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Morais VDS, Reis Santana LM, Bezerra JF, Cruz FE, Rocha de Souza T, Tahmasebi R, Alves Raposo RA, Marcatti R, Garcia Barbosa EM, Hefford PM, Buccheri R, Cerdeira Sabino E, Charlys da Costa A. Detection of coinfection with Primate Erythroparvovirus 1 and arboviruses (DENV, CHIKV and ZIKV) in individuals with acute febrile illness in the state of Rio Grande do Norte in 2016. PLoS Negl Trop Dis 2023; 17:e0011701. [PMID: 37917659 PMCID: PMC10645361 DOI: 10.1371/journal.pntd.0011701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 11/14/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Arthropod-borne viruses, known as arboviruses, pose substantial risks to global public health. Dengue (DENV), Chikungunya (CHIKV) and Zika (ZIKV) viruses stand out as significant concerns in Brazil and worldwide. Their overlapping clinical manifestations make accurate diagnosis a challenge, underscoring the need for reliable laboratory support. This study employs a comprehensive molecular diagnostic approach to track viral infections in individuals with acute febrile illness, a period marked by widespread outbreaks of DENV, CHIKV and ZIKV. METHODS Between January and August 2016, we received a total of 713 serum samples obtained from individuals with acute febrile illness, previously tested for DENV, CHIKV or ZIKV, with initial negative results, from LACEN-NATAL. Of the total 713 samples, 667 were from females (354 of them pregnant) and 46 from males. Molecular diagnosis was conducted using the Multiplex RT-qPCR technique for simultaneous detection of DENV, CHIKV and ZIKV. Additionally, we performed differential diagnosis by RT-qPCR for other viruses of the Flavivirus, Alphavirus Enterovirus genera and qPCR for Primate Erythroparvovirus 1 (B19V) species, in accordance with Ministry of Health guidelines. RESULTS Among the 713 cases, 78.2% tested positive for viral infections, including 48% with CHIKV viremia, 0.6% with DENV and 0.1% with ZIKV. Arboviral coinfections totaled 2.4%, including DENV-CHIKV (1.7%) and CHIKV-ZIKV (0.7%). Moreover, 8% exhibited B19V viremia. Simultaneous infections were identified in 17.5%, encompassing B19V-CHIKV (17.1%), B19V-DENV (0.1%), and B19V-ZIKV (0.3%) Triple infections were observed in 1.3% of cases with B19V-DENV-CHIKV (1%) and B19V-CHIKV-ZIKV (0.3%). CONCLUSION Molecular testing demonstrated high efficacy in diagnosing prevalent arboviruses and detecting multiple coinfections. This approach helps to elucidate etiologies for symptomatic cases, especially during arbovirus outbreaks, and aids comprehensive surveillance. Our findings underscore the importance of monitoring co-circulating pathogens, such as B19V, with implications for clinical management, particularly in pregnant individuals. This study enhances our understanding of arbovirus epidemiology and reinforces the critical role of molecular diagnosis in disease surveillance and control.
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Affiliation(s)
| | - Lídia Maria Reis Santana
- Sao Paulo Health Department/Epidemiological Surveillance Center “Prof. Alexandre Vranjac”, Sao Paulo, Brazil
- Federal University of São Paulo, Sao Paulo, Brazil
| | | | | | | | - Roozbeh Tahmasebi
- University of Sao Paulo/Department of Infectious and Parasitic Diseases, Sao Paulo, Brazil
| | | | - Roberta Marcatti
- University of Sao Paulo/Department of Infectious and Parasitic Diseases, Sao Paulo, Brazil
| | | | | | - Renata Buccheri
- Vitalant Research Institute, Department of Epidemiology, San Francisco, California, United States of America
| | - Ester Cerdeira Sabino
- University of Sao Paulo/Department of Infectious and Parasitic Diseases, Sao Paulo, Brazil
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Ferreira NE, da Costa AC, Kallas EG, Silveira CGT, de Oliveira ACS, Honorato L, Paião HGO, Lima SH, de M. Vasconcelos D, Côrtes MF, Costa SF, Mendoza TRT, Gomes HR, Witkin SS, Mendes-Correa MC. Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated with Haemophilus influenzae Meningitis in a Newborn. Curr Issues Mol Biol 2023; 45:6958-6966. [PMID: 37754223 PMCID: PMC10529629 DOI: 10.3390/cimb45090439] [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: 06/09/2023] [Revised: 07/12/2023] [Accepted: 07/15/2023] [Indexed: 09/28/2023] Open
Abstract
Parvovirus B19 infection is associated with a wide range of clinical manifestations, from asymptomatic to severe neurological disorders. Its major clinical symptoms, fever and rash, are common to multiple viruses, and laboratory tests to detect B19 are frequently not available. Thus, the impact of B19 on public health remains unclear. We report the case of a 38-day old girl admitted to São Paulo Clinical Hospital, Brazil, with an initial diagnosis of bacterial meningitis, seizures, and acute hydrocephalus. Antibiotic therapy was maintained for one week after admission and discontinued after negative laboratory results were obtained. Nine days after symptoms onset, a cerebral spinal fluid (CSF) sample revealed persistent pleocytosis. The complete B19 complete genome was subsequently identified in her CSF by a metagenomic next-generation sequencing approach. This report highlights the possible involvement of B19 in the occurrence of acute neurological manifestations and emphasizes that its possible involvement might be better revealed by the use of metagenomic technology to detect viral agents in clinical situations of unknown or uncertain etiology.
