469; 79.4%) had ≥1 underlying condition, including hypertension, cardiovascular disease, diabetes, chronic kidney disease, or immunosuppression due to medications or disease. Median hospitalization length of stay was 12 days (interquartile range, 6-23 days). During hospitalization, 1317 (42%) patients had acute respiratory failure and/or sepsis/septic shock, 772 (24.8%) experienced acute kidney failure, and 470 (15.1%) had paralysis; 272 (8.8%) patients died. Nearly 47% (1444) of patients were discharged for additional care. During these 14 years, $838 680 664 (mean $59.9 million/year) was charged for WNV hospitalizations, 73.9% through government payers at a median charge of $142 321/patient. CONCLUSIONS WNV-associated hospitalizations were substantial and costly in California. Hospitalization incidence was higher in males, elderly persons, and patients with underlying conditions. WNV persists as a costly and severe public health threat in California.
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Affiliation(s)
- Robert E Snyder
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Gail Sondermeyer Cooksey
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Vicki Kramer
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Seema Jain
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
| | - Duc J Vugia
- Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento and Richmond, California, USA
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24
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Danforth ME, Fischer M, Snyder RE, Lindsey NP, Martin SW, Kramer VL. Characterizing Areas with Increased Burden of West Nile Virus Disease in California, 2009-2018. Vector Borne Zoonotic Dis 2021; 21:620-627. [PMID: 34077676 PMCID: PMC8380797 DOI: 10.1089/vbz.2021.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
West Nile virus (WNV) is a mosquito-borne flavivirus that can cause severe neurological disease in humans, for which there is no treatment or vaccine. From 2009 to 2018, California has reported more human disease cases than any other state in the United States. We sought to identify smaller geographic areas within the 10 California counties with the highest number of WNV cases that accounted for disproportionately large numbers of human cases from 2009 to 2018. Eleven areas, consisting of groups of high-burden ZIP codes, were identified in nine counties within southern California and California's Central Valley. Despite containing only 2% of California's area and 17% of the state's population, these high-burden ZIP codes accounted for 44% of WNV cases reported and had a mean annual incidence that was 2.4 times the annual state incidence. Focusing mosquito control and public education efforts in these areas would lower WNV disease burden.
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Affiliation(s)
- Mary E. Danforth
- California Department of Public Health, Sacramento, California, USA
| | - Marc Fischer
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Robert E. Snyder
- California Department of Public Health, Sacramento, California, USA
| | - Nicole P. Lindsey
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Stacey W. Martin
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Vicki L. Kramer
- California Department of Public Health, Sacramento, California, USA
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25
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Curren EJ, Shankar MB, Fischer M, Meltzer MI, Staples JE, Gould CV. Cost effectiveness and impact of a targeted age- and incidence-based West Nile virus vaccine strategy. Clin Infect Dis 2021; 73:1565-1570. [PMID: 34117746 DOI: 10.1093/cid/ciab540] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND West Nile virus (WNV) is the leading cause of arboviral disease in the United States and is associated with significant morbidity and mortality. A previous analysis found that a vaccination program targeting persons aged ≥60 years was more cost effective than universal vaccination, but costs remained high. METHODS We used a mathematical Markov model to evaluate cost-effectiveness of an age- and incidence-based WNV vaccination program. We grouped states and large counties (≥100,000 persons aged ≥60 years) by median annual WNV incidence rates from 2004 to 2017 for persons aged ≥60 years. We defined WNV incidence thresholds, in increments of 0.5 cases per 100,000 persons ≥60 years. We calculated potential cost per WNV vaccine-prevented case and per quality adjusted life years (QALYs) saved. RESULTS Vaccinating persons aged ≥60 years in states with an annual incidence of WNV neuroinvasive disease of ≥0.5 per 100,000 resulted in approximately half the cost per health outcome averted compared to vaccinating persons aged ≥60 years in all the contiguous United States. This approach could potentially prevent 37% of all neuroinvasive disease cases and 63% of WNV-related deaths nationally. Employing such a threshold at a county-level further improved cost-effectiveness ratios while preventing 19% and 30% of WNV-related neuroinvasive disease cases and deaths, respectively. CONCLUSIONS An age- and incidence-based WNV vaccination program could be a more cost-effective strategy than an age-based program while still having a substantial impact on lowering WNV-related morbidity and mortality.
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Affiliation(s)
- Emily J Curren
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado, USA.,Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | | | - Marc Fischer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado, USA
| | - Martin I Meltzer
- Division of Preparedness and Emerging Infections, CDC, Atlanta, Georgia, USA
| | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado, USA
| | - Carolyn V Gould
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado, USA
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26
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Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has cast increased attention on emerging infections. Clinicians and public health experts should be aware of emerging infectious causes of encephalitis, mechanisms by which they are transmitted, and clinical manifestations of disease. RECENT FINDINGS A number of arthropod-borne viral infections -- transmitted chiefly by mosquitoes and ticks -- have emerged in recent years to cause outbreaks of encephalitis. Examples include Powassan virus in North America, Chikungunya virus in Central and South America, and tick-borne encephalitis virus in Europe. Many of these viruses exhibit complex life cycles and can infect multiple host animals in addition to humans. Factors thought to influence emergence of these diseases, including changes in climate and land use, are also believed to underlie the emergence of the rickettsial bacterium Orientia tsutsugamushi, now recognized as a major causative agent of acute encephalitis syndrome in South Asia. In addition, the COVID-19 pandemic has highlighted the role of bats as carriers of viruses. Recent studies have begun to uncover mechanisms by which the immune systems of bats are poised to allow for viral tolerance. Several bat-borne infections, including Nipah virus and Ebola virus, have resulted in recent outbreaks of encephalitis. SUMMARY Infectious causes of encephalitis continue to emerge worldwide, in part because of climate change and human impacts on the environment. Expansion of surveillance measures will be critical in rapid diagnosis and limiting of outbreaks in the future.
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27
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Stefano GB, Büttiker P, Weissenberger S, Martin A, Ptacek R, Kream RM. Editorial: The Pathogenesis of Long-Term Neuropsychiatric COVID-19 and the Role of Microglia, Mitochondria, and Persistent Neuroinflammation: A Hypothesis. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021; 27:e933015. [PMID: 34016942 PMCID: PMC8120907 DOI: 10.12659/msm.933015] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Persistent comorbidities occur in patients who initially recover from acute coronavirus disease 2019 (COVID-19) due to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ‘Long COVID’ involves the central nervous system (CNS), resulting in neuropsychiatric symptoms and signs, including cognitive impairment or ‘brain fog’ and chronic fatigue syndrome. There are similarities in these persistent complications between SARS-CoV-2 and the Ebola, Zika, and influenza A viruses. Normal CNS neuronal mitochondrial function requires high oxygen levels for oxidative phosphorylation and ATP production. Recent studies have shown that the SARS-CoV-2 virus can hijack mitochondrial function. Persistent changes in cognitive functioning have also been reported with other viral infections. SARS-CoV-2 infection may result in long-term effects on immune processes within the CNS by causing microglial dysfunction. This short opinion aims to discuss the hypothesis that the pathogenesis of long-term neuropsychiatric COVID-19 involves microglia, mitochondria, and persistent neuroinflammation.
