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Lesmes-Rodríguez LC, Pedraza-Castillo LN, Jaramillo-Hernández DA. HCoV-NL63 and HCoV-HKU1 seroprevalence and its relationship with the clinical features of COVID-19 patients from Villavicencio, Colombia. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024; 44:340-354. [PMID: 39241243 DOI: 10.7705/biomedica.7168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 04/11/2024] [Indexed: 09/08/2024]
Abstract
INTRODUCTION Due to the cross-reactivity between SARS-CoV-2 and common human coronaviruses, previous infections with these viruses could contribute to serological or cellular cross-protection against severe COVID-19. However, protective immunity may not develop, or pre-existing immunity could increase COVID-19 severity. OBJECTIVE To determine the seroprevalence of IgG antibodies against HCoV-NL63 and HCoV-HKU1 and correlate previous exposure with COVID-19 signs in patients from Villavicencio. MATERIALS AND METHODS A cross-sectional retrospective study was conducted. ELISA technique was used to search for IgG antibodies against HCoV-NL3 and HCoV-HKU1 in patients with positive RT-qPCR results for SARS-CoV-2. Patients were grouped according to COVID-19 clinical characteristics in four groups: group 1: asymptomatic (n = 23); group 2: hospitalized (n = 24); group 3: intensive care units (n = 24), and group 4: dead (n = 22). RESULTS The overall seroprevalence of IgG antibodies against HCoV was 74.2% (n = 69; 95% CI: 65.3-83.1), with 66.7% of HCoV-NL63 (n = 62; 95% CI: 57,1-76,2), and 25.8% of HCoV-HKU1 (n = 24; 95% CI: 16,9-34,7). Based on crosstab analysis, prior exposure to HCoV-NL63 was associated with protection against severe COVID-19 (p = 0.042; adjusted OR = 0.159; 95% CI: 0.027-0.938), and previous coinfection of HCoV-NL63 and HCoVHKU1 was considered a positive association to severe COVID-19 (p = 0.048; adjusted OR = 16.704; 95% CI: 1.020 - 273.670). CONCLUSION To our knowledge, this is the first study addressing seroprevalence of HCoV IgG antibodies in Colombia and Latin America. Previous exposure to HCoV-NL63 could protect against severe COVID-19, whereas patients with underlying HCoV-NL63 and HCoVHKU1 coinfection could be hospitalized with severe signs of COVID-19.
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Affiliation(s)
- Lida Carolina Lesmes-Rodríguez
- Departamento de Biología y Química, Facultad de Ciencias Básicas e Ingeniería, Universidad de los Llanos, Villavicencio, Colombia
| | - Luz Natalia Pedraza-Castillo
- Escuela de Ciencias Animales, Facultad de Ciencias Agropecuarias y Recursos Naturales, Universidad de los Llanos, Villavicencio, Colombia
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Li W, Xie L, Zhu X, Yang Y, Wang L, Yang M, Li H, Li X, Yan G, Wu X, Zhao W, Zhang J, Yang G, Guo Y, Li C, Wang R, Shi L, Xiong Z, Xu P, Kong W, Cui M, Yang X, Ba Y. Effectiveness and safety of Qingfei Dayuan granules for treating influenza and upper respiratory tract infections manifested by the pulmonary heat-toxin syndrome: A multicenter, randomized, double-blind, placebo-controlled trial. Front Pharmacol 2023; 14:1133560. [PMID: 37007028 PMCID: PMC10050362 DOI: 10.3389/fphar.2023.1133560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
Background: Patients diagnosed with influenza and upper respiratory tract infections (URTIs) have similar clinical manifestations and biochemical indices and a low detection rate of viral pathogens, mixed infection with diverse respiratory viruses, and targeted antiviral treatment difficulty in the early stage. According to the treatment strategy of “homotherapy for heteropathy” in traditional Chinese medicine (TCM), different diseases with the same clinical symptoms can be treated with the same medicines. Qingfei Dayuan granules (QFDY), a type of Chinese herbal preparation included in the TCM Diagnosis and Treatment Protocol for COVID-19 of Hubei Province issued by the Health Commission of Hubei Province in 2021, are recommended for patients suffering from COVID-19 with symptoms of fever, cough, and fatigue, among others. Additionally, recent studies have shown that QFDY effectively alleviates fever, cough, and other clinical symptoms in patients with influenza and URTIs.Materials and methods: The study was designed as a multicenter, randomized, double-blind, placebo-controlled clinical trial for treatment for influenza and URTIs manifested by pulmonary heat-toxin syndrome (PHTS) with QFDY. A total of 220 eligible patients were enrolled from eight first-class hospitals in five cities of Hubei Province in China and randomly assigned to receive either 15 g of QFDY or a placebo three times a day for 5 days. The primary outcome was the complete fever relief time. Secondary outcomes included efficacy evaluation of TCM syndromes, scores of TCM syndromes, cure rate of each single symptom, incidence of comorbidities and progression to severe conditions, combined medications, and laboratory tests. Safety evaluations mainly involved adverse events (AEs) and changes in vital signs during the study.Results: Compared with the placebo group, the complete fever relief time was shorter in the QFDY group, 24 h (12.0, 48.0) in the full analysis set (FAS) and 24 h (12.0, 49.5) in the per-protocol set (PPS) (p ≤ 0.001). After a 3-day treatment, the clinical recovery rate (22.3% in the FAS and 21.6% in the PPS) and cure rate of cough (38.6% in the FAS and 37.9% in the PPS), a stuffy and running nose, and sneezing (60.0% in the FAS and 59.5% in the PPS) in the QFDY group were higher than those in the placebo group (p < 0.05). The number of patients taking antibiotics for more than 24 h in the placebo group (nine cases) was significantly higher than that in the QFDY group (one case) (p < 0.05). There were no significant differences between the two groups in terms of scores of TCM syndromes, incidence of comorbidities or progression to severe conditions, combined use of acetaminophen tablets or phlegm-resolving medicines, and laboratory tests (p > 0.05). Meanwhile, no significant difference was found in the incidence of AEs and vital signs between the two groups (p > 0.05).Conclusion: The trial showed that QFDY was an effective and safe treatment modality for influenza and URTIs manifested by PHTS because it shortened the complete fever relief time, accelerated clinical recovery, and alleviated symptoms such as cough, a stuffy and running nose, and sneezing during the course of treatment.Clinical trial registration:https://www.chictr.org.cn/showproj.aspx?proj=131702, identifier ChiCTR2100049695.
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Affiliation(s)
- Weinan Li
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- The Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
| | - Lihan Xie
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyun Zhu
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Yi Yang
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Linqun Wang
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Min Yang
- Department of Preventive Medicine, School of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Hengfei Li
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- The Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
| | - Xucheng Li
- Emergency Department, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Guangjun Yan
- Jingzhou Hospital of Traditional Chinese Medicine, Jingzhou, China
| | - Xiongfei Wu
- Department of Infectious Diseases, People’s Hospital of Hanchuan, Hanchuan, China
| | - Weijun Zhao
- Respiratory Department, Yichang Hospital of Traditional Chinese Medicine, Yichang, China
| | | | - Gang Yang
- Department of Respirology, Huangshi Hospital of Traditional Chinese Medicine, Huangshi, China
| | - Yufei Guo
- Fever Outpatient Clinic, Hubei Provincial Hospital of Traditional Medicine and Western Medicine, Wuhan, China
| | - Chengyin Li
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- The Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
| | - Rui Wang
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Lijun Shi
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- The Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
| | - Zhili Xiong
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Puming Xu
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Wenwen Kong
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Mengdi Cui
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Xi Yang
- College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Yuanming Ba
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- The Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
- *Correspondence: Yuanming Ba,
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Bouzid D, Casalino E, Mullaert J, Laurent O, Duval X, Lescure FX, Peiffer Smadja N, Tubiana S, Armand Lefèvre L, Descamps D, Fidouh N, Choquet C, Lucet JC, Visseaux B. Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial. J Antimicrob Chemother 2021; 76:iii20-iii27. [PMID: 34555158 PMCID: PMC8460108 DOI: 10.1093/jac/dkab241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Virus-associated respiratory infections are in the spotlight with the emergence of SARS-CoV-2 and the expanding use of multiplex PCR (mPCR). The impact of molecular testing as a point-of-care test (POCT) in the emergency department (ED) is still unclear. Objectives To compare the impact of a syndromic test performed in the ED as a POCT and in the central laboratory on length of stay (LOS), antibiotic use and single-room assignment. Methods From 19 November 2019 to 9 March 2020, adults with acute respiratory illness seeking care in the ED of a large hospital were enrolled, with mPCR performed with a weekly alternation in the ED as a POCT (week A) or in the central laboratory (week B). Results 474 patients were analysed: 275 during A weeks and 199 during B weeks. Patient characteristics were similar. The hospital LOS (median 7 days during week A versus 7 days during week B, P = 0.29), the proportion of patients with ED-LOS <1 day (63% versus 60%, P = 0.57) and ED antibiotic prescription (59% versus 58%, P = 0.92) were not significantly different. Patients in the POCT arm were more frequently assigned a single room when having a positive PCR for influenza, respiratory syncytial virus and metapneumovirus [52/70 (74%) versus 19/38 (50%) in the central testing arm, P = 0.012]. Conclusions Syndromic testing performed in the ED compared with the central laboratory failed to reduce the LOS or antibiotic consumption in patients with acute respiratory illness, but was associated with an increased single-room assignment among patients in whom a significant respiratory pathogen was detected.
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Affiliation(s)
- Donia Bouzid
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Enrique Casalino
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Jimmy Mullaert
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Department of Epidemiology, Biostatistics and Clinical Research, Bichat-Claude Bernard University Hospital, Paris, France
| | - Odile Laurent
- AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Xavier Duval
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Department of Epidemiology, Biostatistics and Clinical Research, Bichat-Claude Bernard University Hospital, Paris, France
| | - François Xavier Lescure
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Infectious Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Nathan Peiffer Smadja
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Infectious Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Sarah Tubiana
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Department of Epidemiology, Biostatistics and Clinical Research, Bichat-Claude Bernard University Hospital, Paris, France
| | - Laurence Armand Lefèvre
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Bacteriology, Bichat-Claude Bernard University Hospital, Paris, France
| | - Diane Descamps
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Nadhira Fidouh
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Christophe Choquet
- AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Jean-Christophe Lucet
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Infection Control Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Benoit Visseaux
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France
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Aghbash PS, Eslami N, Shirvaliloo M, Baghi HB. Viral coinfections in COVID-19. J Med Virol 2021; 93:5310-5322. [PMID: 34032294 PMCID: PMC8242380 DOI: 10.1002/jmv.27102] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/21/2021] [Accepted: 05/22/2021] [Indexed: 02/06/2023]
Abstract
The most consequential challenge raised by coinfection is perhaps the inappropriate generation of recombinant viruses through the exchange of genetic material among different strains. These genetically similar viruses can interfere with the replication process of each other and even compete for the metabolites required for the maintenance of the replication cycle. Due to the similarity in clinical symptoms of most viral respiratory tract infections, and their coincidence with COVID-19, caused by SARS-CoV-2, it is recommended to develop a comprehensive diagnostic panel for detection of respiratory and nonrespiratory viruses through the evaluation of patient samples. Given the resulting changes in blood markers, such as coagulation factors and white blood cell count following virus infection, these markers can be of diagnostic value in the detection of mixed infection in individuals already diagnosed with a certain viral illness. In this review, we seek to investigate the coinfection of SARS-CoV-2 with other respiratory and nonrespiratory viruses to provide novel insights into the development of highly sensitive diagnostics and effective treatment modalities.