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Affiliation(s)
- Noely Evangelista Ferreira
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Antonio C. da Costa
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Esper G. Kallas
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
| | - Cassia G. T. Silveira
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo 05403-000, Brazil; (C.G.T.S.); (A.C.S.d.O.)
| | - Ana Carolina S. de Oliveira
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo 05403-000, Brazil; (C.G.T.S.); (A.C.S.d.O.)
| | - Layla Honorato
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Heuder G. O. Paião
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Silvia H. Lima
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Dewton de M. Vasconcelos
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Marina F. Côrtes
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Silvia F. Costa
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Tania R. T. Mendoza
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Hélio R. Gomes
- Laboratório de Investigação Médica LIM 15, Hospital da Clinicas da, Faculdade de Medicina da, Universidade de São Paulo, São Paulo 01246-903, Brazil;
| | - Steven S. Witkin
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Maria C. Mendes-Correa
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
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Almada DL, Alves ADR, Leon LAA, Macedo DFR, de Oliveira SA, Siqueira MM, Brown D, Cubel Garcia RDCN. Use of oral fluid samples for the investigation of outbreaks of human parvovirus B19 infection. Braz J Microbiol 2022; 53:1959-1967. [PMID: 36149627 PMCID: PMC9679058 DOI: 10.1007/s42770-022-00828-9] [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: 02/23/2022] [Accepted: 09/08/2022] [Indexed: 01/13/2023] Open
Abstract
The use of oral fluid (OF) samples for serological diagnosis of parvovirus B19 infection during outbreaks of erythema infectiosum had already been demonstrated, but the feasibility of using OF for the characterization of B19 genotypes circulating during outbreaks has not been described. The aim of this study was to assess the use of "in-house" PCR-based assays as a powerful tool for a rapid diagnosis and molecular characterization of B19 strains in OF samples during outbreaks. Paired serum and OF samples collected from anti-B19 IgM-positive patients, during two outbreaks of ertythema infectiosum (1999-2000 and 2004-2005), were tested by conventional (cPCR) and quantitative PCR (qPCR). qPCR was more sensitive than cPCR for detecting B19-DNA in both OF and serum. Overall, OF presented lower viral load (9.97 × 106 UI/mL) than serum (2.42 × 1010 UI/mL) and this difference was statistically significant. All OF samples obtained from patients in the age group < 14 years presented low viral load (< 104 IU/mL). No correlation was found between viral load and the number of days of onset of rash. Sequence analysis from PCR positive OF samples confirmed the circulation of subgenotype 1a (G1a) during these outbreaks. Our findings indicate that PCR-based assays may fail to detect B19-DNA in approximately 50% of OF compared to serum samples. Nevertheless, our study has shown for the first time that the genome sequence of the amplicon from non-invasive clinical sample is useful for molecular genotyping and may be a tool to clarify the genetic diversity of B19 strains circulating in distinct outbreaks.
