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Carlson CJ, Garnier R, Tiu A, Luby SP, Bansal S. Strategic vaccine stockpiles for regional epidemics of emerging viruses: A geospatial modeling framework. Vaccine 2024:S0264-410X(24)00690-X. [PMID: 38902187 DOI: 10.1016/j.vaccine.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]
Abstract
Multinational epidemics of emerging infectious diseases are increasingly common, due to anthropogenic pressure on ecosystems and the growing connectivity of human populations. Early and efficient vaccination can contain outbreaks and prevent mass mortality, but optimal vaccine stockpiling strategies are dependent on pathogen characteristics, reservoir ecology, and epidemic dynamics. Here, we model major regional outbreaks of Nipah virus and Middle East respiratory syndrome, and use these to develop a generalized framework for estimating vaccine stockpile needs based on spillover geography, spatially-heterogeneous healthcare capacity and spatially-distributed human mobility networks. Because outbreak sizes were highly skewed, we found that most outbreaks were readily contained (median stockpile estimate for MERS-CoV: 2,089 doses; Nipah: 1,882 doses), but the maximum estimated stockpile need in a highly unlikely large outbreak scenario was 2-3 orders of magnitude higher (MERS-CoV: ∼87,000 doses; Nipah ∼ 1.1 million doses). Sensitivity analysis revealed that stockpile needs were more dependent on basic epidemiological parameters (i.e., death and recovery rate) and healthcare availability than any uncertainty related to vaccine efficacy or deployment strategy. Our results highlight the value of descriptive epidemiology for real-world modeling applications, and suggest that stockpile allocation should consider ecological, epidemiological, and social dimensions of risk.
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Affiliation(s)
- Colin J Carlson
- Department of Biology, Georgetown University; Department of Epidemiology of Microbial Diseases, Yale University School of Public Health
| | | | - Andrew Tiu
- Department of Biology, Georgetown University
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2
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Rottmayer K, Loeffler-Wirth H, Gruenewald T, Doxiadis I, Lehmann C. Individual Immune Response to SARS-CoV-2 Infection-The Role of Seasonal Coronaviruses and Human Leukocyte Antigen. BIOLOGY 2023; 12:1293. [PMID: 37887003 PMCID: PMC10603889 DOI: 10.3390/biology12101293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
During the coronavirus pandemic, evidence is growing that the severity, susceptibility and host immune response to SARS-CoV-2 infection can be highly variable. Several influencing factors have been discussed. Here, we investigated the humoral immune response against SARS-CoV-2 spike, S1, S2, the RBD, nucleocapsid moieties and S1 of seasonal coronaviruses: hCoV-229E, hCoV-HKU1, hCoV-NL63 and hCoV-OC43, as well as MERS-CoV and SARS-CoV, in a cohort of 512 individuals. A bead-based multiplex assay allowed simultaneous testing for all the above antigens and the identification of different antibody patterns. Then, we correlated these patterns with 11 HLA loci. Regarding the seasonal coronaviruses, we found a moderate negative correlation between antibody levels against hCoV-229E, hCoV-HKU1 and hCoV-NL63 and the SARS-CoV-2 antigens. This could be an indication of the original immunological imprinting. High and low antibody response patterns were distinguishable, demonstrating the individuality of the humoral response towards the virus. An immunogenetical factor associated with a high antibody response (formation of ≥4 different antibodies) was the presence of HLA A*26:01, C*02:02 and DPB1*04:01 alleles, whereas the HLA alleles DRB3*01:01, DPB1*03:01 and DB1*10:01 were enriched in low responders. A better understanding of this variable immune response could enable more individualized protective measures.
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Affiliation(s)
- Karla Rottmayer
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany
| | - Henry Loeffler-Wirth
- Interdisciplinary Centre for Bioinformatics, IZBI, Leipzig University, Haertelstr. 16–18, 04107 Leipzig, Germany
| | - Thomas Gruenewald
- Clinic for Infectious Diseases and Tropical Medicine, Klinikum Chemnitz, Flemmingstraße 2, 09116 Chemnitz, Germany
| | - Ilias Doxiadis
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany
| | - Claudia Lehmann
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany
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Meehan MT, Hughes A, Ragonnet RR, Adekunle AI, Trauer JM, Jayasundara P, McBryde ES, Henderson AS. Replicating superspreader dynamics with compartmental models. Sci Rep 2023; 13:15319. [PMID: 37714942 PMCID: PMC10504364 DOI: 10.1038/s41598-023-42567-3] [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: 04/06/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023] Open
Abstract
Infectious disease outbreaks often exhibit superspreader dynamics, where most infected people generate no, or few secondary cases, and only a small fraction of individuals are responsible for a large proportion of transmission. Although capturing this heterogeneity is critical for estimating outbreak risk and the effectiveness of group-specific interventions, it is typically neglected in compartmental models of infectious disease transmission-which constitute the most common transmission dynamic modeling framework. In this study we propose different classes of compartmental epidemic models that incorporate transmission heterogeneity, fit them to a number of real outbreak datasets, and benchmark their performance against the canonical superspreader model (i.e., the negative binomial branching process model). We find that properly constructed compartmental models can capably reproduce observed superspreader dynamics and we provide the pathogen-specific parameter settings required to do so. As a consequence, we also show that compartmental models parameterized according to a binary clinical classification have limited support.