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Affiliation(s)
- Parisa S. Aghbash
- Immunology Research CenterTabriz University of Medical SciencesTabrizIran
- Infectious and Tropical Diseases Research CenterTabriz University of Medical SciencesTabrizIran
| | - Narges Eslami
- Infectious and Tropical Diseases Research CenterTabriz University of Medical SciencesTabrizIran
- Drug Applied Research CentreTabriz University of Medical SciencesTabrizIran
| | - Milad Shirvaliloo
- Infectious and Tropical Diseases Research CenterTabriz University of Medical SciencesTabrizIran
- Drug Applied Research CentreTabriz University of Medical SciencesTabrizIran
| | - Hossein B. Baghi
- Immunology Research CenterTabriz University of Medical SciencesTabrizIran
- Infectious and Tropical Diseases Research CenterTabriz University of Medical SciencesTabrizIran
- Department of Virology, Faculty of MedicineTabriz University of Medical SciencesTabrizIran
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5
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McMinn BR, Korajkic A, Kelleher J, Herrmann MP, Pemberton AC, Ahmed W, Villegas EN, Oshima K. Development of a large volume concentration method for recovery of coronavirus from wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 774:145727. [PMID: 33607441 PMCID: PMC7870434 DOI: 10.1016/j.scitotenv.2021.145727] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/26/2021] [Accepted: 02/04/2021] [Indexed: 04/15/2023]
Abstract
Levels of severe acute respiratory coronavirus type 2 (SARS CoV 2) RNA in wastewater could act as an effective means to monitor coronavirus disease 2019 (COVID-19) within communities. However, current methods used to detect SARS CoV 2 RNA in wastewater are limited in their ability to process sufficient volumes of source material, inhibiting our ability to assess viral load. Typically, viruses are concentrated from large liquid volumes using two stage concentration, primary and secondary. Here, we evaluated a dead-end hollow fiber ultrafilter (D-HFUF) for primary concentration, followed by the CP Select™ for secondary concentration from 2 L volumes of primary treated wastewater. Various amendments to each concentration procedure were investigated to optimally recover seeded OC43 (betacoronavirus) from wastewater. During primary concentration, the D-HFUF recovered 69 ± 18% (n = 29) of spiked OC43 from 2 L of wastewater. For secondary concentration, the CP Select™ system using the Wastewater Application settings was capable of processing 100 mL volumes of primary filter eluates in <25 min. A hand-driven syringe elution proved to be significantly superior (p = 0.0299) to the CP Select™ elution for recovering OC43 from filter eluates, 48 ± 2% compared to 31 ± 3%, respectively. For the complete method (primary and secondary concentration combined), the D-HFUF and CP select/syringe elution achieved overall 22 ± 4% recovery of spiked OC43 through (n = 8) replicate filters. Given the lack of available standardized methodology confounded by the inherent limitations of relying on viral RNA for wastewater surveillance of SARS CoV 2, it is important to acknowledge these challenges when interpreting this data to estimate community infection rates. However, the development of methods that can substantially increase sample volumes will likely allow for reporting of quantifiable viral data for wastewater surveillance, equipping public health officials with information necessary to better estimate community infection rates.
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Affiliation(s)
- Brian R McMinn
- Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, United States.
| | - Asja Korajkic
- Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, United States
| | - Julie Kelleher
- Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, United States
| | - Michael P Herrmann
- Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, United States
| | - Adin C Pemberton
- Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, United States
| | - Warish Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia
| | - Eric N Villegas
- Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, United States
| | - Kevin Oshima
- Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, United States
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Johnson EK, Sylte D, Chaves SS, Li Y, Mahe C, Nair H, Paget J, van Pomeren T, Shi T, Viboud C, James SL. Hospital utilization rates for influenza and RSV: a novel approach and critical assessment. Popul Health Metr 2021; 19:31. [PMID: 34126993 PMCID: PMC8204427 DOI: 10.1186/s12963-021-00252-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/31/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Influenza and respiratory syncytial virus (RSV) contribute significantly to the burden of acute lower respiratory infection (ALRI) inpatient care, but heterogeneous coding practices and availability of inpatient data make it difficult to estimate global hospital utilization for either disease based on coded diagnoses alone. METHODS This study estimates rates of influenza and RSV hospitalization by calculating the proportion of ALRI due to influenza and RSV and applying this proportion to inpatient admissions with ALRI coded as primary diagnosis. Proportions of ALRI attributed to influenza and RSV were extracted from a meta-analysis of 360 total sources describing inpatient hospital admissions which were input to a Bayesian mixed effects model over age with random effects over location. Results of this model were applied to inpatient admission datasets for 44 countries to produce rates of hospital utilization for influenza and RSV respectively, and rates were compared to raw coded admissions for each disease. RESULTS For most age groups, these methods estimated a higher national admission rate than the rate of directly coded influenza or RSV admissions in the same inpatient sources. In many inpatient sources, International Classification of Disease (ICD) coding detail was insufficient to estimate RSV burden directly. The influenza inpatient burden estimates in older adults appear to be substantially underestimated using this method on primary diagnoses alone. Application of the mixed effects model reduced heterogeneity between countries in influenza and RSV which was biased by coding practices and between-country variation. CONCLUSIONS This new method presents the opportunity of estimating hospital utilization rates for influenza and RSV using a wide range of clinical databases. Estimates generally seem promising for influenza and RSV associated hospitalization, but influenza estimates from primary diagnosis seem highly underestimated among older adults. Considerable heterogeneity remains between countries in ALRI coding (i.e., primary vs non-primary cause), and in the age profile of proportion positive for influenza and RSV across studies. While this analysis is interesting because of its wide data utilization and applicability in locations without laboratory-confirmed admission data, understanding the sources of variability and data quality will be essential in future applications of these methods.
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Affiliation(s)
- Emily K Johnson
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA.
| | - Dillon Sylte
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
- Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - You Li
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cedric Mahe
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
- Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands
| | - Tayma van Pomeren
- Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands
| | - Ting Shi
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Spencer L James
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department. Emerg Med Int 2021; 2021:2344212. [PMID: 34221509 PMCID: PMC8213466 DOI: 10.1155/2021/2344212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022] Open
Abstract
Procalcitonin (PCT) may be useful for early risk stratification in the emergency department (ED), but the transposition of published data to routine emergency practice is sometimes limited. An observational retrospective study was conducted in the adult ED of the Reims University Hospital (France). Over one year, 852 patients suspected of infection were included, of mean age 61.7 years (SD: 22.6), and 624 (73.2%) were hospitalized following ED visit. Overall, 82 (9.6%) patients died during their hospitalization with an odds ratio (OR) of 5.10 (95% CI: 2.19-11.87) for PCT ≥ 0.5, in multivariate logistic regression analyses. Moreover, 78 (9.2%) patients were admitted to an ICU, 74 (8.7%) had attributable bacteremia, and 56 (6.6%) evolved toward septic shock with an OR of 4.37 (2.08-9.16), 6.38 (2.67-15.24), and 6.38 (2.41-16.86), respectively, for PCT ≥ 0.5. The highest discriminatory values were found for patients with age <65 years, but PCT lost its discrimination power for in-hospital mortality in patients with a bronchopulmonary infection site or a temperature ≥37.8°C and for ICU admission in patients with severe clinical presentations. PCT could be helpful in risk stratification, but several limitations must be considered, including being sometimes outperformed by a simple clinical examination.
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Liu J, Wang M, Zhao Z, Lin X, Zhang P, Yue Q, Zhang T, Meng Y. Viral and bacterial coinfection among hospitalized children with respiratory tract infections. Am J Infect Control 2020; 48:1231-1236. [PMID: 32113661 PMCID: PMC7132732 DOI: 10.1016/j.ajic.2020.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND The epidemiology of Mycoplasma pneumoniae (MP) and local dominant etiologies of pathogens that cause respiratory tract infections (RTIs) among central China children (≤14 years old) hospitalized are poorly understood. METHODS A total of 10,429 specimens were analyzed, and IgM antibodies against 9 respiratory pathogens including MP were detected using indirect immunofluorescence assay from serum. RESULTS It showed that 59.3% of the enrolled children were positive for at least 1 pathogen; highest detection rates included those between 3 and <6 years of age (70.4%), female (63.2%), and who were hospitalized in 2014 (80.9%). The most predominant pathogen was MP (45.6%), followed by Parainfluenza viruses (PIVs) (22.6%) and influenza B viruses (IFVB) (14.7%). Coinfection was observed in 2,907 specimens (27.9%); the coinfection combination containing MP and PIVs had the highest detection rate of 15%, followed by MP and IFVB as well as IFVB and PIVs. CONCLUSIONS MP was the most commonly detected bacteria among hospitalized children, which should be included in the differential diagnosis for hospitalized children with RTI. These findings will contribute to the effective prevention and therapeutic approaches of pathogens among local children suffering from RTI.
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Affiliation(s)
- Junxiao Liu
- Department of Medical Laboratory, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China; Department of Gynecology, Luoyang Clinical Research Center of Obstetrics, Gynecology and Reproductive Medicine, Luoyang Central Hospital, Luoyang, Henan, China.
| | - Mengli Wang
- Department of Medical Laboratory, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
| | - Zhihong Zhao
- Department of Blood Transfusion, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
| | - Xiao Lin
- Department of Technology, Beijing Zhifang Science and Technology Development Limited Company, Luoyang, Henan, China
| | - Pei Zhang
- Department of Gynecology, Luoyang Clinical Research Center of Obstetrics, Gynecology and Reproductive Medicine, Luoyang Central Hospital, Luoyang, Henan, China; Department of Gynecology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
| | - Qingfen Yue
- Department of Gynecology, Luoyang Clinical Research Center of Obstetrics, Gynecology and Reproductive Medicine, Luoyang Central Hospital, Luoyang, Henan, China; Department of Gynecology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
| | - Ting Zhang
- Department of Medical Laboratory, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
| | - Yujuan Meng
- Department of Medical Laboratory, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
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Tan JY, Sim XYJ, Wee LE, Chua YY, Cherng BPZ, Ng IM, Conceicao EP, Wong TJ, Yang Y, Aung MK, Ling ML, Venkatachalam I. A comparative study on the clinical features of COVID-19 with non-SARS-CoV-2 respiratory viral infections. J Med Virol 2020; 93:1548-1555. [PMID: 32881022 DOI: 10.1002/jmv.26486] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/14/2020] [Accepted: 08/30/2020] [Indexed: 01/05/2023]
Abstract
During this coronavirus disease 2019 (COVID-19) pandemic, physicians have the important task of risk stratifying patients who present with acute respiratory illnesses. Clinical presentation of COVID-19, however, can be difficult to distinguish from other respiratory viral infections. Thus, identifying clinical features that are strongly associated with COVID-19 in comparison to other respiratory viruses can aid risk stratification and testing prioritization especially in situations where resources for virological testing and resources for isolation facilities are limited. In our retrospective cohort study comparing the clinical presentation of COVID-19 and other respiratory viral infections, we found that anosmia and dysgeusia were symptoms independently associated with COVID-19 and can be important differentiating symptoms in patients presenting with acute respiratory illness. On the other hand, laboratory abnormalities and radiological findings were not statistically different between the two groups. In comparing outcomes, patients with COVID-19 were more likely to need high dependency or intensive care unit care and had a longer median length of stay. With our findings, we emphasize that epidemiological risk factors and clinical symptoms are more useful than laboratory and radiological abnormalities in differentiating COVID-19 from other respiratory viral infections.
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Affiliation(s)
- Jing Yuan Tan
- Department of Internal Medicine, Singapore General Hospital, Singapore
| | - Xiang Ying Jean Sim
- Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Liang En Wee
- Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Ying-Ying Chua
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | | | - Ian Matthias Ng
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Edwin Philip Conceicao
- Department of Internal Medicine, Singapore General Hospital, Singapore.,Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Tzu-Jung Wong
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
| | - Yong Yang
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - May Kyawt Aung
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Moi Lin Ling
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Indumathi Venkatachalam
- Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
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10
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Lu G, Peng X, Li R, Liu Y, Wu Z, Wang X, Zhang D, Zhao J, Sun Y, Zhang L, Yang P, Wang Q. An outbreak of acute respiratory infection at a training base in Beijing, China due to human adenovirus type B55. BMC Infect Dis 2020; 20:537. [PMID: 32703176 PMCID: PMC7376533 DOI: 10.1186/s12879-020-05258-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/14/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Twelve students experienced symptoms of acute respiratory infection (ARI) at a training base in Beijing from August 26 to August 30, 2015. We investigated the cause of this ARI outbreak. METHODS In partnership with the local center for disease control, we collected a total of twelve pharyngeal swab specimens as well as demographic information for the affected patients. We used multiplex real-time PCR to screen for sixteen common respiratory viruses in these samples. To isolate HAdV, we inoculated Hep-2 cells with the human adenovirus (HAdV)-positive samples and then carried out sequencing and phylogenetic analysis of the hexon, fiber, and penton genes of the isolated adenoviruses. In addition, we analyzed the entire genome of one strain isolated from the index case to identify single-nucleotide substitutions. RESULTS We identified ten HAdV-positive students using multiplex real-time PCR. None of the students were co-infected with other viruses. We successfully isolated seven HAdV strains from the pharyngeal swab specimens. The coding sequences of the hexon, fiber, and penton genes of these seven HAdV strains were identical, suggesting that they represented seven strains from a single virus clone. One HAdV isolate obtained from the index case, BJDX-01-2015, was selected for whole genome analysis. From this isolate, we obtained a 34,774-nucleotide sequence. The genome of BJDX-01-2015 clustered with HAdV-B55 in phylogenetic analyses and had 99.97% identity with human adenovirus 55 isolate HAdV-B/CHN/BJ01/2011/55 (GenBank accession no. JX491639). CONCLUSIONS We identified HAdV-B55 as the strain associated with the August 2015 ARI outbreak at a training base in Beijing. This was the first reported outbreak in Beijing due to HAdV-B55. Continuous surveillance of respiratory adenoviruses is urgently needed to understand the epidemiological and evolutionary features of HAdV-B55, and an epidemiological modeling approach may provide further insights into this emerging public health threat. Furthermore, the clinical laboratory data from this outbreak provides important reference for the clinical diagnosis and may ultimately aid in informing the development of strategies to control and prevent respiratory tract infections caused by HAdV-B55.
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Affiliation(s)
- Guilan Lu
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Xiaomin Peng
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Renqing Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Yimeng Liu
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Zhanguo Wu
- Daxing District Center for Disease Prevention and Control, Beijing, 102600, China
| | - Xifeng Wang
- Daxing District Center for Disease Prevention and Control, Beijing, 102600, China
| | - Daitao Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Jiachen Zhao
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Ying Sun
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Li Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Peng Yang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China.
