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Soto-Garita C, Murillo T, Chávez-Peraza I, Campos-Ávila J, Prado-Hidalgo G, Drexler JF, Moreira-Soto A, Corrales-Aguilar E. Epidemiological, virological and clinical characterization of a Dengue/Zika outbreak in the Caribbean region of Costa Rica 2017-2018. Front Cell Infect Microbiol 2024; 14:1421744. [PMID: 38988809 PMCID: PMC11233455 DOI: 10.3389/fcimb.2024.1421744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024] Open
Abstract
The increase in incidence and geographical expansion of viruses transmitted by the Aedes mosquitoes, such as dengue (DENV) and zika (ZIKV) in the Americas, represents a burden for healthcare systems in tropical and subtropical regions. These and other under-detected arboviruses co-circulate in Costa Rica, adding additional complexity to their management due to their shared epidemiological behavior and similarity of symptoms in early stages. Since diagnostics of febrile illness is mostly based on clinical symptoms alone, we gathered acute-phase serum and urine from 399 samples of acute dengue-like cases from two healthcare facilities of Costa Rica, during an outbreak of arboviruses from July 2017 to May 2018, and tested them using molecular and serological methods. The analyses showed that of the clinically presumptive arbovirus cases that were reported, only 39.4% (n=153) of the samples were confirmed positive by RT-PCR to be DENV (DENV (10.3%), CHIKV (0.2%), ZIKV (27.3%), or mixed infections (1.5%). RT-PCR for other alphaviruses and flaviviruses, and PCR for Leptospira sp were negative. Furthermore, to assess flavivirus positivity in post-acute patients, the negative sera were tested against Dengue-IgM. 20% of sera were found positive, confounding even more the definitive number of cases, and emphasizing the need of several distinct diagnostic tools for accurate diagnostics. Molecular characterization of the prM and E genes from isolated viruses revealed that the American/Asian genotype of DENV-2 and the Asian lineage of ZIKV were circulating during this outbreak. Two different clades of DENV-2 American/Asian genotype were identified to co-circulate in the same region and a difference in the platelet and leukocyte count was noted between people infected with each clade, suggesting a putative distinct virulence. Our study sheds light on the necessity for healthcare strategies in managing arbovirus outbreaks, emphasizing the importance of comprehensive molecular and serological diagnostic approaches, as well as molecular characterization. This approach aids in enhancing our understanding of the clinical and epidemiological aspects of arboviral diseases during outbreaks. Our research highlights the need to strengthen training programs for health professionals and the need to increase research-based on laboratory evidence for diagnostic accuracy, guidance, development and implementation of public health interventions and epidemiological surveillance.
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Affiliation(s)
- Claudio Soto-Garita
- Research Center for Tropical Diseases (CIET) and Faculty of Microbiology, University of Costa Rica, San José, Costa Rica
- National Reference Centre for Virology, Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), San José, Costa Rica
| | - Tatiana Murillo
- Research Center for Tropical Diseases (CIET) and Faculty of Microbiology, University of Costa Rica, San José, Costa Rica
| | - Ileana Chávez-Peraza
- Siquirres Integral Healthcare Center (CAIS), Costa Rican Social Security Fund (CCSS), Limón, Costa Rica
| | - Josué Campos-Ávila
- Siquirres Integral Healthcare Center (CAIS), Costa Rican Social Security Fund (CCSS), Limón, Costa Rica
| | - Grace Prado-Hidalgo
- Talamanca Healthcare Center, Costa Rican Social Security Fund (CCSS), Limón, Costa Rica
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF), Associated Partner Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andres Moreira-Soto
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany
| | - Eugenia Corrales-Aguilar
- Research Center for Tropical Diseases (CIET) and Faculty of Microbiology, University of Costa Rica, San José, Costa Rica
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Roßbacher L, Malafa S, Huber K, Thaler M, Aberle SW, Aberle JH, Heinz FX, Stiasny K. Effect of previous heterologous flavivirus vaccinations on human antibody responses in tick-borne encephalitis and dengue virus infections. J Med Virol 2023; 95:e29245. [PMID: 38009693 PMCID: PMC10952712 DOI: 10.1002/jmv.29245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/11/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
