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Curns AT, Rha B, Lively JY, Sahni LC, Englund JA, Weinberg GA, Halasa NB, Staat MA, Selvarangan R, Michaels M, Moline H, Zhou Y, Perez A, Rohlfs C, Hickey R, Lacombe K, McHenry R, Whitaker B, Schuster J, Pulido CG, Strelitz B, Quigley C, Dnp GW, Avadhanula V, Harrison CJ, Stewart LS, Schlaudecker E, Szilagyi PG, Klein EJ, Boom J, Williams JV, Langley G, Gerber SI, Hall AJ, McMorrow ML. Respiratory Syncytial Virus-Associated Hospitalizations Among Children <5 Years Old: 2016 to 2020. Pediatrics 2024; 153:e2023062574. [PMID: 38298053 DOI: 10.1542/peds.2023-062574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the leading cause of hospitalization in US infants. Accurate estimates of severe RSV disease inform policy decisions for RSV prevention. METHODS We conducted prospective surveillance for children <5 years old with acute respiratory illness from 2016 to 2020 at 7 pediatric hospitals. We interviewed parents, reviewed medical records, and tested midturbinate nasal ± throat swabs by reverse transcription polymerase chain reaction for RSV and other respiratory viruses. We describe characteristics of children hospitalized with RSV, risk factors for ICU admission, and estimate RSV-associated hospitalization rates. RESULTS Among 13 524 acute respiratory illness inpatients <5 years old, 4243 (31.4%) were RSV-positive; 2751 (64.8%) of RSV-positive children had no underlying condition or history of prematurity. The average annual RSV-associated hospitalization rate was 4.0 (95% confidence interval [CI]: 3.8-4.1) per 1000 children <5 years, was highest among children 0 to 2 months old (23.8 [95% CI: 22.5-25.2] per 1000) and decreased with increasing age. Higher RSV-associated hospitalization rates were found in premature versus term children (rate ratio = 1.95 [95% CI: 1.76-2.11]). Risk factors for ICU admission among RSV-positive inpatients included: age 0 to 2 and 3 to 5 months (adjusted odds ratio [aOR] = 1.97 [95% CI: 1.54-2.52] and aOR = 1.56 [95% CI: 1.18-2.06], respectively, compared with 24-59 months), prematurity (aOR = 1.32 [95% CI: 1.08-1.60]) and comorbid conditions (aOR = 1.35 [95% CI: 1.10-1.66]). CONCLUSIONS Younger infants and premature children experienced the highest rates of RSV-associated hospitalization and had increased risk of ICU admission. RSV prevention products are needed to reduce RSV-associated morbidity in young infants.
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Affiliation(s)
- Aaron T Curns
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joana Y Lively
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leila C Sahni
- Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | | | - Mary A Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Marian Michaels
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Heidi Moline
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yingtao Zhou
- Centers for Disease Control and Prevention, Atlanta, Georgia
- TDB Communications, Inc, Atlanta, Georgia
| | - Ariana Perez
- Centers for Disease Control and Prevention, Atlanta, Georgia
- GDIT, Atlanta, Georgia
| | - Chelsea Rohlfs
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Robert Hickey
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Rendie McHenry
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brett Whitaker
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Christina Quigley
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Vasanthi Avadhanula
- Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | | | - Elizabeth Schlaudecker
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Peter G Szilagyi
- UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California
| | | | - Julie Boom
- Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - John V Williams
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gayle Langley
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan I Gerber
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aron J Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Edens C, Clopper BR, DeVies J, Benitez A, McKeever ER, Johns D, Wolff B, Selvarangan R, Schuster JE, Weinberg GA, Szilagyi PG, Dawood FS, Radhakrishnan L, Quigley C, Sahni LC, Halasa N, Stewart LS, McMorrow ML, Whitaker B, Zerr DM, Avadhanula V, Williams JV, Michaels MG, Kite-Powell A, Englund JA, Staat MA, Hartnett K, Moline HL, Cohen AL, Diaz M. Notes from the Field: Reemergence of Mycoplasma pneumoniae Infections in Children and Adolescents After the COVID-19 Pandemic, United States, 2018-2024. MMWR Morb Mortal Wkly Rep 2024; 73:149-151. [PMID: 38386615 PMCID: PMC10899077 DOI: 10.15585/mmwr.mm7307a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