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11
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Epidemiology and Clinical Symptoms Related to Seasonal Coronavirus Identified in Patients with Acute Respiratory Infections Consulting in Primary Care over Six Influenza Seasons (2014-2020) in France. Viruses 2020; 12:v12060630. [PMID: 32532138 PMCID: PMC7354536 DOI: 10.3390/v12060630] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 01/08/2023] Open
Abstract
There is currently debate about human coronavirus (HCoV) seasonality and pathogenicity, as epidemiological data are scarce. Here, we provide epidemiological and clinical features of HCoV patients with acute respiratory infection (ARI) examined in primary care general practice. We also describe HCoV seasonality over six influenza surveillance seasons (week 40 to 15 of each season) from the period 2014/2015 to 2019/2020 in Corsica (France). A sample of patients of all ages presenting for consultation for influenza-like illness (ILI) or ARI was included by physicians of the French Sentinelles Network during this period. Nasopharyngeal samples were tested for the presence of 21 respiratory pathogens by real-time RT-PCR. Among the 1389 ILI/ARI patients, 105 were positive for at least one HCoV (7.5%). On an annual basis, HCoVs circulated from week 48 (November) to weeks 14–15 (May) and peaked in week 6 (February). Overall, among the HCoV-positive patients detected in this study, HCoV-OC43 was the most commonly detected virus, followed by HCoV-NL63, HCoV-HKU1, and HCoV-229E. The HCoV detection rates varied significantly with age (p = 0.00005), with the age group 0–14 years accounting for 28.6% (n = 30) of HCoV-positive patients. Fever and malaise were less frequent in HCoV patients than in influenza patients, while sore throat, dyspnoea, rhinorrhoea, and conjunctivitis were more associated with HCoV positivity. In conclusion, this study demonstrates that HCoV subtypes appear in ARI/ILI patients seen in general practice, with characteristic outbreak patterns primarily in winter. This study also identified symptoms associated with HCoVs in patients with ARI/ILI. Further studies with representative samples should be conducted to provide additional insights into the epidemiology and clinical features of HCoVs.
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12
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Chaung J, Chan D, Pada S, Tambyah PA. Coinfection with COVID-19 and coronavirus HKU1-The critical need for repeat testing if clinically indicated. J Med Virol 2020; 92:1785-1786. [PMID: 32293743 PMCID: PMC7262189 DOI: 10.1002/jmv.25890] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Jenna Chaung
- Department of Medicine, Ng Teng Fong General Hospital, Singapore
| | - Douglas Chan
- Department of Laboratory Medicine, Ng Teng Fong General Hospital, Singapore
| | - Surinder Pada
- Department of Medicine, Ng Teng Fong General Hospital, Singapore
| | - Paul A Tambyah
- Department of Medicine, National University Hospital, Singapore
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13
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Lehrich BM, Goshtasbi K, Raad RA, Ganti A, Papagiannopoulos P, Tajudeen BA, Kuan EC. Aggregate Prevalence of Chemosensory and Sinonasal Dysfunction in SARS-CoV-2 and Related Coronaviruses. Otolaryngol Head Neck Surg 2020; 163:156-161. [PMID: 32423285 DOI: 10.1177/0194599820929278] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Much of the published literature regarding the novel coronavirus disease 2019 (COVID-19) constitutes lower respiratory system symptomatology, while there exists a paucity of data describing the complicated sequelae of the upper respiratory system, including chemosensory and/or sinonasal dysfunction. This study utilized the National Library of Medicine's PubMed/MEDLINE database to query for articles describing COVID-19, SARS-CoV-2, SARS-CoV-1, MERS-CoV, and other coronaviruses, with any mention of smell, taste, or other chemosensory or sinonasal dysfunction. Aggregate analysis demonstrated an incidence of 49.6% (n = 497 of 1002; 95% CI, 46.5%-52.7%), 47.9% (n = 480 of 1002; 95% CI, 44.8%-51.0%), and 17.9% (n = 880 of 4909; 95% CI, 16.9%-19.0%) for smell loss, taste loss, and smell or taste loss, respectively, in patients infected with SARS-CoV-2. Additionally, there were significantly higher incidences of runny nose/rhinorrhea/rhinitis and nasal congestion/obstruction/blockage in other coronaviruses as compared with SARS-CoV-2 (P < .001). Understanding these less well-characterized symptoms may help develop measures for estimating early markers of disease prevalence and/or resolution. Level of evidence: 4.
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Affiliation(s)
- Brandon M Lehrich
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Richard A Raad
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Ashwin Ganti
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Peter Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
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14
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Palani N, Sistla S. Epidemiology and phylogenetic analysis of respiratory viruses from 2012 to 2015 - A sentinel surveillance report from union territory of Puducherry, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020; 8:1225-1235. [PMID: 32346655 PMCID: PMC7187823 DOI: 10.1016/j.cegh.2020.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/22/2020] [Indexed: 12/29/2022] Open
Abstract
Background Acute respiratory infections (ARI) are the most common illnesses affecting people of all ages worldwide. Viruses contribute to 30–70% of acute respiratory infections. Identification of these respiratory viruses is not given high priority except influenza; however, the knowledge about prevalence of non-influenza viruses, their seasonal pattern and genetic evolution have significant epidemiological value. Methods As a part of National Influenza-like illness surveillance programme, respiratory specimens were collected children and adults with symptoms of ILI or ARI, between January 2012 and March 2015 (including SARI cases). Real-time PCR was done to identify 13 respiratory viruses. Sequencing was done for representative isolates of each virus using ABI 3730 Genetic Analyzer. Results During the study period between January 2012 and March 2015, a total of 648 patients with symptoms of ARI were included in this study. The mean age of the patients was 20.2 years (SD = 19.13, median = 18); 292 (45.1%) were children (≤13 years) and 356 (54.9%) were adults. Respiratory viruses were identified in 44% (287/648) of all patients. Influenza accounted for the maximum number of cases- 179/648 (27.6%). Among the non-influenza viruses, RSV predominated with 34 cases (5.2%), followed by HMPV 24 (3.7%) and PIV-3 20 (3%). Four patients died due to INF A/H1N1 (2012-2, 2015-2) as a result of acute respiratory distress syndrome (ARDS) (CFR 3.7%). Among the non-influenza viruses, no particular seasonality pattern was observed over the different months of the study period. Conclusion Antibiotic usage in treating acute respiratory infections empirically is not justified as nearly half of ARI are due to viruses; nearly 28% of them were due to influenza viruses. Among the non-influenza viruses, RSV predominated, followed by HMPV. This study is based on an active influenza surveillance initiated after 2009 pandemic influenza outbreak, in the Union territory of Puducherry which has contributed significantly to the knowledge of the burden of influenza and non-influenza viruses among children and adults. Such surveillance network has paved the way for better diagnosis and timely therapeutic interventions. First data on the epidemiology of respiratory viruses from this region after 1974. First study to report corona virus, HCoV OC43 from India, and only the second Indian study to document corona virus, HCoV229E. This study is the first study to analyse the genetic sequence of HCoV-229E and OC-43. Influenza accounted for the maximum number of cases in the study population, 27%; four patients died of Acute respiratory distress syndrome (ARDS) due to influenza A/H1N1; CFR- 3.7%. Among the non-influenza viruses, RSV pre-dominated followed HMPV and PIV-3. No deaths were reported due to non-influenza viral ARI. RSV was detected almost equally in adults and children. Distinct pattern was observed in seasonality of influenza viruses but not for non-influenza viruses.
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Affiliation(s)
- Nandhini Palani
- National Reference Laboratory for Tuberculosis, National Institute for Research in Tuberculosis, 600031, Chennai, India
| | - Sujatha Sistla
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, 605006, Puducherry, India
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15
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Abstract
Respiratory syncytial virus (RSV) is the most common pathogen associated with acute lower respiratory tract infections in young children. RSV is also a major viral pathogen causing severe lung disease in the adult population, particularly among the elderly. We conducted a review of adult RSV studies published from January 1970 to February 2017 to determine the burden of disease among adults worldwide. There were no restrictions on health care setting or definition of RSV infection. A total of 1530 published studies were identified, 95 of which were included in this review. The incidence rates of hospitalised RSV acute respiratory tract infection (ARI) in adults >65 years old ranged from 7.3 to 13.0/105 population in Africa and Asia and from 190 to 254/105 population in the USA. Higher incidence rates (195–1790/105 population) were observed in adults ≥50 years old for outpatient or emergency visits in the USA. Of all ARI patients, RSV accounted for 1–10% in adults and 2–14% in patients with chronic diseases or transplantation. Given the limitations in the existing data, significant efforts should be made to generate evidence on the burden of RSV infections in adults and to estimate the potential impact of future preventive interventions.
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16
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Epidemiology of respiratory syncytial virus infections in Chennai, south India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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17
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Zhao Y, Lu R, Shen J, Xie Z, Liu G, Tan W. Comparison of viral and epidemiological profiles of hospitalized children with severe acute respiratory infection in Beijing and Shanghai, China. BMC Infect Dis 2019; 19:729. [PMID: 31429710 PMCID: PMC6701130 DOI: 10.1186/s12879-019-4385-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/15/2019] [Indexed: 12/16/2022] Open
Abstract
Background No comparison data have been reported on viral and epidemiological profiles of hospitalized children with severe acute respiratory infection (SARI) in Beijing or Shanghai, China. Methods We collected 700 nasopharyngeal aspirates (NPA) from hospitalized children with SARI in Beijing (northern China) and Shanghai (southern China). Multiple respiratory viruses (including 15 common viruses) were screened by validated polymerase chain reaction (PCR) or real-time reverse transcription-PCR assays and confirmed by sequencing. Demographic data and the distribution of viral infections were also examined. Results Of 700 samples, 547 (78.1%) tested positive for viral infections. The picornaviruses (PIC), which included rhinovirus (RV) and enterovirus (EV), were the most common (34.0%), followed by respiratory syncytial virus (RSV) (28.3%), human bocavirus (HBoV) (19.1%), adenovirus (ADV) (13.7%), human coronaviruses (HCoV) (10.7%), influenza A and B (8.9%), parainfluenza virus (PIV 1–3) (7.9%), and human metapneumovirus (HMPV) (5.0%). PIC (RV/EV) and RSV were the most prevalent etiological agents of SARI in both cities. The total and age-matched prevalence of RSV, HCoV, and hMPV among SARI children under 5 years old were significantly higher in Beijing than in Shanghai. Different age and seasonal distribution patterns of the viral infections were found between Beijing and Shanghai. Conclusions Viral infection was tested and shown to be the most prevalent etiological agent among children with SARI in either the Beijing or the Shanghai area, while showing different patterns of viral and epidemiological profiles. Our findings provide a better understanding of the roles of geographic location and climate in respiratory viral infections in hospitalized children with SARI.
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Affiliation(s)
- Yanjie Zhao
- Key Laboratory of Laboratory Medicine, Ministry of Education, and Institute of Medical Virology, Wenzhou Medical University, Zhejiang, China.,National Institute for Viral Disease Control and Prevention, China CDC, 155Changbai Road, Beijing, 102206, Changping District, China
| | - Roujian Lu
- National Institute for Viral Disease Control and Prevention, China CDC, 155Changbai Road, Beijing, 102206, Changping District, China
| | - Jun Shen
- Children's Hospital of Fudan University, Shanghai, China
| | - Zhengde Xie
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Gaoshan Liu
- Key Laboratory of Laboratory Medicine, Ministry of Education, and Institute of Medical Virology, Wenzhou Medical University, Zhejiang, China
| | - Wenjie Tan
- Key Laboratory of Laboratory Medicine, Ministry of Education, and Institute of Medical Virology, Wenzhou Medical University, Zhejiang, China. .,National Institute for Viral Disease Control and Prevention, China CDC, 155Changbai Road, Beijing, 102206, Changping District, China.
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18
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Development and optimized pairing of mouse monoclonal antibodies for detecting hemagglutinin in novel H7 subtype influenza viruses. SCIENCE CHINA-LIFE SCIENCES 2019; 63:279-289. [PMID: 31147904 PMCID: PMC7089150 DOI: 10.1007/s11427-018-9486-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/23/2019] [Indexed: 02/02/2023]
Abstract
The H7 subtype avian influenza threatens public health with respect to poultry and humans. Thus, a specific and sensitive diagnostic test is essential for the management of H7 subtype influenza infections. In this study, five mouse monoclonal antibodies (mAbs) against hemagglutinin (HA) of influenza A/Anhui/1/2013 (H7N9) were produced and characterized by the Western blot, immunofluorescence, and hemagglutination inhibition assays. All five specific mAbs reacted with the HA protein of H7N9 but not with that of H1N1, H3N2, or H5N1. With the combination arrays of capture and detection antibodies, the matched pair mAbs (1C4-coated and 2D7-labeled) were selected and employed in a double-antibody sandwich ELISA (DAS-ELISA). Detection limits of the sandwich ELISA were 0.45 ng mL−1 for the HA protein derived from A/Anhui/1/2013 (H7N9); or 1 and 2 HA units/50 µL for A/Anhui/1/2013 (H7N9) and A/GD/17SF003/2016 (H7N9), respectively. These anti-HA mAbs against subtype H7 and the novel DAS-ELISA provide a valuable approach for specific detection of the H7 subtype influenza virus and quantification of its HA protein, especially for the novel epidemic H7N9.