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Affiliation(s)
- Michael T Meehan
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, 4811, Australia.
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, 4811, Australia.
| | - Angus Hughes
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia
| | - Romain R Ragonnet
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia
| | - Adeshina I Adekunle
- Defence Science and Technology Group, Department of Defence, Melbourne, 3207, Australia
| | - James M Trauer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia
| | - Pavithra Jayasundara
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, 4811, Australia
| | - Alec S Henderson
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, 4811, Australia
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Guo S, Xue Y, Yuan R, Liu M. An improved method of global dynamics: Analyzing the COVID-19 model with time delays and exposed infection. CHAOS (WOODBURY, N.Y.) 2023; 33:2890945. [PMID: 37192391 DOI: 10.1063/5.0144553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
Considering the transmission characteristics of the coronavirus disease 2019 (COVID-19), there are certain time delays in the transition from susceptible individuals to exposed individuals after contact with exposed, symptomatically infected, and asymptomatically infected individuals. A COVID-19 model with time delays and exposed infection is developed and then the global dynamics of this model is investigated by an improved method; moreover, the numerical simulations are carried out. It is shown that the COVID-19-free equilibrium T0 is globally asymptotically stable (GAS) if and only if the control reproduction number Rc≤1, while T0 is unstable and the COVID-19 equilibrium T∗ is GAS if and only if Rc>1. The numerical results reveal that strengthening quarantine measures is helpful to control the COVID-19 epidemic in India. Furthermore, when Rc<1, the numbers of symptomatically infected, asymptomatically infected, and quarantined individuals eventually tend to the zero equilibrium state, and with the increase in the time delay, the three kinds of variables change faster and their peaks become larger; when Rc>1, the three kinds of variables eventually tend to the positive equilibrium state, which are oscillatory and the amplitudes of the oscillation enlarge as the value of time delay increases. The numerical results show that when Rc<1, the smaller the value of time delay, the smaller the final epidemic size. In short, the longer it takes time for susceptible individuals to transform exposed individuals, the harder COVID-19 will be controlled.
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Affiliation(s)
- Songbai Guo
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing 102616, People's Republic of China
| | - Yuling Xue
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing 102616, People's Republic of China
| | - Rong Yuan
- School of Computer Science and Technology, North University of China, Shanxi, Taiyuan 030051, People's Republic of China
| | - Maoxing Liu
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing 102616, People's Republic of China
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Al-Tawfiq JA. What is the burden of asymptomatic coronavirus infections? New Microbes New Infect 2023; 52:101101. [PMID: 36817611 PMCID: PMC9930374 DOI: 10.1016/j.nmni.2023.101101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Zhang C, Wang H, Wen Z, Gu M, Liu L, Li X. Asymptomatic Transmissibility Calls for Implementing a Zero-COVID Strategy to End the Current Global Crisis. Front Cell Infect Microbiol 2022; 12:836409. [PMID: 35521224 PMCID: PMC9062041 DOI: 10.3389/fcimb.2022.836409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/14/2022] [Indexed: 12/26/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented global challenges. A zero-COVID strategy is needed to end the crisis, but there is a lack of biological evidence. In the present study, we collected available data on SARS, MERS, and COVID-19 to perform a comprehensive comparative analysis and visualization. The study results revealed that the fatality rate of COVID-19 is low, whereas its death toll is high compared to SARS and MERS. Moreover, COVID-19 had a higher asymptomatic rate. In particular, COVID-19 exhibited unique asymptomatic transmissibility. Further, we developed a foolproof operating software in Python language to simulate COVID-19 spread in Wuhan, showing that the cumulative cases of existing asymptomatic spread would be over 100 times higher than that of only symptomatic spread. This confirmed the essential role of asymptomatic transmissibility in the uncontrolled global spread of COVID-19, which enables the necessity of implementing the zero-COVID policy. In conclusion, we revealed the triggering role of the asymptomatic transmissibility of COVID-19 in this unprecedented global crisis, which offers support to the zero-COVID strategy against the recurring COVID-19 spread.
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Affiliation(s)
- Chaobao Zhang
- Department of Geriatric Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China
- Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Hongzhi Wang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Zilu Wen
- Department of Scientific Research, Shanghai Public Health Clinical Center, Shanghai, China
| | - Mingjun Gu
- Department of Endocrinology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Lianyong Liu
- Department of Endocrinology, Punan Hospital, Shanghai, China
| | - Xiangqi Li
- Department of Endocrinology, Gongli Hospital, The Second Military Medical University, Shanghai, China
- *Correspondence: Xiangqi Li,
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Di Gennaro F, Petrosillo N. New endemic and pandemic pathologies with interhuman airborne transmission through ear, nose and throat anatomical sites. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:S5-S13. [PMID: 35763270 PMCID: PMC9137375 DOI: 10.14639/0392-100x-suppl.1-42-2022-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 12/23/2022]
Abstract
The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has once again stigmatised the importance of airborne pathogens and their clinical, social and public health impact. Respiratory viruses are transmitted between individuals when the pathogen is released from the upper airways or from the lower respiratory tract of an infected individual. Airborne transmission is defined as the inhalation of the infectious aerosol, named droplet nuclei which size is smaller than 5 mm and that can be inhaled at a distance up to 2 metres. This route of transmission is relevant for viral respiratory pathogens, including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome (MERS)-CoV, influenza virus, human rhinovirus, respiratory syncytial virus (RSV) and other respiratory virus families that differ in viral and genomic structures, susceptibility of a population to the infection, severity, transmissibility, ways of transmission and seasonal recurrence. Human respiratory viruses generally infect cells of the upper respiratory tract, eliciting respiratory signs and symptoms, sometimes without the possibility to differentiate them clinically. As seen by the current Coronavirus Disease 2019 (COVID-19) pandemic, human respiratory viruses can substantially contribute to increased morbidity and mortality, economic losses and, eventually, social disruption. In this article, we describe the structural, clinical and transmission aspects of the main respiratory viruses responsible for endemic, epidemic and pandemic infections.
