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Whitehill GD, Joy J, Marino FE, Krause R, Mallick S, Courtney H, Park K, Carey J, Hoh R, Hartig H, Pae V, Sarvadhavabhatla S, Donaire S, Deeks SG, Lynch RM, Lee SA, Bar KJ. Autologous neutralizing antibody responses after antiretroviral therapy in acute and early HIV-1. J Clin Invest 2024; 134:e176673. [PMID: 38652564 PMCID: PMC11142743 DOI: 10.1172/jci176673] [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: 10/16/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUNDEarly antiretroviral therapy initiation (ARTi) in HIV-1 restricts reservoir size and diversity while preserving immune function, potentially improving opportunities for immunotherapeutic cure strategies. For antibody-based cure approaches, the development of autologous neutralizing antibodies (anAbs) after acute/early ARTi is relevant but is poorly understood.METHODSWe characterized antibody responses in a cohort of 23 participants following ARTi in acute HIV (<60 days after acquisition) and early HIV (60-128 days after acquisition).RESULTSPlasma virus sequences at the time of ARTi revealed evidence of escape from anAbs after early, but not acute, ARTi. HIV-1 envelopes representing the transmitted/founder virus(es) (acute ARTi) or escape variants (early ARTi) were tested for sensitivity to longitudinal plasma IgG. After acute ARTi, no anAb responses developed over months to years of suppressive ART. In 2 of the 3 acute ARTi participants who experienced viremia after ARTi, however, anAbs arose shortly thereafter. After early ARTi, anAbs targeting those early variants developed between 12 and 42 weeks of ART and continued to increase in breadth and potency thereafter.CONCLUSIONResults indicate a threshold of virus replication (~60 days) required to induce anAbs, after which they continue to expand on suppressive ART to better target the range of reservoir variants.TRIAL REGISTRATIONClinicalTrials.gov NCT02656511.FUNDINGNIH grants U01AI169767, R01AI162646, UM1AI164570, UM1AI164560, U19AI096109, K23GM112526, T32AI118684, P30AI045008, P30AI027763, R24AI067039; Gilead Sciences grant INUS2361354; Viiv Healthcare grant A126326.
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Affiliation(s)
| | - Jaimy Joy
- Department of Medicine, Division of Infectious Disease, and
| | | | - Ryan Krause
- Department of Medicine, Division of Infectious Disease, and
| | | | | | - Kyewon Park
- Center for AIDS Research, Virus and Reservoirs Technology Core, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John Carey
- Center for AIDS Research, Virus and Reservoirs Technology Core, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecca Hoh
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, UCSF, San Francisco, California, USA
| | - Heather Hartig
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, UCSF, San Francisco, California, USA
| | - Vivian Pae
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, UCSF, San Francisco, California, USA
| | - Sannidhi Sarvadhavabhatla
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, UCSF, San Francisco, California, USA
| | - Sophia Donaire
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, UCSF, San Francisco, California, USA
| | - Steven G. Deeks
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, UCSF, San Francisco, California, USA
| | - Rebecca M. Lynch
- Department of Microbiology, Immunology, and Tropical Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Sulggi A. Lee
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, UCSF, San Francisco, California, USA
| | - Katharine J. Bar
- Department of Medicine, Division of Infectious Disease, and
- Center for AIDS Research, Virus and Reservoirs Technology Core, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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2
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Cantoni D, Wilkie C, Bentley EM, Mayora-Neto M, Wright E, Scott S, Ray S, Castillo-Olivares J, Heeney JL, Mattiuzzo G, Temperton NJ. Correlation between pseudotyped virus and authentic virus neutralisation assays, a systematic review and meta-analysis of the literature. Front Immunol 2023; 14:1184362. [PMID: 37790941 PMCID: PMC10544934 DOI: 10.3389/fimmu.2023.1184362] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023] Open
Abstract
Background The virus neutralization assay is a principal method to assess the efficacy of antibodies in blocking viral entry. Due to biosafety handling requirements of viruses classified as hazard group 3 or 4, pseudotyped viruses can be used as a safer alternative. However, it is often queried how well the results derived from pseudotyped viruses correlate with authentic virus. This systematic review and meta-analysis was designed to comprehensively evaluate the correlation between the two assays. Methods Using PubMed and Google Scholar, reports that incorporated neutralisation assays with both pseudotyped virus, authentic virus, and the application of a mathematical formula to assess the relationship between the results, were selected for review. Our searches identified 67 reports, of which 22 underwent a three-level meta-analysis. Results The three-level meta-analysis revealed a high level of correlation between pseudotyped viruses and authentic viruses when used in an neutralisation assay. Reports that were not included in the meta-analysis also showed a high degree of correlation, with the exception of lentiviral-based pseudotyped Ebola viruses. Conclusion Pseudotyped viruses identified in this report can be used as a surrogate for authentic virus, though care must be taken in considering which pseudotype core to use when generating new uncharacterised pseudotyped viruses.
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Affiliation(s)
- Diego Cantoni
- MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, United Kingdom
| | - Craig Wilkie
- School of Mathematics & Statistics, University of Glasgow, Glasgow, United Kingdom
| | - Emma M. Bentley
- Medicines and Healthcare Products Regulatory Agency, South Mimms, United Kingdom
| | - Martin Mayora-Neto
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham, United Kingdom
| | - Edward Wright
- Viral Pseudotype Unit, School of Life Sciences, University of Sussex, Brighton, United Kingdom
| | - Simon Scott
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham, United Kingdom
| | - Surajit Ray
- School of Mathematics & Statistics, University of Glasgow, Glasgow, United Kingdom
| | - Javier Castillo-Olivares
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge University, Cambridge, United Kingdom
| | - Jonathan Luke Heeney
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge University, Cambridge, United Kingdom
- DIOSynVax, University of Cambridge, Cambridge, United Kingdom
| | - Giada Mattiuzzo
- Medicines and Healthcare Products Regulatory Agency, South Mimms, United Kingdom
| | - Nigel James Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham, United Kingdom
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3
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Vien Chinh C, Phu Quoc V, Huynh Tan L, Nguyen Van D, Pham Quang T, Le Van B. Persistence of vaccine-induced antibody to A/H5N1 influenza after 30 and 36 months of vaccination. Epidemiol Health 2021; 43:e2021076. [PMID: 34645208 PMCID: PMC8854785 DOI: 10.4178/epih.e2021076] [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: 04/07/2021] [Accepted: 10/06/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives An A/H5N1 vaccine named IVACFLU-A/ H5N1 was accepted to use in Vietnam, however, antibody persistence after vaccination has not been well characterized yet. We examined the persistence of antibodies after vaccination and related risk factors in individuals enrolled in phase II with 15 mcg dose, 2 injections 21 days apart, IVACFLU-A/ H5N1 vaccine trials in Ninh Hoa, Vietnam. Methods We used a longitudinal study to follow 86 participants without control groups. They were tested anti-A/H5N1 IgG seronegative at baseline and received all two doses of the vaccine. Blood was drawn at 30 and 36 months after the full vaccination to assess antibody status. Antibody persistence status is compared by demographics and exposure risk factors using a univariate logistic regression. Results Overall incidence of persisting at least 1/10 of A/H5N1 antibodies was 84.9% and 52.3% after 30 months and 36 months of IVACFLU-A/H5N1 vaccination. The odds of antibody persistence were more significant in older people but lower in people who experienced flu-like symptoms in the past 18 months or between two visits. We recorded no differences between A/H5N1 antibodies persistence and exposure risk factors including having poultry farms, contacting with poultry, and slaughtering and processing poultry. Conclusion This study demonstrated noteworthy antibody persistence, indicated by seroconversion rate and geometric mean titer at 30 and 36-month post-vaccination, of the IVACFLU-A/H5N1 vaccine. There is a need for further studies on older people, and those who experienced flu-like symptoms to decide the suitable time for the booster shot.
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Affiliation(s)
- Chien Vien Chinh
- Institute of Vaccines and Medical Biologicals (IVAC), Nha Trang, Viet Nam.,TAY NGUYEN Institute of Hygiene and Epidemiology, Buon Me Thuot, Viet Nam
| | | | - Loc Huynh Tan
- Ninh Hoa District Medical Center, Khanh Hoa, Viet Nam
| | - Duoc Nguyen Van
- Institute of Vaccines and Medical Biologicals (IVAC), Nha Trang, Viet Nam
| | - Thai Pham Quang
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.,Institute of Preventive medicine and Public health, Hanoi medical University, Hanoi, Viet Nam
| | - Be Le Van
- Institute of Vaccines and Medical Biologicals (IVAC), Nha Trang, Viet Nam
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4
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Toon K, Bentley EM, Mattiuzzo G. More Than Just Gene Therapy Vectors: Lentiviral Vector Pseudotypes for Serological Investigation. Viruses 2021; 13:217. [PMID: 33572589 PMCID: PMC7911487 DOI: 10.3390/v13020217] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 12/13/2022] Open
Abstract
Serological assays detecting neutralising antibodies are important for determining the immune responses following infection or vaccination and are also often considered a correlate of protection. The target of neutralising antibodies is usually located in the Envelope protein on the viral surface, which mediates cell entry. As such, presentation of the Envelope protein on a lentiviral particle represents a convenient alternative to handling of a potentially high containment virus or for those viruses with no established cell culture system. The flexibility, relative safety and, in most cases, ease of production of lentiviral pseudotypes, have led to their use in serological assays for many applications such as the evaluation of candidate vaccines, screening and characterization of anti-viral therapeutics, and sero-surveillance. Above all, the speed of production of the lentiviral pseudotypes, once the envelope sequence is published, makes them important tools in the response to viral outbreaks, as shown during the COVID-19 pandemic in 2020. In this review, we provide an overview of the landscape of the serological applications of pseudotyped lentiviral vectors, with a brief discussion on their production and batch quality analysis. Finally, we evaluate their role as surrogates for the real virus and possible alternatives.
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Affiliation(s)
- Kamilla Toon
- Division of Virology, National Institute for Biological Standards and Control-MHRA, Blanche Lane, South Mimms EN6 3QG, UK;
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Emma M. Bentley
- Division of Virology, National Institute for Biological Standards and Control-MHRA, Blanche Lane, South Mimms EN6 3QG, UK;
| | - Giada Mattiuzzo
- Division of Virology, National Institute for Biological Standards and Control-MHRA, Blanche Lane, South Mimms EN6 3QG, UK;
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5
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Chen X, Wang W, Wang Y, Lai S, Yang J, Cowling BJ, Horby PW, Uyeki TM, Yu H. Serological evidence of human infections with highly pathogenic avian influenza A(H5N1) virus: a systematic review and meta-analysis. BMC Med 2020; 18:377. [PMID: 33261599 PMCID: PMC7709391 DOI: 10.1186/s12916-020-01836-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/02/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Highly pathogenic avian influenza A(H5N1) virus poses a global public health threat given severe and fatal zoonotic infections since 1997 and ongoing A(H5N1) virus circulation among poultry in several countries. A comprehensive assessment of the seroprevalence of A(H5N1) virus antibodies remains a gap and limits understanding of the true risk of A(H5N1) virus infection. METHODS We conducted a systematic review and meta-analysis of published serosurveys to assess the risk of subclinical and clinically mild A(H5N1) virus infections. We assessed A(H5N1) virus antibody titers and changes in titers among populations with variable exposures to different A(H5N1) viruses. RESULTS Across studies using the World Health Organization-recommended seropositive definition, the point estimates of the seroprevalence of A(H5N1) virus-specific antibodies were higher in poultry-exposed populations (range 0-0.6%) and persons exposed to both human A(H5N1) cases and infected birds (range 0.4-1.8%) than in close contacts of A(H5N1) cases or the general population (none to very low frequencies). Seroprevalence was higher in persons exposed to A(H5N1) clade 0 virus (1.9%, range 0.7-3.2%) than in participants exposed to other clades of A(H5N1) virus (range 0-0.5%) (p < 0.05). Seroprevalence was higher in poultry-exposed populations (range 0-1.9%) if such studies utilized antigenically similar A(H5N1) virus antigens in assays to A(H5N1) viruses circulating among poultry. CONCLUSIONS These low seroprevalences suggest that subclinical and clinically mild human A(H5N1) virus infections are uncommon. Standardized serological survey and laboratory methods are needed to fully understand the extent and risk of human A(H5N1) virus infections.
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Affiliation(s)
- Xinhua Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Wei Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Yan Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Shengjie Lai
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Peter W Horby
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China.