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Affiliation(s)
- Daiana Lima Almada
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Arthur Daniel Rocha Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Luciane Almeida Amado Leon
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Solange Artimos de Oliveira
- Serviço de Infectologia do Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Marilda Mendonça Siqueira
- Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - David Brown
- Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Yek C, Pacheco AR, Vanaerschot M, Bohl JA, Fahsbender E, Aranda-Díaz A, Lay S, Chea S, Oum MH, Lon C, Tato CM, Manning JE. Metagenomic Pathogen Sequencing in Resource-Scarce Settings: Lessons Learned and the Road Ahead. FRONTIERS IN EPIDEMIOLOGY 2022; 2:926695. [PMID: 36247976 PMCID: PMC9558322 DOI: 10.3389/fepid.2022.926695] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/29/2022] [Indexed: 06/16/2023]
Abstract
Metagenomic next-generation sequencing (mNGS) is the process of sequencing all genetic material in a biological sample. The technique is growing in popularity with myriad applications including outbreak investigation, biosurveillance, and pathogen detection in clinical samples. However, mNGS programs are costly to build and maintain, and additional obstacles faced by low- and middle-income countries (LMICs) may further widen global inequities in mNGS capacity. Over the past two decades, several important infectious disease outbreaks have highlighted the importance of establishing widespread sequencing capacity to support rapid disease detection and containment at the source. Using lessons learned from the COVID-19 pandemic, LMICs can leverage current momentum to design and build sustainable mNGS programs, which would form part of a global surveillance network crucial to the elimination of infectious diseases.
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Affiliation(s)
- Christina Yek
- Department of Critical Care Medicine, National Institutes of Health Clinical Center, Bethesda, MD, United States
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, United States
| | - Andrea R. Pacheco
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | | | - Jennifer A. Bohl
- Vaccine Immunology Program, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States
| | | | - Andrés Aranda-Díaz
- Chan Zuckerberg Initiative, Redwood City, CA, United States
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Sreyngim Lay
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Sophana Chea
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Meng Heng Oum
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Chanthap Lon
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | | | - Jessica E. Manning
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, United States
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
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Alves ADR, Raposo JV, de Sousa RMP, Cardoso CAA, Costa PKSDF, Araújo JM, Barreiro STA, Bressan CDS, Calvet GA, de Souza RV, Brasil P, Cubel Garcia RDCN, Pinto MA, de Paula VS, Amado LA. Beyond arboviruses: A multicenter study to evaluate differential diagnosis of rash diseases and acute febrile illness cases in Rio de Janeiro, Brazil. PLoS One 2022; 17:e0271758. [PMID: 35905118 PMCID: PMC9337664 DOI: 10.1371/journal.pone.0271758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 07/07/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION A wide variety of viruses can cause rash diseases (RDs) or acute febrile illness (AFIs) in children, adolescents and adults; however, approximately 19% of RD cases and 40% of AFI cases remain without a defined etiology. Parvovirus B19 (B19V) and herpesvirus infection can also cause RD and/or AFI, and in some risk groups, these infections can become persistent (or latent) and may require hospital treatment. Since these infections do not have mandatory reporting, they can be hidden by other diseases, such as those caused by arboviruses (e.g., dengue virus). In this context, the aim of this study was to pursue the differential laboratory diagnoses of B19V and herpesvirus infections in patients with RD and AFI, without a defined etiology, seen in hospitals and/or reference centers for infectious diseases in Rio de Janeiro. METHODS A total of 114 participants were enrolled in the study, including 54 children and 60 adults. B19V infection was assessed by real-time PCR (qPCR) and ELISA (anti-B19V IgM and IgG). EBV was assessed through qPCR, and betaherpesviruses (HCMV, HHV-6 and HHV-7) were assessed through multiplex qPCR. Sociodemographic and clinical data were obtained from the medical record data of these participants. RESULTS The median age of children with RD was 2 years (interquartile range (IQR): 5), and 55.6% were male. Among adults with AFI, the median age was 38 years (IQR: 21), and 56.7% were female. Regarding RD patients, viral prevalence (and load) were 5.5%(104IU/mL), 3.4%(104IU/mL), 5.5%(104IU/mL) and 11.1%(105IU/mL) for B19V, EBV, HCMV and HHV-6 infection, respectively, and in AFI patients they were 6.6%(105IU/mL), 1.6%(103IU/mL), 3.3%(104IU/mL) for B19V, HCMV and HHV-6, respectively. HHV-7 was not detected in RD or AFI patients. CONCLUSION These results suggest the importance of including B19V and herpesviruses in the differential laboratory diagnoses for patients with RD and AFI, not only for epidemiological purposes but also for the proper management of the patient.