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Affiliation(s)
| | - Nicola Petrosillo
- Infection Control & Infectious Disease Service, University Hospital Campus Bio-Medico, Rome, Italy
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Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion and occupational exposure of employees at a Swiss university hospital: A large longitudinal cohort study. Infect Control Hosp Epidemiol 2022; 43:326-333. [PMID: 33736734 PMCID: PMC8082127 DOI: 10.1017/ice.2021.117] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The dynamics of coronavirus disease 2019 (COVID-19) seroconversion of hospital employees are understudied. We measured the proportion of seroconverted employees and evaluated risk factors for seroconversion during the first pandemic wave. METHODS In this prospective cohort study, we recruited Geneva University Hospitals employees and sampled them 3 times, every 3 weeks from March 30 to June 12, 2020. We measured the proportion of seroconverted employees and determined prevalence ratios of risk factors for seroconversion using multivariate mixed-effects Poisson regression models. RESULTS Overall, 3,421 participants (29% of all employees) were included, with 92% follow-up. The proportion of seroconverted employees increased from 4.4% (95% confidence interval [CI], 3.7%-5.1%) at baseline to 8.5% [(95% CI, 7.6%-9.5%) at the last visit. The proportions of seroconverted employees working in COVID-19 geriatrics and rehabilitation (G&R) wards (32.3%) and non-COVID-19 G&R wards (12.3%) were higher compared to office workers (4.9%) at the last visit. Only nursing assistants had a significantly higher risk of seroconversion compared to office workers (11.7% vs 4.9%; P = .006). Significant risk factors for seroconversion included the use of public transportation (adjusted prevalence ratio, 1.59; 95% CI, 1.25-2.03), known community exposure to severe acute respiratory coronavirus virus 2 (2.80; 95% CI, 2.22-3.54), working in a ward with a nosocomial COVID outbreak (2.93; 95% CI, 2.27-3.79), and working in a COVID-19 G&R ward (3.47; 95% CI, 2.45-4.91) or a non-COVID-19 G&R ward (1.96; 95% CI, 1.46-2.63). We observed an association between reported use of respirators and lower risk of seroconversion (0.73; 95% CI, 0.55-0.96). CONCLUSION Additional preventive measures should be implemented to protect employees in G&R wards. Randomized trials on the protective effect of respirators are urgently needed.
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Menasria T, Aguilera M. Genomic Diversity of SARS-CoV-2 in Algeria and North African Countries: What We Know So Far and What We Expect? Microorganisms 2022; 10:microorganisms10020467. [PMID: 35208920 PMCID: PMC8877871 DOI: 10.3390/microorganisms10020467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022] Open
Abstract
Here, we report a first comprehensive genomic analysis of SARS-CoV-2 variants circulating in North African countries, including Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, with respect to genomic clades and mutational patterns. As of December 2021, a total of 1669 high-coverage whole-genome sequences submitted to EpiCoV GISAID database were analyzed to infer clades and mutation annotation compared with the wild-type variant Wuhan-Hu-1. Phylogenetic analysis of SARS-CoV-2 genomes revealed the existence of eleven GISAID clades with GR (variant of the spike protein S-D614G and nucleocapsid protein N-G204R), GH (variant of the ORF3a coding protein ORF3a-Q57H) and GK (variant S-T478K) being the most common with 25.9%, 19.9%, and 19.6%, respectively, followed by their parent clade G (variant S-D614G) (10.3%). Lower prevalence was noted for GRY (variant S-N501Y) (5.1%), S (variant ORF8-L84S) (3.1%) and GV (variant of the ORF3a coding protein NS3-G251V) (2.0%). Interestingly, 1.5% of total genomes were assigned as GRA (Omicron), the newly emerged clade. Across the North African countries, 108 SARS-CoV-2 lineages using the Pangolin assignment were identified, whereby most genomes fell within six major lineages and variants of concern (VOC) including B.1, the Delta variants (AY.X, B.1.617.2), C.36, B.1.1.7 and B.1.1. The effect of mutations in SAR-CoV-2 genomes highlighted similar profiles with D614G spike (S) and ORF1b-P314L variants as the most changes found in 95.3% and 87.9% of total sequences, respectively. In addition, mutations affecting other viral proteins appeared frequently including; N:RG203KR, N:G212V, NSP3:T428I, ORF3a:Q57H, S:N501Y, M:I82T and E:V5F. These findings highlight the importance of genomic surveillance for understanding the SARS-CoV-2 genetic diversity and its spread patterns, leading to a better guiding of public health intervention measures. The know-how analysis of the present work could be implemented worldwide in order to overcome this health crisis through harmonized approaches.