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6
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Liao F, Nishimura H, Ito H, Zhang Y, Matsuzaki Y. Longitudinal course of influenza C virus antibody titers of healthy adults in Sendai, Japan. J Clin Virol 2020; 133:104662. [PMID: 33137705 DOI: 10.1016/j.jcv.2020.104662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/19/2020] [Accepted: 10/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Influenza C virus causes mild respiratory diseases in humans. Previous studies suggested that the predominant hemagglutinin-esterase gene lineage circulating in children might be selected among the adult population, yet the prevalence of influenza C virus in adults has not been described. OBJECTIVES To evaluate the frequency of influenza C virus infection in adults. STUDY DESIGN We performed hemagglutination inhibition assays of serum samples collected at periodic occupational medical checkups from employees of a hospital. A total of 679 serum samples were collected from 57 subjects who participated in biannual medical checkups between 2011 and 2016 as part of a longitudinal series. Titers of antibodies against the C/Kanagawa and C/Sao Paulo lineage viruses were detected. RESULTS Ten serum sample pairs from among the 57 subjects showed at least a four-fold increase in influenza C antibody titers. Samples from three subjects exhibited antibody titer increases for both the C/Kanagawa and C/Sao Paulo lineages, four subjects showed an increased titer against the C/Sao Paulo lineage, and three subjects showed an increased titer against the C/Kanagawa lineage. Half of the antibody titer increases for the C/Kanagawa lineage were detected in May 2014, while the increases for the C/Sao Paulo lineage were detected from 2011 to 2016. CONCLUSION The 5-year influenza C virus infection rate was estimated at 17.5 %. There were antibodies that cross-reacted with the C/Sao Paulo and C/Kanagawa lineages. The results suggest that C/Sao Paulo was the main lineage in the adult population of this area, with cocirculation of the C/Kanagawa lineage.
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Affiliation(s)
- Feng Liao
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan; Department of Respiratory Medicine, The First People's Hospital of Yunnan Province, 650022, Kunming, PR China
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan
| | - Hiroko Ito
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan
| | - Yunhui Zhang
- Department of Respiratory Medicine, The First People's Hospital of Yunnan Province, 650022, Kunming, PR China
| | - Yoko Matsuzaki
- Department of Infectious Diseases, Yamagata University, Faculty of Medicine, Iida-Nishi, Yamagata, 990-9585, Japan.
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7
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Haveri A, Ikonen N, Savolainen-Kopra C, Julkunen I. Long-lasting heterologous antibody responses after sequential vaccination with A/Indonesia/5/2005 and A/Vietnam/1203/2004 pre-pandemic influenza A(H5N1) virus vaccines. Vaccine 2020; 39:402-411. [PMID: 33246672 DOI: 10.1016/j.vaccine.2020.11.041] [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] [Received: 05/09/2020] [Revised: 11/04/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Avian influenza A(H5N1) viruses have caused sporadic infections in humans and thus they pose a significant global health threat. Among symptomatic patients the case fatality rate has been ca. 50%. H5N1 viruses exist in multiple clades and subclades and several candidate vaccines have been developed to prevent A(H5N1) infection as a principal measure for preventing the disease. METHODS Serum antibodies against various influenza A(H5N1) clade viruses were measured in adults by ELISA-based microneutralization and haemagglutination inhibition tests before and after vaccination with two different A(H5N1) vaccines in 2009 and 2011. RESULTS Two doses of AS03-adjuvanted A/Indonesia/5/2005 vaccine induced good homologous but poor heterologous neutralizing antibody responses against different clade viruses. However, non-adjuvanted A/Vietnam/1203/2004 booster vaccination in 2011 induced very strong and long-lasting homologous and heterologous antibody responses while homologous response remained weak in naïve subjects. CONCLUSIONS Sequential vaccination with two different A(H5N1) pre-pandemic vaccines induced long-lasting high level cross-clade immunity against influenza A(H5N1) strains, thus supporting a prime-boost vaccination strategy in pandemic preparedness plans.
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Affiliation(s)
- Anu Haveri
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), POB 30, 00271 Helsinki, Finland.
| | - Niina Ikonen
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), POB 30, 00271 Helsinki, Finland
| | - Carita Savolainen-Kopra
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), POB 30, 00271 Helsinki, Finland
| | - Ilkka Julkunen
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), POB 30, 00271 Helsinki, Finland; Institute of Biomedicine, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520 Turku, Finland
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8
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Prager KC, Buhnerkempe MG, Greig DJ, Orr AJ, Jensen ED, Gomez F, Galloway RL, Wu Q, Gulland FMD, Lloyd-Smith JO. Linking longitudinal and cross-sectional biomarker data to understand host-pathogen dynamics: Leptospira in California sea lions (Zalophus californianus) as a case study. PLoS Negl Trop Dis 2020; 14:e0008407. [PMID: 32598393 PMCID: PMC7351238 DOI: 10.1371/journal.pntd.0008407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 07/10/2020] [Accepted: 05/21/2020] [Indexed: 12/20/2022] Open
Abstract
Confronted with the challenge of understanding population-level processes, disease ecologists and epidemiologists often simplify quantitative data into distinct physiological states (e.g. susceptible, exposed, infected, recovered). However, data defining these states often fall along a spectrum rather than into clear categories. Hence, the host-pathogen relationship is more accurately defined using quantitative data, often integrating multiple diagnostic measures, just as clinicians do to assess their patients. We use quantitative data on a major neglected tropical disease (Leptospira interrogans) in California sea lions (Zalophus californianus) to improve individual-level and population-level understanding of this Leptospira reservoir system. We create a "host-pathogen space" by mapping multiple biomarkers of infection (e.g. serum antibodies, pathogen DNA) and disease state (e.g. serum chemistry values) from 13 longitudinally sampled, severely ill individuals to characterize changes in these values through time. Data from these individuals describe a clear, unidirectional trajectory of disease and recovery within this host-pathogen space. Remarkably, this trajectory also captures the broad patterns in larger cross-sectional datasets of 1456 wild sea lions in all states of health but sampled only once. Our framework enables us to determine an individual's location in their time-course since initial infection, and to visualize the full range of clinical states and antibody responses induced by pathogen exposure. We identify predictive relationships between biomarkers and outcomes such as survival and pathogen shedding, and use these to impute values for missing data, thus increasing the size of the useable dataset. Mapping the host-pathogen space using quantitative biomarker data enables more nuanced understanding of an individual's time course of infection, duration of immunity, and probability of being infectious. Such maps also make efficient use of limited data for rare or poorly understood diseases, by providing a means to rapidly assess the range and extent of potential clinical and immunological profiles. These approaches yield benefits for clinicians needing to triage patients, prevent transmission, and assess immunity, and for disease ecologists or epidemiologists working to develop appropriate risk management strategies to reduce transmission risk on a population scale (e.g. model parameterization using more accurate estimates of duration of immunity and infectiousness) and to assess health impacts on a population scale.
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Affiliation(s)
- K. C. Prager
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, California, United States of America
| | - Michael G. Buhnerkempe
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, California, United States of America
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, United States of America
| | - Denise J. Greig
- The Marine Mammal Center, Sausalito, California, United States of America
- California Academy of Sciences, San Francisco, California, United States of America
| | - Anthony J. Orr
- Marine Mammal Laboratory, Alaska Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, Seattle, Washington, United States of America
| | - Eric D. Jensen
- U.S. Navy Marine Mammal Program, Naval Information Warfare Center Pacific, San Diego, California, United States of America
| | - Forrest Gomez
- National Marine Mammal Foundation, San Diego, California, United States of America
| | - Renee L. Galloway
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Qingzhong Wu
- Hollings Marine Laboratory, National Ocean Service, Charleston, South Carolina, United States of America
| | - Frances M. D. Gulland
- The Marine Mammal Center, Sausalito, California, United States of America
- Karen Dryer Wildlife Health Center, University of California Davis, California, United States of America
| | - James O. Lloyd-Smith
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, California, United States of America
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9
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Kaslow DC. Certainty of success: three critical parameters in coronavirus vaccine development. NPJ Vaccines 2020; 5:42. [PMID: 32509338 PMCID: PMC7248068 DOI: 10.1038/s41541-020-0193-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 01/24/2023] Open
Abstract
Vaccines for 17 viral pathogens have been licensed for use in humans. Previously, two critical biological parameters of the pathogen and the host–pathogen interaction—incubation period and broadly protective, relative immunogenicity—were proposed to account for much of the past successes in vaccine development, and to be useful in estimating the “certainty of success” of developing an effective vaccine for viral pathogens for which a vaccine currently does not exist. In considering the “certainty of success” in development of human coronavirus vaccines, particularly SARS-CoV-2, a third, related critical parameter is proposed—infectious inoculum intensity, at an individual-level, and force of infection, at a population-level. Reducing the infectious inoculum intensity (and force of infection, at a population-level) is predicted to lengthen the incubation period, which in turn is predicted to reduce the severity of illness, and increase the opportunity for an anamnestic response upon exposure to the circulating virus. Similarly, successfully implementing individual- and population-based behaviors that reduce the infectious inoculum intensity and force of infection, respectively, while testing and deploying COVID-19 vaccines is predicted to increase the “certainty of success” of demonstrating vaccine efficacy and controlling SARS-CoV-2 infection, disease, death, and the pandemic itself.
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Affiliation(s)
- David C Kaslow
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121 USA
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10
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Wang Q, Xu K, Xie W, Yang L, Chen H, Shi N, Bao C, Huang H, Zhang X, Liao Y, Jin H. Seroprevalence of H7N9 infection among humans: A systematic review and meta-analysis. Influenza Other Respir Viruses 2020; 14:587-595. [PMID: 32157809 PMCID: PMC7431636 DOI: 10.1111/irv.12736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/27/2019] [Accepted: 02/19/2020] [Indexed: 12/12/2022] Open
Abstract
In spring 2013, a novel avian-origin influenza A (H7N9) virus emerged in mainland China. The burden of H7N9 infection was estimated based on systematic review and meta-analysis. The systematic search for available literature was conducted using Chinese and English databases. We calculated the pooled seroprevalence of H7N9 infection and its 95% confidence interval by using Freeman-Tukey double arcsine transformation. Out of 16 890 records found using Chinese and English databases, 54 articles were included in the meta-analysis. These included studies of a total of 64 107 individuals. The pooled seroprevalence of H7N9 infection among humans was 0.122% (95% CI: 0.023, 0.275). In high-risk populations, the highest pooled seroprevalence was observed among close contacts (1.075%, 95% CI: 0.000, 4.357). The seroprevalence among general population was (0.077%, 95% CI: 0.011, 0.180). Our study discovered that asymptomatic infection of H7N9 virus did occur, even if the seroprevalence among humans was low.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Ke Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Weihua Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Haiyan Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Haodi Huang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xuefeng Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yilan Liao
- The State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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11
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Chen J, Zhu H, Horby PW, Wang Q, Zhou J, Jiang H, Liu L, Zhang T, Zhang Y, Chen X, Deng X, Nikolay B, Wang W, Cauchemez S, Guan Y, Uyeki TM, Yu H. Specificity, kinetics and longevity of antibody responses to avian influenza A(H7N9) virus infection in humans. J Infect 2020; 80:310-319. [PMID: 31954742 PMCID: PMC7112568 DOI: 10.1016/j.jinf.2019.11.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/26/2019] [Accepted: 11/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The long-term dynamics of antibody responses in patients with influenza A(H7N9) virus infection are not well understood. METHODS We conducted a longitudinal serological follow-up study in patients who were hospitalized with A(H7N9) virus infection, during 2013-2018. A(H7N9) virus-specific antibody responses were assessed by hemagglutination inhibition (HAI) and neutralization (NT) assays. A random intercept model was used to fit a curve to HAI antibody responses over time. HAI antibody responses were compared by clinical severity. RESULTS Of 67 patients with A(H7N9) virus infection, HAI antibody titers reached 40 on average 11 days after illness onset and peaked at a titer of 290 after three months, and average titers of ≥80 and ≥40 were present until 11 months and 22 months respectively. HAI antibody responses were significantly higher in patients who experienced severe disease, including respiratory failure and acute respiratory distress syndrome, compared with patients who experienced less severe illness. CONCLUSIONS Patients with A(H7N9) virus infection who survived severe disease mounted higher antibody responses that persisted for longer periods compared with those that experienced moderate disease. Studies of convalescent plasma treatment for A(H7N9) patients should consider collection of donor plasma from survivors of severe disease between 1 and 11 months after illness onset.