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Affiliation(s)
- Arthur Daniel Rocha Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Jéssica Vasques Raposo
- Laboratório de Virologia Molecular, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | | | | | | | | | - Clarisse da Silveira Bressan
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Guilherme Amaral Calvet
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Rogério Valls de Souza
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Patrícia Brasil
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Vanessa Salete de Paula
- Laboratório de Virologia Molecular, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Luciane Almeida Amado
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Is the ZIKV Congenital Syndrome and Microcephaly Due to Syndemism with Latent Virus Coinfection? Viruses 2021; 13:v13040669. [PMID: 33924398 PMCID: PMC8069280 DOI: 10.3390/v13040669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/02/2021] [Accepted: 04/10/2021] [Indexed: 01/04/2023] Open
Abstract
The emergence of the Zika virus (ZIKV) mirrors its evolutionary nature and, thus, its ability to grow in diversity or complexity (i.e., related to genome, host response, environment changes, tropism, and pathogenicity), leading to it recently joining the circle of closed congenital pathogens. The causal relation of ZIKV to microcephaly is still a much-debated issue. The identification of outbreak foci being in certain endemic urban areas characterized by a high-density population emphasizes that mixed infections might spearhead the recent appearance of a wide range of diseases that were initially attributed to ZIKV. Globally, such coinfections may have both positive and negative effects on viral replication, tropism, host response, and the viral genome. In other words, the possibility of coinfection may necessitate revisiting what is considered to be known regarding the pathogenesis and epidemiology of ZIKV diseases. ZIKV viral coinfections are already being reported with other arboviruses (e.g., chikungunya virus (CHIKV) and dengue virus (DENV)) as well as congenital pathogens (e.g., human immunodeficiency virus (HIV) and cytomegalovirus (HCMV)). However, descriptions of human latent viruses and their impacts on ZIKV disease outcomes in hosts are currently lacking. This review proposes to select some interesting human latent viruses (i.e., herpes simplex virus 2 (HSV-2), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), human parvovirus B19 (B19V), and human papillomavirus (HPV)), whose virological features and co-exposition with ZIKV may provide evidence of the syndemism process, shedding some light on the emergence of the ZIKV-induced global congenital syndrome in South America.
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Cnc Garcia RD, Leon LA. Human parvovirus B19: a review of clinical and epidemiological aspects in Brazil. Future Microbiol 2021; 16:37-50. [PMID: 33438475 DOI: 10.2217/fmb-2020-0123] [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] [Indexed: 12/23/2022] Open
Abstract
Since the first evidence of human parvovirus B19 (B19V) infection in late 80s, several studies have been conducted to clarify the spectrum of clinical diseases in Brazil. B19V infection is prevalent in the general population and has exhibited a cyclical pattern of occurrence every 4-5 years, with the predominance of genotype 1 over 3b. During epidemic periods the wide range of clinical conditions, such as ertythema infectiosum, arthropathy, transient aplastic crisis, nonimmune hydrops fetalis and B19V-hepatitis were diagnosed. However, many infections are likely asymptomatic or have a self-limiting clinical course and are not readly diagnosed. Besides, the similarity of the symptoms of ertythema infectiosum to other rash diseases and the broadly circulation of arboviruses makes differential diagnosis more difficult. In this article, we provide a historical comprehensive overview of the research on parvovirus B19 conducted in Brazil, with a focus on the clinical and epidemiological aspects of the infection.