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Affiliation(s)
- George B Stefano
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Pascal Büttiker
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Simon Weissenberger
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Anders Martin
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Radek Ptacek
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Richard M Kream
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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28
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Graham JB, Swarts JL, Edwards KR, Voss KM, Green R, Jeng S, Miller DR, Mooney MA, McWeeney SK, Ferris MT, Pardo-Manuel de Villena F, Gale M, Lund JM. Correlation of Regulatory T Cell Numbers with Disease Tolerance upon Virus Infection. Immunohorizons 2021; 5:157-169. [PMID: 33893179 PMCID: PMC8281504 DOI: 10.4049/immunohorizons.2100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/19/2021] [Indexed: 11/19/2022] Open
Abstract
The goal of a successful immune response is to clear the pathogen while sparing host tissues from damage associated with pathogen replication and active immunity. Regulatory T cells (Treg) have been implicated in maintaining this balance as they contribute both to the organization of immune responses as well as restriction of inflammation and immune activation to limit immunopathology. To determine if Treg abundance prior to pathogen encounter can be used to predict the success of an antiviral immune response, we used genetically diverse mice from the collaborative cross infected with West Nile virus (WNV). We identified collaborative cross lines with extreme Treg abundance at steady state, either high or low, and used mice with these extreme phenotypes to demonstrate that baseline Treg quantity predicted the magnitude of the CD8 T cell response to WNV infection, although higher numbers of baseline Tregs were associated with reduced CD8 T cell functionality in terms of TNF and granzyme B expression. Finally, we found that abundance of CD44+ Tregs in the spleen at steady state was correlated with an increased early viral load within the spleen without an association with clinical disease. Thus, we propose that Tregs participate in disease tolerance in the context of WNV infection by tuning an appropriately focused and balanced immune response to control the virus while at the same time minimizing immunopathology and clinical disease. We hypothesize that Tregs limit the antiviral CD8 T cell function to curb immunopathology at the expense of early viral control as an overall host survival strategy.
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Affiliation(s)
- Jessica B Graham
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jessica L Swarts
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kristina R Edwards
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kathleen M Voss
- Center for Innate Immunity and Immune Disease, Department of Immunology, University of Washington School of Medicine, Seattle, WA
| | - Richard Green
- Center for Innate Immunity and Immune Disease, Department of Immunology, University of Washington School of Medicine, Seattle, WA
| | - Sophia Jeng
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR.,OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Darla R Miller
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michael A Mooney
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR.,OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Shannon K McWeeney
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR.,OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR.,Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR
| | - Martin T Ferris
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Fernando Pardo-Manuel de Villena
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Michael Gale
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Jennifer M Lund
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA; .,Department of Global Health, University of Washington, Seattle, WA
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29
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Holcomb KM, Reiner RC, Barker CM. Spatio-temporal impacts of aerial adulticide applications on populations of West Nile virus vector mosquitoes. Parasit Vectors 2021; 14:120. [PMID: 33627165 PMCID: PMC7905633 DOI: 10.1186/s13071-021-04616-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/29/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Aerial applications of insecticides that target adult mosquitoes are widely used to reduce transmission of West Nile virus to humans during periods of epidemic risk. However, estimates of the reduction in abundance following these treatments typically focus on single events, rely on pre-defined, untreated control sites and can vary widely due to stochastic variation in population dynamics and trapping success unrelated to the treatment. METHODS To overcome these limitations, we developed generalized additive models fitted to mosquito surveillance data collected from CO2-baited traps in Sacramento and Yolo counties, California from 2006 to 2017. The models accounted for the expected spatial and temporal trends in the abundance of adult female Culex (Cx.) tarsalis and Cx. pipiens in the absence of aerial spraying. Estimates for the magnitude of deviation from baseline abundance following aerial spray events were obtained from the models. RESULTS At 1-week post-treatment with full spatial coverage of the trapping area by pyrethroid or pyrethrin products, Cx. pipiens abundance was reduced by a mean of 52.4% (95% confidence intrval [CI] - 65.6, - 36.5%) while the use of at least one organophosphate pesticide resulted in a mean reduction of 76.2% (95% CI - 82.8, - 67.9%). For Cx. tarsalis, at 1-week post-treatment with full coverage there was a reduction in abundance of 30.7% (95% CI - 54.5, 2.5%). Pesticide class was not a significant factor contributing to the reduction. In comparison, repetition of spraying over three to four consecutive weeks resulted in similar estimates for Cx. pipiens and estimates of somewhat smaller magnitude for Cx. tarsalis. CONCLUSIONS Aerial adulticides are effective for achieving a rapid short-term reduction of the abundance of the primary West Nile virus vectors, Cx. tarsalis and Cx. pipiens. A larger magnitude of reduction was estimated in Cx. pipiens, possibly due to the species' focal distribution. Effects of aerial sprays on Cx. tarsalis populations are likely modulated by the species' large dispersal ability, population sizes and vast productive larval habitat present in the study area. Our modeling approach provides a new way to estimate effects of public health pesticides on vector populations using routinely collected observational data and accounting for spatio-temporal trends and contextual factors like weather and habitat. This approach does not require pre-selected control sites and expands upon past studies that have focused on the effects of individual aerial treatment events.
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Affiliation(s)
- Karen M Holcomb
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, 98121, USA
| | - Christopher M Barker
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA.
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30
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Autochthonous Transmission of West Nile Virus by a New Vector in Iran, Vector-Host Interaction Modeling and Virulence Gene Determinants. Viruses 2020; 12:v12121449. [PMID: 33339336 PMCID: PMC7766443 DOI: 10.3390/v12121449] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/27/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
Using molecular techniques and bioinformatics tools, we studied the vector-host interactions and the molecular epidemiology of West Nile virus (WNV) in western Iran. Mosquitoes were collected during 2017 and 2018. DNA typing assays were used to study vector-host interactions. Mosquitoes were screened by RT-PCR for the genomes of five virus families. WNV-positive samples were fully sequenced and evolutionary tree and molecular architecture were constructed by Geneious software and SWISS-MODEL workspace, respectively. A total of 5028 mosquito specimens were collected and identified. The most prevalent species was Culex (Cx.) pipiens complex (57.3%). Analysis of the blood-feeding preferences of blood-fed mosquitoes revealed six mammalian and one bird species as hosts. One mosquito pool containing non-blood-fed Cx. theileri and one blood-fed Culex pipiens pipiens (Cpp.) biotype pipiens were positive for WNV. A phylogram indicated that the obtained WNV sequences belonged to lineage 2, subclade 2 g. Several amino acid substitutions suspected as virulence markers were observed in the Iranian WNV strains. The three-dimensional structural homology model of the E-protein identified hot spot domains known to facilitate virus invasion and neurotropism. The recent detection of WNV lineage 2 in mosquitoes from several regions of Iran in consecutive years suggests that the virus is established in the country.