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Kubale J, Kujawski S, Chen I, Wu Z, Khader IA, Hasibra I, Whitaker B, Gresh L, Simaku A, Simões EAF, Al-Gazo M, Rogers S, Gerber SI, Balmaseda A, Tallo VL, Al-Sanouri TM, Porter R, Bino S, Azziz-Baumgartner E, McMorrow M, Hunt D, Thompson M, Biggs HM, Gordon A. Etiology of Acute Lower Respiratory Illness Hospitalizations Among Infants in 4 Countries. Open Forum Infect Dis 2023; 10:ofad580. [PMID: 38130597 PMCID: PMC10733183 DOI: 10.1093/ofid/ofad580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Background Recent studies explored which pathogens drive the global burden of pneumonia hospitalizations among young children. However, the etiology of broader acute lower respiratory tract infections (ALRIs) remains unclear. Methods Using a multicountry study (Albania, Jordan, Nicaragua, and the Philippines) of hospitalized infants and non-ill community controls between 2015 and 2017, we assessed the prevalence and severity of viral infections and coinfections. We also estimated the proportion of ALRI hospitalizations caused by 21 respiratory pathogens identified via multiplex real-time reverse transcription polymerase chain reaction with bayesian nested partially latent class models. Results An overall 3632 hospitalized infants and 1068 non-ill community controls participated in the study and had specimens tested. Among hospitalized infants, 1743 (48.0%) met the ALRI case definition for the etiology analysis. After accounting for the prevalence in non-ill controls, respiratory syncytial virus (RSV) was responsible for the largest proportion of ALRI hospitalizations, although the magnitude varied across sites-ranging from 65.2% (95% credible interval, 46.3%-79.6%) in Albania to 34.9% (95% credible interval, 20.0%-49.0%) in the Philippines. While the fraction of ALRI hospitalizations caused by RSV decreased as age increased, it remained the greatest driver. After RSV, rhinovirus/enterovirus (range, 13.4%-27.1%) and human metapneumovirus (range, 6.3%-12.0%) were the next-highest contributors to ALRI hospitalizations. Conclusions We observed substantial numbers of ALRI hospitalizations, with RSV as the largest source, particularly in infants aged <3 months. This underscores the potential for vaccines and long-lasting monoclonal antibodies on the horizon to reduce the burden of ALRI in infants worldwide.
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Affiliation(s)
- John Kubale
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephanie Kujawski
- Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Irena Chen
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Zhenke Wu
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Iris Hasibra
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Brett Whitaker
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lionel Gresh
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Artan Simaku
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Eric A F Simões
- Section of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Mahmoud Al-Gazo
- The Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Shannon Rogers
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan I Gerber
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Veronica L Tallo
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Metro Manila, Philippines
| | | | - Rachael Porter
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Silvia Bino
- Department of Epidemiology and Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Eduardo Azziz-Baumgartner
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Meredith McMorrow
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Mark Thompson
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Holly M Biggs