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Affiliation(s)
- Junbo Chen
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Huachen Zhu
- Joint Institute of Virology (STU-HKU), Shantou University, Shantou 515041, China; State Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Peter W Horby
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Qianli Wang
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Jiaxin Zhou
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Hui Jiang
- Beijing Chest Hospital, Capital Medical University, Beijing 101149, China; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
| | - Liwei Liu
- Joint Institute of Virology (STU-HKU), Shantou University, Shantou 515041, China
| | - Tianchen Zhang
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang 330000, China
| | - Yongli Zhang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xinhua Chen
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Xiaowei Deng
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Birgit Nikolay
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, 75015 Paris, France
| | - Wei Wang
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, 75015 Paris, France
| | - Yi Guan
- Joint Institute of Virology (STU-HKU), Shantou University, Shantou 515041, China; State Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Hongjie Yu
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China.
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12
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13
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Evidence of exposure and human seroconversion during an outbreak of avian influenza A(H5N1) among poultry in Cameroon. Emerg Microbes Infect 2019; 8:186-196. [PMID: 30866772 PMCID: PMC6455145 DOI: 10.1080/22221751.2018.1564631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
From May 2016 to March 2017, 22 poultry outbreaks of avian influenza A(H5N1) were reported in Cameroon, mainly in poultry farms and live bird markets. No human cases were reported. In this study, we sought to describe the 2016 A(H5N1) outbreak strain and to investigate the risk of infection in exposed individuals. We find that highly pathogenic influenza subtype A(H5N1), clade 2.3.2.1c from Cameroon is closely related phylogenetically and antigenically to strains isolated in central and western Africa at the time. No molecular markers of increased human transmissibility were noted; however, seroconversion was detected in two poultry workers (1.5% of total screened). Therefore, the continued outbreaks of avian influenza in poultry and the risk of zoonotic human infection highlight the crucial need for continued and vigilant influenza surveillance and research in Africa, especially in areas of high poultry trade, such as Cameroon.
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14
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Koutsakos M, Kedzierska K, Subbarao K. Immune Responses to Avian Influenza Viruses. THE JOURNAL OF IMMUNOLOGY 2019; 202:382-391. [DOI: 10.4049/jimmunol.1801070] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/24/2018] [Indexed: 12/26/2022]
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15
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Zhao M, Chen J, Tan S, Dong T, Jiang H, Zheng J, Quan C, Liao Q, Zhang H, Wang X, Wang Q, Bi Y, Liu F, Feng L, Horby PW, Klenerman P, Gao GF, Liu WJ, Yu H. Prolonged Evolution of Virus-Specific Memory T Cell Immunity after Severe Avian Influenza A (H7N9) Virus Infection. J Virol 2018; 92:e01024-18. [PMID: 29925664 PMCID: PMC6096810 DOI: 10.1128/jvi.01024-18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 06/15/2018] [Indexed: 12/19/2022] Open
Abstract
Since 2013, influenza A H7N9 virus has emerged as the most common avian influenza virus subtype causing human infection, and it is associated with a high fatality risk. However, the characteristics of immune memory in patients who have recovered from H7N9 infection are not well understood. We assembled a cohort of 45 H7N9 survivors followed for up to 15 months after infection. Humoral and cellular immune responses were analyzed in sequential samples obtained at 1.5 to 4 months, 6 to 8 months, and 12 to 15 months postinfection. H7N9-specific antibody concentrations declined over time, and protective antibodies persisted longer in severely ill patients admitted to the intensive care unit (ICU) and patients presenting with acute respiratory distress syndrome (ARDS) than in patients with mild disease. Frequencies of virus-specific gamma interferon (IFN-γ)-secreting T cells were lower in critically ill patients requiring ventilation than in patients without ventilation within 4 months after infection. The percentages of H7N9-specific IFN-γ-secreting T cells tended to increase over time in patients ≥60 years or in critically ill patients requiring ventilation. Elevated levels of antigen-specific CD8+ T cells expressing the lung-homing marker CD49a were observed at 6 to 8 months after H7N9 infection compared to those in samples obtained at 1.5 to 4 months. Our findings indicate the prolonged reconstruction and evolution of virus-specific T cell immunity in older or critically ill patients and have implications for T cell-directed immunization strategies.IMPORTANCE Avian influenza A H7N9 virus remains a major threat to public health. However, no previous studies have determined the characteristics and dynamics of virus-specific T cell immune memory in patients who have recovered from H7N9 infection. Our findings showed that establishment of H7N9-specific T cell memory after H7N9 infection was prolonged in older and severely affected patients. Severely ill patients mounted lower T cell responses in the first 4 months after infection, while T cell responses tended to increase over time in older and severely ill patients. Higher levels of antigen-specific CD8+ T cells expressing the lung-homing marker CD49a were detected at 6 to 8 months after infection. Our results indicated a long-term impact of H7N9 infection on virus-specific memory T cells. These findings advance our understanding of the dynamics of virus-specific memory T cell immunity after H7N9 infection, which is relevant to the development of T cell-based universal influenza vaccines.
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Affiliation(s)
- Min Zhao
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Junbo Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Shuguang Tan
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China
| | - Tao Dong
- Medical Research Council Human Immunology Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Hui Jiang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiandong Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chuansong Quan
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiaohong Liao
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hangjie Zhang
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiling Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Qianli Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yuhai Bi
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China
| | - Fengfeng Liu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peter W Horby
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - George F Gao
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - William J Liu
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
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16
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Ma MJ, Liu C, Wu MN, Zhao T, Wang GL, Yang Y, Gu HJ, Cui PW, Pang YY, Tan YY, Hang H, Lin B, Qin JC, Fang LQ, Cao WC, Cheng LL. Influenza A(H7N9) Virus Antibody Responses in Survivors 1 Year after Infection, China, 2017. Emerg Infect Dis 2018; 24:663-672. [PMID: 29432091 PMCID: PMC5875250 DOI: 10.3201/eid2404.171995] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Avian influenza A(H7N9) virus has caused 5 epidemic waves in China since its emergence in 2013. We investigated the dynamic changes of antibody response to this virus over 1 year postinfection in 25 patients in Suzhou City, Jiangsu Province, China, who had laboratory-confirmed infections during the fifth epidemic wave, October 1, 2016–February 14, 2017. Most survivors had relatively robust antibody responses that decreased but remained detectable at 1 year. Antibody response was variable; several survivors had low or undetectable antibody titers. Hemagglutination inhibition titer was >1:40 for <40% of the survivors. Measured in vitro in infected mice, hemagglutination inhibition titer predicted serum protective ability. Our findings provide a helpful serologic guideline for identifying subclinical infections and for developing effective vaccines and therapeutics to counter H7N9 virus infections.
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17
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Ly S, Horwood P, Chan M, Rith S, Sorn S, Oeung K, Nguon K, Chan S, Y P, Parry A, Tsuyuoka R, Ly S, Richner B, Laurent D, Vong S, Dussart P, Buchy P, Tarantola A. Seroprevalence and Transmission of Human Influenza A(H5N1) Virus before and after Virus Reassortment, Cambodia, 2006-2014. Emerg Infect Dis 2018; 23:300-303. [PMID: 28098551 PMCID: PMC5324818 DOI: 10.3201/eid2302.161232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Thirty-five human influenza A(H5N1) cases were reported in Cambodia during 2013–2014 after emergence of a clade 1.1.2 reassortant virus. We tested 881 villagers and found 2 cases of pauci- or asymptomatic infection. Seroprevalence after emergence of the reassortant strain (0.2%) was lower than the aggregate seroprevalence of 1.3% reported in earlier studies.
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18
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Harfoot R, Webby RJ. H5 influenza, a global update. J Microbiol 2017; 55:196-203. [PMID: 28243942 DOI: 10.1007/s12275-017-7062-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 02/15/2017] [Indexed: 12/27/2022]
Abstract
H5 influenza viruses have caused much alarm globally due to their high pathogenic potential. As yet we have not seen sustained spread of the virus amongst humans despite a high prevalence of the virus in avian populations. Nevertheless, isolated human cases of infection have demonstrated high mortality and there are substantial efforts being taken to monitor the evolution of the virus and to undertake preparedness activities. Here we review and discuss the evolution of the A/goose/Guangdong/1/96 (H5N1) virus with emphasis on recent events.
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Affiliation(s)
- Rhodri Harfoot
- St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, Tennessee, USA
| | - Richard J Webby
- St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, Tennessee, USA.
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19
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Sikkema RS, Freidl GS, de Bruin E, Koopmans M. Weighing serological evidence of human exposure to animal influenza viruses - a literature review. ACTA ACUST UNITED AC 2016; 21:30388. [PMID: 27874827 PMCID: PMC5114483 DOI: 10.2807/1560-7917.es.2016.21.44.30388] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/30/2016] [Indexed: 02/02/2023]
Abstract
Assessing influenza A virus strains circulating in animals and their potential to cross the species barrier and cause human infections is important to improve human influenza surveillance and preparedness. We reviewed studies describing serological evidence of human exposure to animal influenza viruses. Comparing serological data is difficult due to a lack of standardisation in study designs and in laboratory methods used in published reports. Therefore, we designed a scoring system to assess and weigh specificity of obtained serology results in the selected articles. Many studies report reliable evidence of antibodies to swine influenza viruses among persons occupationally exposed to pigs. Most avian influenza studies target H5, H7 and H9 subtypes and most serological evidence of human exposure to avian influenza viruses is reported for these subtypes. Avian influenza studies receiving a low grade in this review often reported higher seroprevalences in humans compared with studies with a high grade. Official surveillance systems mainly focus on avian H5 and H7 viruses. Swine influenza viruses and avian subtypes other than H5 and H7 (emphasising H9) should be additionally included in official surveillance systems. Surveillance efforts should also be directed towards understudied geographical areas, such as Africa and South America.
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Affiliation(s)
- Reina Saapke Sikkema
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Bilthoven, the Netherlands.,Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Gudrun Stephanie Freidl
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Bilthoven, the Netherlands.,Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Erwin de Bruin
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Marion Koopmans
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Bilthoven, the Netherlands.,Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
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20
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Ly S, Vong S, Cavailler P, Mumford E, Mey C, Rith S, Van Kerkhove MD, Sorn S, Sok T, Tarantola A, Buchy P. Environmental contamination and risk factors for transmission of highly pathogenic avian influenza A(H5N1) to humans, Cambodia, 2006-2010. BMC Infect Dis 2016; 16:631. [PMID: 27809855 PMCID: PMC5095992 DOI: 10.1186/s12879-016-1950-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Highly pathogenic avian influenza A (H5N1) virus has been of public health concern since 2003. Probable risk factors for A(H5N1) transmission to human have been demonstrated in several studies or epidemiological reports. However, transmission patterns may differ according to demographic characteristics of the population and local practices. This article aggregates these data from three studies with data collected in the previous surveys in 2006 and 2007 to further examine the risks factors associated with presence of anti-A(H5) antibodies among villagers residing within outbreak areas. METHODS We aggregated 5-year data (2006-2010) from serology survey and matched case-control studies in Cambodia to further examine the risks factors associated with A(H5N1) infection among villagers in the outbreak areas. RESULTS Serotesting among villagers detected 35 (1.5 % [0-2.6]) positive cases suggesting recent exposure to A(H5N1) virus. Practices associated with A(H5N1) infection among all ages were: having poultry cage or nesting area under or adjacent to the house (OR: 6.7 [1.6-28.3]; p = 0.010) and transporting poultry to market (OR: 17.6 [1.6-193.7]; p = 0.019). Practices found as risk factors for the infection among age under 20 years were swimming/bathing in ponds also accessed by domestic poultry (OR: 4.6 [1.1-19.1]; p = 0.038). Association with consuming wild birds reached borderline significance (p = 0.066). CONCLUSION Our results suggest that swimming/bathing in contaminated pond water and close contact with poultry may present a risk of A(H5N1) transmission to human.