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Clé M, Eldin P, Briant L, Lannuzel A, Simonin Y, Van de Perre P, Cabié A, Salinas S. Neurocognitive impacts of arbovirus infections. J Neuroinflammation 2020; 17:233. [PMID: 32778106 PMCID: PMC7418199 DOI: 10.1186/s12974-020-01904-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/17/2020] [Indexed: 12/15/2022] Open
Abstract
Arthropod-borne viruses or arbovirus, are most commonly associated with acute infections, resulting on various symptoms ranging from mild fever to more severe disorders such as hemorrhagic fever. Moreover, some arboviral infections can be associated with important neuroinflammation that can trigger neurological disorders including encephalitis, paralysis, ophthalmological impairments, or developmental defects, which in some cases, can lead to long-term defects of the central nervous system (CNS). This is well illustrated in Zika virus-associated congenital brain malformations but also in West Nile virus-induced synaptic dysfunctions that can last well beyond infection and lead to cognitive deficits. Here, we summarize clinical and mechanistic data reporting on cognitive disturbances triggered by arboviral infections, which may highlight growing public health issues spanning the five continents.
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Affiliation(s)
- Marion Clé
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, Montpellier, France
| | - Patrick Eldin
- Institute of Research in Infectiology of Montpellier, CNRS, University of Montpellier, Montpellier, France
| | - Laurence Briant
- Institute of Research in Infectiology of Montpellier, CNRS, University of Montpellier, Montpellier, France
| | - Annie Lannuzel
- Neurology Unit, INSERM CIC 1424, Guadeloupe University Hospital, Université des Antilles, Pointe-à-Pitre, Guadeloupe, France
- INSERM U1127, CNRS, UMR7225, Brain and Spine Institute, Sorbonne University Medical School, Paris, France
| | - Yannick Simonin
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, CHU Montpellier, Montpellier, France
| | - André Cabié
- INSERM CIC 1424, Infectious Disease and Tropical Medicine Unit, Martinique University Hospital, Université des Antilles EA4537, Martinique, France.
| | - Sara Salinas
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, Montpellier, France.
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West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and "One Health" Implications. Pathogens 2020; 9:pathogens9070589. [PMID: 32707644 PMCID: PMC7400489 DOI: 10.3390/pathogens9070589] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023] Open
Abstract
West Nile virus (WNV) is an important zoonotic flavivirus responsible for mild fever to severe, lethal neuroinvasive disease in humans, horses, birds, and other wildlife species. Since its discovery, WNV has caused multiple human and animal disease outbreaks in all continents, except Antarctica. Infections are associated with economic losses, mainly due to the cost of treatment of infected patients, control programmes, and loss of animals and animal products. The pathogenesis of WNV has been extensively investigated in natural hosts as well as in several animal models, including rodents, lagomorphs, birds, and reptiles. However, most of the proposed pathogenesis hypotheses remain contentious, and much remains to be elucidated. At the same time, the unavailability of specific antiviral treatment or effective and safe vaccines contribute to the perpetuation of the disease and regular occurrence of outbreaks in both endemic and non-endemic areas. Moreover, globalisation and climate change are also important drivers of the emergence and re-emergence of the virus and disease. Here, we give an update of the pathobiology, epidemiology, diagnostics, control, and “One Health” implications of WNV infection and disease.
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Long-term, West Nile virus-induced neurological changes: A comparison of patients and rodent models. Brain Behav Immun Health 2020; 7:100105. [PMID: 34589866 PMCID: PMC8474605 DOI: 10.1016/j.bbih.2020.100105] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/07/2020] [Accepted: 07/12/2020] [Indexed: 02/06/2023] Open
Abstract
West Nile virus (WNV) is a mosquito-borne virus that can cause severe neurological disease in those infected. Those surviving infection often present with long-lasting neurological changes that can severely impede their lives. The most common reported symptoms are depression, memory loss, and motor dysfunction. These sequelae can persist for the rest of the patients’ lives. The pathogenesis behind these changes is still being determined. Here, we summarize current findings in human cases and rodent models, and discuss how these findings indicate that WNV induces a state in the brain similar neurodegenerative diseases. Rodent models have shown that infection leads to persistent virus and inflammation. Initial infection in the hippocampus leads to neuronal dysfunction, synapse elimination, and astrocytosis, all of which contribute to memory loss, mimicking findings in neurodegenerative diseases such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). WNV infection acts on pathways, such as ubiquitin-signaled protein degradation, and induces the production of molecules, including IL-1β, IFN-γ, and α-synuclein, that are associated with neurodegenerative diseases. These findings indicate that WNV induces neurological damage through similar mechanisms as neurodegenerative diseases, and that pursuing research into the similarities will help advance our understanding of the pathogenesis of WNV-induced neurological sequelae. In patients with and without diagnosed WNND, there are long-lasting neurological sequelae that can mimic neurodegenerative diseases. Some rodent models of WNV reproduce some of these changes with mechanisms similar to neurodegenerative diseases. There is significant overlap between WNV and ND pathogenesis and this has been understudied. Further research needs to be done to determine accuracy of animal models compared to human patients.
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Goh VSL, Mok CK, Chu JJH. Antiviral Natural Products for Arbovirus Infections. Molecules 2020; 25:molecules25122796. [PMID: 32560438 PMCID: PMC7356825 DOI: 10.3390/molecules25122796] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 12/14/2022] Open
Abstract
Over the course of the last 50 years, the emergence of several arboviruses have resulted in countless outbreaks globally. With a high proportion of infections occurring in tropical and subtropical regions where arthropods tend to be abundant, Asia in particular is a region that is heavily affected by arboviral diseases caused by dengue, Japanese encephalitis, West Nile, Zika, and chikungunya viruses. Major gaps in protection against the most significant emerging arboviruses remains as there are currently no antivirals available, and vaccines are only available for some. A potential source of antiviral compounds could be discovered in natural products—such as vegetables, fruits, flowers, herbal plants, marine organisms and microorganisms—from which various compounds have been documented to exhibit antiviral activities and are expected to have good tolerability and minimal side effects. Polyphenols and plant extracts have been extensively studied for their antiviral properties against arboviruses and have demonstrated promising results. With an abundance of natural products to screen for new antiviral compounds, it is highly optimistic that natural products will continue to play an important role in contributing to antiviral drug development and in reducing the global infection burden of arboviruses.