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Affiliation(s)
- Taha Menasria
- Department of Applied Biology, Faculty of Exact Sciences and Natural and Life Sciences, University of Larbi Tebessi, Tebessa 12002, Algeria
- Department of Microbiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Correspondence: or (T.M.); (M.A.)
| | - Margarita Aguilera
- Department of Microbiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Correspondence: or (T.M.); (M.A.)
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Peiris M, Perlman S. Unresolved questions in the zoonotic transmission of MERS. Curr Opin Virol 2022; 52:258-264. [PMID: 34999369 PMCID: PMC8734234 DOI: 10.1016/j.coviro.2021.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 02/08/2023]
Abstract
The Middle East Respiratory Syndrome-coronavirus (MERS-CoV) is the second of three zoonotic coronaviruses to infect humans since 2002, causing severe pneumonia. Unlike SARS-CoV-1 and SARS-CoV-2, the causes of the severe acute respiratory syndrome and Covid-19, respectively, MERS-CoV is enzootic in dromedary camels, a domestic/companion animal present across Africa, the Middle East and Central or South Asia and is sporadically transmitted to humans. However, it does not transmit readily from human to human except in hospital and household settings. Human MERS disease is reported only from the Arabian Peninsula (and only since 2012 even though the virus was detected in camels from at least the early 1990's) and in travelers from this region. Remarkably, no zoonotic MERS disease has been detected in Africa or Asia, even in areas of high density of MERS-CoV infected dromedaries. Here, we review aspects of MERS biology and epidemiology that might contribute to this lack of correlation between sites of camel infection and human zoonotic disease. Since MERS-CoV or MERS-like CoV have pandemic potential, further investigations into this disparity is critical, to forestall pandemics caused by this virus.
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Affiliation(s)
- Malik Peiris
- HKU-Pasteur Research Pole, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, P.R. China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong (HKU), Pokfulam, Hong Kong Special Administrative Region, P.R. China.
| | - Stanley Perlman
- Department of Microbiology and Immunology, University of Iowa, Iowa City, IA 52242, United States.
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Mata AS, Dourado SMP. Mathematical modeling applied to epidemics: an overview. THE SAO PAULO JOURNAL OF MATHEMATICAL SCIENCES 2021; 15:1025-1044. [PMID: 38624924 PMCID: PMC8482738 DOI: 10.1007/s40863-021-00268-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 12/13/2022]
Abstract
This work presents an overview of the evolution of mathematical modeling applied to the context of epidemics and the advances in modeling in epidemiological studies. In fact, mathematical treatments have contributed substantially in the epidemiology area since the formulation of the famous SIR (susceptible-infected-recovered) model, in the beginning of the 20th century. We presented the SIR deterministic model and we also showed a more realistic application of this model applying a stochastic approach in complex networks. Nowadays, computational tools, such as big data and complex networks, in addition to mathematical modeling and statistical analysis, have been shown to be essential to understand the developing of the disease and the scale of the emerging outbreak. These issues are fundamental concerns to guide public health policies. Lately, the current pandemic caused by the new coronavirus further enlightened the importance of mathematical modeling associated with computational and statistical tools. For this reason, we intend to bring basic knowledge of mathematical modeling applied to epidemiology to a broad audience. We show the progress of this field of knowledge over the years, as well as the technical part involving several numerical tools.
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Affiliation(s)
- Angélica S. Mata
- Departamento de Física, Universidade Federal de Lavras, 37200-900 Lavras, MG Brazil
| | - Stela M. P. Dourado
- Departamento de Ciências da Saúde, Universidade Federal de Lavras, 37200-900 Lavras, MG Brazil
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12
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Munyua PM, Ngere I, Hunsperger E, Kochi A, Amoth P, Mwasi L, Tong S, Mwatondo A, Thornburg N, Widdowson MA, Njenga MK. Low-Level Middle East Respiratory Syndrome Coronavirus among Camel Handlers, Kenya, 2019. Emerg Infect Dis 2021; 27:1201-1205. [PMID: 33754992 PMCID: PMC8007315 DOI: 10.3201/eid2704.204458] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Although seroprevalence of Middle East respiratory coronavirus syndrome is high among camels in Africa, researchers have not detected zoonotic transmission in Kenya. We followed a cohort of 262 camel handlers in Kenya during April 2018–March 2020. We report PCR-confirmed Middle East respiratory coronavirus syndrome in 3 asymptomatic handlers.
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13
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Nissen K, Hagbom M, Krambrich J, Akaberi D, Sharma S, Ling J, Hoffman T, Svensson L, Bondeson K, Salaneck E. Presymptomatic viral shedding and infective ability of SARS-CoV-2; a case report. Heliyon 2021; 7:e06328. [PMID: 33644482 PMCID: PMC7894094 DOI: 10.1016/j.heliyon.2021.e06328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/25/2021] [Accepted: 02/17/2021] [Indexed: 12/11/2022] Open
Abstract
Possible pre- or asymptomatic transmission has been reported, both from SARS-CoV and from MERS-CoV outbreaks, although this appears to be uncommon. In contrast, during the COVID-19 pandemic, an increasing number of studies and case reports indicate that pre- or asymptomatic transmission of SARS-CoV-2 is not only possible but also occurs frequently. We report repeated rRT-PCR detection of SARS-CoV-2 in a health care worker and demonstrate infective ability up to three days prior to mild COVID-19 symptoms. rRT-PCR indicated high viral levels approximately three days after exposure. Viral samples collected one and three days prior to symptoms exhibited infectivity on Vero E6 cells, confirmed by detection of double-stranded RNA by immunofluorescence, assessment of cytopathic effect (CPE) and rRT-PCR. SARS-CoV-2 specific IgM and IgG antibodies were detected by day 9 and 15, respectively, after symptom onset. We propose that this provides evidence for potential early presymptomatic transmission of SARS-CoV-2 and that infectivity may be manifest shortly after exposure.