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Affiliation(s)
- Sowath Ly
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sirenda Vong
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Philippe Cavailler
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
- Agence de Médecine Préventive, Ferney-Voltaire, France
| | | | - Channa Mey
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sareth Rith
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | | | - San Sorn
- National Veterinary Research Institute, Ministry of Agriculture Forestry and Fisheries, Phnom Penh, Cambodia
| | - Touch Sok
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | | | - Philippe Buchy
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
- GSK Vaccines R&D, 150 Beach Road, 189720 Singapore, Singapore
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21
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Shimizu K, Wulandari L, Poetranto ED, Setyoningrum RA, Yudhawati R, Sholikhah A, Nastri AM, Poetranto AL, Candra AYR, Puruhito EF, Takahara Y, Yamagishi Y, Yamaoka M, Hotta H, Ustumi T, Lusida MI, Soetjipto, Shimizu YK, Soegiarto G, Mori Y. Seroevidence for a High Prevalence of Subclinical Infection With Avian Influenza A(H5N1) Virus Among Workers in a Live-Poultry Market in Indonesia. J Infect Dis 2016; 214:1929-1936. [PMID: 27923953 PMCID: PMC5142092 DOI: 10.1093/infdis/jiw478] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/03/2016] [Indexed: 02/02/2023] Open
Abstract
Background. In Indonesia, highly pathogenic avian influenza A(H5N1) virus has become endemic in poultry and has caused sporadic deadly infections in human. Since 2012, we have conducted fixed-point surveillance of avian influenza viruses at a live-poultry market in East Java, Indonesia. In this study, we examined the seroprevalence of avian influenza A(H5N1) virus infection among market workers. Methods. Sera were collected from 101 workers in early 2014 and examined for antibody activity against avian A(H5N1) Eurasian lineage virus by a hemagglutination-inhibition (HI) assay. Results. By the HI assay, 84% of the sera tested positive for antibody activity against the avian virus. Further analysis revealed that the average HI titer in 2014 was 2.9-fold higher than in 2012 and that seroconversion occurred in 44% of paired sera (11 of 25) between 2012 and 2014. A medical history survey was performed in 2016; responses to questionnaires indicated that none of workers had had severe acute respiratory illness during 2013. Conclusions. This study provides evidence of a high prevalence of avian A(H5N1) virus infection in 2013 among workers at a live-poultry market. However, because no instances of hospitalizations were reported, we can conclude the virus did not manifest any clinical symptoms in workers.
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Affiliation(s)
- Kazufumi Shimizu
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Laksmi Wulandari
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pulmonology and Respiratory Medicine
| | - Emmanuel D Poetranto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Clinical Science, Faculty of Veterinary Medicine, Airlangga University, Surabaya, Indonesia
| | - Retno A Setyoningrum
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pediatrics
| | - Resti Yudhawati
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pulmonology and Respiratory Medicine
| | - Amelia Sholikhah
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pediatrics
| | - Aldise M Nastri
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Anna L Poetranto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Adithya Y R Candra
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Edith F Puruhito
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Yusuke Takahara
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Yoshiaki Yamagishi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Masaoki Yamaoka
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Hak Hotta
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Takako Ustumi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Maria I Lusida
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Soetjipto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Yohko K Shimizu
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Gatot Soegiarto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Internal Medicine, Faculty of Medicine
| | - Yasuko Mori
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
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Horm SV, Tarantola A, Rith S, Ly S, Gambaretti J, Duong V, Y P, Sorn S, Holl D, Allal L, Kalpravidh W, Dussart P, Horwood PF, Buchy P. Intense circulation of A/H5N1 and other avian influenza viruses in Cambodian live-bird markets with serological evidence of sub-clinical human infections. Emerg Microbes Infect 2016; 5:e70. [PMID: 27436362 PMCID: PMC5141262 DOI: 10.1038/emi.2016.69] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 04/13/2016] [Accepted: 04/25/2016] [Indexed: 01/05/2023]
Abstract
Surveillance for avian influenza viruses (AIVs) in poultry and environmental samples was conducted in four live-bird markets in Cambodia from January through November 2013. Through real-time RT-PCR testing, AIVs were detected in 45% of 1048 samples collected throughout the year. Detection rates ranged from 32% and 18% in duck and chicken swabs, respectively, to 75% in carcass wash water samples. Influenza A/H5N1 virus was detected in 79% of samples positive for influenza A virus and 35% of all samples collected. Sequence analysis of full-length haemagglutinin (HA) and neuraminidase (NA) genes from A/H5N1 viruses, and full-genome analysis of six representative isolates, revealed that the clade 1.1.2 reassortant virus associated with Cambodian human cases during 2013 was the only A/H5N1 virus detected during the year. However, multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) analysis of HA and NA genes revealed co-circulation of at least nine low pathogenic AIVs from HA1, HA2, HA3, HA4, HA6, HA7, HA9, HA10 and HA11 subtypes. Four repeated serological surveys were conducted throughout the year in a cohort of 125 poultry workers. Serological testing found an overall prevalence of 4.5% and 1.8% for antibodies to A/H5N1 and A/H9N2, respectively. Seroconversion rates of 3.7 and 0.9 cases per 1000 person-months participation were detected for A/H5N1 and A/H9N2, respectively. Peak AIV circulation was associated with the Lunar New Year festival. Knowledge of periods of increased circulation of avian influenza in markets should inform intervention measures such as market cleaning and closures to reduce risk of human infections and emergence of novel AIVs.
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Affiliation(s)
- Srey Viseth Horm
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Arnaud Tarantola
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Sareth Rith
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Sowath Ly
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Juliette Gambaretti
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Veasna Duong
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Phalla Y
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - San Sorn
- National Veterinary Research Institute, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh 12000, Cambodia
| | - Davun Holl
- National Veterinary Research Institute, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh 12000, Cambodia
| | - Lotfi Allal
- Food and Agriculture Organization, Phnom Penh 12000, Cambodia
| | | | - Philippe Dussart
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Paul F Horwood
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia
| | - Philippe Buchy
- Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh 12000, Cambodia.,GlaxoSmithKline Pte Ltd, Singapore 189720, Singapore
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Park SW, Perera RAPM, Choe PG, Lau EHY, Choi SJ, Chun JY, Oh HS, Song KH, Bang JH, Kim ES, Kim HB, Park WB, Kim NJ, Poon LLM, Peiris M, Oh MD. Comparison of serological assays in human Middle East respiratory syndrome (MERS)-coronavirus infection. ACTA ACUST UNITED AC 2016; 20:30042. [PMID: 26538277 DOI: 10.2807/1560-7917.es.2015.20.41.30042] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/15/2015] [Indexed: 02/03/2023]
Abstract
Plaque reduction neutralisation tests (PRNT), microneutralisation (MN), Middle East respiratory syndrome (MERS)-spike pseudoparticle neutralisation (ppNT) and MERS S1-enzyme-linked immunosorbent assay (ELISA) antibody titres were compared using 95 sera from 17 patients with MERS, collected two to 46 days after symptom onset. Neutralisation tests correlated well with each other and moderately well with S1 ELISA. Moreover to compare antigenic similarity of genetically diverse MERS-CoV clades, the response of four sera from two patients sampled at two time periods during the course of illness were tested by 90% PRNT. Genetically diverse MERS-CoV clades were antigenically homogenous.
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24
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Reusken CB, Farag EA, Haagmans BL, Mohran KA, Godeke GJ, Raj S, Alhajri F, Al-Marri SA, Al-Romaihi HE, Al-Thani M, Bosch BJ, van der Eijk AA, El-Sayed AM, Ibrahim AK, Al-Molawi N, Müller MA, Pasha SK, Drosten C, AlHajri MM, Koopmans MP. Occupational Exposure to Dromedaries and Risk for MERS-CoV Infection, Qatar, 2013-2014. Emerg Infect Dis 2016. [PMID: 26196891 PMCID: PMC4517733 DOI: 10.3201/eid2108.150481] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We determined the presence of neutralizing antibodies to Middle East respiratory syndrome coronavirus in persons in Qatar with and without dromedary contact. Antibodies were only detected in those with contact, suggesting dromedary exposure as a risk factor for infection. Findings also showed evidence for substantial underestimation of the infection in populations at risk in Qatar.
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25
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Heidari A, Mancin M, Nili H, Pourghanbari GH, Lankarani KB, Leardini S, Cattoli G, Monne I, Piccirillo A. Serological evidence of H9N2 avian influenza virus exposure among poultry workers from Fars province of Iran. Virol J 2016; 13:16. [PMID: 26817813 PMCID: PMC4728806 DOI: 10.1186/s12985-016-0472-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/20/2016] [Indexed: 02/08/2023] Open
Abstract
Background Since the 1990s, influenza A viruses of the H9N2 subtype have been causing infections in the poultry population around the globe. This influenza subtype is widely circulating in poultry and human cases of AI H9N2 have been sporadically reported in countries where this virus is endemic in domestic birds. The wide circulation of H9N2 viruses throughout Europe and Asia along with their ability to cause direct infection in mammals and humans, raises public health concerns. H9N2 AI was reported for the first time in Iran in 1998 and at present it is endemic in poultry. This study was carried out to evaluate the exposure to H9N2 AI viruses among poultry workers from the Fars province. Methods 100 poultry workers and 100 healthy individuals with no professional exposure to poultry took part in this study. Serum samples were tested for antibodies against two distinct H9N2 avian influenza viruses, which showed different phylogenetic clustering and important molecular differences, such as at the amino acid (aa) position 226 (Q/L) (H3 numbering), using haemagglutination inhibition (HI) and microneutralization (MN) assays. Results Results showed that 17 % of the poultry workers were positive for the A/chicken/Iran/10VIR/854-5/2008 virus in MN test and 12 % in HI test using the titer ≥40 as positive cut-off value. Only 2 % of the poultry workers were positive for the A/chicken/Iran/12VIR/9630/1998 virus. Seroprevalence of non exposed individuals for both H9N2 strains was below 3 % by both tests. Statistical analyses models showed that exposure to poultry significantly increases the risk of infection with H9N2 virus. Conclusions The results have demonstrated that exposure to avian H9N2 viruses had occurred among poultry workers in the Fars province of Iran. Continuous surveillance programmes should be implemented to monitor the presence of avian influenza infections in humans and to evaluate their potential threat to poultry workers and public health. Electronic supplementary material The online version of this article (doi:10.1186/s12985-016-0472-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A Heidari
- Research and Innovation Department, Istituto Zooprofilattico Sperimentale delle Venezie, OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE collaborating Center for Diseases at the Human-Animal Interface, Viale dell'Università 10, Legnaro, PD, 35020, Italy. .,Department of Comparative Biomedicine and Food Science, University of Padua, Legnaro, PD, Italy.
| | - M Mancin
- Food safety department, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Viale dell'Università 10, Legnaro, PD, 35020, Italy.
| | - H Nili
- Avian Diseases Research Center, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
| | - G H Pourghanbari
- Avian Diseases Research Center, School of Veterinary Medicine, Shiraz University, Shiraz, Iran. .,School of Veterinary Medicine, Ardakan University, Yazd, Iran.
| | - K B Lankarani
- Health Policy Research Center of Shiraz University of Medical Science, Shiraz, Iran.
| | - S Leardini
- Research and Innovation Department, Istituto Zooprofilattico Sperimentale delle Venezie, OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE collaborating Center for Diseases at the Human-Animal Interface, Viale dell'Università 10, Legnaro, PD, 35020, Italy.
| | - G Cattoli
- Research and Innovation Department, Istituto Zooprofilattico Sperimentale delle Venezie, OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE collaborating Center for Diseases at the Human-Animal Interface, Viale dell'Università 10, Legnaro, PD, 35020, Italy.
| | - I Monne
- Research and Innovation Department, Istituto Zooprofilattico Sperimentale delle Venezie, OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE collaborating Center for Diseases at the Human-Animal Interface, Viale dell'Università 10, Legnaro, PD, 35020, Italy.
| | - A Piccirillo
- Department of Comparative Biomedicine and Food Science, University of Padua, Legnaro, PD, Italy.
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26
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Nasreen S, Khan SU, Luby SP, Gurley ES, Abedin J, Zaman RU, Sohel BM, Rahman M, Hancock K, Levine MZ, Veguilla V, Wang D, Holiday C, Gillis E, Sturm-Ramirez K, Bresee JS, Rahman M, Uyeki TM, Katz JM, Azziz-Baumgartner E. Highly pathogenic Avian Influenza A(H5N1) virus infection among workers at live bird markets, Bangladesh, 2009-2010. Emerg Infect Dis 2015; 21:629-37. [PMID: 25811942 PMCID: PMC4378465 DOI: 10.3201/eid2104.141281] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Evidence of infection was low despite frequent exposure to infected poultry and low use of personal protective equipment. The risk for influenza A(H5N1) virus infection is unclear among poultry workers in countries where the virus is endemic. To assess H5N1 seroprevalence and seroconversion among workers at live bird markets (LBMs) in Bangladesh, we followed a cohort of workers from 12 LBMs with existing avian influenza surveillance. Serum samples from workers were tested for H5N1 antibodies at the end of the study or when LBM samples first had H5N1 virus–positive test results. Of 404 workers, 9 (2%) were seropositive at baseline. Of 284 workers who completed the study and were seronegative at baseline, 6 (2%) seroconverted (7 cases/100 poultry worker–years). Workers who frequently fed poultry, cleaned feces from pens, cleaned food/water containers, and did not wash hands after touching sick poultry had a 7.6 times higher risk for infection compared with workers who infrequently performed these behaviors. Despite frequent exposure to H5N1 virus, LBM workers showed evidence of only sporadic infection.