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Biggs HM, Simões EAF, Abu Khader I, Thompson MG, Gordon A, Hunt DR, DeGroote NP, Porter RM, Bino S, Marar BI, Gresh L, de Jesus-Cornejo J, Langley G, Thornburg NJ, Peret TCT, Whitaker B, Zhang Y, Wang L, Patel MC, McMorrow M, Campbell W, Hasibra I, Duka E, Al-Gazo M, Kubale J, Sanchez F, Lucero MG, Tallo VL, Azziz-Baumgartner E, Simaku A, Gerber SI. Respiratory Syncytial Virus Infection among Hospitalized Infants in Four Middle-Income Countries. J Pediatric Infect Dis Soc 2023:piad042. [PMID: 37313727 DOI: 10.1093/jpids/piad042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Understanding respiratory syncytial virus (RSV) global epidemiology is important to inform future prevention strategies. METHODS Hospitalized infants <1-year-old with acute illness were enrolled prospectively in Albania, Jordan, Nicaragua, and Philippines during respiratory seasons in 2015-2017. Medical chart review, parental interview, and post-discharge follow up were conducted. Respiratory specimens were tested using real-time RT-PCR for RSV. Infant characteristics associated with very severe illness (intensive care unit [ICU] admission or receipt of supplemental oxygen) were assessed using logistic regression to adjust for potential confounders (age, sex, study site, preterm birth). RESULTS Of 3,634 enrolled hospitalized infants, 1,129 (31%) tested positive for RSV. The median age of RSV-positive infants was 2.7 (IQR: 1.4 to 6.1) months and 665 (59%) were male. Very severe illness in 583 (52%) RSV-positive infants was associated with younger age (aOR 4.1, 95% CI: 2.6-6.5 for 0-2 compared to 9-11-months; p<0.01), , low weight-for-age z-score (aOR 1.9, 95%CI: 1.2-2.8; p<0.01), ICU care after birth (aOR 1.6, 95%CI: 1.0-2.5; p=0.48), and cesarean delivery (aOR 1.4, 95% CI: 1.0-1.8; p=.03). RSV subgroups A and B co-circulated at all sites with alternating predominance by year; subgroup was not associated with severity (aOR 1.0, 95% CI: 0.8-1.4). Nine (0.8%) RSV-positive infants died during admission or within ≤30 days of discharge, of which 7 (78%) were <6-months-old. CONCLUSIONS RSV was associated with nearly a third of infant acute illness hospitalizations in four middle-income countries during the respiratory season, where, in addition to young age, factors including low weight-for-age might be important predictors of severity. RSV prevention strategies targeting young infants could substantially reduce RSV-associated hospitalizations in middle-income countries.
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Affiliation(s)
- Holly M Biggs
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eric A F Simões
- Section of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Ilham Abu Khader
- The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Mark G Thompson
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Nicholas P DeGroote
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachael M Porter
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Silvia Bino
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | | | - Lionel Gresh
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Joanne de Jesus-Cornejo
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Gayle Langley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie J Thornburg
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Teresa C T Peret
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brett Whitaker
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yange Zhang
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lijuan Wang
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mira C Patel
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Meredith McMorrow
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Iris Hasibra
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Enkeleda Duka
- Pediatric Department, Mother Theresa University Hospital Center, Tirana, Albania
| | - Mahmoud Al-Gazo
- The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Felix Sanchez
- Hospital Infantil Manuel de Jesus Rivera, Ministry of Health, Managua, Nicaragua
| | - Marilla G Lucero
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Veronica L Tallo
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Artan Simaku
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Saiman L, Prill MM, Wilmont S, Neu N, Alba L, Hill-Ricciuti A, Larson E, Whitaker B, Lu X, Garg S, Gerber SI, Kim L. Surveillance for Acute Respiratory Illnesses in Pediatric Chronic Care Facilities. J Pediatric Infect Dis Soc 2023; 12:49-52. [PMID: 36219180 DOI: 10.1093/jpids/piac109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022]
Abstract
Overall, 119 (33%) of 364 pediatric chronic care facility residents experienced 182 acute respiratory illnesses (ARIs) that met the surveillance definition which led to 31 (17%) emergency room visits, 34 (19%) acute care hospitalizations, and/or 25 (14%) ICU admissions. Continued PCR-positivity was observed in 35% of ARIs during follow-up testing.