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Affiliation(s)
- Rita de Cnc Garcia
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense (UFF), Rua Professor Hernani Melo 101, Niterói, RJ 22430 190, Brazil
| | - Luciane Aa Leon
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Avenida Brasil 4365, Manguinhos, RJ 21040 360, Brazil
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High prevalence of parvovirus B19 infection in patients with chronic kidney disease under hemodialysis: A multicenter study. Int J Infect Dis 2020; 100:350-356. [PMID: 32927082 DOI: 10.1016/j.ijid.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Parvovirus B19 (B19V) infection is commonly acute and self-limited, but in chronic kidney disease (CKD) patients under dialysis treatment, this infection could increase susceptibility to acute and chronic anemia. The aim of this study was to evaluate the frequency and risk of B19V infection among Brazilian CKD patients under dialysis. METHODS A study was conducted among 221 CKD patients and a control group of 142 blood donors. B19V infection was evaluated in serum samples by real-time PCR, and ELISA (anti-B19V IgM and IgG). RESULTS B19V DNA was detected in 65% (145/221) of CKD patients, which was significantly higher (p < 0.001) than in the blood donors (6.3%). Simultaneous detection of B19V IgG and viremia was shown in 40.3% of CKD patients, which was indicative of persistent B19V infection. CKD patients showed an increased risk of developing B19V infection (OR = 28.1, CI = 13.5-58.5, p = 0.001). CONCLUSIONS Despite an absence of clinical signs of B19V infection, these data highlight the importance of B19V infection in this high-risk population, since a persistent B19V infection could become clinically significant after renal transplant. Moreover, the persistent viremia should be considered as a potential risk, mainly because of the contamination of dialysis equipment.
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Grolhier C, Pronier C, Belem A, Dina J, Vabret A, Grau JHA, Tattevin P, Thibault V. When a viral eruption hides another one: intrafamilial outbreak of parvovirus B19 and measles virus co-infections: case report. BMC Infect Dis 2020; 20:496. [PMID: 32652942 PMCID: PMC7353773 DOI: 10.1186/s12879-020-05183-4] [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: 02/27/2020] [Accepted: 06/21/2020] [Indexed: 12/04/2022] Open
Abstract
Background Despite high overall population vaccine coverage, identified clusters of persons refraining from vaccination interfere with pursued measles elimination. Clinical diagnosis of measles is often obvious due to its typical rash. Yet, febrile rashes may occur during many viral infections. Misdiagnosis of a specific primary viral infection may have severe consequences, particularly in immunocompromised subjects or pregnant women. To our knowledge, this case presentation is the first description of a measles and parvovirus B19 coinfection outbreak. Analysis of this outbreak underlines rash diagnosis difficulties and potential serology interpretation pitfalls. This case report is helpful for the clinicians in the context of measles re-emergence and proposes several methods to improve the diagnosis approach. Case presentation We investigated an outbreak of rash in 6 out of 8 Traveler family members presenting to Rennes University Hospital (West of France). Anti-B19V and measles IgM/IgG antibodies were measured and detection of Parvovirus B19 and measles virus genomes were done on blood and/or respiratory samples. Virological investigations finally documented 6 cases of parvovirus B19 infections, including 4 associated with measles. Interestingly, in the four coinfection cases, the rash was typical of B19V primary infection for the two children but typical of measles for the two adults. Clinical diagnosis of rash may be misleading and thorough virological investigations may be required to avoid misdiagnosis. Conclusions This investigation first reports an intra-familial outbreak of MeV/B19V coinfections highlighting the high transmissibility of both viruses and the diagnostic challenges of dual rash-associated infections. This report also underlines the potential deleterious consequences of failure to identify measles cases, especially in a community with low vaccination coverage.
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Affiliation(s)
- Claire Grolhier
- Department of Virology, Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France
| | - Charlotte Pronier
- Department of Virology, Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France
| | - Arielle Belem
- Univ Rennes, Infectious Diseases and Intensive Care Unit, CHU Rennes, F-35000, Rennes, France
| | - Julia Dina
- Department of Virology, Normandie Univ, UNICAEN, UNIROUEN, GRAM 2.0, CHU Caen, F-14 000, Caen, France
| | - Astrid Vabret
- Department of Virology, Normandie Univ, UNICAEN, UNIROUEN, GRAM 2.0, CHU Caen, F-14 000, Caen, France
| | - José-Hector Aranda Grau
- Regional Health Agency - French Brittany, Direction of Public Health, F-35000, Rennes, France
| | - Pierre Tattevin
- Univ Rennes, Infectious Diseases and Intensive Care Unit, CHU Rennes, F-35000, Rennes, France
| | - Vincent Thibault
- Department of Virology, Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France.