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Affiliation(s)
- Karolina Nissen
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Marie Hagbom
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Janina Krambrich
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Dario Akaberi
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Sumit Sharma
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jiaxin Ling
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tove Hoffman
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Lennart Svensson
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Dept of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kåre Bondeson
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
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14
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Nissen K, Hagbom M, Krambrich J, Akaberi D, Sharma S, Ling J, Hoffman T, Svensson L, Bondeson K, Salaneck E. Presymptomatic viral shedding and infective ability of SARS-CoV-2; a case report. Heliyon 2021. [PMID: 33644482 DOI: 10.21203/rs.3.rs-36269/v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
Possible pre- or asymptomatic transmission has been reported, both from SARS-CoV and from MERS-CoV outbreaks, although this appears to be uncommon. In contrast, during the COVID-19 pandemic, an increasing number of studies and case reports indicate that pre- or asymptomatic transmission of SARS-CoV-2 is not only possible but also occurs frequently. We report repeated rRT-PCR detection of SARS-CoV-2 in a health care worker and demonstrate infective ability up to three days prior to mild COVID-19 symptoms. rRT-PCR indicated high viral levels approximately three days after exposure. Viral samples collected one and three days prior to symptoms exhibited infectivity on Vero E6 cells, confirmed by detection of double-stranded RNA by immunofluorescence, assessment of cytopathic effect (CPE) and rRT-PCR. SARS-CoV-2 specific IgM and IgG antibodies were detected by day 9 and 15, respectively, after symptom onset. We propose that this provides evidence for potential early presymptomatic transmission of SARS-CoV-2 and that infectivity may be manifest shortly after exposure.
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Affiliation(s)
- Karolina Nissen
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Marie Hagbom
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Janina Krambrich
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Dario Akaberi
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Sumit Sharma
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jiaxin Ling
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tove Hoffman
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Lennart Svensson
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Dept of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kåre Bondeson
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
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15
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Invisible epidemics: ethics and asymptomatic infection. Monash Bioeth Rev 2020; 38:1-16. [PMID: 33326062 PMCID: PMC7738616 DOI: 10.1007/s40592-020-00123-z] [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] [Accepted: 11/18/2020] [Indexed: 11/08/2022]
Abstract
Interactions between microbes and human hosts can lead to a wide variety of possible outcomes including benefits to the host, asymptomatic infection, disease (which can be more or less severe), and/or death. Whether or not they themselves eventually develop disease, asymptomatic carriers can often transmit disease-causing pathogens to others. This phenomenon has a range of ethical implications for clinical medicine, public health, and infectious disease research. The implications of asymptomatic infection are especially significant in situations where, and/or to the extent that, the microbe in question is transmissible, potentially harmful, and/or untreatable. This article reviews the history and concept of asymptomatic infection, and relevant ethical issues associated with this phenomenon. It illustrates the role and ethical significance of asymptomatic infection in outbreaks, epidemics, and pandemics–including recent crises involving drug resistance, Zika, and Covid19. Serving as the Introduction to this Special Issue of Monash Bioethics Review, it also provides brief summaries of the other articles comprising this collection.
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16
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Liu J, Xie W, Wang Y, Xiong Y, Chen S, Han J, Wu Q. A comparative overview of COVID-19, MERS and SARS: Review article. Int J Surg 2020; 81:1-8. [PMID: 32730205 PMCID: PMC7382925 DOI: 10.1016/j.ijsu.2020.07.032] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 02/07/2023]
Abstract
Following the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), a third, highly pathogenic coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appearing at end of 2019 led to a pandemic, increased panic and attracted global attention. This review analyzes the epidemiology, etiology, clinical characteristics, treatment and sequelae of the severe acute respiratory syndrome (SARS), the Middle East respiratory syndrome (MERS) and the 2019 novel coronavirus disease (COVID-19) to help provide direction for further studies that can help understand COVID-19.
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Affiliation(s)
- Jie Liu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wanli Xie
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yanting Wang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yue Xiong
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shiqiang Chen
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jingjing Han
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Qingping Wu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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17
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Squeri R, Levita A, Intelisano R, Costa GB, Mancuso G, Grasso L, D'Amato S, Mazzitelli F, Squeri A, Midiri A, Biondo C, Alesci D, Bonaccorso V, Bitto A, Genovese C. Correct management and low rate of contagiousness of healthcare workers in a University Hospital in Southern Italy: from contact tracing to serological investigation. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:79-86. [PMID: 32701920 PMCID: PMC8023094 DOI: 10.23750/abm.v91i9-s.10118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023]
Abstract
The COVID-19 epidemic, which began in Wuhan in December 2019, quickly spread all over the world, leading in a few months to a high number of deaths also in healthcare workers. The purpose of the study is to a) describe the importance of a correct management of SARS-CoV-2 infections; b) report the number of positive healthcare workers after the epidemic phase and to describe their socio-characteristics data, the main methods of transmission and the symptoms; c) to report the seroconversion rate of healthcare workers (HCWs). The study was conducted from March 9, 2020 to June 19, 2020 in three phases:1) in a first phase, we implemented the guidelines to be followed for patient care in our hospital; 2) in a second phase, we provided the epidemiological investigation/contact tracing of HCWs; 3) we collected swabs on all healthcare workers and we also performed serological investigation. The number of healthcare workers under surveillance is of 2611 subjects and, of these, only 0.65% contracted COVID-19. In particular, 70.6% of these have been infected in the healthcare setting, 11, 8% in the family and 17.6% returning from high risk areas. Ultimately, only 0.1% of HCWs dedicated to the treatment of COVID-19 patients contracted the infection (one was asymptomatic). Only 2% of HCWS were positive for serological investigation.