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27
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To KKW, Hung IFN, Lui YM, Mok FKY, Chan ASF, Li PTW, Wong TL, Ho DTY, Chan JFW, Chan KH, Yuen KY. Ongoing transmission of avian influenza A viruses in Hong Kong despite very comprehensive poultry control measures: A prospective seroepidemiology study. J Infect 2015; 72:207-13. [PMID: 26632329 DOI: 10.1016/j.jinf.2015.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 10/03/2015] [Accepted: 10/20/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Stringent measures have been implemented in Hong Kong to prevent human infections due to avian influenza viruses (AIVs). Here, we report the seroprevalence of AIVs among high risk population. METHODS In this prospective study, blood samples were collected in October and November 2013 and in July 2014 from workers at live poultry market (LPM) and pig/cattle slaughterhouse (SH) in Hong Kong. Serum antibody titers against A(H5N1), A(H7N9) and A(H9N2) were determined. RESULTS When an hemagglutination inhibition (HI) titer of 40 was used as the cutoff, the A(H5N1) seropositive rate among LPM workers increased from 0% in 2013 to 37.8% in 2014 (P < 0.001) and the A(H9N2) seropositive rate increased from 10% to 55.6% (P < 0.001). There was no significant increase in A(H7N9) seropositive rate for LPM workers irrespective of cutoff titer. For SH workers, there was no significant increase in HI titer for any AIVs. Significantly more LPM workers had a ≥4-fold increase in A(H5N1) HI titer from 2013 to 2014 than SH workers (60% vs 8.3%, P = 0.020). CONCLUSIONS There was a significant increase of serum A(H5N1) and A(H9N2) HI titers among Hong Kong LPM workers between 2013 and 2014. Although we cannot exclude some degree of antibody cross-reactivity with other influenza viruses, our results suggest the occurrence of subclinical AIV infections in this population.
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Affiliation(s)
- Kelvin K W To
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China; Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Ivan F N Hung
- Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China; Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yin-Ming Lui
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Florence K Y Mok
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Andy S F Chan
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Patrick T W Li
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Tin-Lun Wong
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Deborah T Y Ho
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Jasper F W Chan
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China; Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Kwok-Hung Chan
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China; Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Kwok-Yung Yuen
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China; Department of Microbiology, The University of Hong Kong, Hong Kong, China.
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28
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Suboptimal Humoral Immune Response against Influenza A(H7N9) Virus Is Related to Its Internal Genes. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:1235-43. [PMID: 26446420 DOI: 10.1128/cvi.00443-15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 09/28/2015] [Indexed: 11/20/2022]
Abstract
Influenza A(H7N9) virus pneumonia is associated with a high case fatality rate in humans. Multiple viral factors have been postulated to account for the high virulence of the virus. It has been reported that patients with influenza A(H7N9) virus infection have relatively low titers of neutralizing antibodies compared to those with seasonal influenza virus infections. In this study, we compared serum hemagglutination inhibition (HI) and microneutralization (MN) antibody titers of mice challenged with wild-type A(H7N9) viruses [H7N9(Anhui) and H7N9(Zhejiang)], an A(H1N1)pdm09 virus [pH1N1(2009)], and a recombinant A(H7N9) virus with PR8/H1N1 internal genes (rg-PR8-H7-N9). All mice infected by H7N9(Anhui) and H7N9(Zhejiang) developed serum HI antibodies at 14 days postinfection (dpi) but no detectable MN antibodies, even at 28 dpi. A low level of neutralizing activity was detected in H7N9(Anhui)- and H7N9(Zhejiang)-infected mice using fluorescent focus MN assay, but convalescent-phase serum samples obtained from H7N9(Anhui)-infected mice did not reduce the mortality of naive mice after homologous virus challenge. Reinfection with homologous A(H7N9) virus induced higher HI and MN titers than first infection. In contrast, pH1N1(2009) virus infection induced robust HI and MN antibody responses, even during the first infection. Moreover, rg-PR8-H7-N9 induced significantly higher HI and MN antibody titers than H7N9(Zhejiang). In conclusion, the internal genes of A(H7N9) virus can affect the humoral immune response against homologous viral surface proteins, which may also contribute to the virulence of A(H7N9) virus.
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Khuntirat B, Love CS, Buddhari D, Heil GL, Gibbons RV, Rothman AL, Srikiatkhachorn A, Gray GC, Yoon IK. Absence of neutralizing antibodies against influenza A/H5N1 virus among children in Kamphaeng Phet, Thailand. J Clin Virol 2015. [PMID: 26209384 DOI: 10.1016/j.jcv.2015.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Influenza A/H5N1 actively circulated in Kamphaeng Phet (KPP), Thailand from 2004 to 2006. A prospective longitudinal cohort study of influenza virus infection in 800 adults conducted during 2008-2010 in KPP suggested that subclinical or mild H5N1 infections had occurred among this adult cohort. However, this study was conducted after the peak of H5N1 activity in KPP. Coincidentally, banked serum samples were available from a prospective longitudinal cohort study of primary school children who had undergone active surveillance for febrile illnesses from 2004 to 2007 and lived in the same district of KPP as the adult cohort. OBJECTIVES We sought to investigate whether subclinical or mild H5N1 infections had occurred among KPP residents during the peak of H5N1 activity from 2004 to 2006. STUDY DESIGN H5N1 microneutralization (MN) assay was performed on banked serum samples from a prospective longitudinal cohort study of primary school children who had undergone active surveillance for febrile illnesses in KPP. Annual blood samples collected from 2004 to 2006 from 251 children were selected based on the criteria that they lived in villages with documented H5N1 infection. RESULT No H5N1 neutralizing antibodies were detected in 753 annual blood samples from 251 children. CONCLUSION During 2004-2006, very few subclinical or mild H5N1 infections occurred in KPP. Elevated H5N1 MN titers found in the adult cohort in 2008 were likely due to cross-reactivity from other influenza virus subtypes highlighting the complexities in interpreting influenza serological data.
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Affiliation(s)
- Benjawan Khuntirat
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
| | | | - Darunee Buddhari
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Gary L Heil
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Robert V Gibbons
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Alan L Rothman
- Institute for Immunology and Informatics, University of Rhode Island, Providence, Rhode Island, USA
| | - Anon Srikiatkhachorn
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Gregory C Gray
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - In-Kyu Yoon
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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Carnell GW, Ferrara F, Grehan K, Thompson CP, Temperton NJ. Pseudotype-based neutralization assays for influenza: a systematic analysis. Front Immunol 2015; 6:161. [PMID: 25972865 PMCID: PMC4413832 DOI: 10.3389/fimmu.2015.00161] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 03/25/2015] [Indexed: 12/02/2022] Open
Abstract
The use of vaccination against the influenza virus remains the most effective method of mitigating the significant morbidity and mortality caused by this virus. Antibodies elicited by currently licensed influenza vaccines are predominantly hemagglutination-inhibition (HI)-competent antibodies that target the globular head of hemagglutinin (HA) thus inhibiting influenza virus entry into target cells. These antibodies predominantly confer homosubtypic/strain specific protection and only rarely confer heterosubtypic protection. However, recent academia or pharma-led R&D toward the production of a “universal vaccine” has centered on the elicitation of antibodies directed against the stalk of the influenza HA that has been shown to confer broad protection across a range of different subtypes (H1–H16). The accurate and sensitive measurement of antibody responses elicited by these “next-generation” influenza vaccines is, however, hampered by the lack of sensitivity of the traditional influenza serological assays HI, single radial hemolysis, and microneutralization. Assays utilizing pseudotypes, chimeric viruses bearing influenza glycoproteins, have been shown to be highly efficient for the measurement of homosubtypic and heterosubtypic broadly neutralizing antibodies, making them ideal serological tools for the study of cross-protective responses against multiple influenza subtypes with pandemic potential. In this review, we will analyze and compare literature involving the production of influenza pseudotypes with particular emphasis on their use in serum antibody neutralization assays. This will enable us to establish the parameters required for optimization and propose a consensus protocol to be employed for the further deployment of these assays in influenza vaccine immunogenicity studies.
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Affiliation(s)
- George William Carnell
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway , Chatham Maritime, Kent , UK
| | - Francesca Ferrara
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway , Chatham Maritime, Kent , UK
| | - Keith Grehan
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway , Chatham Maritime, Kent , UK
| | - Craig Peter Thompson
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway , Chatham Maritime, Kent , UK ; Department of Zoology, University of Oxford , Oxford , UK ; The Jenner Institute Laboratories, University of Oxford , Oxford , UK
| | - Nigel James Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway , Chatham Maritime, Kent , UK
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31
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Vinh DN, Boni MF. Statistical identifiability and sample size calculations for serial seroepidemiology. Epidemics 2015; 12:30-9. [PMID: 26342240 PMCID: PMC4558460 DOI: 10.1016/j.epidem.2015.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 02/12/2015] [Accepted: 02/24/2015] [Indexed: 11/30/2022] Open
Abstract
We investigate whether disease dynamics can be inferred by repeated serum collections. Measuring antibody waning is critical for inference in serological time series. Collecting 200 samples every 2 months allows for inference of transmission parameters. Low-level seasonality is difficult to detect statistically.
Inference on disease dynamics is typically performed using case reporting time series of symptomatic disease. The inferred dynamics will vary depending on the reporting patterns and surveillance system for the disease in question, and the inference will miss mild or underreported epidemics. To eliminate the variation introduced by differing reporting patterns and to capture asymptomatic or subclinical infection, inferential methods can be applied to serological data sets instead of case reporting data. To reconstruct complete disease dynamics, one would need to collect a serological time series. In the statistical analysis presented here, we consider a particular kind of serological time series with repeated, periodic collections of population-representative serum. We refer to this study design as a serial seroepidemiology (SSE) design, and we base the analysis on our epidemiological knowledge of influenza. We consider a study duration of three to four years, during which a single antigenic type of influenza would be circulating, and we evaluate our ability to reconstruct disease dynamics based on serological data alone. We show that the processes of reinfection, antibody generation, and antibody waning confound each other and are not always statistically identifiable, especially when dynamics resemble a non-oscillating endemic equilibrium behavior. We introduce some constraints to partially resolve this confounding, and we show that transmission rates and basic reproduction numbers can be accurately estimated in SSE study designs. Seasonal forcing is more difficult to identify as serology-based studies only detect oscillations in antibody titers of recovered individuals, and these oscillations are typically weaker than those observed for infected individuals. To accurately estimate the magnitude and timing of seasonal forcing, serum samples should be collected every two months and 200 or more samples should be included in each collection; this sample size estimate is sensitive to the antibody waning rate and the assumed level of seasonal forcing.
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Affiliation(s)
- Dao Nguyen Vinh
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam
| | - Maciej F Boni
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
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32
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Khan SU, Anderson BD, Heil GL, Liang S, Gray GC. A Systematic Review and Meta-Analysis of the Seroprevalence of Influenza A(H9N2) Infection Among Humans. J Infect Dis 2015; 212:562-9. [PMID: 25712969 DOI: 10.1093/infdis/jiv109] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/17/2015] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Given that influenza A(H9N2) is recognized as a pandemic threat, we evaluated the overall burden of influenza A(H9N2) infections among avian-exposed human populations. METHODS We performed a systematic search of PubMed, AGRICOLA, and CAB Abstracts databases for literature published during 1997-2013. Studies reporting serological evidence of human influenza A(H9N2) infection among avian-exposed populations were included. We used a World Health Organization (WHO)-recommended case definition for serological evidence of infection based on results of hemagglutination inhibition (HI) and microneutralization (MN) assays. We calculated overall seroprevalence through a random effects meta-analysis model. RESULTS Seroprevalence data reported by the studies ranged from 1% to 43% (median, 9%) by HI, which was not significantly different from the seroprevalence estimated through the WHO-recommended case definition (median, 1.3%; range, 0.5%-42.6%). Reported seroprevalence by MN ranged from 0.6% to 9% (median, 2.7%), which was greater than the seroprevalence estimated through the WHO-recommended case definition (median, 0.3%; range, 0.1%-1.4%). CONCLUSIONS A small proportion of avian-exposed humans had evidence of influenza A(H9N2) infection. As the virus has a near global distribution in poultry, it seems likely that present surveillance efforts are missing mild or asymptomatic infections among avian-exposed persons. It seems prudent to closely monitor avian-exposed populations for influenza A(H9N2) infection to provide prepandemic warnings.