Arthropod-borne flaviviruses include a number of medically relevant human pathogens such as the mosquito-borne dengue (DEN), Zika, and yellow fever (YF) viruses as well as tick-borne encephalitis virus (TBEV). All flaviviruses are antigenically related and anamnestic responses due to prior immunity can modulate antibody specificities in subsequent infections or vaccinations. In our study, we analyzed the induction of broadly flavivirus cross-reactive antibodies in tick-borne encephalitis (TBE) and DEN patients without or with prior flavivirus exposure through TBE and/or YF vaccination, and determined the contribution of these antibodies to TBE and dengue virus (DENV) neutralization. In addition, we investigated the formation of cross-reactive antibodies in TBE-vaccination breakthroughs (VBTs). A TBEV infection without prior YF or TBE vaccination induced predominantly type-specific antibodies. In contrast, high levels of broadly cross-reactive antibodies were found in samples from TBE patients prevaccinated against YF as well as in DEN patients prevaccinated against TBE and/or YF. While these cross-reactive antibodies did not neutralize TBEV, they were effective in neutralizing DENV. This discrepancy points to structural differences between the two viruses and indicates that broadly cross-reactive epitopes are less accessible in TBEV than in DENV. In TBE VBT infections, type-specific antibodies dominated the antibody response, thus revealing no difference from that of unvaccinated TBE patients. Our results emphasize significant differences in the structural properties of different flaviviruses that have an impact on the induction of broadly cross-reactive antibodies and their functional activities in virus neutralization.
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Affiliation(s)
- Lena Roßbacher
- Center for VirologyMedical University of ViennaViennaAustria
| | - Stefan Malafa
- Center for VirologyMedical University of ViennaViennaAustria
| | - Kristina Huber
- Division of Infectious Diseases and Tropical MedicineUniversity Hospital, LMU MunichMunichGermany
| | - Melissa Thaler
- Center for VirologyMedical University of ViennaViennaAustria
- Present address:
Department of Medical MicrobiologyLeiden University Medical CenterLeidenThe Netherlands
| | | | | | - Franz X. Heinz
- Center for VirologyMedical University of ViennaViennaAustria
| | - Karin Stiasny
- Center for VirologyMedical University of ViennaViennaAustria
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Kinsella P, Moso M, Martin G, Karapangiotidis T, Karamalakis D, Nicholson S, Batty M, Jackson K, Marsland M, Thomson T, Manoharan L, O'brien H, Friedman ND, Bond K, Williamson DA, Lim CK. Laboratory evaluation of ELISA and indirect immunofluorescence assay in response to emergence of Japanese encephalitis virus genotype IV in Australia. J Clin Virol 2023; 168:105580. [PMID: 37717487 DOI: 10.1016/j.jcv.2023.105580] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/14/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023]
Abstract
The unexpected recent emergence of Japanese encephalitis virus (JEV) genotype IV in multiple southern states of Australia necessitated an evaluation of JEV serological tests suitable for diagnosing acute infection and for seroprevalence studies. This study examined the analytical and clinical performance of two high-throughput JEV assays, Euroimmun immunofluorescence assay (IFA) and Euroimmun enzyme-linked immunosorbent assay (ELISA), across four cohorts; (1) surveillance of piggery workers in outbreak areas, (2) surveillance of residents in outbreak areas, (3) acute JEV infection and (4) post-JEV vaccination. ELISA and IFA IgM demonstrated minimal cross-reactivity (0-1.8%) with other endemic flaviviruses, with high sensitivity (100%) for acute JEV infection in this low endemicity setting. Differences in IgG serodynamics between the two assays suggest convalescent and paired testing with IgM are critical in diagnosing acute infection. High assay concordance was observed between ELISA and IFA when used in serosurveillance (97.4% agreement, Cohen' κ 0.74 [95% CI 0.614-0.860]) and vaccination cohorts (91.1% agreement, Cohen's κ 0.806 [95% CI 0.672-0.941]). In conclusion, this study highlights the clinical & epidemiological applications and limitations of these two commercial JEV assays.