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10
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Di Paola N, Sanchez-Lockhart M, Zeng X, Kuhn JH, Palacios G. Viral genomics in Ebola virus research. Nat Rev Microbiol 2020; 18:365-378. [PMID: 32367066 PMCID: PMC7223634 DOI: 10.1038/s41579-020-0354-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2020] [Indexed: 12/20/2022]
Abstract
Filoviruses such as Ebola virus continue to pose a substantial health risk to humans. Advances in the sequencing and functional characterization of both pathogen and host genomes have provided a wealth of knowledge to clinicians, epidemiologists and public health responders during outbreaks of high-consequence viral disease. Here, we describe how genomics has been historically used to investigate Ebola virus disease outbreaks and how new technologies allow for rapid, large-scale data generation at the point of care. We highlight how genomics extends beyond consensus-level sequencing of the virus to include intra-host viral transcriptomics and the characterization of host responses in acute and persistently infected patients. Similar genomics techniques can also be applied to the characterization of non-human primate animal models and to known natural reservoirs of filoviruses, and metagenomic sequencing can be the key to the discovery of novel filoviruses. Finally, we outline the importance of reverse genetics systems that can swiftly characterize filoviruses as soon as their genome sequences are available.
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Affiliation(s)
- Nicholas Di Paola
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Mariano Sanchez-Lockhart
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Xiankun Zeng
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA
| | - Gustavo Palacios
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA.
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Fahsbender E, Charlys da-Costa A, Elise Gill D, Augusto de Padua Milagres F, Brustulin R, Julio Costa Monteiro F, Octavio da Silva Rego M, Soares D’Athaide Ribeiro E, Cerdeira Sabino E, Delwart E. Plasma virome of 781 Brazilians with unexplained symptoms of arbovirus infection include a novel parvovirus and densovirus. PLoS One 2020; 15:e0229993. [PMID: 32134963 PMCID: PMC7058308 DOI: 10.1371/journal.pone.0229993] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/19/2020] [Indexed: 12/16/2022] Open
Abstract
Plasma from patients with dengue-like symptoms was collected in 2013 to 2016 from the Brazilian states of Tocantins and Amapa. 781 samples testing negative for IgM against Dengue, Zika, and Chikungunya viruses and for flaviviruses, alphaviruses and enteroviruses RNA using RT-PCRs were analyzed using viral metagenomics. Viral particles-associated nucleic acids were enriched, randomly amplified, and deep sequenced in 102 mini-pools generating over 2 billion reads. Sequence data was analyzed for the presence of known and novel eukaryotic viral reads. Anelloviruses were detected in 80%, human pegivirus 1 in 19%, and parvovirus B19 in 17% of plasma pools. HIV and enteroviruses were detected in two pools each. Previously uncharacterized viral genomes were also identified, and their presence in single plasma samples confirmed by PCR. Chapparvovirus and ambidensovirus genomes, both in the Parvoviridae family, were partially characterized showing 33% and 34% identity in their NS1 sequences to their closest relative. Molecular surveillance using pre-existing plasma from febrile patients provides a readily scalable approach for the detection of novel, potentially emerging, viruses.
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Affiliation(s)
- Elizabeth Fahsbender
- Vitalant Research Institute, San Francisco, CA, United States of America
- UCSF Dept. of Laboratory Medicine, University of California–San Francisco, San Francisco, CA, United States of America
| | - Antonio Charlys da-Costa
- School of Medicine & Institute of Tropical Medicine, University of Sao Paulo, Infectious Disease, Sao Paulo, Brazil
| | - Danielle Elise Gill
- School of Medicine & Institute of Tropical Medicine, University of Sao Paulo, Infectious Disease, Sao Paulo, Brazil
| | - Flavio Augusto de Padua Milagres
- Public Health Laboratory State (LACEN/TO), Secretary of Health of Tocantins, Palmas, TO, Brazil
- Federal University of Tocantins, Palmas, Tocantins, Brazil
| | - Rafael Brustulin
- Public Health Laboratory State (LACEN/TO), Secretary of Health of Tocantins, Palmas, TO, Brazil
- Federal University of Tocantins, Palmas, Tocantins, Brazil
| | | | | | | | - Ester Cerdeira Sabino
- School of Medicine & Institute of Tropical Medicine, University of Sao Paulo, Infectious Disease, Sao Paulo, Brazil
| | - Eric Delwart
- Vitalant Research Institute, San Francisco, CA, United States of America
- UCSF Dept. of Laboratory Medicine, University of California–San Francisco, San Francisco, CA, United States of America
- * E-mail:
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