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Affiliation(s)
- Salah Uddin Khan
- Department of Environmental and Global Health, College of Public Health and Health Professions Emerging Pathogens Institute, University of Florida, Gainesville
| | - Benjamin D Anderson
- Department of Environmental and Global Health, College of Public Health and Health Professions Emerging Pathogens Institute, University of Florida, Gainesville Division of Infectious Diseases, Global Health Institute, & Nicholas School of the Environment, Duke University, Durham, North Carolina Laboratory of One Health Research, Program in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore
| | - Gary L Heil
- Department of Environmental and Global Health, College of Public Health and Health Professions Emerging Pathogens Institute, University of Florida, Gainesville
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions Emerging Pathogens Institute, University of Florida, Gainesville
| | - Gregory C Gray
- Division of Infectious Diseases, Global Health Institute, & Nicholas School of the Environment, Duke University, Durham, North Carolina Laboratory of One Health Research, Program in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore
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Safety, potential efficacy, and pharmacokinetics of specific polyclonal immunoglobulin F(ab')₂ fragments against avian influenza A (H5N1) in healthy volunteers: a single-centre, randomised, double-blind, placebo-controlled, phase 1 study. THE LANCET. INFECTIOUS DISEASES 2015; 15:285-92. [PMID: 25662592 DOI: 10.1016/s1473-3099(14)71072-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Human infection with the avian influenza A H5N1 virus results in disease with a high fatality rate, against which antiviral treatments have limited efficacy. We aimed to investigate the safety, pharmacokinetics, and therapeutic potential of specific polyclonal immunoglobulin equine F(ab')₂ fragments raised against influenza A/Vietnam/1194/2004 virus (H5N1 subtype) in healthy volunteers. METHODS We did a randomised, double-blind, placebo-controlled, single-centre phase 1 study. In stage 1 (one infusion) and stage 2 (five infusions) of the trial, we randomly assigned healthy male volunteers to receive once-daily intravenous infusions of 0·85 U/kg body weight of F(ab')₂ or once-daily saline placebo. Randomisation was done centrally, with one block of four patients and one block for substitutes (three actives, one placebo) in stage 1, and two blocks of six patients (five actives and one placebo) and the same block for substitutes in stage 2. The primary objective was assessment of the clinical and laboratory safety of F(ab')₂, which was monitored for 22 days in the group that received one dose (assessments on days 0-2, 4, 8, 15, and 22) and 33 days in the group that received five doses (days 0-6, 8, 10, 12, 19, 26, and 33). A final post-study safety assessment was done at 120 days. We also assessed pharmacokinetic outcomes, and assayed haemagglutination and seroneutralisation activity. Analysis was done according to intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT02295813. FINDINGS We enrolled 16 healthy Asian men between Sept 28 and Dec 28, 2012, and randomly assigned 13 to one or five doses of F(ab')₂ and three to placebo. F(ab')₂ was well tolerated, and no deaths or serious adverse events occurred. Three patients had mild adverse events (one each of blepharospasm, sinusitis, and pyrexia). The pyrexia (38°C) was regarded as probably related to the infusion, and resolved after 37 min. Our laboratory assessments of blood and urine samples and physical examinations of heart rate, electrocardiogram readings, and weight showed no clinically significant safety issues. Mean peak plasma concentrations were 19·3 μg/mL (SD 3·5) with the one dose schedule and 23·0 μg/mL (4·5) with the five-dose schedule. F(ab')₂ were still detectable in plasma on average up to 5 days after five doses. Haemagglutination inhibition was only increased after the third dose, but in-vitro seroneutralisation activity was transiently increased after each of the five doses to concentrations regarded as clinically beneficial in infected patients. INTERPRETATION F(ab')₂ showed good safety, tolerability, and therapeutic potential for managing of H5N1 exposed patients. FUNDING Fab'entech.
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Reed C, Bruden D, Byrd KK, Veguilla V, Bruce M, Hurlburt D, Wang D, Holiday C, Hancock K, Ortiz JR, Klejka J, Katz JM, Uyeki TM. Characterizing wild bird contact and seropositivity to highly pathogenic avian influenza A (H5N1) virus in Alaskan residents. Influenza Other Respir Viruses 2014; 8:516-23. [PMID: 24828535 PMCID: PMC4181814 DOI: 10.1111/irv.12253] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Highly pathogenic avian influenza A (HPAI) H5N1 viruses have infected poultry and wild birds on three continents with more than 600 reported human cases (59% mortality) since 2003. Wild aquatic birds are the natural reservoir for avian influenza A viruses, and migratory birds have been documented with HPAI H5N1 virus infection. Since 2005, clade 2.2 HPAI H5N1 viruses have spread from Asia to many countries. OBJECTIVES We conducted a cross-sectional seroepidemiological survey in Anchorage and western Alaska to identify possible behaviors associated with migratory bird exposure and measure seropositivity to HPAI H5N1. METHODS We enrolled rural subsistence bird hunters and their families, urban sport hunters, wildlife biologists, and a comparison group without bird contact. We interviewed participants regarding their exposures to wild birds and collected blood to perform serologic testing for antibodies against a clade 2.2 HPAI H5N1 virus strain. RESULTS Hunters and wildlife biologists reported exposures to wild migratory birds that may confer risk of infection with avian influenza A viruses, although none of the 916 participants had evidence of seropositivity to HPAI H5N1. CONCLUSIONS We characterized wild bird contact among Alaskans and behaviors that may influence risk of infection with avian influenza A viruses. Such knowledge can inform surveillance and risk communication surrounding HPAI H5N1 and other influenza viruses in a population with exposure to wild birds at a crossroads of intercontinental migratory flyways.
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Affiliation(s)
- Carrie Reed
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlanta, GA, USA
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Dana Bruden
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - Kathy K Byrd
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlanta, GA, USA
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - Vic Veguilla
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Michael Bruce
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - Debby Hurlburt
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - David Wang
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Crystal Holiday
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Kathy Hancock
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Justin R Ortiz
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlanta, GA, USA
- Departments of Medicine and Global Health, University of WashingtonSeattle, WA, USA
| | - Joe Klejka
- Yukon Kuskokwim Health CorporationBethel, AK, USA
| | - Jacqueline M Katz
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
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Disease severity is associated with differential gene expression at the early and late phases of infection in nonhuman primates infected with different H5N1 highly pathogenic avian influenza viruses. J Virol 2014; 88:8981-97. [PMID: 24899188 DOI: 10.1128/jvi.00907-14] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Occasional transmission of highly pathogenic avian H5N1 influenza viruses to humans causes severe pneumonia with high mortality. To better understand the mechanisms via which H5N1 viruses induce severe disease in humans, we infected cynomolgus macaques with six different H5N1 strains isolated from human patients and compared their pathogenicity and the global host responses to the virus infection. Although all H5N1 viruses replicated in the respiratory tract, there was substantial heterogeneity in their replicative ability and in the disease severity induced, which ranged from asymptomatic to fatal. A comparison of global gene expression between severe and mild disease cases indicated that interferon-induced upregulation of genes related to innate immunity, apoptosis, and antigen processing/presentation in the early phase of infection was limited in severe disease cases, although interferon expression was upregulated in both severe and mild cases. Furthermore, coexpression analysis of microarray data, which reveals the dynamics of host responses during the infection, demonstrated that the limited expression of these genes early in infection led to a failure to suppress virus replication and to the hyperinduction of genes related to immunity, inflammation, coagulation, and homeostasis in the late phase of infection, resulting in a more severe disease. Our data suggest that the attenuated interferon-induced activation of innate immunity, apoptosis, and antigen presentation in the early phase of H5N1 virus infection leads to subsequent severe disease outcome. IMPORTANCE Highly pathogenic avian H5N1 influenza viruses sometimes transmit to humans and cause severe pneumonia with ca. 60% lethality. The continued circulation of these viruses poses a pandemic threat; however, their pathogenesis in mammals is not fully understood. We, therefore, investigated the pathogenicity of six H5N1 viruses and compared the host responses of cynomolgus macaques to the virus infection. We identified differences in the viral replicative ability of and in disease severity caused by these H5N1 viruses. A comparison of global host responses between severe and mild disease cases identified the limited upregulation of interferon-stimulated genes early in infection in severe cases. The dynamics of the host responses indicated that the limited response early in infection failed to suppress virus replication and led to hyperinduction of pathological condition-related genes late in infection. These findings provide insight into the pathogenesis of H5N1 viruses in mammals.
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Little evidence of subclinical avian influenza virus infections among rural villagers in Cambodia. PLoS One 2014; 9:e97097. [PMID: 24819948 PMCID: PMC4018260 DOI: 10.1371/journal.pone.0097097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 04/14/2014] [Indexed: 11/19/2022] Open
Abstract
In 2008, 800 adults living within rural Kampong Cham Province, Cambodia were enrolled in a prospective cohort study of zoonotic influenza transmission. After enrollment, participants were contacted weekly for 24 months to identify acute influenza-like illnesses (ILI). Follow-up sera were collected at 12 and 24 months. A transmission substudy was also conducted among the family contacts of cohort members reporting ILI who were influenza A positive. Samples were assessed using serological or molecular techniques looking for evidence of infection with human and avian influenza viruses. Over 24 months, 438 ILI investigations among 284 cohort members were conducted. One cohort member was hospitalized with a H5N1 highly pathogenic avian influenza (HPAI) virus infection and withdrew from the study. Ninety-seven ILI cases (22.1%) were identified as influenza A virus infections by real-time RT-PCR; none yielded evidence for AIV. During the 2 years of follow-up, 21 participants (3.0%) had detectable antibody titers (≥1∶10) against the studied AIVs: 1 against an avian-like A/Migratory duck/Hong Kong/MPS180/2003(H4N6), 3 against an avian-like A/Teal/Hong Kong/w312/97(H6N1), 9 (3 of which had detectible antibody titers at both 12- and 24-month follow-up) against an avian-like A/Hong Kong/1073/1999(H9N2), 6 (1 detected at both 12- and 24-month follow-up) against an avian-like A/Duck/Memphis/546/74(H11N9), and 2 against an avian-like A/Duck/Alberta/60/76(H12N5). With the exception of the one hospitalized cohort member with H5N1 infection, no other symptomatic avian influenza infections were detected among the cohort. Serological evidence for subclinical infections was sparse with only one subject showing a 4-fold rise in microneutralization titer over time against AvH12N5. In summary, despite conducting this closely monitored cohort study in a region enzootic for H5N1 HPAI, we were unable to detect subclinical avian influenza infections, suggesting either that these infections are rare or that our assays are insensitive at detecting them.
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Okoye JO, Eze DC, Krueger WS, Heil GL, White SK, Merrill HR, Gray GC. Evidence for subclinical H5N1 avian influenza infections among Nigerian poultry workers. J Med Virol 2014; 86:2070-5. [PMID: 24677113 DOI: 10.1002/jmv.23909] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2014] [Indexed: 12/27/2022]
Abstract
In recent years Nigeria has experienced sporadic incursions of highly pathogenic H5N1 avian influenza among poultry. In 2008, 316 poultry-exposed agricultural workers, and 54 age-group matched non-poultry exposed adults living in the Enugu or Ebonyi States of Nigeria were enrolled and then contacted monthly for 24 months to identify acute influenza-like-illnesses. Annual follow-up sera and questionnaire data were collected at 12 and 24 months. Participants reporting influenza-like illness completed additional questionnaires, and provided nasal and pharyngeal swabs and acute and convalescent sera. Swab and sera specimens were studied for evidence of influenza A virus infection. Sera were examined for elevated antibodies against 12 avian influenza viruses by microneutralization and 3 human viruses by hemagglutination inhibition. Four (3.2%) of the 124 acute influenza-like-illness investigations yielded molecular evidence of influenza, but virus could not be cultured. Serial serum samples from five poultry-exposed subjects had a ≥4-fold change in microneutralization titers against A/CK/Nigeria/07/1132123(H5N1), with three of those having titers ≥1:80 (maximum 1:1,280). Three of the five subjects (60%) reported a preceding influenza-like illness. Hemagglutination inhibition titers were ≥4-fold increases against one of the human viruses in 260 participants. While cross-reactivity from antibodies against other influenza viruses cannot be ruled out as a partial confounder, over the course of the 2-year follow-up, at least 3 of 316 (0.9%) poultry-exposed subjects had evidence for subclinical HPAI H5N1 infections. If these data represent true infections, it seems imperative to increase monitoring for avian influenza among Nigeria's poultry and poultry workers.