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Affiliation(s)
- Lisa Saiman
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.,Department of Infection Prevention & Control, New York-Presbyterian Hospital, New York, New York, USA
| | - Mila M Prill
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sibyl Wilmont
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Natalie Neu
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Luis Alba
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Alexandra Hill-Ricciuti
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Elaine Larson
- Columbia University School of Nursing, New York, New York, USA
| | - Brett Whitaker
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xiaoyan Lu
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,United States Public Health Service, Rockville, Maryland, USA
| | - Susan I Gerber
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsay Kim
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,United States Public Health Service, Rockville, Maryland, USA
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Banerjee D, Lee BR, Harrison CJ, Lively JY, Whitaker B, Zhou Y, Selvarangan R. 377. Use of Mid-Turbinate Swab (MTS) versus Throat Swab (TS) for Detection of Respiratory Pathogens in Children, Kansas City, Missouri, November 2015 – May 2019. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
An optimal specimen collection method is important for pathogen detection in respiratory surveillance studies. Mid-turbinate swab (MTS) in combination with throat swab (TS) were used for collecting samples from children enrolled in Kansas City site of the New Vaccine Surveillance Network (NVSN), a prospective surveillance network for acute respiratory infections. A standalone MTS is used for standard of care (SOC) testing. We compared detections from NVSN MTS+TS vs. SOC MTS samples collected ±1 day of each other to evaluate the sensitivity of the single MTS collection in children.
Methods
Nucleic acid extracts from NVSN MTS+TS samples were tested by Luminex NxTag Respiratory Pathogen Panel (NxTag RPP). SOC MTS samples were tested by BioFire® Respiratory Panel 1.7. (FilmArray). All children, aged < 18 years enrolled in the inpatient and Emergency Department for NVSN (November 2015 to May 2019) with available historical MTS SOC testing results ±1 day of enrollment were included in the study. Concordance between results of NVSN MTS+TS and SOC MTS testing was measured.
Results
Paired NVSN and SOC samples were available from 315 subjects with median age of 16.8 months (IQR 5.0 months – 61.7 months); 59.3% (189/315) were from male subjects. An overall positivity of 93.6% was noted with 295 detections by one sample or the other. Of the 295 detections, 231 (78%) detections were in both samples; 35 (12%) detections by MTS+TS; and 29 (10%) detections by MTS only. High concordance ( >90%) and very good Kappa values (Table 1) between the 2 specimen collection methods was noted for most pathogens. 72% of discrepant samples were from children with median age 13.2 months (IQR 8.0 months – 38.6 months).
Conclusion
We observed high concordance between MTS and MTS+TS for all targets. Most discrepant samples were from young children in whom adequate sampling can be challenging, perhaps reducing sensitivity. Differences in time of collection and testing, and platform differences (NxTag RPP vs. FilmArray) may have impacted our data, e.g. due to variable assay sensitivities for specific targets. Regardless of these differences, our data show comparable performance between MTS alone and MTS+TS suggesting that MTS alone may be sufficient for respiratory pathogen surveillance in children.
Disclosures
Brian R. Lee, PhD, MPH, CDC: Grant/Research Support|Merck: Grant/Research Support Christopher J Harrison, MD, Astellas: Grant/Research Support|GSK: Grant/Research Support|Merck: Grant/Research Support|Pediatric news: Honoraria|Pfizer: Grant/Research Support Rangaraj Selvarangan, BVSc, PhD, D(ABMM), FIDSA, F(AAM), BioFire: Grant/Research Support|Luminex: Grant/Research Support.