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Affiliation(s)
- Raffaele Squeri
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
| | | | | | - Gaetano Bruno Costa
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - Giuseppe Mancuso
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Loredana Grasso
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Smeralda D'Amato
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy.
| | - Francesco Mazzitelli
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy.
| | - Andrea Squeri
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Angelina Midiri
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Carmelo Biondo
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Domenica Alesci
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Vincen Bonaccorso
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Alessandra Bitto
- Department of Clinical and Experimental Medicine, University of Messina, c/o AOU Policlinico G. Martino, Via C. Valeria Gazzi, Messina, 98125, Italy.
| | - Cristina Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
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18
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de Sandes-Freitas TV, Canito Brasil IR, Oliveira Sales MLDMB, Studart E Neves Lunguinho MS, Pimentel ÍRS, Josino da Costa LAT, Esmeraldo RDM. Lessons from SARS-CoV-2 screening in a Brazilian organ transplant unit. Transpl Infect Dis 2020; 22:e13376. [PMID: 32573894 PMCID: PMC7361162 DOI: 10.1111/tid.13376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 01/08/2023]
Abstract
Protecting immunosuppressed patients during infectious disease outbreaks is crucial. During this novel coronavirus disease 2019 pandemic, preserving “clean areas” in hospitals assisting organ transplant recipients is key to protect them and to preserve transplantation activity. Evidence suggests that asymptomatic carriers might transmit the SARS‐CoV‐2, challenging the implementation of transmission preventive strategies. We report a single‐center experience using universal SARS‐CoV‐2 screening for all inpatients and newly admitted patients to an Organ Transplant Unit located in a region with significantly high community‐based transmission.
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Affiliation(s)
- Tainá Veras de Sandes-Freitas
- Transplant Division, Hospital Geral de Fortaleza, Fortaleza, Brazil.,Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Brazil.,State University of Ceará, Professional Master's Degree in Organ Transplantation, Fortaleza, Brazil
| | - Ivelise Regina Canito Brasil
- Transplant Division, Hospital Geral de Fortaleza, Fortaleza, Brazil.,State University of Ceará, Professional Master's Degree in Organ Transplantation, Fortaleza, Brazil
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19
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Lessler J, Orenstein WA. The Many Faces of Emerging and Reemerging Infectious Disease. Epidemiol Rev 2020; 41:1-5. [PMID: 31680167 DOI: 10.1093/epirev/mxz011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/20/2019] [Accepted: 10/01/2019] [Indexed: 12/29/2022] Open
Abstract
The emergence of disease threats can take many forms, from the adaptation of a traditionally zoonotic pathogen for efficient spread in humans, to the development of antibiotic resistance in well-known pathogens, to the creation of new niches for established disease through social and societal changes. In this commentary, the authors explore these various facets of disease emergence through the lens of the papers included in this issue of Epidemiologic Reviews. The authors explore multiple aspects of emergence and the ways in which emergent pathogens can be controlled with the limited tools available. In doing so, they put the papers in this issue in the context of the broader research agenda around understanding and combatting emergent pathogens.
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20
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Barry M, Phan MV, Akkielah L, Al-Majed F, Alhetheel A, Somily A, Alsubaie SS, McNabb SJ, Cotten M, Zumla A, Memish ZA. Nosocomial outbreak of the Middle East Respiratory Syndrome coronavirus: A phylogenetic, epidemiological, clinical and infection control analysis. Travel Med Infect Dis 2020; 37:101807. [PMID: 32599173 PMCID: PMC7319941 DOI: 10.1016/j.tmaid.2020.101807] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/21/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022]
Abstract
Background Middle East Respiratory Syndrome coronavirus (MERS-CoV) continues to cause intermittent community and nosocomial outbreaks. Obtaining data on specific source(s) and transmission dynamics of MERS-CoV during nosocomial outbreaks has been challenging. We performed a clinical, epidemiological and phylogenetic investigation of an outbreak of MERS-CoV at a University Hospital in Riyadh, Kingdom of Saudi Arabia. Methods Clinical, epidemiological and infection control data were obtained from patients and Healthcare workers (HCWs). Full genome sequencing was conducted on nucleic acid extracted directly from MERS-CoV PCR-confirmed clinical samples and phylogenetic analysis performed. Phylogenetic analysis combined with published MERS-CoV genomes was performed. HCWs compliance with infection control practices was also assessed. Results Of 235 persons investigated, there were 23 laboratory confirmed MERS cases, 10 were inpatients and 13 HCWs. Eight of 10 MERS inpatients died (80% mortality). There were no deaths among HCWs. The primary index case assumed from epidemiological investigation was not substantiated phylogenetically. 17/18 MERS cases were linked both phylogenetically and epidemiologically. One asymptomatic HCW yielded a MERS-CoV genome not directly linked to any other case in the investigation. Five HCWs with mild symptoms yielded >75% full MERS-CoV genome sequences. HCW compliance with use of gowns was 62.1%, gloves 69.7%, and masks 57.6%. Conclusions Several factors and sources, including a HCW MERS-CoV ‘carrier phenomenon’, occur during nosocomial MERS-CoV outbreaks. Phylogenetic analyses of MERS-CoV linked to clinical and epidemiological information is essential for outbreak investigation. The specific role of apparently healthy HCWs in causing nosocomial outbreaks requires further definition.