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19
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Ek P, Böttiger B, Dahlman D, Hansen KB, Nyman M, Nilsson AC. A combination of naso- and oropharyngeal swabs improves the diagnostic yield of respiratory viruses in adult emergency department patients. Infect Dis (Lond) 2019; 51:241-248. [PMID: 30760088 DOI: 10.1080/23744235.2018.1546055] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Along with the current development of molecular diagnostic methods of respiratory viruses, the bedside patient sampling techniques need to be evaluated. We here asked the question whether the addition of an oropharynx swab to the traditional nasopharynx swab might improve the diagnostic yield of multiplex PCR analysis. Ct values from the two sampling sites were compared as well as patient tolerability. METHODS In an emergency department in Malmö, Sweden, 98 adult patients with respiratory disease were sampled both from the nasopharynx and oropharynx for virus diagnostics by PCR. RESULTS Influenza (AH1, AH3, B), human metapneumovirus (hMPV) or respiratory syncytial virus (RSV) were detected by PCR in 58 subjects. The diagnostic yield was improved by combining nasopharyngeal and oropharyngeal sampling - a virus was detected in another 6 patients compared to traditional nasopharyngeal sampling (p = .031, McNemar's test). In 38/55 subjects viral load was higher in the nasopharynx than in the oropharynx. Self-reported discomfort was significantly lower from oropharyngeal sampling than from nasopharyngeal sampling. CONCLUSIONS Adding an oropharynx sample to a nasopharynx sample increased the diagnostic yield of respiratory viruses. Oropharyngeal sampling was well tolerated.
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Affiliation(s)
- Peter Ek
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
| | - Blenda Böttiger
- b Department of Clinical Microbiology, Division of Laboratory Medicine , Lund University , Lund , Sweden
| | - Disa Dahlman
- c Division of Psychiatry, Department of Clinical Sciences Lund , Lund University , Lund , Sweden.,d Malmö Addiction Centre , Skåne University Hospital , Malmö , Sweden.,e Center for Primary Health Care Research, Department of Clinical Sciences , Lund University/Region Skåne , Malmö , Sweden
| | - Karin B Hansen
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
| | - Mattias Nyman
- b Department of Clinical Microbiology, Division of Laboratory Medicine , Lund University , Lund , Sweden
| | - Anna C Nilsson
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
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Loubet P, Voiriot G, Neuville M, Visseaux B, Timsit JF. Virus respiratoires dans les pneumonies associées aux soins. MEDECINE INTENSIVE REANIMATION 2018. [DOI: 10.3166/rea-2018-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Les pneumonies acquises à l’hôpital (PAH) sont fréquentes. À l’ère des techniques diagnostiques de biologie moléculaire (multiplex polymerase chain reaction), les rares données disponibles estiment que les virus respiratoires sont impliqués dans 22 à 32 % des épisodes. Les patients immunodéprimés constituent probablement la population la plus à risque. La présentation clinique et radiologique ne diffère pas entre pneumonies bactériennes, virales et mixtes (virus–bactérie). L’excrétion prolongée de virus respiratoires dans les voies aériennes a été rapportée chez les patients immunodéprimés. Elle pourrait promouvoir la co-infection bactérienne, associée à des durées d’hospitalisation prolongées. L’acquisition intrahospitalière a été démontrée chez tous les virus respiratoires. Elle encourage la mise en œuvre et le respect des mesures d’hygiène et de confinement, dans l’objectif de protéger soignants, visiteurs et patients. De nombreux points restent largement méconnus, relatifs aux interactions entre virus respiratoires et pathogènes non viraux, aux périodes d’incubation, ou encore aux durées d’excrétion virale. L’amélioration des techniques diagnostiques et l’accumulation de données épidémiologiques et cliniques devraient permettre de mieux appréhender le rôle des virus respiratoires dans les PAH. Cette meilleure connaissance aidera à rationaliser l’utilisation des tests de détection et facilitera l’interprétation de leurs résultats. Elle guidera aussi le clinicien dans l’utilisation future des nombreuses molécules antivirales actuellement en développement clinique chez l’homme.
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21
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Kim JM, Jung HD, Cheong HM, Lee A, Lee NJ, Chu H, Lee JY, Kim SS, Choi JH. Nation-wide surveillance of human acute respiratory virus infections between 2013 and 2015 in Korea. J Med Virol 2018; 90:1177-1183. [PMID: 29488229 PMCID: PMC7166751 DOI: 10.1002/jmv.25069] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/21/2017] [Indexed: 01/08/2023]
Abstract
The prevalence of eight respiratory viruses detected in patients with acute respiratory infections (ARIs) in Korea was investigated through analysis of data recorded by the Korea Influenza and Respiratory Viruses Surveillance System (KINRESS) from 2013 to 2015. Nasal aspirate and throat swabs specimens were collected from 36 915 patients with ARIs, and viral nucleic acids were detected by real‐time (reverse‐transcription) polymerase chain reaction for eight respiratory viruses, including human respiratory syncytial viruses (HRSVs), influenza viruses (IFVs), human parainfluenza viruses (HPIVs), human coronaviruses (HCoVs), human rhinovirus (HRV), human adenovirus (HAdV), human bocavirus (HBoV), and human metapneumovirus (HMPV). The overall positive rate of patient specimens was 49.4% (18 236/36 915), 5% of which carried two or more viruses simultaneously. HRV (15.6%) was the most predominantly detected virus, followed by IFVs (14.6%), HAdV (7.5%), HPIVs (5.8%), HCoVs (4.2%), HRSVs (3.6%), HBoV (1.9%), and HMPV (1.6%). Most of the ARIs were significantly correlated with clinical symptoms of fever, cough, and runny nose. Although HRV and HAdV were frequently detected throughout the year in patients, other respiratory viruses showed apparent seasonality. HRSVs and IFVs were the major causative agents of acute respiratory diseases in infants and young children. Overall, this study demonstrates a meaningful relationship between viral infection and typical manifestations of known clinical features as well as seasonality, age distribution, and co‐infection among respiratory viruses. Therefore, these data could provide useful information for public health management and to enhance patient care for primary clinicians.
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Affiliation(s)
- Jeong-Min Kim
- Division of Emerging Infectious Disease and Vector Research, Cheongju-si, South Korea
| | - Hee-Dong Jung
- Division of Research Planning, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | | | - Anna Lee
- Division of Viral Disease, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Nam-Joo Lee
- Division of Viral Disease, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Hyuk Chu
- Bacterial Disease Research, Cheongju-si, South Korea
| | - Joo-Yeon Lee
- Division of Emerging Infectious Disease and Vector Research, Cheongju-si, South Korea
| | | | - Jang-Hoon Choi
- Viral Disease Research, Center for Infectious Diseases Research, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
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Jennings L, Huang QS, Barr I, Lee PI, Kim WJ, Buchy P, Sanicas M, Mungall BA, Chen J. Literature review of the epidemiology of influenza B disease in 15 countries in the Asia-Pacific region. Influenza Other Respir Viruses 2018; 12:383-411. [PMID: 29127742 PMCID: PMC5907823 DOI: 10.1111/irv.12522] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 01/06/2023] Open
Abstract
Influenza control strategies focus on the use of trivalent influenza vaccines containing two influenza A virus subtypes and one of the two circulating influenza type B lineages (Yamagata or Victoria). Mismatches between the vaccine B lineage and the circulating lineage have been regularly documented in many countries, including those in the Asia‐Pacific region. We conducted a literature review with the aim of understanding the relative circulation of influenza B viruses in Asia‐Pacific countries. PubMed and Western Pacific Region Index Medicus were searched for relevant articles on influenza type B published since 1990 in English language for 15 Asia‐Pacific countries. Gray literature was also accessed. From 4834 articles identified, 121 full‐text articles were analyzed. Influenza was reported as an important cause of morbidity in the Asia‐Pacific region, affecting all age groups. In all 15 countries, influenza B was identified and associated with between 0% and 92% of laboratory‐confirmed influenza cases in any one season/year. Influenza type B appeared to cause more illness in children aged between 1 and 10 years than in other age groups. Epidemiological data for the two circulating influenza type B lineages remain limited in several countries in the Asia‐Pacific, although the co‐circulation of both lineages was seen in countries where strain surveillance data were available. Mismatches between circulating B lineages and vaccine strains were observed in all countries with available data. The data suggest that a shift from trivalent to quadrivalent seasonal influenza vaccines could provide additional benefits by providing broader protection.
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Affiliation(s)
- Lance Jennings
- Canterbury District Health Board, Christchurch, New Zealand
| | - Qiu Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Ian Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, VIC, Australia
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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Wei L, Xie Q, Hou JL, Tang H, Ning Q, Cheng J, Nan Y, Zhang L, Li J, Jiang J, McNabb B, Zhang F, Camus G, Mo H, Osinusi A, Brainard DM, Gong G, Mou Z, Wu S, Wang G, Hu P, Gao Y, Jia J, Duan Z. Ledipasvir/sofosbuvir for treatment-naive and treatment-experienced Chinese patients with genotype 1 HCV: an open-label, phase 3b study. Hepatol Int 2018; 12:126-132. [PMID: 29637511 PMCID: PMC5904238 DOI: 10.1007/s12072-018-9856-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/15/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic hepatitis C virus (HCV) infection is a significant medical burden in China, affecting more than 10 million persons. In clinical trials and real-world settings, treatment with ledipasvir/sofosbuvir in patients with genotype 1 HCV infection resulted in high sustained virologic response rates. Ledipasvir/sofosbuvir may provide a highly effective, short-duration, single-tablet regimen for Chinese patients with HCV infection. METHODS Chinese patients with genotype 1 HCV infection who were HCV treatment naive or treatment experienced, without cirrhosis or with compensated cirrhosis, were treated with open-label ledipasvir/sofosbuvir for 12 weeks. The primary efficacy endpoint was sustained virologic response 12 weeks after completing treatment (SVR12). For treatment-naive patients, SVR12 was compared to a historical rate of 57%. The primary safety endpoint was adverse events leading to permanent discontinuation of study drug; serious adverse events were also evaluated. The presence of resistance-associated substitutions (RASs) was evaluated by viral sequencing. RESULTS All 206 enrolled patients achieved SVR12 (100%; 95% CI 98-100%), including 106 treatment-naive patients (100%; 95% CI 97-100%), which was superior to a historical SVR rate of 57% (p < 0.001). All patients with baseline NS5A and NS5B RASs (14 and 1% of patients, respectively) achieved SVR12. The most common adverse events were viral upper respiratory tract infection (17%), upper respiratory tract infection (14%), and cough (6%). There were no discontinuations due to adverse events; and no treatment-related serious adverse events were reported. CONCLUSION Ledipasvir/sofosbuvir is a well tolerated and highly effective treatment for Chinese patients with genotype 1 HCV, regardless of prior treatment experience, cirrhosis status, or the presence of pretreatment RASs.
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Affiliation(s)
- Lai Wei
- Beijing Key Lab for Hepatitis C and Immunologic Liver Disease, Peking University Hepatology Institute, Peking University People's Hospital, 11 Xizhimen S St, Xicheng District, Beijing, 100044, China.
| | - Qing Xie
- Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jin Lin Hou
- Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Hong Tang
- West China Hospital, Sichuan University, Chengdu, China
| | - Qin Ning
- Tongji Hospital of Tongji Medical College, Huanzhong University of Science and Technology, Wuhan, China
| | - Jun Cheng
- Beijing Ditan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yuemin Nan
- The Third Hospital of Hebei Medical University, Hebei, China
| | - Lunli Zhang
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Li
- The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jianning Jiang
- The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | | | | | | | | | | | | | - Guozhong Gong
- The Second Xiangya Hospital of Central South University, Changsha, China
| | | | - Shanming Wu
- Clinical Center of Shanghai Public Health, Shanghai, China
| | | | - Peng Hu
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanhang Gao
- The First Hospital of Jilin University, Changchun, China
| | - Jidong Jia
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhongping Duan
- Beijing You-An Hospital, Capital Medical University, Beijing, China
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Hansen GT, Moore J, Herding E, Gooch T, Hirigoyen D, Hanson K, Deike M. Clinical decision making in the emergency department setting using rapid PCR: Results of the CLADE study group. J Clin Virol 2018; 102:42-49. [PMID: 29494950 PMCID: PMC7106512 DOI: 10.1016/j.jcv.2018.02.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/15/2018] [Accepted: 02/19/2018] [Indexed: 11/06/2022]
Abstract
The influence of an influenza diagnosis on patient managed during ED visits is examined. An influenza diagnosis in the ED is actionable, impacting empiric management in 61% of cases. The clinical diagnosis of influenza, based on presenting symptoms, lacks sensitivity at 36%. A 30 min result from collection to report could be achieved in the ED for 91.7%, of cases tested. ED testing resulted in savings of $200.40/ED visit but is dependent on avoiding planned admissions.