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Affiliation(s)
- Vanessa Shi Li Goh
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore;
- Infectious Disease Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Chee-Keng Mok
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore;
- Infectious Disease Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Correspondence: (C.-K.M.); (J.J.H.C.)
| | - Justin Jang Hann Chu
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore;
- Infectious Disease Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Collaborative and Translation Unit for HFMD, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore
- Correspondence: (C.-K.M.); (J.J.H.C.)
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Abstract
PURPOSE OF REVIEW The present review will outline neuroprotective and neurotoxic effects of central nervous system (CNS) infiltrating T cells during viral infections. Evidence demonstrating differential roles for antiviral effector and resident memory T-cell subsets in virologic control and immunopathology in the CNS will be discussed. Potential therapeutic targets emanating from a growing understanding of T-cell-initiated neuropathology that impacts learning and memory will also be delineated. RECENT FINDINGS The critical role for T cells in preventing and clearing CNS infections became incontrovertible during the era of acquired immunodeficiency syndrome. Recent studies have further defined differential roles of T-cell subsets, including resident memory T cells (Trm), in antiviral immunity and, unexpectedly, in postinfectious cognitive dysfunction. Mechanisms of T-cell-mediated effects include differential innate immune signaling within neural cells that are virus-specific. SUMMARY T-cell cytokines that are essential for cell-mediated virologic control during neurotropic viral infections have recently been identified as potential targets to prevent post-infection memory disorders. Further identification of T-cell subsets, their antigen specificity, and postinfection localization of Trm will enhance the efficacy of immunotherapies through minimization of immunopathology.
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Affiliation(s)
| | - Robyn S. Klein
- Departments of Medicine
- Pathology and Immunology
- Neurosciences Washington University School of Medicine, St. Louis, Missouri, USA
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Pacenti M, Sinigaglia A, Franchin E, Pagni S, Lavezzo E, Montarsi F, Capelli G, Barzon L. Human West Nile Virus Lineage 2 Infection: Epidemiological, Clinical, and Virological Findings. Viruses 2020; 12:v12040458. [PMID: 32325716 PMCID: PMC7232435 DOI: 10.3390/v12040458] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/08/2020] [Accepted: 04/16/2020] [Indexed: 11/30/2022] Open
Abstract
West Nile virus (WNV) lineage 2 is expanding and causing large outbreaks in Europe. In this study, we analyzed the epidemiological, clinical, and virological features of WNV lineage 2 infection during the large outbreak that occurred in northern Italy in 2018. The study population included 86 patients with neuroinvasive disease (WNND), 307 with fever (WNF), and 34 blood donors. Phylogenetic analysis of WNV full genome sequences from patients’ samples showed that the virus belonged to the widespread central/southern European clade of WNV lineage 2 and was circulating in the area at least since 2014. The incidence of WNND and WNF progressively increased with age and was higher in males than in females. Among WNND patients, the case fatality rate was 22%. About 70% of blood donors reported symptoms during follow-up. Within the first week after symptom onset, WNV RNA was detectable in the blood or urine of 80% of patients, while 20% and 40% of WNND and WNF patients, respectively, were WNV IgM-seronegative. In CSF samples of WNND patients, WNV RNA was typically detectable when WNV IgM antibodies were absent. Blunted or no WNV IgM response and high WNV IgG levels were observed in seven patients with previous flavivirus immunity.
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Affiliation(s)
- Monia Pacenti
- Microbiology and Virology Unit, Padova University Hospital, I-35128 Padova, Italy; (M.P.); (E.F.); (S.P.)
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padova, I-35121 Padova, Italy; (A.S.); (E.L.)
| | - Elisa Franchin
- Microbiology and Virology Unit, Padova University Hospital, I-35128 Padova, Italy; (M.P.); (E.F.); (S.P.)
- Department of Molecular Medicine, University of Padova, I-35121 Padova, Italy; (A.S.); (E.L.)
| | - Silvana Pagni
- Microbiology and Virology Unit, Padova University Hospital, I-35128 Padova, Italy; (M.P.); (E.F.); (S.P.)
- Department of Molecular Medicine, University of Padova, I-35121 Padova, Italy; (A.S.); (E.L.)
| | - Enrico Lavezzo
- Department of Molecular Medicine, University of Padova, I-35121 Padova, Italy; (A.S.); (E.L.)
| | - Fabrizio Montarsi
- Istituto Zooprofilattico Sperimentale delle Venezie, I-35020 Legnaro PD, Italy; (F.M.); (G.C.)
| | - Gioia Capelli
- Istituto Zooprofilattico Sperimentale delle Venezie, I-35020 Legnaro PD, Italy; (F.M.); (G.C.)
| | - Luisa Barzon
- Microbiology and Virology Unit, Padova University Hospital, I-35128 Padova, Italy; (M.P.); (E.F.); (S.P.)
- Department of Molecular Medicine, University of Padova, I-35121 Padova, Italy; (A.S.); (E.L.)
- Correspondence: ; Tel.: +39-049-8218946
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Gnann JW, Agrawal A, Hart J, Buitrago M, Carson P, Hanfelt-Goade D, Tyler K, Spotkov J, Freifeld A, Moore T, Reyno J, Masur H, Jester P, Dale I, Li Y, Aban I, Lakeman FD, Whitley RJ. Lack of Efficacy of High-Titered Immunoglobulin in Patients with West Nile Virus Central Nervous System Disease. Emerg Infect Dis 2020; 25:2064-2073. [PMID: 31625835 PMCID: PMC6810207 DOI: 10.3201/eid2511.190537] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Immunoglobulin administered to adults with neuroinvasive disease appeared to be safe but was not demonstrated to improve clinical outcomes. West Nile Virus (WNV) can result in clinically severe neurologic disease. There is no treatment for WNV infection, but administration of anti-WNV polyclonal human antibody has demonstrated efficacy in animal models. We compared Omr-IgG-am, an immunoglobulin product with high titers of anti-WNV antibody, with intravenous immunoglobulin (IVIG) and normal saline to assess safety and efficacy in patients with WNV neuroinvasive disease as part of a phase I/II, randomized, double-blind, multicenter study in North America. During 2003–2006, a total of 62 hospitalized patients were randomized to receive Omr-IgG-am, standard IVIG, or normal saline (3:1:1). The primary endpoint was medication safety. Secondary endpoints were morbidity and mortality, measured using 4 standardized assessments of cognitive and functional status. The death rate in the study population was 12.9%. No significant differences were found between groups receiving Omr-IgG-am compared with IVIG or saline for either the safety or efficacy endpoints.