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Affiliation(s)
- Paul Kinsella
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Michael Moso
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Genevieve Martin
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Theo Karapangiotidis
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia
| | - Di Karamalakis
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia
| | - Suellen Nicholson
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia
| | - Mitch Batty
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Kathy Jackson
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | | | | | | | | | | | - Katherine Bond
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Deborah A Williamson
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Chuan Kok Lim
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia; Department of Infectious Diseases, Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia.
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4
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Gdoura M, Touati R, Kalthoum S, Ben Slama R, Fatnassi N, Mrad M, Ammari L, Brahmi N, Ben Jazia A, Hogga N, Triki H, Haddad-Boubaker S. Presumed Protective Role for Anti-Hepatitis B Virus Antibodies Against COVID-19 Severe Cases: A Clinical Study Confirming in silico Hypothesis. Front Med (Lausanne) 2022; 9:909660. [PMID: 35872771 PMCID: PMC9305696 DOI: 10.3389/fmed.2022.909660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for COVID-19 disease which is known to have a broad clinical spectrum, from asymptomatic to critical presentation leading to death. Many researchers have investigated the factors impacting the course of the disease. Our previous in silico study suggested a possible protective effect of Hepatitis B, Tetanus and Measles vaccines against COVID-19. In continuity, we conducted a cross-sectional clinical study in order to confirm our in silico assumptions regarding the HBs-Ag antibodies. Methods A representative sex- and age-matched sample of patients with confirmed COVID-19 was selected (n = 340). All clinical presentations were equally represented. Using an ELISA test, each patient benefited of a serology for the detection and measurement of the anti-HBs specific IgG antibodies. The obtained results allowed determining the different correlations between these antibody titers and the disease severity. The R® software and the MedCalc® software served to calculate the Spearman's coefficient of rank correlation (rho) for the obtained titers per severity group as well as the different other calculations and figure representations. Results A significant positive correlation was found with the anti-HBs titers (rho = 0.107; p = 0.04). High anti-HBs titers were significantly associated with the mild presentation of COVID-19. A significant difference was found between the obtained titers per severity class (chi-2 test, p = 0.03). Discussion/Conclusion Our findings demonstrated that anti-HBs titers were significantly higher for patients having mild COVID-19 presentations. We presume that being immunized against the HB may play a protective role in the course of the disease. Our study provided more key elements in understanding the disparity of the clinical spectrum among regions.
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Affiliation(s)
- Mariem Gdoura
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Clinical Biology, Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
- *Correspondence: Mariem Gdoura
| | - Raoua Touati
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sana Kalthoum
- Centre National de Veille Zoosanitaire, Tunis, Tunisia
| | - Rania Ben Slama
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nouel Fatnassi
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Centre National de Veille Zoosanitaire, Tunis, Tunisia
| | - Mehdi Mrad
- Laboratory of Biochemistry, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Lamia Ammari
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Infectious Diseases Departement, Rabta Hospital, Tunis, Tunisia
| | - Nozha Brahmi
- Intensive Care Service, Emergence Medical Assistance Center, Tunis, Tunisia
| | - Amira Ben Jazia
- Intensive Care Service, Emergence Medical Assistance Center, Tunis, Tunisia
| | - Nahed Hogga
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sondes Haddad-Boubaker
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Sondes Haddad-Boubaker
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5