Background Emergency Departments (ED) are challenged during influenza season by patients who present acutely during sporadic ED visits. ED management is largely empiric, often occurring without reliable diagnostics needed for targeted therapies, safe outpatient discharge, or hospital admissions. Objective To evaluate the impact of the influenza diagnosis on physician decision making during ED visits using the Cobas Liat® influenza A + B assay. Study design Prospective study assessing the impact of rapid (<30 min), reverse-transcriptase polymerase chain reaction (RT-PCR) influenza testing on physician decision making in the ED. Physician responses established pre-and post-diagnosis management courses which required confirmation via secondary documentation in the medical record. Changes in physician decision making were analyzed across four clinical touchpoints: (i) admission/discharge status, (ii) medical procedures, (iii) antiviral and antibiotic prescribing, and (iv) laboratory studies. Results An influenza diagnosis changed patient management courses, relative to empiric, pre-diagnosis plans, in in 61% of the cases resulting in cost savings of $49,420-to-$42,270 over 143 patients and 104 days during influenza season resulting in a cost savings of $200.40/ED visit. Evaluation over 2000 ED patient visits projects cost savings > $578,000 due to deferred admissions, and reduction in antiviral prescribing. Sensitivity of ED-based influenza testing using the Cobas Liat® assay was equivalent to centralized lab testing at 98.8% sensitivity and 98.5% specificity respectively. Conclusion Providing rapid, RT-PCR influenza testing to ED settings is actionable and used to guide patient care decisions. Understanding the cascade of events linked to the influenza diagnosis in the ED provides overall cost savings which offset the cost of providing ED-based testing.
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Affiliation(s)
- Glen T Hansen
- Department of Pathology & Laboratory Medicine, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States; Department of Pathology & Laboratory Medicine, University of Minnesota, United States; University of Minnesota, Department of Infectious Disease, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States.
| | - Johanna Moore
- Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States.
| | - Emily Herding
- Minneapolis Medical Research Foundation, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States.
| | - Tami Gooch
- Department of Pathology & Laboratory Medicine, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States.
| | - Diane Hirigoyen
- Department of Pathology & Laboratory Medicine, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States.
| | - Kevan Hanson
- Department of Pathology & Laboratory Medicine, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States.
| | - Marcia Deike
- Department of Pathology & Laboratory Medicine, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States.
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Whole-genome analyses of human adenovirus type 55 emerged in Tibet, Sichuan and Yunnan in China, in 2016. PLoS One 2017; 12:e0189625. [PMID: 29240811 PMCID: PMC5730161 DOI: 10.1371/journal.pone.0189625] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/28/2017] [Indexed: 12/16/2022] Open
Abstract
Three outbreaks of acute respiratory disease occurred at military camps in 2016 at Tibet, Sichuan and Yunnan province, China. The pathogen induced these three outbreaks were all confirmed as HAdV-55 by genotype-specific PCR. The outbreak in Tibet was the first report that HAdV-55 occurred in the high altitude (HA, above sea level 3658 m). This study aims to determine the gene variation and evolution characteristics of these viral strains. Three strains of adenoviruses, LS89/Tibet/2016 (GenBank accession no. KY002683), SF04/SC/2016 (GenBank accession no. KY002684) and KM03/YN/2016 (GenBank accession no. KY002685) were obtained and confirmed by wholegenome sequencing. No multi-gene fragments recombination were found in these isolated HAdV-55 virus compared with previous reported HAdV-55 strains in China. The outbreaks in Tibet and in Sichuan continuously occurred. Virus isolated from Tibet (LS89/Tibet/2016) and Sichuan (SF04/SC/2016) had a similar mutation pattern and had a closer genetic evolutionary distance than KM03/YN/2016 strain, which indicates that the pathogens causing these two outbreaks may be of the same origin. Moreover, we found that heating was an effective way to inactive these viruses, which provide valuable information for the development of HAdV-55 vaccines. Our data provide new information for genetic evolution of HAdV-55, and contribute to the prevention and control of HAdV-55 infection in the future.
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Prevalence of respiratory viruses among adults, by season, age, respiratory tract region and type of medical unit in Paris, France, from 2011 to 2016. PLoS One 2017; 12:e0180888. [PMID: 28708843 PMCID: PMC5510824 DOI: 10.1371/journal.pone.0180888] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/22/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Multiplex PCR tests have improved our understanding of respiratory viruses' epidemiology by allowing their wide range detection. We describe here the burden of these viruses in hospital settings over a five-year period. METHODS All respiratory samples from adult patients (>20 years old) tested by multiplex-PCR at the request of physicians, from May 1 2011 to April 30 2016, were included retrospectively. Viral findings are reported by season, patient age group, respiratory tract region (upper or lower) and type of clinical unit (intensive care unit, pneumology unit, lung transplantation unit and other medical units). RESULTS In total, 7196 samples (4958 patients) were included; 29.2% tested positive, with viral co-infections detected in 1.6% of samples. Overall, two viral groups accounted for 60.2% of all viruses identified: picornaviruses (rhinovirus or enterovirus, 34.3%) and influenza (26.6%). Influenza viruses constituted the group most frequently identified in winter (34.4%), in the upper respiratory tract (32%) and in patients over the age of 70 years (36.4%). Picornavirus was the second most frequently identified viral group in these populations and in all other groups, including lower respiratory tract infections (41.3%) or patients in intensive care units (37.6%). CONCLUSION This study, the largest to date in Europe, provides a broad picture of the distribution of viruses over seasons, age groups, types of clinical unit and respiratory tract regions in the hospital setting. It highlights the burden associated with the neglected picornavirus group. These data have important implications for the future development of vaccines and antiviral drugs.
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Kanwar A, Selvaraju S, Esper F. Human Coronavirus-HKU1 Infection Among Adults in Cleveland, Ohio. Open Forum Infect Dis 2017; 4:ofx052. [PMID: 28616442 PMCID: PMC5466428 DOI: 10.1093/ofid/ofx052] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 03/20/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Human coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness. Coronavirus-HKU1 has been described predominantly among children less than 5 years of age in the United States with few studies characterizing the disease spectrum among adults. METHODS Nasopharyngeal specimens of patients with respiratory symptoms were analyzed for CoV-HKU1 by NxTAG Respiratory Pathogen Panel multiplex assay from February 7, 2016 to April 30, 2016. Epidemiologic, clinical, and laboratory data were collected on adults (patients >18 years) whose samples screened positive. RESULTS Of 832 adult respiratory specimens screened, 13 (1.6%) cases of CoV-HKU1 were identified. Adults age ranged between 23 and 75 years and 6 (46%) were males. All of whom had 1 or more respiratory symptoms, and 5 (38%) also reported 1 or more gastrointestinal symptoms. Eleven (85%) reported history of smoking and 5 (38%) used inhaled steroids. Seven (54%) required hospitalization, 5 (71%) of these needed supplemental oxygen, and 2 (29%) were admitted to intensive care. Median length of hospitalization was 5 days. Eight (62%) received antibiotics despite identification of CoV-HKU1. Infectious work-up in 1 patient who died did not reveal any other pathogen. In 2 (15%) CoV-HKU1-positive adults, the only viral coinfection detected was influenza A. CONCLUSIONS Coronavirus-HKU1 accounted for 1.6% of adult respiratory infections and should be considered in differential diagnosis of severe respiratory illnesses among adults.
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Affiliation(s)
- Anubhav Kanwar
- Department of Internal Medicine, Division of Infectious Diseases and HIV Medicine and
| | - Suresh Selvaraju
- Department of Pathology, MetroHealth Medical Center, Cleveland, Ohio
| | - Frank Esper
- Department of Pediatrics, Division of Infectious Diseases, University Hospitals, Cleveland Medical Center, Ohio
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Distribution and Molecular Characterization of Human Adenovirus and Epstein-Barr Virus Infections in Tonsillar Lymphocytes Isolated from Patients Diagnosed with Tonsillar Diseases. PLoS One 2016; 11:e0154814. [PMID: 27136093 PMCID: PMC4852932 DOI: 10.1371/journal.pone.0154814] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/19/2016] [Indexed: 11/19/2022] Open
Abstract
Surgically removed palatine tonsils provide a conveniently accessible source of T and B lymphocytes to study the interplay between foreign pathogens and the host immune system. In this study we have characterised the distribution of human adenovirus (HAdV), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in purified tonsillar T and B cell-enriched fractions isolated from three patient age groups diagnosed with tonsillar hypertrophy and chronic/recurrent tonsillitis. HAdV DNA was detected in 93 out of 111 patients (84%), while EBV DNA was detected in 58 patients (52%). The most abundant adenovirus type was HAdV-5 (68%). None of the patients were positive for HCMV. Furthermore, 43 patients (39%) showed a co-infection of HAdV and EBV. The majority of young patients diagnosed with tonsillar hypertrophy were positive for HAdV, whereas all adult patients diagnosed with chronic/recurrent tonsillitis were positive for either HAdV or EBV. Most of the tonsils from patients diagnosed with either tonsillar hypertrophy or chronic/recurrent tonsillitis showed a higher HAdV DNA copy number in T compared to B cell-enriched fraction. Interestingly, in the majority of the tonsils from patients with chronic/recurrent tonsillitis HAdV DNA was detected in T cells only, whereas hypertrophic tonsils demonstrated HAdV DNA in both T and B cell-enriched fractions. In contrast, the majority of EBV positive tonsils revealed a preference for EBV DNA accumulation in the B cell-enriched fraction compared to T cell fraction irrespective of the patients' age.
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Wang H, Zheng Y, Deng J, Wang W, Liu P, Yang F, Jiang H. Prevalence of respiratory viruses among children hospitalized from respiratory infections in Shenzhen, China. Virol J 2016; 13:39. [PMID: 26952107 PMCID: PMC4782311 DOI: 10.1186/s12985-016-0493-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/22/2016] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND The prevalence of local dominant viral etiologies is important for clinical management and prevention of common viral respiratory tract infections. Unfortunately, there is limited large-scale data about common viral respiratory infection in south China. To survey dominant viral etiology and seasonality of acute respiratory infections in hospitalized children, a 4-year consecutive study was conducted in Shenzhen, China. METHODS Nasopharyngeal swab specimens were obtained from 30,443 hospitalized children younger than 14 years with respiratory tract diseases in Shenzhen Children's Hospital from January 2012 to December 2015. Nasopharyngeal swabs were routinely examined by direct immunofluorescence assay to detect respiratory agents including seven respiratory viruses. Data were analyzed to describe the frequency and seasonality. RESULTS Of the 30,443 children enrolled in the study, 4428 (14.55 %) were positive for at least one viral pathogen, among whom 4110 (92.82 %) were ≤3 years of age. The predominant viruses were respiratory syncytial virus (RSV, 68.11 %), adenovirus (ADV, 16.01 %) and parainfluenza virus 3 (PIV-3, 11.0 %). The common respiratory viruses detected peaked in the spring (17.69 %), and were minimal in autumn (9.73 %), but PIVs detection peaked in November. The common virus detection rate in male subjects (15.40 %) was significantly higher than in female subjects (13.02 %). PIVs detection rates were complementary with RSV in autumn in each year. CONCLUSIONS This study demonstrated common respiratory viruses were the major cause of hospitalized acute respiratory infection (ARI) in children in Shenzhen, China. RSV was the most common detected infection, while ADV was the predominant pathogen in hospitalized children. These findings provide a better understanding of virus distribution among children of different ages, infection stratification by gender, and seasonality, all of which will contribute to modification of therapeutic approaches and development of effective prevention strategies for each respiratory virus infection during peak seasons.
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Affiliation(s)
- Heping Wang
- Department of Respiratory Diseases, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, 518026, China.
| | - Yuejie Zheng
- Department of Respiratory Diseases, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, 518026, China.
| | - Jikui Deng
- Department of Respiratory Diseases, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, 518026, China.
| | - Wenjian Wang
- Department of Respiratory Diseases, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, 518026, China.
| | - Ping Liu
- Department of Respiratory Diseases, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, 518026, China.
| | - Fanghua Yang
- Department of Respiratory Diseases, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, 518026, China.
| | - Hanfang Jiang
- Department of Respiratory Diseases, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, 518026, China.
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Structure of Main Protease from Human Coronavirus NL63: Insights for Wide Spectrum Anti-Coronavirus Drug Design. Sci Rep 2016; 6:22677. [PMID: 26948040 PMCID: PMC4780191 DOI: 10.1038/srep22677] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/17/2016] [Indexed: 12/14/2022] Open
Abstract
First identified in The Netherlands in 2004, human coronavirus NL63 (HCoV-NL63) was found to cause worldwide infections. Patients infected by HCoV-NL63 are typically young children with upper and lower respiratory tract infection, presenting with symptoms including croup, bronchiolitis, and pneumonia. Unfortunately, there are currently no effective antiviral therapy to contain HCoV-NL63 infection. CoV genomes encode an integral viral component, main protease (M(pro)), which is essential for viral replication through proteolytic processing of RNA replicase machinery. Due to the sequence and structural conservation among all CoVs, M(pro) has been recognized as an attractive molecular target for rational anti-CoV drug design. Here we present the crystal structure of HCoV-NL63 M(pro) in complex with a Michael acceptor inhibitor N3. Structural analysis, consistent with biochemical inhibition results, reveals the molecular mechanism of enzyme inhibition at the highly conservative substrate-recognition pocket. We show such molecular target remains unchanged across 30 clinical isolates of HCoV-NL63 strains. Through comparative study with M(pro)s from other human CoVs (including the deadly SARS-CoV and MERS-CoV) and their related zoonotic CoVs, our structure of HCoV-NL63 M(pro) provides critical insight into rational development of wide spectrum antiviral therapeutics to treat infections caused by human CoVs.