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West Nile Virus Vaccine Design by T Cell Epitope Selection: In Silico Analysis of Conservation, Functional Cross-Reactivity with the Human Genome, and Population Coverage. J Immunol Res 2020; 2020:7235742. [PMID: 32258174 PMCID: PMC7106935 DOI: 10.1155/2020/7235742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 12/05/2019] [Indexed: 12/22/2022] Open
Abstract
West Nile Virus (WNV) causes a debilitating and life-threatening neurological disease in humans. Since its emergence in Africa 50 years ago, new strains of WNV and an expanding geographical distribution have increased public health concerns. There are no licensed therapeutics against WNV, limiting effective infection control. Vaccines represent the most efficacious and efficient medical intervention known. Epitope-based vaccines against WNV remain significantly underexploited. Here, we use a selection protocol to identify a set of conserved prevalidated immunogenic T cell epitopes comprising a putative WNV vaccine. Experimentally validated immunogenic WNV epitopes and WNV sequences were retrieved from the IEDB and West Nile Virus Variation Database. Clustering and multiple sequence alignment identified a smaller subset of representative sequences. Protein variability analysis identified evolutionarily conserved sequences, which were used to select a diverse set of immunogenic candidate T cell epitopes. Cross-reactivity and human leukocyte antigen-binding affinities were assessed to eliminate unsuitable epitope candidates. Population protection coverage (PPC) quantified individual epitopes and epitope combinations against the world population. 3 CD8+ T cell epitopes (ITYTDVLRY, TLARGFPFV, and SYHDRRWCF) and 1 CD4+ epitope (VTVNPFVSVATANAKVLI) were selected as a putative WNV vaccine, with an estimated PPC of 97.14%.
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Patel A, Lynch F, Shepherd SA. Newer Immunotherapies for the Treatment of Acute Neuromuscular Disease in the Critical Care Unit. Curr Treat Options Neurol 2020; 22:7. [PMID: 32052202 DOI: 10.1007/s11940-020-0616-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OPINION STATEMENT PURPOSE OF REVIEW: In this review, we discuss current treatment options for commonly encountered neuromuscular disorders in intensive care units. We will discuss epidemiology, pathophysiology, and acute and chronic treatment options for myasthenia gravis, Guillain-Barré syndrome, West Nile virus, Botulism, and amyotrophic lateral sclerosis. RECENT FINDINGS Eculizumab is the newest immunomodulator therapy approved by the Food and Drug Administration in treatment of myasthenia gravis, shown to improve long-term functional outcomes. Edaravone is the newest therapy in management of amyotrophic lateral sclerosis, shown to slow functional deterioration. Efgartigimod showed great promise in a phase 2 safety and efficacy trial in the treatment of stable generalized myasthenia gravis. Eculizumab was found to be safe in a small phase 2 trial for use in Guillain-Barré syndrome. Currently, therapies such as plasma exchange, intravenous immunoglobulins, and steroids remain the mainstay of treatment in the ICU for many neuromuscular disorders. While there are some newer immunotherapies available, few have been studied in the acute setting. However, with the advent of new immunotherapies and biologics, changes in these approaches may be on the horizon.
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Affiliation(s)
- Alok Patel
- Department of Neurology, Rush University Medical Center, 1725 W Harrison St, Suite 1121, Chicago, IL, 60612, USA
| | - Fiona Lynch
- Department of Neurology, Rush University Medical Center, 1725 W Harrison St, Suite 1121, Chicago, IL, 60612, USA
| | - Starane A Shepherd
- Department of Neurology, Rush University Medical Center, 1725 W Harrison St, Suite 1121, Chicago, IL, 60612, USA.
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40
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Shing E, Wang J, Nelder MP, Parpia C, Gubbay JB, Loeb M, Kristjanson E, Marchand-Austin A, Moore S, Russell C, Sider D, Sander B. The direct healthcare costs attributable to West Nile virus illness in Ontario, Canada: a population-based cohort study using laboratory and health administrative data. BMC Infect Dis 2019; 19:1059. [PMID: 31847823 PMCID: PMC6918579 DOI: 10.1186/s12879-019-4596-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/24/2019] [Indexed: 11/27/2022] Open
Abstract
Background West Nile virus (WNV) is a mosquito-borne flavivirus, first detected in the Western Hemisphere in 1999 and spread across North America over the next decade. Though endemic in the most populous areas of North America, few studies have estimated the healthcare costs associated with WNV. The objective of this study was to determine direct healthcare costs attributable to WNV illness in Ontario, Canada. Methods We conducted a cost-of-illness study on incident laboratory confirmed and probable WNV infected subjects identified from the provincial laboratory database from Jan 1, 2002 through Dec 31, 2012. Infected subjects were linked to health administrative data and matched to uninfected subjects. We used phase-of-care methods to calculate costs for 3 phases of illness: acute infection, continuing care, and final care prior to death. Mean 10-day attributable costs were reported in 2014 Canadian dollars, per capita. Sensitivity analysis was conducted to test the impact of WNV neurologic syndromes on healthcare costs. Results One thousand five hundred fifty-one laboratory confirmed and probable WNV infected subjects were ascertained; 1540 (99.3%) were matched to uninfected subjects. Mean age of WNV infected subjects was 49.1 ± 18.4 years, 50.5% were female. Mean costs attributable to WNV were $1177 (95% CI: $1001, $1352) for acute infection, $180 (95% CI: $122, $238) for continuing care, $11,614 (95% CI: $5916, $17,313) for final care - acute death, and $3199 (95% CI: $1770, $4627) for final care - late death. Expected 1-year costs were $13,648, adjusted for survival. Three hundred seventeen infected subjects were diagnosed with at least one neurologic syndrome and greatest healthcare costs in acute infection were associated with encephalitis ($4710, 95% CI: $3770, $5650). Conclusions WNV is associated with increased healthcare resource utilization across all phases of care. High-quality studies are needed to understand the health system impact of vector-borne diseases and evaluate the cost effectiveness of novel WNV interventions.