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Yadav PD, Kaur H, Gupta N, Sahay RR, Sapkal GN, Shete AM, Deshpande GR, Mohandas S, Majumdar T, Patil S, Pandit P, Kumar A, Nyayanit DA, Sreelatha KH, Manjusree S, Sami H, Khan HM, Malhotra A, Dhingra K, Gadepalli R, Sudha Rani V, Singh MK, Joshi Y, Dudhmal M, Duggal N, Chabbra M, Dar L, Gawande P, Yemul J, Kalele K, Arjun R, Nagamani K, Borkakoty B, Sahoo G, Praharaj I, Dutta S, Barde P, Jaryal SC, Rawat V. Zika a Vector Borne Disease Detected in Newer States of India Amidst the COVID-19 Pandemic. Front Microbiol 2022; 13:888195. [PMID: 35756041 PMCID: PMC9226610 DOI: 10.3389/fmicb.2022.888195] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background During the second wave of the COVID-19 pandemic, outbreaks of Zika were reported from Kerala, Uttar Pradesh, and Maharashtra, India in 2021. The Dengue and Chikungunya negative samples were retrospectively screened to determine the presence of the Zika virus from different geographical regions of India. Methods During May to October 2021, the clinical samples of 1475 patients, across 13 states and a union territory of India were screened and re-tested for Dengue, Chikungunya and Zika by CDC Trioplex Real time RT-PCR. The Zika rRTPCR positive samples were further screened with anti-Zika IgM and Plaque Reduction Neutralization Test. Next generation sequencing was used for further molecular characterization. Results The positivity was observed for Zika (67), Dengue (121), and Chikungunya (10) amongst screened cases. The co-infections of Dengue/Chikungunya, Dengue/Zika, and Dengue/Chikungunya/Zika were also observed. All Zika cases were symptomatic with fever (84%) and rash (78%) as major presenting symptoms. Of them, four patients had respiratory distress, one presented with seizures, and one with suspected microcephaly at birth. The Asian Lineage of Zika and all four serotypes of Dengue were found in circulation. Conclusion Our study indicates the spread of the Zika virus to several states of India and an urgent need to strengthen its surveillance.
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Affiliation(s)
- Pragya D Yadav
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Harmanmeet Kaur
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Rima R Sahay
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Gajanan N Sapkal
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Anita M Shete
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Gururaj R Deshpande
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | | | - Triparna Majumdar
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Savita Patil
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Priyanka Pandit
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Abhinendra Kumar
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Dimpal A Nyayanit
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - K H Sreelatha
- Virus Research and Diagnostic Laboratory, Government Medical College, Thiruvananthapuram, India
| | - S Manjusree
- Virus Research and Diagnostic Laboratory, Government Medical College, Thiruvananthapuram, India
| | - Hiba Sami
- Virus Research and Diagnostic Laboratory, Jawaharlal Nehru Medical College, Aligarh, India
| | - Haris Mazoor Khan
- Virus Research and Diagnostic Laboratory, Jawaharlal Nehru Medical College, Aligarh, India
| | - Anuradha Malhotra
- Virus Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Kanwardeep Dhingra
- Virus Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Ravisekhar Gadepalli
- Virus Research and Diagnostic Laboratory, All India Institute of Medical Sciences, Jodhpur, India
| | - V Sudha Rani
- Virus Research and Diagnostic Laboratory, Osmania Medical College Hyderabad, Hyderabad, India
| | - Manoj Kumar Singh
- Virus Research and Diagnostic Laboratory, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Yash Joshi
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Manisha Dudhmal
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Nandini Duggal
- Virus Research and Diagnostic Laboratory, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Mala Chabbra
- Virus Research and Diagnostic Laboratory, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Lalit Dar
- Virus Research and Diagnostic Laboratory, All India Institute of Medical Sciences, New Delhi, India
| | - Pranita Gawande
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Jyoti Yemul
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Kaumudi Kalele
- Indian Council of Medical Research, National Institute of Virology, Pune, India
| | | | - K Nagamani
- Virus Research and Diagnostic Laboratory, Gandhi Medical College, Secunderabad, India
| | - Biswa Borkakoty
- Virus Research and Diagnostic Laboratory, ICMR-Regional Medical Research Centre, Dibrugarh, India
| | - Ganesh Sahoo
- Virus Research and Diagnostic Laboratory, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | - Ira Praharaj
- Virus Research and Diagnostic Laboratory, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Shanta Dutta
- Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Pradip Barde
- Virus Research and Diagnostic Laboratory, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - S C Jaryal
- Virus Research and Diagnostic Laboratory, Dr. Rajendra Prasad Government Medical College, Tanda, India
| | - Vinita Rawat
- Virus Research and Diagnostic Laboratory, Government Medical College, Haldwani, India
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