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Liu T, Li Z, Zhang S, Song S, Julong W, Lin Y, Guo N, Xing C, Xu A, Bi Z, Wang X. Viral Etiology of acute respiratory tract infections in hospitalized children and adults in Shandong Province, China. Virol J 2015; 12:168. [PMID: 26467854 PMCID: PMC4606902 DOI: 10.1186/s12985-015-0388-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/20/2015] [Indexed: 11/17/2022] Open
Abstract
Background The dominant viral etiologies responsible for acute respiratory infections (ARIs) are poorly understood, particularly among hospitalized patients. Improved etiological insight is needed to improve clinical management and prevention of ARIs. Methods Clinical and demographic information and throat swabs were collected from 607 patients from 2011 to 2013 in Shandong Province, China. Multiplex RT-PCR (SeeplexTM RV detection, Seegene) was performed to detected 12 respiratory viral pathogens. Results A total of 607 hospitalized patients were enrolled from 2011 to 2013. Viruses were identified in 35.75 % (217/607) of cases, including 78 influenza virus A and B (IVA and IVB), 47 para-influenza viruses (PIVs), 41 respiratory syncytial virus (RSV) and 38 adenovirus (ADV). For the children under 15 year old, the common detected viruses were influenza viruses, RSV, PIVS and ADV, while the principal respiratory viruses were human coronaviruses (HCoV), PIVs, influenza viruses for the old adults. Co-infections with multiple viruses were detected in 15.67 % of patients. Children under 5 years were more likely to have one or more detectable virus associated with their ARI. The peak of ARI caused by the respiratory viruses occurred in winter. Conclusion This study demonstrated respiratory viruses were the major cause of hospitalized ARI patients in Shandong Province, influenza virus was the most common detected, RSV was the highest incidence among the young children (≤5 years). These findings also gave a better understand of virus distribution among different age and seasons, which help to consider potential therapeutic approaches and develop effective prevention strategies for respiratory virus infection.
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Affiliation(s)
- Ti Liu
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Zhong Li
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Shengyang Zhang
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Shaoxia Song
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Wu Julong
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Yi Lin
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Nongjian Guo
- Jinan Central Hospital Affiliated to Shandong University, Jinan, 250014, Shandong, China.
| | - Chunyan Xing
- Jinan Central Hospital Affiliated to Shandong University, Jinan, 250014, Shandong, China.
| | - Aiqiang Xu
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Zhenqiang Bi
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong University Institute for Prevention Medicine, Jinan, 250014, Shandong, China.
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Shih HI, Wang HC, Su IJ, Hsu HC, Wang JR, Sun HFS, Chou CH, Ko WC, Hsieh MI, Wu CJ. Viral Respiratory Tract Infections in Adult Patients Attending Outpatient and Emergency Departments, Taiwan, 2012-2013: A PCR/Electrospray Ionization Mass Spectrometry Study. Medicine (Baltimore) 2015; 94:e1545. [PMID: 26402811 PMCID: PMC4635751 DOI: 10.1097/md.0000000000001545] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Viral etiologies of respiratory tract infections (RTIs) have been less studied in adult than in pediatric populations. Furthermore, the ability of PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) to detect enteroviruses and rhinoviruses in respiratory samples has not been well evaluated. We sought to use PCR/ESI-MS to comprehensively investigate the viral epidemiology of adult RTIs, including testing for rhinoviruses and enteroviruses. Nasopharyngeal or throat swabs from 267 adults with acute RTIs (212 upper RTIs and 55 lower RTIs) who visited a local clinic or the outpatient or emergency departments of a medical center in Taiwan between October 2012 and June 2013 were tested for respiratory viruses by both virus isolation and PCR/ESI-MS. Throat swabs from 15 patients with bacterial infections and 27 individuals without active infections were included as control samples. Respiratory viruses were found in 23.6%, 47.2%, and 47.9% of the 267 cases by virus isolation, PCR/ESI-MS, and both methods, respectively. When both methods were used, the influenza A virus (24.3%) and rhinoviruses (9.4%) were the most frequently identified viruses, whereas human coronaviruses, human metapneumovirus (hMPV), enteroviruses, adenoviruses, respiratory syncytial virus, and parainfluenza viruses were identified in small proportions of cases (<5% of cases for each type of virus). Coinfection was observed in 4.1% of cases. In the control group, only 1 (2.4%) sample tested positive for a respiratory virus by PCR/ESI-MS. Patients who were undergoing steroid treatment, had an active malignancy, or suffered from chronic obstructive pulmonary disease (COPD) were at risk for rhinovirus, hMPV, or parainfluenza infections, respectively. Overall, immunocompromised patients, patients with COPD, and patients receiving dialysis were at risk for noninfluenza respiratory virus infection. Rhinoviruses (12.7%), influenza A virus (10.9%), and parainfluenza viruses (7.3%) were the most common viruses involved in the 55 cases of lower RTIs. The factors of parainfluenza infection, old age, and immunosuppression were independently associated with lower RTIs. In conclusion, PCR/ESI-MS improved the diagnostic yield for viral RTIs. Non-influenza respiratory virus infections were associated with patients with comorbidities and with lower RTIs. Additional studies that delineate the clinical need for including non-influenza respiratory viruses in the diagnostic work-up in these populations are warranted.
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Affiliation(s)
- Hsin-I Shih
- From the Departments of Emergency Medicine (H-IS, H-CH); Public Health (H-IS); Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University (C-HC, W-CK, C-JW); National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes (H-CW, I-JS, J-RW, M-IH, C-JW); Department of Medical Laboratory Science and Biotechnology (J-RW); and Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (HSS)
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Liu J, Ai H, Xiong Y, Li F, Wen Z, Liu W, Li T, Qin K, Wu J, Liu Y. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China. PLoS One 2015; 10:e0119170. [PMID: 25751402 PMCID: PMC4353725 DOI: 10.1371/journal.pone.0119170] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 01/10/2015] [Indexed: 11/20/2022] Open
Abstract
Acute respiratory tract infections (ARTIs) are associated with significant morbidity and mortality worldwide, especially in children under the age of 5 years. Almost 2 million children die from ARTIs each year, and most of them are from developing countries. The prevalence and correlation of pathogens in ARTIs are poorly understood, but are critical for improving case prevention, treatment, and management. In this study, we investigated the prevalence and correlation of infectious agents in children with ARTIs. A total of 39,756 children with one or more symptoms, including fever, cough, sore throat, tonsillitis, pharyngitis, herpangina, pneumonia, and bronchiolitis, were enrolled in the study. All patients were hospitalized in Wuhan Children’s Hospital between October 1, 2010 and September 30, 2012, and were evaluated for infectious agents. Pathogens, including Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenoviruses, respiratory syncytial virus, parainfluenza virus, Legionella pneumophila, Chlamydophila pneumoniae, and Coxiella burnetii, were screened simultaneously in patient blood samples using anti-pathogen IgM tests. Regression analysis was used to reveal correlations among the pathogens. Our results showed that one or more pathogens were identified in 10,206 patients, and that Mycoplasma pneumoniae, adenoviruses, and influenza B virus were the leading infectious agents. Mixed-infections of pathogens were detected in 2,391 cases, with Mycoplasma pneumoniae as the most frequent pathogen. The most common agents in the co-infections were Mycoplasma pneumoniae and influenza B virus. Regression analysis revealed a linear correlation between the proportion of mixed infections and the incidence of multi-pathogen infections. The prevalence of infectious agents in children with ARTIs was determined. Equations were established to estimate multiple infections by single-pathogen detection. This revealed a linear correlation for pathogens in children with ARTIs. This study provides useful information for improving case prevention and management.
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Affiliation(s)
- Jia Liu
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
| | - Hongwu Ai
- Department of Clinical Laboratory, Wuhan Children’s Hospital, Wuhan, China
| | - Ying Xiong
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
| | - Fu Li
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
| | - Zhou Wen
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
| | - Weiyong Liu
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
| | - Tongya Li
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
| | - Kai Qin
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
| | - Jianguo Wu
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
- * E-mail: (JW); (YL)
| | - Yingle Liu
- State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, China
- * E-mail: (JW); (YL)
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Surveillance of acute respiratory infections among outpatients: A pilot study in Isfahan city. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2015; 20:115-21. [PMID: 25983761 DOI: pmid/25983761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 08/26/2013] [Accepted: 02/11/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Considering that there was not any regional survey in Isfahan, Iran regarding the epidemiology of acute respiratory tract infections (ARTI) in different age groups of general population, the aim of this study was to determine the epidemiologic feature of ARTIs in Isfahan using multiplex polymerase chain reaction (PCR) method. MATERIALS AND METHODS In this cross-sectional study, patients aged <80 years with symptoms of ARTI were studied, during 2009-2010 Nasopharyngeal and dry throat swab specimens were collected and pathogens of ARTI was determined using multiplex real-time PCR. RESULTS In this study, 455 cases with ARTI were studied. Mean age of studied population was 29.9 ± 18.5 (range: 0.2-80). Symptoms such as sore throat (86.3%), coryza (68.0%) and dry cough (54.3%) were the most common symptoms in all studied groups, whereas fever was the most clinical presentation of younger patients (<15 years old) and headache and skeletal pain were the most common symptoms of older patients (>15 years old). Rhinovirus was the most common cause of ARTI in patients aged <5 years and those aged >50 years. Influenza virus B was the most common cause of ARTI in patients aged 5-50 years. CONCLUSION Our study provides baseline information on the epidemiologic and clinical feature of outpatients with ARTIs in Isfahan city. Though our findings in this pilot study could be helpful in diagnosis, treatment, and prevention of ARTI, planning preventive interventional.
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Clinical relevance of multiple respiratory virus detection in adult patients with acute respiratory illness. J Clin Microbiol 2015; 53:1172-7. [PMID: 25631799 DOI: 10.1128/jcm.03298-14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Because increasing numbers of nasopharyngeal swab specimens from adult patients with acute respiratory illness (ARI) are being tested by respiratory virus (RV) multiplex reverse transcriptase PCR (RVM-RT-PCR), multiple RV detection (MRVD) is being encountered more frequently. However, the clinical relevance of MRVD in adult patients has rarely been evaluated. The clinical characteristics of hospitalized adult patients with ARI and MRVD by RVM-RT-PCR tests were compared to those of patients with single RV detection (SRVD) during a single year at a tertiary care center. MRVD was observed in 26 of the 190 adult patients (13.7%). The patients with MRVD had a higher incidence of chronic lung disease than the patients with SRVD (34.6% versus 15.9%, crude odds ratio [OR]=2.81, 95% confidence interval [CI]=1.13 to 6.98, P=0.03). Although the former were more likely than the latter to receive mechanical ventilation (19.2% versus 6.7%, crude OR=3.31, 95% CI=1.05 to 10.47, P=0.049), the length of hospital stay (median, 7 versus 6.5 days; P=0.66), and the in-hospital mortality rate (7.7% versus 4.3%, crude OR=1.87, 95% CI=0.37 to 9.53, P=0.35) were not different between the two groups. In multivariate analysis, chronic lung disease was associated with MRVD (adjusted OR=3.08, 95% CI=1.12 to 8.46, P=0.03). In summary, it was not uncommon to encounter adult patients with ARI and MRVD by RVM-RT-PCR tests of nasopharyngeal swab specimens. MRVD was associated with chronic lung disease rather than the severity of the ARI.
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McClure DL, Kieke BA, Sundaram ME, Simpson MD, Meece JK, Sifakis F, Gasser RA, Belongia EA. Seasonal incidence of medically attended respiratory syncytial virus infection in a community cohort of adults ≥50 years old. PLoS One 2014; 9:e102586. [PMID: 25025344 PMCID: PMC4099308 DOI: 10.1371/journal.pone.0102586] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/20/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diagnostic testing for respiratory syncytial virus (RSV) is not routinely performed in adults. We estimated medically attended RSV seasonal incidence in a community cohort of adults ≥50 years old during four influenza seasons (2006-07 through 2009-10). METHODS Patients seeking care for acute respiratory illness (ARI) were prospectively enrolled and tested for RSV by multiplex RT-PCR. Results from enrolled patients were used to estimate projected cases among non-enrolled patients with ARI. The seasonal incidence of medically attended RSV was the sum of actual and projected cases divided by the community cohort denominator. Since each enrollment period did not include the entire RSV season, incidence estimates were adjusted to account for the statewide proportion of RSV occurring outside the study enrollment period. RESULTS There were 16,088 to 17,694 adults in the cohort each season and 164 RSV cases in all 4 seasons. The overall seasonal incidence of medically attended RSV was 154 episodes (95% CI, 132-180) per 10,000 persons; the incidence was highest in 2007-08 (179) and lowest in 2006-07 (110). Among persons 50-59, 60-69, and ≥70 years old, RSV incidence was 124 (95% CI, 99-156), 147 (95% CI, 110-196), and 199 (95% CI, 153-258), respectively. CONCLUSIONS The incidence of medically attended RSV increased with age and was similar during four seasons.