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Affiliation(s)
- Emily Shing
- Public Health Ontario, Toronto, Ontario, Canada.
| | - John Wang
- Public Health Ontario, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | | | | | | | - Mark Loeb
- Department of Pathology and Molecular Medicine; Department of Health Research, Evidence, and Impact; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | | - Doug Sider
- Public Health Ontario, Toronto, Ontario, Canada
| | - Beate Sander
- Public Health Ontario, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
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41
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Parrino D, Brescia G, Trimarchi MV, Tealdo G, Sasset L, Cattelan AM, Bovo R, Marioni G. Cochlear-Vestibular Impairment due to West Nile Virus Infection. Ann Otol Rhinol Laryngol 2019; 128:1198-1202. [PMID: 31366220 DOI: 10.1177/0003489419866219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES West Nile virus (WNV) has been spreading over the last 20 years. Human infection is asymptomatic in most cases. When the disease becomes clinically manifest, it may involve a range of issues, from a mild infection with flu-like symptoms to a neuroinvasive disease. Albeit rarely, WNV-associated sensorineural hearing loss (SNHL) has also been reported. Here we describe two new cases of SNHL and balance impairment caused by WNV infection. METHODS The patients were investigated with repeated audiometric tests and, for the first time, videonystagmography was also used. RESULTS Unlike findings in the few other published cases, an improvement in audiometric thresholds and vestibular function was documented in both of our patients. CONCLUSIONS In the light of our findings, a prospective study would be warranted on a large series of patients with WNV infection in order: (i) to better define the epidemiology of the related cochlear-vestibular involvement; and (ii) to elucidate the virus-related changes to peripheral and central auditory and vestibular functions.
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Affiliation(s)
- Daniela Parrino
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Giuseppe Brescia
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | | | - Giulia Tealdo
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Lolita Sasset
- Unit of Tropical and Infectious Diseases, Azienda Ospedaliera- Padova University, Padova, Italy
| | - Anna Maria Cattelan
- Unit of Tropical and Infectious Diseases, Azienda Ospedaliera- Padova University, Padova, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
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42
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Garber C, Soung A, Vollmer LL, Kanmogne M, Last A, Brown J, Klein RS. T cells promote microglia-mediated synaptic elimination and cognitive dysfunction during recovery from neuropathogenic flaviviruses. Nat Neurosci 2019; 22:1276-1288. [PMID: 31235930 PMCID: PMC6822175 DOI: 10.1038/s41593-019-0427-y] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 05/16/2019] [Indexed: 11/09/2022]
Abstract
T cells clear virus from the CNS and dynamically regulate brain functions, including spatial learning, through cytokine signaling. Here we determined whether hippocampal T cells that persist after recovery from infection with West Nile virus (WNV) or Zika virus (ZIKV) impact hippocampal-dependent learning and memory. Using newly established models of viral encephalitis recovery in adult animals, we show that in mice that have recovered from WNV or ZIKV infection, T cell-derived interferon-γ (IFN-γ) signaling in microglia underlies spatial-learning defects via virus-target-specific mechanisms. Following recovery from WNV infection, mice showed presynaptic termini elimination with lack of repair, while for ZIKV, mice showed extensive neuronal apoptosis with loss of postsynaptic termini. Accordingly, animals deficient in CD8+ T cells or IFN-γ signaling in microglia demonstrated protection against synapse elimination following WNV infection and decreased neuronal apoptosis with synapse recovery following ZIKV infection. Thus, T cell signaling to microglia drives post-infectious cognitive sequelae that are associated with emerging neurotropic flaviviruses.
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Affiliation(s)
- Charise Garber
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Allison Soung
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Lauren L Vollmer
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Marlene Kanmogne
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Aisling Last
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Jasmine Brown
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Robyn S Klein
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA.
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA.
- Department of Neuroscience, Washington University School of Medicine, St Louis, MO, USA.
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43
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Lenka A, Kamat A, Mittal SO. Spectrum of Movement Disorders in Patients With Neuroinvasive West Nile Virus Infection. Mov Disord Clin Pract 2019; 6:426-433. [PMID: 31392241 DOI: 10.1002/mdc3.12806] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/28/2019] [Accepted: 06/05/2019] [Indexed: 11/05/2022] Open
Abstract
Background West Nile virus (WNV) is a flavivirus that is recognized as one of the common causes of arboviral neurological disease in the world. WNV infections usually manifest with constitutional symptoms such as fever, fatigue, myalgia, rash, arthralgia, and headache. Neuroinvasive WNV infections are characterized by signs and symptoms suggestive of meningitis, encephalitis, meningoencephalitis, and acute flaccid paralysis. In addition, many patients with neuroinvasive WNV infection develop a wide range of movement disorders. This article aims to comprehensively review the spectrum and natural course of the movement disorders observed in patients with neuroinvasive WNV infections. Methods A literature search was performed in March 2019 (in PubMed and EMBASE) to identify articles for this review. Results Movement disorders observed in the context of WNV infections include tremor, opsoclonus-myoclonus, parkinsonism, myoclonus, ataxia, and chorea. Most often, these movement disorders resolve within a few weeks to months with an indolent course. The commonly observed tremor phenotypes include action tremor of the upper extremities (bilateral > unilateral). Tremor in patients with West Nile meningitis subsides earlier than that in patients with West Nile encephalitis/acute flaccid paralysis. Opsoclonus-myoclonus in WNV infections responds well to intravenous immunoglobulins/plasmapheresis/corticosteroids. Parkinsonism has been reported to be mild in nature and usually lasts for a few weeks to months in the majority of the patients. Conclusion A wide spectrum of movement disorders is observed in neuroinvasive WNV infections. Longitudinal studies are warranted to obtain better insights into the natural course of these movement disorders.
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Affiliation(s)
- Abhishek Lenka
- Department of Neurology MedStar Georgetown University Hospital Washington DC USA
| | - Anuja Kamat
- Department of Internal Medicine Texas Tech University Health Sciences Center Amarillo TX USA
| | - Shivam Om Mittal
- Department of Neurology Cleveland Clinic Abu Dhabi United Arab Emirates
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Slonchak A, Clarke B, Mackenzie J, Amarilla AA, Setoh YX, Khromykh AA. West Nile virus infection and interferon alpha treatment alter the spectrum and the levels of coding and noncoding host RNAs secreted in extracellular vesicles. BMC Genomics 2019; 20:474. [PMID: 31182021 PMCID: PMC6558756 DOI: 10.1186/s12864-019-5835-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 05/23/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Extracellular vesicles (EVs) are small membrane vesicles secreted by the cells that mediate intercellular transfer of molecules and contribute to transduction of various signals. Viral infection and action of pro-inflammatory cytokines has been shown to alter molecular composition of EV content. Transfer of antiviral proteins by EVs is thought to contribute to the development of inflammation and antiviral state. Altered incorporation of selected host RNAs into EVs in response to infection has also been demonstrated for several viruses, but not for WNV. Considering the medical significance of flaviviruses and the importance of deeper knowledge about the mechanisms of flavivirus-host interactions we assessed the ability of West Nile virus (WNV) and type I interferon (IFN), the main cytokine regulating antiviral response to WNV, to alter the composition of EV RNA cargo. RESULTS We employed next generation sequencing to perform transcriptome-wide profiling of RNA cargo in EVs produced by cells infected with WNV or exposed to IFN-alpha. RNA profile of EVs secreted by uninfected cells was also determined and used as a reference. We found that WNV infection significantly changed the levels of certain host microRNAs (miRNAs), small noncoding RNAs (sncRNAs) and mRNAs incorporated into EVs. Treatment with IFN-alpha also altered miRNA and mRNA profiles in EV but had less profound effect on sncRNAs. Functional classification of RNAs differentially incorporated into EVs upon infection and in response to IFN-alpha treatment demonstrated association of enriched in EVs mRNAs and miRNAs with viral processes and pro-inflammatory pathways. Further analysis revealed that WNV infection and IFN-alpha treatment changed the levels of common and unique mRNAs and miRNAs in EVs and that IFN-dependent and IFN-independent processes are involved in regulation of RNA sorting into EVs during infection. CONCLUSIONS WNV infection and IFN-alpha treatment alter the spectrum and the levels of mRNAs, miRNAs and sncRNAs in EVs. Differentially incorporated mRNAs and miRNAs in EVs produced in response to WNV infection and to IFN-alpha treatment are associated with viral processes and host response to infection. WNV infection affects composition of RNA cargo in EVs via IFN-dependent and IFN-independent mechanisms.