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Affiliation(s)
- Mazin Barry
- Infectious Diseases Division, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
| | - My Vt Phan
- Virus Genomics, Wellcome Trust Sanger Institute, Hinxton, United Kingdom.
| | - Layan Akkielah
- Department of Internal Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - Fahad Al-Majed
- Infectious Diseases Division, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
| | - Abdulkarim Alhetheel
- Division of Microbiology, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
| | - Ali Somily
- Division of Microbiology, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
| | - Sarah Suliman Alsubaie
- Division of Pediatric Infectious Diseases, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
| | - Scott Jn McNabb
- Emory University, Rollins School of Public Health, Atlanta, GA, USA.
| | - Matthew Cotten
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda; MRC-University of Glasgow Centre for Virus Research, Glasgow, UK.
| | - Alimuddin Zumla
- Division of Infection and Immunity, Center for Clinical Microbiology, University College London, UK; National Institute of Health Research Biomedical Research Centre at UCL Hospitals, London, UK.
| | - Ziad A Memish
- Senior Infectious Diseases Consultant & Director Research & Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia; Faculty of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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21
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Cimolai N. Features of enteric disease from human coronaviruses: Implications for COVID-19. J Med Virol 2020; 92:1834-1844. [PMID: 32462689 PMCID: PMC7283829 DOI: 10.1002/jmv.26066] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/25/2020] [Indexed: 01/19/2023]
Abstract
Coronaviruses have long been studied in both human and veterinary fields. Whereas the initial detection of endemic human respiratory coronaviruses was problematic, detection of these and newly discovered human coronaviruses has been greatly facilitated with major advances in the laboratory. Nevertheless, technological factors can affect the accuracy and timeliness of virus detection. Many human coronaviruses can be variably found in stool samples. All human coronaviruses have been variably associated with symptoms of gastroenteritis. Coronaviruses can occasionally be cultured from enteric specimens, but most detection is accomplished with genetic amplification technologies. Excretion of viral RNA in stool can extend for a prolonged period. Culture‐positive stool samples have been found to exceed a fourteen day period after onset of infection for some coronaviruses. Virus can also sometimes be cultured from patients' respiratory samples during the late incubation period. Relatively asymptomatic patients may excrete virus. Both viable and nonviable virus can be found in the immediate environment of the patient, the health care worker, and less often the public. These lessons from the past study of animal and human coronaviruses can be extended to presumptions for severe acute respiratory syndrome coronavirus 2. Already, the early reports from the coronavirus disease‐2019 pandemic are confirming some concerns. These data have the cumulative potential to cause us to rethink some current and common public health and infection control strategies. coronaviruses are variably found in human enteric samples during the course of infection. abdominal and intestinal illnesses are associated with coronavirus infections. enteric excretion of live virus and viral RNA have been confirmed. occasionally, live virus can be found in stool samples to exceed a fourteen day period after disease onset, and virus can also be cultured from these samples during the late incubation period or from asymptomatic individuals.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, Children's and Women's Health Centre of British Columbia, The University of British Columbia, Vancouver, British Columbia, Canada
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22
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Amer FA. Individuals with covert severe acute respiratory syndrome coronavirus 2 infection: Are they a critical booby-trap? Rev Soc Bras Med Trop 2020; 53:e20200231. [PMID: 32491107 PMCID: PMC7269528 DOI: 10.1590/0037-8682-0231-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Fatma Abdelaziz Amer
- Zagazig Faculty of Medicine, Department of Medical Microbiology
and Immunology, Zagazig, Egypt
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23
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Jalava K. First respiratory transmitted food borne outbreak? Int J Hyg Environ Health 2020; 226:113490. [PMID: 32088598 PMCID: PMC7129563 DOI: 10.1016/j.ijheh.2020.113490] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 12/23/2022]
Abstract
The world is faced with a remarkable coronavirus outbreak with epicentre in Wuhan, China. Altogether 40554 cases have been confirmed globally with novel coronavirus (SARS-CoV-2) until February 10, 2020. Rigorous surveillance in other countries is required to prevent further global expansion of the outbreak, but resolving the exact mechanism of the initial transmission events is crucial. Most initial cases had visited Huanan South Seafood Market in Wuhan selling also various exotic live animals. Based on the limited initial human-to-human transmission and timely clustering of cases in Huanan market among elderly men, coupled with knowledge that coronaviruses are derived from animals and relationship of SARS-CoV-2 to bat coronavirus, zoonotic transmission in the first instance is probable. To target the actions, similar epidemiological actions to human cases are needed with animal or food exposures. According to current information, an exceptionally wide contamination of seafood market might explain the initiation of the SARS-CoV-2 outbreak. Seafood tanks, air contamination by live animals or rodents are possibilities, but sold animals normally come from various sources. The mode of transmission may become clearer in future: usually in outbreak investigations, hindsight is easy, but for now information about the initial source of this outbreak is limited.