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Affiliation(s)
- John O Okoye
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Nigeria
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Herbreteau CH, Jacquot F, Rith S, Vacher L, Nguyen L, Carbonnelle C, Lotteau V, Jolivet M, Raoul H, Buchy P, Saluzzo JF. Specific polyclonal F(ab')2 neutralize a large panel of highly pathogenic avian influenza A viruses (H5N1) and control infection in mice. Immunotherapy 2014; 6:699-708. [PMID: 24673720 DOI: 10.2217/imt.14.40] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIM There is still no specific therapy for infection with the highly pathogenic avian influenza A virus (HPAI) H5N1, which caused 39 human cases with a 64% fatality rate in 2013. MATERIALS & METHODS We prepared highly purified specific equine polyclonal immunoglobulin fragments (F(ab')2) against H5N1 and tested them for efficacy in vitro and with different administration schedules in H5N1-challenged BALB/c mice. RESULTS in vitro, F(ab')2 neutralized 21 different H5N1 strains from different areas, representative of 11 different clades and sub-clades and 9 years of evolution of the virus. In vivo mouse experiments identified that the most efficient administration protocol consists of five consecutive daily injections after infection; 10 mg/kg giving a 60% increase in survival. CONCLUSION These data demonstrate the ability of anti-H5N1 F(ab')2 to markedly reduce the mortality and morbidity associated with infection of mice with HPAI H5N1 virus, and their potential for human therapy.
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Little evidence of avian or equine influenza virus infection among a cohort of Mongolian adults with animal exposures, 2010-2011. PLoS One 2014; 9:e85616. [PMID: 24465622 PMCID: PMC3897462 DOI: 10.1371/journal.pone.0085616] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 12/05/2013] [Indexed: 12/13/2022] Open
Abstract
Avian (AIV) and equine influenza virus (EIV) have been repeatedly shown to circulate among Mongolia’s migrating birds or domestic horses. In 2009, 439 Mongolian adults, many with occupational exposure to animals, were enrolled in a prospective cohort study of zoonotic influenza transmission. Sera were drawn upon enrollment and again at 12 and 24 months. Participants were contacted monthly for 24 months and queried regarding episodes of acute influenza-like illnesses (ILI). Cohort members confirmed to have acute influenza A infections, permitted respiratory swab collections which were studied with rRT-PCR for influenza A. Serologic assays were performed against equine, avian, and human influenza viruses. Over the 2 yrs of follow-up, 100 ILI investigations in the cohort were conducted. Thirty-six ILI cases (36%) were identified as influenza A infections by rRT-PCR; none yielded evidence for AIV or EIV. Serological examination of 12 mo and 24 mo annual sera revealed 37 participants had detectable antibody titers (≥1∶10) against studied viruses during the course of study follow-up: 21 against A/Equine/Mongolia/01/2008(H3N8); 4 against an avian A/Teal/Hong Kong/w3129(H6N1), 11 against an avian-like A/Hong Kong/1073/1999(H9N2), and 1 against an avian A/Migrating duck/Hong Kong/MPD268/2007(H10N4) virus. However, all such titers were <1∶80 and none were statistically associated with avian or horse exposures. A number of subjects had evidence of seroconversion to zoonotic viruses, but the 4-fold titer changes were again not associated with avian or horse exposures. As elevated antibodies against seasonal influenza viruses were high during the study period, it seems likely that cross-reacting antibodies against seasonal human influenza viruses were a cause of the low-level seroreactivity against AIV or EIV. Despite the presence of AIV and EIV circulating among wild birds and horses in Mongolia, there was little evidence of AIV or EIV infection in this prospective study of Mongolians with animal exposures.
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Burnell FJ, Holmes MA, Roiko AH, Lowe JB, Heil GL, White SK, Gray GC. Little evidence of human infection with equine influenza during the 2007 epizootic, Queensland, Australia. J Clin Virol 2013; 59:100-3. [PMID: 24360918 DOI: 10.1016/j.jcv.2013.11.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/18/2013] [Accepted: 11/26/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Equine influenza virus (EIV) is considered enzootic in Europe (except Iceland), Asia, North Africa, and North and South America. When EIV outbreaks occur they may severely impact the equine and tourist industries. Australia faced its first EIV outbreak beginning in August of 2007. The outbreak was concentrated in New South Wales and Queensland, with more than 1400 confirmed EIV infections in horses during the first month. Rapid response from the equine industry and the federal government was successful and Australia was declared free from EIV by the end of 2007. OBJECTIVES This cross-sectional study was designed to examine associations between exposure to EIV-infected horses and evidence of EIV infection in humans. STUDY DESIGN Employing informed consent, between October 2007 and April 2008, 100 subjects (89 with horse exposures and 11 non-exposed) were enrolled during equine events and at the University of the Sunshine Coast. All subjects provided a blood sample and were asked to complete an online questionnaire including health history, animal exposure and demographic information. Sera samples were tested for the presence of antibodies against two H3N8 EIV strains using microneutralization, hemagglutination inhibition, and enzyme-linked lectin assays. RESULTS Evidence for H3N8 infection was sparse, with only 9 study participants having any indication of H3N8 infection and the seroreactivity seen was low and easily explained by cross-reactions against human influenza strains or vaccines. CONCLUSIONS These data provide little evidence to support the premise that EIV infections occurred among humans exposed to EIV-infected horses during the 2007 Australian epizootic.
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Affiliation(s)
- Fiona J Burnell
- School of Health & Sport Sciences, Faculty of Science, Health, Education, & Engineering, University of the Sunshine Coast, Maroochydore, Australia
| | - Mark A Holmes
- School of Health & Sport Sciences, Faculty of Science, Health, Education, & Engineering, University of the Sunshine Coast, Maroochydore, Australia
| | - Anne H Roiko
- School of Health & Sport Sciences, Faculty of Science, Health, Education, & Engineering, University of the Sunshine Coast, Maroochydore, Australia
| | - John B Lowe
- School of Health & Sport Sciences, Faculty of Science, Health, Education, & Engineering, University of the Sunshine Coast, Maroochydore, Australia
| | - Gary L Heil
- College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Sarah K White
- College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Gregory C Gray
- College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
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Yang W, Petkova E, Shaman J. The 1918 influenza pandemic in New York City: age-specific timing, mortality, and transmission dynamics. Influenza Other Respir Viruses 2013; 8:177-88. [PMID: 24299150 PMCID: PMC4082668 DOI: 10.1111/irv.12217] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2013] [Indexed: 01/11/2023] Open
Abstract
Background The 1918 influenza pandemic caused disproportionately high mortality among certain age groups. The mechanisms underlying these differences are not fully understood. Objectives To explore the dynamics of the 1918 pandemic and to identify potential age-specific transmission patterns. Methods We examined 1915–1923 daily mortality data in New York City (NYC) and estimated the outbreak duration and initial effective reproductive number (Re) for each 1-year age cohort. Results Four pandemic waves occurred from February 1918 to April 1920. The fractional mortality increase (i.e. ratio of excess mortality to baseline mortality) was highest among teenagers during the first wave. This peak shifted to 25- to 29-year-olds in subsequent waves. The distribution of age-specific mortality during the last three waves was strongly correlated (r = 0·94 and 0·86). With each wave, the pandemic appeared to spread with a comparable early growth rate but then attenuate with varying rates. For the entire population, Re estimates made assuming 2-day serial interval were 1·74 (1·27), 1·74 (1·43), 1·66 (1·25), and 1·86 (1·37), respectively, during the first week (first 3 weeks) of each wave. Using age-specific mortality, the average Re estimates over the first week of each wave were 1·62 (95% CI: 1·55–1·68), 1·68 (1·65–1·72), 1·67 (1·61–1·73), and 1·69 (1·63–1·74), respectively; Re was not significantly different either among age cohorts or between waves. Conclusions The pandemic generally caused higher mortality among young adults and might have spread mainly among school-aged children during the first wave. We propose mechanisms to explain the timing and transmission dynamics of the four NYC pandemic waves.
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Affiliation(s)
- Wan Yang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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Nasreen S, Uddin Khan S, Azziz-Baumgartner E, Hancock K, Veguilla V, Wang D, Rahman M, Alamgir ASM, Sturm-Ramirez K, Gurley ES, Luby SP, Katz JM, Uyeki TM. Seroprevalence of antibodies against highly pathogenic avian influenza A (H5N1) virus among poultry workers in Bangladesh, 2009. PLoS One 2013; 8:e73200. [PMID: 24039887 PMCID: PMC3764173 DOI: 10.1371/journal.pone.0073200] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 07/17/2013] [Indexed: 01/09/2023] Open
Abstract
We conducted a cross-sectional study in 2009 to determine the seroprevalence and risk factors for highly pathogenic avian influenza A (H5N1) [HPAI H5N1] virus antibodies among poultry workers at farms and live bird markets with confirmed/suspected poultry outbreaks during 2009 in Bangladesh. We tested sera by microneutralization assay using A/Bangladesh/207095/2008 (H5N1; clade 2.2.2) virus with confirmation by horse red blood cell hemagglutination inhibition and H5-specific Western blot assays. We enrolled 212 workers from 87 farms and 210 workers from three live bird markets. One hundred and two farm workers (48%) culled poultry. One hundred and ninety-three farm workers (91%) and 178 market workers (85%) reported direct contact with poultry that died during a laboratory confirmed HPAI H5N1 poultry farm outbreak or market poultry die-offs from suspected HPAI H5N1. Despite exposure to sick poultry, no farm or market poultry workers were seropositive for HPAI H5N1 virus antibodies (95% confidence interval 0-1%).
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Affiliation(s)
- Sharifa Nasreen
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- * E-mail:
| | - Salah Uddin Khan
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Kathy Hancock
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vic Veguilla
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - David Wang
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Government of Bangladesh, Dhaka, Bangladesh
| | - A. S. M. Alamgir
- Institute of Epidemiology, Disease Control and Research, Government of Bangladesh, Dhaka, Bangladesh
| | - Katharine Sturm-Ramirez
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily S. Gurley
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Stephen P. Luby
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jacqueline M. Katz
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Timothy M. Uyeki
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Krueger WS, Khuntirat B, Yoon IK, Blair PJ, Chittagarnpitch M, Putnam SD, Supawat K, Gibbons RV, Bhuddari D, Pattamadilok S, Sawanpanyalert P, Heil GL, Gray GC. Prospective study of avian influenza virus infections among rural Thai villagers. PLoS One 2013; 8:e72196. [PMID: 23977250 PMCID: PMC3745375 DOI: 10.1371/journal.pone.0072196] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 07/07/2013] [Indexed: 11/18/2022] Open
Abstract
Background In 2008, 800 rural Thai adults living within Kamphaeng Phet Province were enrolled in a prospective cohort study of zoonotic influenza transmission. Serological analyses of enrollment sera suggested this cohort had experienced subclinical avian influenza virus (AIV) infections with H9N2 and H5N1 viruses. Methods After enrollment, participants were contacted weekly for 24mos for acute influenza-like illnesses (ILI). Cohort members confirmed to have influenza A infections were enrolled with their household contacts in a family transmission study involving paired sera and respiratory swab collections. Cohort members also provided sera at 12 and 24 months after enrollment. Serologic and real-time RT-PCR assays were performed against avian, swine, and human influenza viruses. Results Over the 2 yrs of follow-up, 81 ILI investigations in the cohort were conducted; 31 (38%) were identified as influenza A infections by qRT-PCR. Eighty-three household contacts were enrolled; 12 (14%) reported ILIs, and 11 (92%) of those were identified as influenza infections. A number of subjects were found to have slightly elevated antibodies against avian-like A/Hong Kong/1073/1999(H9N2) virus: 21 subjects (2.7%) at 12-months and 40 subjects (5.1%) at 24-months. Among these, two largely asymptomatic acute infections with H9N2 virus were detected by >4-fold increases in annual serologic titers (final titers 1∶80). While controlling for age and influenza vaccine receipt, moderate poultry exposure was significantly associated with elevated H9N2 titers (adjusted OR = 2.3; 95% CI, 1.04–5.2) at the 24-month encounter. One subject had an elevated titer (1∶20) against H5N1 during follow-up. Conclusions From 2008–10, evidence for AIV infections was sparse among this rural population. Subclinical H9N2 AIV infections likely occurred, but serological results were confounded by antibody cross-reactions. There is a critical need for improved serological diagnostics to more accurately detect subclinical AIV infections in humans.