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Affiliation(s)
- Andrii Slonchak
- The Australian Infectious Diseases Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, MBS building 76, Cooper Rd, St Lucia, QLD, 4072, Australia
| | - Brian Clarke
- The Australian Infectious Diseases Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, MBS building 76, Cooper Rd, St Lucia, QLD, 4072, Australia
- The Pirbright Institute, Ash Rd, Pirbright, Surrey, GU24 GNF, UK
| | - Jason Mackenzie
- The Peter Doherty Institute for Infection and Immunity, Department of Microbiology and Immunology, The University of Melbourne, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia
| | - Alberto Anastacio Amarilla
- The Australian Infectious Diseases Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, MBS building 76, Cooper Rd, St Lucia, QLD, 4072, Australia
| | - Yin Xiang Setoh
- The Australian Infectious Diseases Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, MBS building 76, Cooper Rd, St Lucia, QLD, 4072, Australia
| | - Alexander A Khromykh
- The Australian Infectious Diseases Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, MBS building 76, Cooper Rd, St Lucia, QLD, 4072, Australia.
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Maximova OA, Pletnev AG. Flaviviruses and the Central Nervous System: Revisiting Neuropathological Concepts. Annu Rev Virol 2019; 5:255-272. [PMID: 30265628 DOI: 10.1146/annurev-virology-092917-043439] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Flaviviruses are major emerging human pathogens on a global scale. Some flaviviruses can infect the central nervous system of the host and therefore are regarded as neurotropic. The most clinically relevant classical neurotropic flaviviruses include Japanese encephalitis virus, West Nile virus, and tick-borne encephalitis virus. In this review, we focus on these flaviviruses and revisit the concepts of flaviviral neurotropism, neuropathogenicity, neuroinvasion, and resultant neuropathogenesis. We attempt to synthesize the current knowledge about interactions between the central nervous system and flaviviruses from the neuroanatomical and neuropathological perspectives and address some misconceptions and controversies. We hope that revisiting these neuropathological concepts will improve the understanding of flaviviral neuroinfections. This, in turn, may provide further guiding foundations for relevant studies of other emerging or geographically expanding flaviviruses with neuropathogenic potential, such as Zika virus and dengue virus, and pave the way for intelligent therapeutic strategies harnessing potentially beneficial, protective host responses to interfere with disease progression and outcome.
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Affiliation(s)
- Olga A Maximova
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA; ,
| | - Alexander G Pletnev
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA; ,
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Gorchakov R, Gulas-Wroblewski BE, Ronca SE, Ruff JC, Nolan MS, Berry R, Alvarado RE, Gunter SM, Murray KO. Optimizing PCR Detection of West Nile Virus from Body Fluid Specimens to Delineate Natural History in an Infected Human Cohort. Int J Mol Sci 2019; 20:ijms20081934. [PMID: 31010160 PMCID: PMC6514913 DOI: 10.3390/ijms20081934] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/14/2022] Open
Abstract
West Nile virus (WNV), a mosquito-borne arbovirus, remains a major global health concern. In this study, we optimized PCR methods then assessed serially-collected whole blood (WB), urine (UR), saliva, and semen specimens from a large cohort of WNV-positive participants to evaluate the natural history of infection and persistent shedding of WNV RNA. Viral RNA extraction protocols for frozen WB and UR specimens were optimized and validated through spiking experiments to maximize recovery of viral RNA from archived specimens and to assess the degradation of WNV RNA in stored UR specimens. The resultant procedures were used in conjunction with PCR detection to identify WNV-positive specimens and to quantify their viral loads. A total of 59 of 352 WB, 10 of 38 UR, and 2 of 34 saliva specimens tested positive for WNV RNA. Although a single semen specimen was positive 22 days post onset, we could not definitively confirm the presence of WNV RNA in the remaining specimens. WNV RNA-positive UR specimens exhibited profound loss of viral RNA during storage, highlighting the need for optimal preservation pre-storage. This study provides optimized methods for WNV RNA detection among different fluid types and offers alternative options for diagnostic testing during the acute stages of WNV.
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Affiliation(s)
- Rodion Gorchakov
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Bonnie E Gulas-Wroblewski
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
- Department of Wildlife and Fisheries Sciences, Texas A&M University, College Station, TX 77843, USA.
| | - Shannon E Ronca
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Jeanne C Ruff
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Melissa S Nolan
- University of South Carolina, Arnold School of Public Health, Columbia, SC 29208, USA.