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Affiliation(s)
- David L. McClure
- Marshfield Clinic Research Foundation, Marshfield, Wisconsin, United States of America
- * E-mail:
| | - Burney A. Kieke
- Marshfield Clinic Research Foundation, Marshfield, Wisconsin, United States of America
| | - Maria E. Sundaram
- Marshfield Clinic Research Foundation, Marshfield, Wisconsin, United States of America
| | - Melissa D. Simpson
- Marshfield Clinic Research Foundation, Marshfield, Wisconsin, United States of America
| | - Jennifer K. Meece
- Marshfield Clinic Research Foundation, Marshfield, Wisconsin, United States of America
| | | | | | - Edward A. Belongia
- Marshfield Clinic Research Foundation, Marshfield, Wisconsin, United States of America
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Prevalence and genetic diversity analysis of human coronavirus OC43 among adult patients with acute respiratory infections in Beijing, 2012. PLoS One 2014; 9:e100781. [PMID: 24987849 PMCID: PMC4079595 DOI: 10.1371/journal.pone.0100781] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 05/27/2014] [Indexed: 02/08/2023] Open
Abstract
To determine the prevalence, epidemiology and genetic diversity of human coronavirus OC43 (HCoV-OC43) among adult patients with acute respiratory infections (ARI) in Beijing,five hundred and fifty-nine nasopharyngeal swab samples were collected from adult patients with ARI in Beijing. The prevalence of HCoV-OC43 infection among these patients was assessed using two different OneStep reverse transcription polymerase chain reaction (RT-PCR) assays. The epidemiological profiles of the patients with HCoV-OC43 infection were described. Partial S and N genes of HCoV-OC43 circulating strains were sequenced followed by phylogenetic analysis and amino acid alignment. Our results showed that the prevalence of HCoV-OC43 infection was 12.52% (95% CI: 9.78–15.26%), and the epidemic peak occurred in autumn. Fifty partial S and 40 partial N fragments were obtained from these patients. Phylogenetic analysis based on neighbour-joining method showed that at least three distinct clusters (A, B, C/D) of HCoV-OC43 strains were circulating among adult patients with ARI in Beijing. In addition, some novel unique clusters (UNT) of HCoV-OC43 were found in the S- and N-based phylogenetic trees. Furthermore, consensus amino acids substitutes for each cluster were also found after alignment of partial S or N sequence coding region in this study. In conclusion, we herein describe the prevalence of HCoV-OC43 among adult patients and provide substantial evidence for the genetic diversity of HCoV-OC43 circulating in Beijing.
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Reina J, López-Causapé C, Rojo-Molinero E, Rubio R. Clinico-epidemiological characteristics of acute respiratory infections caused by coronavirus OC43, NL63 and 229E. Rev Clin Esp 2014; 214:499-504. [PMID: 34170982 PMCID: PMC7094643 DOI: 10.1016/j.rce.2014.05.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/16/2014] [Accepted: 05/18/2014] [Indexed: 11/05/2022]
Abstract
Antecedentes y objetivos Las infecciones respiratorias agudas son una entidad muy frecuente en la población general. La mayoría de ellas son debidas a infecciones víricas. Este estudio pretende precisar las características clínicas y epidemiológicas de los pacientes adultos con infección respiratoria por los coronavirus OC43, NL63 y 229E. Pacientes y métodos Entre enero del 2013 y febrero del 2014 se estudió prospectivamente a todos los pacientes con sospecha clínica de infección respiratoria mediante la toma de un frotis faríngeo y la realización de una reacción en cadena de la polimerasa en transcripción reversa en tiempo real en búsqueda de coronavirus. Resultados En 48 casos (7,0% de los 686 pacientes incluidos; 12,6% de los 381 en los que se detectó algún virus) se pudo demostrar la presencia de algún coronavirus. En 24 casos se trataba del OC43 (50%), en 14 del NL63 (29%) y en 10 del 229E (21%). La edad media fue de 54,5 años, con un ligero predominio de varones. Las presentaciones clínicas más frecuentes fueron el cuadro gripal inespecífico (43,7%), la neumonía (29,2%) y la agudización de enfermedad pulmonar obstructiva crónica (8,3%). El 52% de los pacientes precisaron ingreso hospitalario, en 2 ocasiones en cuidados intensivos. No se produjo ningún fallecimiento. Conclusión Las infecciones respiratorias agudas causadas por coronavirus inciden preferentemente en varones fumadores en la edad media de la vida, frecuentemente afectados de enfermedades previas. La sintomatología clínica mas frecuente ha sido el cuadro gripal inespecífico.
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Affiliation(s)
- J Reina
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España.
| | - C López-Causapé
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España
| | - E Rojo-Molinero
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España
| | - R Rubio
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España
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Reina J, López-Causapé C, Rojo-Molinero E, Rubio R. Clinico-epidemiological characteristics of acute respiratory infections caused by coronavirus OC43, NL63 and 229E. Rev Clin Esp 2014. [PMID: 24958321 PMCID: PMC7103947 DOI: 10.1016/j.rceng.2014.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Acute respiratory infection is a very common condition in the general population. The majority of these infections are due to viruses. This study attempted to determine the clinical and epidemiological characteristics of adult patients with respiratory infection by the coronavirus OC43, NL63 and 229E. PATIENTS AND METHODS Between January 2013 and February 2014, we prospectively studied all patients with suspected clinical respiratory infection by taking throat swabs and performing a reverse transcription polymerase chain reaction in search of coronavirus. RESULTS In 48 cases (7.0% of the 686 enrolled patients; 12.6% of the 381 in whom a virus was detected) the presence of a coronavirus demonstrated. In 24 cases, the virus was OC43 (50%); in 14 cases, the virus was NL63 (29%); and in 10 cases, the virus was 229E (21%). The mean age was 54.5 years, with a slight predominance of men. The most common clinical presentations were nonspecific influenza symptoms (43.7%), pneumonia (29.2%) and chronic obstructive pulmonary disease exacerbation (8.3%). Fifty-two percent of the patients required hospitalization, and 2 patients required intensive care. There were no deaths. CONCLUSION Acute respiratory infections caused by coronavirus mainly affect middle-aged male smokers, who are often affected by previous diseases. The most common clinical picture has been nonspecific influenza symptoms.
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Affiliation(s)
- J Reina
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España.
| | - C López-Causapé
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España
| | - E Rojo-Molinero
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España
| | - R Rubio
- Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España
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Seo YB, Song JY, Choi MJ, Kim IS, Yang TU, Hong KW, Cheong HJ, Kim WJ. Etiology and clinical outcomes of acute respiratory virus infection in hospitalized adults. Infect Chemother 2014; 46:67-76. [PMID: 25024868 PMCID: PMC4091371 DOI: 10.3947/ic.2014.46.2.67] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 02/24/2014] [Accepted: 03/17/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Etiologies and clinical profiles of acute respiratory viral infections need to be clarified to improve preventive and therapeutic strategies. MATERIALS AND METHODS A retrospective observational study at a single, university-affiliated center was performed to evaluate the respiratory viral infection etiologies in children compared to that in adults and to document the clinical features of common viral infections for adults from July 2009 to April 2012. RESULTS The common viruses detected from children (2,800 total patients) were human rhinovirus (hRV) (31.8%), adenovirus (AdV) (19.2%), respiratory syncytial virus (RSV) A (17.4%), RSV B (11.7%), and human metapneumovirus (hMPV) (9.8%). In comparison, influenza virus A (IFA) had the highest isolation rate (28.5%), followed by hRV (15.5%), influenza virus B (IFB) (15.0%), and hMPV (14.0%), in adults (763 total patients). Multiple viruses were detected in single specimens from 22.4% of children and 2.0% of adults. IFA/IFB, RSV A/B, and hMPV exhibited strong seasonal detection and similar circulating patterns in children and adults. Adult patients showed different clinical manifestations according to causative viruses; nasal congestion and rhinorrhea were more common in hRV and human coronavirus (hCoV) infection. Patients with RSV B, hRV, or AdV tended to be younger, and those infected with RSV A and hMPV were likely to be older. Those with RSV A infection tended to stay longer in hospital, enter the intensive care unit more frequently, and have a fatal outcome more often. The bacterial co-detection rate was 26.5%, and those cases were more likely to have lower respiratory tract involvement (P = 0.001), longer hospital stay (P = 0.001), and higher mortality (P = 0.001). CONCLUSIONS The etiologic virus of an acute respiratory infection can be cautiously inferred based on a patient's age and clinical features and concurrent epidemic data. Large-scale prospective surveillance studies are required to provide more accurate information about respiratory viral infection etiology, which could favorably influence clinical outcomes.
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Affiliation(s)
- Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Min Ju Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - In Seon Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Tea Un Yang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Wook Hong
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Zhang D, He Z, Xu L, Zhu X, Wu J, Wen W, Zheng Y, Deng Y, Chen J, Hu Y, Li M, Cao K. Epidemiology characteristics of respiratory viruses found in children and adults with respiratory tract infections in southern China. Int J Infect Dis 2014; 25:159-64. [PMID: 24927663 PMCID: PMC7110535 DOI: 10.1016/j.ijid.2014.02.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/18/2014] [Accepted: 02/21/2014] [Indexed: 11/22/2022] Open
Abstract
Background The World Health Organization (WHO) ranks respiratory tract infection (RTI) as the second leading cause of death worldwide for children under 5 years of age. The aim of this work was to evaluate the epidemiology characteristics of respiratory viruses found in children and adults with RTI from July 2009 to June 2012 in southern China. Methods In this work, a total of 14 237 nasopharyngeal swabs (14 237 patients from 25 hospitals) were analyzed, and seven respiratory viruses (influenza virus, respiratory syncytial virus, parainfluenza virus, adenovirus, human metapneumovirus, human coronavirus, human bocavirus) were detected using PCR/RT-PCR from nasopharyngeal swabs. Results The demographic characteristics, viral prevalence, age distribution, seasonal distribution, and pathogen spectrum of the patients with RTIs were analyzed. Co-infection was observed in 483 specimens, but it was more common in male patients, inpatients, children, and young adults. It varied by season, being more prevalent in the spring and summer and less so in the winter. Human coronavirus and human bocavirus were the most common pathogens, tending to occur in co-infection with other respiratory viruses. Conclusions This work adds to our knowledge of the epidemiology characteristics of these seven common respiratory viruses among patients with RTI in southern China. The detection of the specific viral causes of infection provides a useful starting point for an understanding of illness attributable to respiratory infection, and might also provide data relevant to the development of prevention strategies.
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Affiliation(s)
- Dingmei Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Zhenjian He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Lin Xu
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Xun Zhu
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Jueheng Wu
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Weitao Wen
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Yun Zheng
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Yu Deng
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Jieling Chen
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Yiwen Hu
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China
| | - Mengfeng Li
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China.
| | - Kaiyuan Cao
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, China.