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Affiliation(s)
- Katri Jalava
- Department of Mathematics and Statistics (Faculty of Social Sciences), University of Helsinki, Finland; Department of Food Hygiene and Environmental Health (Faculty of Veterinary Medicine), University of Helsinki, Finland.
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24
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Yin S, Peng Y, Ren Y, Hu M, Tang L, Xiang Z, Li X, Wang M, Wang W. The implications of preliminary screening and diagnosis: Clinical characteristics of 33 mild patients with SARS-CoV-2 infection in Hunan, China. J Clin Virol 2020; 128:104397. [PMID: 32388472 PMCID: PMC7192082 DOI: 10.1016/j.jcv.2020.104397] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/08/2020] [Accepted: 04/27/2020] [Indexed: 12/15/2022]
Abstract
We first described the epidemiological characteristics of patients with SARS-CoV-2 in Hunan and these patients were early mild cases. The clinical symptoms, laboratory results, and imaging reports of patients with COVID-19 in the Hunan area were different from Wuhan area. For non-Wuhan epidemic areas, more attention should be paid to the nucleic acid test results of throat swabs and stools. Reduced whole blood lymph count can be used as an adjuvant diagnosis of early SARS-CoV-2 infection. Attention should be paid to asymptomatic carriers, and this is of great significance for the control of the global epidemic.
Background In December 2019, coronavirus Disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China. The disease has rapidly spread from Wuhan to other regions. Objectives To describe the clinical manifestations and epidemiological characteristics of patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in Hunan Province in 2020. Study design From January 19 to February 7, 2020, 33 patients with positive in nucleic acid test of pharyngeal swab were retrospectively collected and analyzed. Results There are 33 COVID-19 patients (16 male, 17 female), and the median age was 46 years. Nineteen patients (48 %) were associated with a family cluster outbreak. Seventeen patients (52 %) had traveled or lived in Hubei Province. These patients are early mild cases, most common symptoms are fever [23 (70 %)] and cough [13 (39 %)]. Most patients' white blood cell counts are normal, while they manifest as significant reduction in lymphocytes [17/28 (61 %)]. The levels of c-reactive protein and erythrocyte sedimentation rate suggest a typical viral infection. Procalcitonin did not increase and D-dimer increased slightly. Lactate dehydrogenase (LDH) levels have elevated in most patients. CT images of these patients showed bilateral multiple plaques or nodular ground-glass opacities (68.4 %). Fecal nucleic acid results were positive in eight COVID-19 patients accompanied with diarrhea. Tear nucleic acid results were negative in six COVID-19 patients. And four asymptomatic patients were infected with SARS-CoV-2. Conclusions The clinical symptoms, laboratory results and imaging reports of patients with COVID-19 in Hunan area are significantly different from those in Wuhan area. For non-Wuhan epidemic areas, more attention should be paid to nucleic acid test results of throat swabs and stools, and it is not easily to diagnose based on clinical symptoms and CT results. Reduced whole blood lymph count can be used as an adjuvant diagnosis of early SARS-CoV-2 infection. Attention should be paid to asymptomatic carriers, which is of great significance for the control of the global epidemic.
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Affiliation(s)
- Sheng Yin
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Yizhi Peng
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Yaping Ren
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Min Hu
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Lingli Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Zhongyuan Xiang
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Xianping Li
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Min Wang
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
| | - Wenlong Wang
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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25
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Memish ZA, Perlman S, Van Kerkhove MD, Zumla A. Middle East respiratory syndrome. Lancet 2020; 395:1063-1077. [PMID: 32145185 PMCID: PMC7155742 DOI: 10.1016/s0140-6736(19)33221-0] [Citation(s) in RCA: 277] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/04/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023]
Abstract
The Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonotic pathogen that was first identified in humans in Saudi Arabia and Jordan in 2012. Intermittent sporadic cases, community clusters, and nosocomial outbreaks of MERS-CoV continue to occur. Between April 2012 and December 2019, 2499 laboratory-confirmed cases of MERS-CoV infection, including 858 deaths (34·3% mortality) were reported from 27 countries to WHO, the majority of which were reported by Saudi Arabia (2106 cases, 780 deaths). Large outbreaks of human-to-human transmission have occurred, the largest in Riyadh and Jeddah in 2014 and in South Korea in 2015. MERS-CoV remains a high-threat pathogen identified by WHO as a priority pathogen because it causes severe disease that has a high mortality rate, epidemic potential, and no medical countermeasures. This Seminar provides an update on the current knowledge and perspectives on MERS epidemiology, virology, mode of transmission, pathogenesis, diagnosis, clinical features, management, infection control, development of new therapeutics and vaccines, and highlights unanswered questions and priorities for research, improved management, and prevention.
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Affiliation(s)
- Ziad A Memish
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Research Center, King Saud Medical City Ministry of Health, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Stanley Perlman
- Department of Microbiology and Immunology, and Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Maria D Van Kerkhove
- Infectious Hazards Management, Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, UK; National Institute for Health Research Biomedical Research Centre, University College London Hospitals, London, UK.
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