| | - Rebecca Berry
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - R Elias Alvarado
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Sarah M Gunter
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Kristy O Murray
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
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Woods CW, Sanchez AM, Swamy GK, McClain MT, Harrington L, Freeman D, Poore EA, Slifka DK, Poer DeRaad DE, Amanna IJ, Slifka MK, Cai S, Shahamatdar V, Wierzbicki MR, Amegashie C, Walter EB. An observer blinded, randomized, placebo-controlled, phase I dose escalation trial to evaluate the safety and immunogenicity of an inactivated West Nile virus Vaccine, HydroVax-001, in healthy adults. Vaccine 2019; 37:4222-4230. [PMID: 30661836 PMCID: PMC6640644 DOI: 10.1016/j.vaccine.2018.12.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 01/08/2023]
Abstract
Background West Nile virus (WNV) is the most common mosquito-borne infection in the United States. HydroVax-001 WNV is a hydrogen peroxide inactivated, whole virion (WNV-Kunjin strain) vaccine adjuvanted with aluminum hydroxide. Methods We performed a phase 1, randomized, placebo-controlled, double-blind (within dosing group), dose escalation clinical trial of the HydroVax-001 WNV vaccine administered via intramuscular injection. This trial evaluated 1 mcg and 4 mcg dosages of HydroVax-001 WNV vaccine given intramuscularly on day 1 and day 29 in healthy adults. The two dosing groups of HydroVax-001 were enrolled sequentially and each group consisted of 20 individuals who received HydroVax-001 and 5 who received placebo. Safety was assessed at all study days (days 1, 2, 4 and 15 post dose 1, and days 1, 2, 4, 15, 29, 57, 180 and 365 post dose 2), and reactogenicity was assessed for 14 days after administration of each dose. Immunogenicity was measured by WNV-specific plaque reduction neutralization tests (PRNT50) in the presence or absence of added complement or by WNV-specific enzyme-linked immunosorbent assays (ELISA). Results HydroVax-001 was safe and well-tolerated as there were no serious adverse events or concerning safety signals. At the 1 mcg dose, HydroVax-001 was not immunogenic by PRNT50 but elicited up to 41% seroconversion by WNV-specific ELISA in the per-protocol population (PP) after the second dose. At the 4 mcg dose, HydroVax-001 elicited neutralizing antibody responses in 31% of the PP following the second dose. In the presence of added complement, PRNT50 seroconversion rates increased to 50%, and 75% seroconversion was observed by WNV-specific ELISA. Conclusions The HydroVax-001 WNV vaccine was found to be modestly immunogenic and welltolerated at all dose levels.
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Affiliation(s)
- Christopher W Woods
- Duke Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
| | - Ana M Sanchez
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC, USA
| | - Geeta K Swamy
- Duke Department of Gynecology and Obstetrics, Duke University School of Medicine, Durham, NC, USA
| | - Micah T McClain
- Duke Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Lynn Harrington
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC, USA
| | - Debra Freeman
- Duke Early Phase Research Unit, Duke University School of Medicine, Durham, NC, USA
| | | | | | | | | | - Mark K Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA
| | - Shu Cai
- National Institutes of Health, Division of Microbiology and Infectious Diseases, Bethesda, MD, USA
| | - Venus Shahamatdar
- National Institutes of Health, Division of Microbiology and Infectious Diseases, Bethesda, MD, USA
| | | | | | - Emmanuel B Walter
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC, USA
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Ajam M, Abu-Heija AA, Shokr M, Ajam F, Saydain G. Sinus Bradycardia and QT Interval Prolongation in West Nile Virus Encephalitis: A Case Report. Cureus 2019; 11:e3821. [PMID: 30868034 PMCID: PMC6402859 DOI: 10.7759/cureus.3821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Cardiac arrhythmias were reported in cases of West Nile Virus (WNV) encephalitis; however, the underlying pathophysiology remains incompletely understood. We present a 67-year-old male with altered mental status, later diagnosed with WNV encephalitis. Hospital course was complicated by progressive sinus bradycardia and corrected QT (QTc) prolongation. These findings persisted despite the absence of classical causes and resolved only after improvement of the underlying encephalitis. After excluding classical causes, autonomic dysfunction is one of the proposed mechanisms behind cardiac arrhythmias in WNV encephalitis. Resolution of arrhythmias is expected after the improvement of underlying encephalitis and should be taken into consideration before proceeding for pacemaker placement or other cardiac intervention. Furthermore, this case highlights the importance of continuous cardiac monitoring in WNV encephalitis patients.
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Affiliation(s)
- Mustafa Ajam
- Internal Medicine, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Ahmad A Abu-Heija
- Internal Medicine, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Mohamed Shokr
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Firas Ajam
- Internal Medicine, Jersey Shore University Medical Center, Neptune City, USA
| | - Ghulam Saydain
- Internal Medicine, Detroit Medical Center - Wayne State University, Detroit, USA
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Tandel K, Sharma S, Dash PK, Shukla J, Parida M. Emergence of human West Nile Virus infection among pediatric population in Madhya Pradesh, India. J Med Virol 2018; 91:493-497. [PMID: 30257043 DOI: 10.1002/jmv.25325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/21/2018] [Indexed: 11/10/2022]
Abstract
Human infections caused by West Nile virus (WNV) mostly remain subclinical and self-limited. However, nearly 20% infected people suffer from febrile illness and very few of them (<1%) may get neuroinvasive illness. Mortality has been reported among children. India somehow has reported very less number of WNV cases in the past. We collected cerebrospinal fluid (CSF) samples from 75 pediatric age group patients clinically suffering from acute encephalitis syndrome. Three of these samples were positive by reverse transcriptase polymerase chain reaction using pan flavivirus primers. On sequencing of the 212 bp long-amplified fragment, it was found to be WNV belonging to lineage 1. This is probably the first report of WNV causing encephalitis from this central part of India.
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Affiliation(s)
- Kundan Tandel
- Defence Research and Development Establishment, Gwalior, India
| | - Shashi Sharma
- Defence Research and Development Establishment, Gwalior, India
| | | | - Jyoti Shukla
- Defence Research and Development Establishment, Gwalior, India
| | - Manmohan Parida
- Defence Research and Development Establishment, Gwalior, India
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50
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Lesteberg KE, Beckham JD. Immunology of West Nile Virus Infection and the Role of Alpha-Synuclein as a Viral Restriction Factor. Viral Immunol 2018; 32:38-47. [PMID: 30222521 DOI: 10.1089/vim.2018.0075] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
West Nile virus (WNV) is a single-stranded RNA flavivirus and is a major cause of viral encephalitis worldwide. Experimental models of WNV infection in mice are commonly used to define acute neuroinflammatory responses in the brain. Alpha-synuclein (Asyn) is a protein of primarily neuronal origin and is a major cause of Parkinson's disease (PD), a disorder characterized by loss of dopaminergic neurons. Both WNV and PD pathologies are largely mediated by inflammation of the central nervous system (neuroinflammation) and have overlapping inflammatory pathways. In this review, we highlight the roles of the immune system in both diseases while comparing and contrasting both protective and pathogenic roles of immune cells and their effector proteins. Additionally, we review the current literature showing that Asyn is an important mediator of the immune response with diverging roles in PD (pathogenic) and WNV disease (neuroprotective).
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Affiliation(s)
- Kelsey E Lesteberg
- 1 Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine , Aurora, Colorado
| | - John David Beckham
- 1 Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine , Aurora, Colorado.,2 Division of Neuroimmunology and Neurological Infections, Department of Neurology, University of Colorado School of Medicine , Aurora, Colorado.,3 Veterans Administration, Eastern Colorado Health System , Denver, Colorado
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