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Jeong JH, Kim KH, Jeong SH, Park JW, Lee SM, Seo YH. Comparison of sputum and nasopharyngeal swabs for detection of respiratory viruses. J Med Virol 2014; 86:2122-7. [PMID: 24797344 PMCID: PMC7166652 DOI: 10.1002/jmv.23937] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2014] [Indexed: 11/26/2022]
Abstract
Diagnostic tests for respiratory viral infections use traditionally either nasopharyngeal washes or swabs. Sputum is representative of the lower respiratory tract but is used rarely for viral testing. The aim of this study was to compare the detection rates of respiratory viruses from nasopharyngeal swabs and sputum using a multiplex real‐time reverse transcription‐polymerase chain reaction (RT‐PCR). Adults who were admitted or presented to the clinics of Gil Medical Center with acute respiratory symptoms were recruited from 1 November 2012 to 31 March 2013. Paired specimens of nasopharyngeal swabs and sputum were obtained from 154 subjects, and RNA was extracted and tested for 16 different respiratory viruses using the Anyplex II RV16 Detection kit (Seegene, Seoul, Korea). The positive rate was 53% (81/154) for nasopharyngeal swabs and 68% (105/154) for sputum (P < 0.001). One hundred thirty‐four viruses were identified for 107 illnesses. Influenza A virus, RSV A, HRV, coronavirus OC43, and adenovirus were detected more frequently in sputum samples than in nasopharyngeal swabs (P < 0.001). Importantly, 12 of 44 (27%) influenza A infections and 11 of 27 (41%) RSV infections were positive in only sputum samples. The detection rates of respiratory viruses from sputum samples were significantly higher than those from nasopharyngeal swabs in adults using real‐time multiplex RT‐PCR. These findings suggest that sputum would benefit for the detection of respiratory viruses by nucleic acid amplification tests (NAATs) in patients who produce sputum. Further studies are needed to establish standardized RNA extraction methods from sputum samples. J. Med. Virol. 86:2122–2127, 2014. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Ji Hun Jeong
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea
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43
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Reina J, López C, Morales C, Busquets M. [Analysis of co-infections between influenza A and influenza B viruses and other respiratory viruses, 2012-2013]. Enferm Infecc Microbiol Clin 2014; 32:693-5. [PMID: 24679446 PMCID: PMC7130360 DOI: 10.1016/j.eimc.2014.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/31/2014] [Accepted: 02/24/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Jordi Reina
- Unidad de Virología, Servicio de Microbiología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, España.
| | - Carla López
- Unidad de Virología, Servicio de Microbiología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - Carmen Morales
- Unidad de Virología, Servicio de Microbiología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - María Busquets
- Unidad de Virología, Servicio de Microbiología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, España
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44
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Affiliation(s)
- Suveer Singh
- Chelsea and Westminster Hospital, NHS Foundation Trust, Imperial College, London, UK
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45
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Lu QB, Tong YG, Wo Y, Wang HY, Liu EM, Gray GC, Liu W, Cao WC. Epidemiology of human adenovirus and molecular characterization of human adenovirus 55 in China, 2009-2012. Influenza Other Respir Viruses 2014; 8:302-8. [PMID: 24467816 PMCID: PMC4181478 DOI: 10.1111/irv.12232] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 01/01/2023] Open
Abstract
Background Human adenovirus 55 (HAdV-55) has caused recent outbreaks of acute respiratory disease (ARD) among adults and military trainees. The active surveillance for HAdV infections was sparse in China, and current knowledge on the HAdV-type distributions and its molecular evolution is lacking. Objectives To acquire better understanding on the prevalence and molecular evolution of HAdV-55 strains in China, for an informed strategy for disease control and prevention. Population/Methods Nasopharyngeal aspirates were collected from hospitalized children with ARTI in Chongqing during 2009–2012. The genotype of HAdV isolates were determined by sequencing the partial hexon and fiber genes. Whole genome sequences of HAdV-55 were obtained for molecular evolution analysis. Results About 191 (8·55%) HAdV were detected in 2234 children, including 92 (48·2%) with HAdV-7, 72 (37·7%) with HAdV-3, 6 (3·1%) with HAdV-55, 5 (2·6%) with HAdV-5, 4 (2·1%) with HAdV-1, 1 (0·5%) with HAdV-2, and 11(5·8%) with untyped HAdV. Four of these children developed pneumonia, two of whom were diagnosed with severe pneumonia and/or encephalopathy. HAdV-55 isolates clustered with HAdV-11 sequences based on the hexon gene and clustered with HAdV-14 sequences based on the fiber gene and the whole genome. The overall evolutionary rates of hexon gene, fiber gene, and whole genome of HAdV-55 were estimated at 6·2 × 10−5 s/s/y, 8·0 × 10−5 s/s/y, and 1·7 × 10−5 s/s/y, respectively. Conclusions This study suggested HAdV-55 as an emerging infectious disease pathogen has conserved genetic structure and is closely related to each other. Further molecular investigation based on HAdV-55 of wider origin might facilitate understanding its diversity, dissemination, and transmission in China.
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Affiliation(s)
- Qing-Bin Lu
- School of Public Health, Peking University, Beijing, China
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46
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Rhinoviruses. VIRAL INFECTIONS OF HUMANS 2014. [PMCID: PMC7120790 DOI: 10.1007/978-1-4899-7448-8_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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47
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Zhou W, Lin F, Teng L, Li H, Hou J, Tong R, Zheng C, Lou Y, Tan W. Prevalence of herpes and respiratory viruses in induced sputum among hospitalized children with non typical bacterial community-acquired pneumonia. PLoS One 2013; 8:e79477. [PMID: 24260230 PMCID: PMC3832587 DOI: 10.1371/journal.pone.0079477] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 09/23/2013] [Indexed: 12/25/2022] Open
Abstract
Objective Few comprehensive studies have searched for viruses in infants and young children with community-acquired pneumonia (CAP) in China. The aim of this study was to investigate the roles of human herpes viruses (HHVs) and other respiratory viruses in CAP not caused by typical bacterial infection and to determine their prevalence and clinical significance. Methods Induced sputum (IS) samples were collected from 354 hospitalised patients (infants, n = 205; children, n = 149) with respiratory illness (CAP or non-CAP) admitted to Wenling Hospital of China. We tested for HHVs and respiratory viruses using PCR-based assays. The epidemiological profiles were also analysed. Results High rate of virus detection (more than 98%) and co-infection (more than 80%) were found among IS samples from 354 hospitalised infants and children with respiratory illness in this study. Of 273 CAP samples tested, CMV (91.6%), HHV-6 (50.9%), RSV (37.4%), EBV (35.5%), HBoV (28.2%), HHV-7 (18.3%) and rhinovirus (17.2%) were the most commonly detected viruses. Of 81 non- CAP samples tested, CMV (63%), RSV (49.4%), HHV-6 (42%), EBV (24.7%), HHV-7 (13.6%) and HBoV (8.6%) were the dominant viruses detected. The prevalence of several viral agents (rhinovirus, bocavirus, adenovirus and CMV) among IS samples of CAP were significantly higher than that of non-CAP control group. We also found the prevalence of RSV coinfection with HHVs was also higher among CAP group than that of non-CAP control. Conclusions With sensitive molecular detection techniques and IS samples, high rates of viral identification were achieved in infants and young children with respiratory illness in a rural area of China. The clinical significance of rhinovirus, bocavirus, adenovirus and HHV (especially CMV) infections should receive greater attention in future treatment and prevention studies of CAP in infants and children.
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Affiliation(s)
- Weimin Zhou
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Feng Lin
- Wenling Affiliated Hospital, Wenzhou Medical College, Wenling, Zhejiang, China
| | - Lingfang Teng
- Wenling Affiliated Hospital, Wenzhou Medical College, Wenling, Zhejiang, China
| | - Hua Li
- Wenling Affiliated Hospital, Wenzhou Medical College, Wenling, Zhejiang, China
| | - Jianyi Hou
- Wenling Affiliated Hospital, Wenzhou Medical College, Wenling, Zhejiang, China
| | - Rui Tong
- Institute of Medical Virology, Wenzhou Medical College, Wenzhou, Zhejiang, China
| | - Changhua Zheng
- Wenling Affiliated Hospital, Wenzhou Medical College, Wenling, Zhejiang, China
| | - Yongliang Lou
- Institute of Medical Virology, Wenzhou Medical College, Wenzhou, Zhejiang, China
| | - Wenjie Tan
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
- Institute of Medical Virology, Wenzhou Medical College, Wenzhou, Zhejiang, China
- * E-mail:
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Wang KT, Lin CP, Fang YY, Kao MH, Shih DYC, Lo CF, Wang DY. Sensitivity and specificity of in vitro diagnostic device used for influenza rapid test in Taiwan. J Food Drug Anal 2013; 22:279-284. [PMID: 38620156 PMCID: PMC7128329 DOI: 10.1016/j.jfda.2013.09.011] [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: 04/03/2013] [Revised: 05/17/2013] [Accepted: 06/28/2013] [Indexed: 11/26/2022] Open
Abstract
The pandemic influenza A/H1N1 outbreak resulted in 18,449 deaths in over 214 countries. In Taiwan, the influenza rapid test, an in vitro diagnostic device (Flu-IVD), only requires documented reviews for market approval by the Taiwan Food and Drug Administration. The purpose of this study was to investigate the analytical sensitivity and specificity of Flu-IVDs used in Taiwan. Analytical sensitivity and specificity tests were performed for influenza antigens A/California/7/2009 (H1N1) virus, A/Victoria/210/2009 (H3N2) virus, B/ Brisbane/60/08 virus, and human coronavirus OC43. A total of seven domestic and 31 imported Flu-IVD samples were collected, of which, 20 samples had inadequate labeling, including those with removed package inserts or incorrect insert information. The analytical sensitivity of Flu-IVDs for A/H1N1, A/H3N2, and Flu B was 500-1000 ng/mL, 1000 ng/mL, and 1000 ng/mL, respectively. For the 50% cell culture infective dose (CCID50) label, the average A/H1N1 and A/H3N2 sensitivity for Flu-IVDs was log10 5.8 ± 0.5 and log10 6.6 ± 0.5 CCID50/mL, respectively. As to the specificity test, no product cross-reacted with human coronavirus OC43. This study provides important information on the Flu-IVD regulation status and can thus help the government formulate policies for the regulation of in vitro diagnostic devices in Taiwan.
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Affiliation(s)
- Kun-Teng Wang
- Section of Biologics, Division of Research and Analysis, Food and Drug Administration, Ministry of Health and Welfare,
Taiwan, ROC
| | - Chia-Pei Lin
- Section of Biologics, Division of Research and Analysis, Food and Drug Administration, Ministry of Health and Welfare,
Taiwan, ROC
| | - Yi-Ya Fang
- Section of Biologics, Division of Research and Analysis, Food and Drug Administration, Ministry of Health and Welfare,
Taiwan, ROC
| | - Ming-Hui Kao
- Section of Biologics, Division of Research and Analysis, Food and Drug Administration, Ministry of Health and Welfare,
Taiwan, ROC
| | - Daniel Yang-Chih Shih
- Division of Research and Analysis, Food and Drug Administration, Ministry of Health and Welfare,
Taiwan, ROC
| | - Chi-Fang Lo
- Food and Drug Administration, Ministry of Health and Welfare,
Taiwan, ROC
| | - Der-Yuan Wang
- Section of Biologics, Division of Research and Analysis, Food and Drug Administration, Ministry of Health and Welfare,
Taiwan, ROC
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Walsh EE, Shin JH, Falsey AR. Clinical impact of human coronaviruses 229E and OC43 infection in diverse adult populations. J Infect Dis 2013; 208:1634-42. [PMID: 23922367 PMCID: PMC3805243 DOI: 10.1093/infdis/jit393] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background. The incidence and clinical impact of coronavirus (CoV) infection in elderly persons and those with underlying cardiopulmonary disease over a long duration is not well described. We determined the incidence and clinical impact of 229E and OC43 CoV in this population during 4 consecutive winters, and compared illnesses to influenza A, respiratory syncytial virus, and human metapneumovirus. Methods. CoV 229E and OC43 were detected by reverse transcription polymerase chain reaction and serology in 4 adult populations under surveillance for acute respiratory illness during the winters of 1999–2003. Cohorts included healthy young adults, healthy elderly adults, high-risk adults with underlying cardiopulmonary disease, and a hospitalized group. Results. Three hundred ninety-eight CoV infections were identified, with annual infection rates ranging from 2.8% to 26% in prospective cohorts, and prevalence ranging from 3.3% to 11.1% in the hospitalized cohort. The incidence of infections with each strain was similar, although asymptomatic infection and viral coinfection was significantly more common with 229E than OC43 infection. Although the incidence and clinical manifestations were similar for each strain, OC43-infected subjects tended to seek more medical care, as OC43 was twice as common as 229E among the hospitalized cohort. Conclusions. CoV infections in the elderly are frequent, likely causing substantial medical disease burden.
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Laboratory surveillance of influenza-like illness in seven teaching hospitals, South Korea: 2011-2012 season. PLoS One 2013; 8:e64295. [PMID: 23717587 PMCID: PMC3661466 DOI: 10.1371/journal.pone.0064295] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 04/11/2013] [Indexed: 01/12/2023] Open
Abstract
Background A well-constructed and properly operating influenza surveillance scheme is essential for public health. This study was conducted to evaluate the distribution of respiratory viruses in patients with influenza-like illness (ILI) through the first teaching hospital-based surveillance scheme for ILI in South Korea. Methods Respiratory specimens were obtained from adult patients (≥18 years) who visited the emergency department (ED) with ILI from week 40, 2011 to week 22, 2012. Multiplex PCR was performed to detect respiratory viruses: influenza virus, adenovirus, coronavirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, parainfluenza virus, bocavirus, and enterovirus. Results Among 1,983 patients who visited the ED with ILI, 811 (40.9%) were male. The median age of patients was 43 years. Influenza vaccination rate was 21.7% (430/1,983) during the 2011–2012 season. At least one comorbidity was found in 18% of patients. The positive rate of respiratory viruses was 52.1% (1,033/1,983) and the total number of detected viruses was 1,100. Influenza A virus was the dominant agent (677, 61.5%) in all age groups. The prevalence of human metapneumovirus was higher in patients more than 50 years old, while adenovirus was detected only in younger adults. In 58 (5.6%) cases, two or more respiratory viruses were detected. The co-incidence case was identified more frequently in patients with hematologic malignancy or organ transplantation recipients, however it was not related to clinical outcomes. Conclusion This study is valuable as the first extensive laboratory surveillance of the epidemiology of respiratory viruses in ILI patients through a teaching hospital-based influenza surveillance system in South Korea.
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