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Affiliation(s)
- Whitney S. Krueger
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Benjawan Khuntirat
- US Army Medical Component - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - In-Kyu Yoon
- US Army Medical Component - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Patrick J. Blair
- Naval Medical Research Unit 2 and Office of Defense Cooperation, Singapore
| | | | - Shannon D. Putnam
- Naval Health Research Center, San Diego, California, United States of America
| | - Krongkaew Supawat
- National Institute of Health, Ministry of Public Health, Bangkok, Thailand
| | - Robert V. Gibbons
- US Army Medical Component - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Darunee Bhuddari
- US Army Medical Component - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | - Gary L. Heil
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Gregory C. Gray
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Liao Q, Bai T, Zhou L, Vong S, Guo J, Lv W, Dong L, Xiang N, Li Z, Huai Y, Zhou J, Li X, Chen RY, Xu Z, Uyeki TM, Shu Y, Yu H. Seroprevalence of antibodies to highly pathogenic avian influenza A (H5N1) virus among close contacts exposed to H5N1 cases, China, 2005-2008. PLoS One 2013; 8:e71765. [PMID: 23967241 PMCID: PMC3742513 DOI: 10.1371/journal.pone.0071765] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 07/03/2013] [Indexed: 11/18/2022] Open
Abstract
To assess the extent of highly pathogenic avian influenza (HPAI) A (H5N1) virus transmission, we conducted sero-epidemiologic studies among close contacts exposed to H5N1 cases in mainland China during 2005-2008. Blood specimens were collected from 87 household members and 332 social contacts of 23 H5N1 index cases for HPAI H5N1 serological testing by modified horse red-blood-cell hemagglutinin inhibition and microneutralization assays. All participants were interviewed with a standardized questionnaire to collect information about the use of personal protective equipment, illness symptoms, exposure to an H5N1 case during the infectious period, and poultry exposures. Two (2.3%) household contacts tested positive for HPAI H5N1 virus antibody, and all social contacts tested negative. Both seropositive cases had prolonged, unprotected, close contact with a different H5N1 index case, including days of bed-care or sleeping together during the index case's infectious period, and did not develop any illness. None of the 419 close contacts used appropriate personal protective equipment including 17% who reported providing bedside care or having physical contact with an H5N1 case for at least 12 hours. Our findings suggest that HPAI H5N1 viruses that circulated among poultry in mainland China from 2005-2008 were not easily transmitted to close contacts of H5N1 cases.
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Affiliation(s)
- Qiaohong Liao
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Tian Bai
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Lei Zhou
- Public Health Emergency Center, China CDC, Beijing, China
| | - Sirenda Vong
- World Health Organization (WHO) Beijing Office, Beijing, China
| | - Junqiao Guo
- Liaoning Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Wei Lv
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Libo Dong
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Nijuan Xiang
- Public Health Emergency Center, China CDC, Beijing, China
| | - Zi Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Yang Huai
- US Centers for Disease Control and Prevention’s International Emerging Infections Program, Beijing, China
| | - Jianfang Zhou
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Xiaodan Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Ray Y. Chen
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Zhen Xu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Timothy M. Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Yuelong Shu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
- * E-mail: (HJY); (YLS)
| | - Hongjie Yu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- * E-mail: (HJY); (YLS)
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45
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Khurelbaatar N, Krueger WS, Heil GL, Darmaa B, Ulziimaa D, Tserennorov D, Baterdene A, Anderson BD, Gray GC. Sparse evidence for equine or avian influenza virus infections among Mongolian adults with animal exposures. Influenza Other Respir Viruses 2013; 7:1246-50. [PMID: 23941547 PMCID: PMC4634246 DOI: 10.1111/irv.12148] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2013] [Indexed: 12/21/2022] Open
Abstract
In recent years, Mongolia has experienced recurrent epizootics of equine influenza virus (EIV) among its 2·1 million horses and multiple incursions of highly pathogenic avian influenza (HPAI) virus via migrating birds. No human EIV or HPAI infections have been reported. In 2009, 439 adults in Mongolia were enrolled in a population‐based study of zoonotic influenza transmission. Enrollment sera were examined for serological evidence of infection with nine avian, three human, and one equine influenza virus strains. Seroreactivity was sparse among participants suggesting little human risk of zoonotic influenza infection.
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46
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Coman A, Maftei DN, Krueger WS, Heil GL, Friary JA, Chereches RM, Sirlincan E, Bria P, Dragnea C, Kasler I, Gray GC. Serological evidence for avian H9N2 influenza virus infections among Romanian agriculture workers. J Infect Public Health 2013; 6:438-47. [PMID: 23999337 DOI: 10.1016/j.jiph.2013.05.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/22/2013] [Accepted: 05/24/2013] [Indexed: 11/19/2022] Open
Abstract
In recent years, wild birds have introduced multiple highly pathogenic avian influenza (HPAI) H5N1 virus infections in Romanian poultry. In 2005 HPAI infections were widespread among domestic poultry and anecdotal reports suggested domestic pigs may also have been exposed. We sought to examine evidence for zoonotic influenza infections among Romanian agriculture workers. Between 2009 and 2010, 363 adult participants were enrolled in a cross-sectional, seroepidemiological study. Confined animal feeding operation (CAFO) swine workers in Tulcea and small, traditional backyard farmers in Cluj-Napoca were enrolled, as well as a non-animal exposed control group from Cluj-Napoca. Enrollment sera were examined for serological evidence of previous infection with 9 avian and 3 human influenza virus strains. Serologic assays showed no evidence of previous infection with 7 low pathogenic avian influenza viruses or with HPAI H5N1. However, 33 participants (9.1%) had elevated microneutralization antibody titers against avian-like A/Hong Kong/1073/1999(H9N2), 5 with titers ≥ 1:80 whom all reported exposure to poultry. Moderate poultry exposure was significantly associated with elevated titers after controlling for the subjects' age (adjusted OR = 3.6; 95% CI, 1.1-12.1). There was no evidence that previous infection with human H3N2 or H2N2 viruses were confounding the H9N2 seroreactivity. These data suggest that H9N2 virus may have circulated in Romanian poultry and occasionally infected man.
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Affiliation(s)
- Alexandru Coman
- Center for Health Policy and Public Health, Institute for Social Research, Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
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47
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Rimmelzwaan GF, Katz JM. Immune responses to infection with H5N1 influenza virus. Virus Res 2013; 178:44-52. [PMID: 23735534 DOI: 10.1016/j.virusres.2013.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 04/03/2013] [Accepted: 05/20/2013] [Indexed: 01/22/2023]
Abstract
Influenza A H5N1 viruses remain a substantial threat to global public health. In particular, the expanding genetic diversity of H5N1 viruses and the associated risk for human adaptation underscore the importance of better understanding host immune responses that may protect against disease or infection. Although much emphasis has been placed on investigating early virus-host interactions and the induction of innate immune responses, little is known of the consequent adaptive immune response to H5N1 virus infection. In this review, we describe the H5N1 virus-specific and cross-reactive antibody and T cell responses in humans and animal models. Data from limited studies suggest that although initially robust, there is substantial waning of the serum antibody responses in survivors of H5N1 virus infection. Characterization of monoclonal antibodies generated from memory B cells of survivors of H5N1 virus infection has provided an understanding of the fine specificity of the human antibody response to H5N1 virus infection and identified strategies for immunotherapy. Human T cell responses induced by infection with seasonal influenza viruses are directed to relatively conserved internal proteins and cross-react with the H5N1 subtype. A role for T cell-based heterosubtypic immunity against H5N1 viruses is suggested in animal studies. Further studies on adaptive immune responses to H5N1 virus infection in both humans and animals are needed to inform the design of optimal immunological treatment and prevention modalities.
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Affiliation(s)
- Guus F Rimmelzwaan
- Viroscience Laboratory, Erasmus Medical Center, Rotterdam, The Netherlands
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48
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Okoye J, Eze D, Krueger WS, Heil GL, Friary JA, Gray GC. Serologic evidence of avian influenza virus infections among Nigerian agricultural workers. J Med Virol 2013; 85:670-6. [DOI: 10.1002/jmv.23520] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 11/08/2022]
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49
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To KK, Ng KH, Que TL, Chan JM, Tsang KY, Tsang AK, Chen H, Yuen KY. Avian influenza A H5N1 virus: a continuous threat to humans. Emerg Microbes Infect 2012; 1:e25. [PMID: 26038430 PMCID: PMC3636560 DOI: 10.1038/emi.2012.24] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/11/2012] [Accepted: 07/16/2012] [Indexed: 01/11/2023]
Abstract
We report the first case of severe pneumonia due to co-infection with the emerging avian influenza A (H5N1) virus subclade 2.3.2.1 and Mycoplasma pneumoniae. The patient was a returning traveller who had visited a poultry market in South China. We then review the epidemiology, virology, interspecies barrier limiting poultry-to-human transmission, clinical manifestation, laboratory diagnosis, treatment and control measures of H5N1 clades that can be transmitted to humans. The recent controversy regarding the experiments involving aerosol transmission of recombinant H5N1 virus between ferrets is discussed. We also review the relative contribution of the poor response to antiviral treatment and the virus-induced hyperinflammatory damage to the pathogenesis and the high mortality of this infection. The factors related to the host, virus or medical intervention leading to the difference in disease mortality of different countries remain unknown. Because most developing countries have difficulty in instituting effective biosecurity measures, poultry vaccination becomes an important control measure. The rapid evolution of the virus would adversely affect the efficacy of poultry vaccination unless a correctly matched vaccine was chosen, manufactured and administered in a timely manner. Vigilant surveillance must continue to allow better preparedness for another poultry or human pandemic due to new viral mutants.
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Affiliation(s)
- Kelvin Kw To
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong , Hong Kong Special Administrative Region, China ; Research Centre of Infection and Immunology, The University of Hong Kong , Hong Kong Special Administrative Region, China ; Department of Microbiology, The University of Hong Kong , Hong Kong Special Administrative Region, China
| | - Kenneth Hl Ng
- Department of Pathology, Tuen Mun Hospital , Hong Kong Special Administrative Region, China
| | - Tak-Lun Que
- Department of Pathology, Tuen Mun Hospital , Hong Kong Special Administrative Region, China
| | - Jacky Mc Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital , Hong Kong Special Administrative Region, China
| | - Kay-Yan Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital , Hong Kong Special Administrative Region, China
| | - Alan Kl Tsang
- Research Centre of Infection and Immunology, The University of Hong Kong , Hong Kong Special Administrative Region, China ; Department of Microbiology, The University of Hong Kong , Hong Kong Special Administrative Region, China
| | - Honglin Chen
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong , Hong Kong Special Administrative Region, China ; Research Centre of Infection and Immunology, The University of Hong Kong , Hong Kong Special Administrative Region, China ; Department of Microbiology, The University of Hong Kong , Hong Kong Special Administrative Region, China
| | - Kwok-Yung Yuen
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong , Hong Kong Special Administrative Region, China ; Research Centre of Infection and Immunology, The University of Hong Kong , Hong Kong Special Administrative Region, China ; Department of Microbiology, The University of Hong Kong , Hong Kong Special Administrative Region, China
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50
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Uyeki TM, Nguyen DC, Rowe T, Lu X, Hu-Primmer J, Huynh LP, Hang NLK, Katz JM. Seroprevalence of antibodies to avian influenza A (H5) and A (H9) viruses among market poultry workers, Hanoi, Vietnam, 2001. PLoS One 2012; 7:e43948. [PMID: 22928049 PMCID: PMC3424239 DOI: 10.1371/journal.pone.0043948] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 07/27/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The frequency of avian influenza A virus infections among poultry workers is not well understood. METHODS A seroprevalence study of market poultry workers and persons without occupational poultry exposure was conducted during 2001 in Hanoi, Vietnam. Sera were tested for avian influenza H5 and H9 antibodies by microneutralization and Western blot assays. RESULTS Seroprevalence of H5 and H9 antibodies was 4% and 3% in poultry workers and 1% and 3.5% in non-poultry workers, respectively. CONCLUSIONS Seroprevalence of H5 and H9 antibodies was low among Hanoi market poultry workers in 2001, but can serve as a baseline for additional studies.
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Affiliation(s)
- Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
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