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Affiliation(s)
| | - Brian R Lee
- Children's Mercy Kansas City , Kansas City, Missouri
| | | | - Joana Y Lively
- Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Brett Whitaker
- Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Yingtao Zhou
- National Center for Immunization and Respiratory Diseases U.S. Centers for Disease Control and Prevention , Atlanta , Georgia
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Nau C, Throop M, Whitaker B, Christy A. 206 The effects of quercetin supplementation during oocyte maturation of the. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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8
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Throop M, Nau C, Christy A, Whitaker B. 207 The effects of vanillic acid supplementation during oocyte maturation on. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Patterson Rosa L, Whitaker B, Allen K, Peters D, Buchanan B, McClure S, Honnas C, Buchanan C, Martin K, Lundquist E, Vierra M, Foster G, Brooks SA, Lafayette C. Genomic loci associated with performance limiting equine overriding spinous processes (kissing spines). Res Vet Sci 2022; 150:65-71. [PMID: 35803009 DOI: 10.1016/j.rvsc.2022.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
Abstract
Commonly known as "Kissing Spines" (KS), the pathological mechanisms underlying impingement and overriding of spinous processes (ORSPs) in horses are poorly understood. Thoroughbreds, Warmbloods, and stock-type breeds, including Paint Horses and Quarter Horses are at increased risk for developing clinical signs of KS. A total of 155 stock-type and Warmblood horses presented at collaborating veterinary clinics and hospitals were examined using a strict clinical and radiographical phenotyping scheme to grade each horse from 0 for unaffected controls to 4 for severe KS. Following genotyping with the Illumina Equine SNP70 array (Illumina, Inc.) a Genome Wide Association Study (GWAS) using 61,229 filtered individual Single Nucleotide Polymorphisms (SNPs) was performed to the KS grade phenotype. Two significantly associated SNPs (BIEC2-668062 and BIEC2-668013) on chromosome 25 defined a ~1.4 Gb candidate region containing approximately 17 coding genes (EquCab3) and 195 ENSEMBL annotated variants. Investigation of the best associated SNP (BIEC2-668062) on chr25 demonstrates a significant correlation with an increase in one KS grade, on average, per A allele in this population. A significant effect of breed group, age, height or sex was not observed in this population. These preliminary results demonstrate the potential for KS diagnosis and preventative measures for WB/ST individuals supported by increased genetic risk for more severe KS grade. We propose further research including other affected breeds and evaluating causative variants, as well as the effect of BIEC2-668062 in these populations.
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Affiliation(s)
| | - B Whitaker
- Brazos Valley Equine Hospitals, Salado, TX 76571, USA
| | - K Allen
- Virginia Equine Imaging Center, The Plains, VA 20198, USA
| | - D Peters
- East-West Equine Sports, Lexington, KY 40583, USA
| | - B Buchanan
- Brazos Valley Equine Hospitals, Salado, TX 76571, USA
| | - S McClure
- Midwest Equine, Boone, IA 50036, USA
| | - C Honnas
- Texas Equine Hospital, Bryan, TX 77807, USA
| | - C Buchanan
- Brazos Valley Equine Hospitals, Salado, TX 76571, USA
| | - K Martin
- Etalon, Inc, Menlo Park, CA 94025, USA
| | | | - M Vierra
- Etalon, Inc, Menlo Park, CA 94025, USA
| | - G Foster
- Etalon, Inc, Menlo Park, CA 94025, USA
| | - S A Brooks
- Department of Animal Science, UF Genetics Institute, University of Florida, Gainesville, FL 32610, USA
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Chaves SS, Park JH, Prill MM, Whitaker B, Park R, Chew GL. Side-by-side comparison of parent vs. technician-collected respiratory swabs in low-income, multilingual, urban communities in the United States. BMC Public Health 2022; 22:103. [PMID: 35031041 PMCID: PMC8760092 DOI: 10.1186/s12889-022-12523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022] Open
Abstract
Background Home-based swabbing has not been widely used. The objective of this analysis was to compare respiratory swabs collected by mothers of 7–12-year-olds living in low-income, multilingual communities in the United States with technician collected swabs. Methods Retrospective data analysis of respiratory samples collected at home by mothers compared to technicians. Anterior nasal and throat specimens collected using flocked swabs were combined in dry tubes. Test was done using TaqMan array cards for viral and bacterial pathogens. Cycle threshold (Ct) values of ribonuclease P (RNP) gene were used to assess specimen quality. Ct < 40 was interpreted as a positive result. Concordance of pathogen yield from mother versus technician collected swabs were analyzed using Cohen’s Kappa coefficients. Correlation analysis, paired t-test, and Wilcoxon signed-rank test for paired samples were used for RNP Ct values. Results We enrolled 36 households in Cincinnati (African American) and 44 (predominately Chinese or Latino) in Boston. In Cincinnati, eight of 32 (25%) mothers did not finish high school, and 11 (34%) had finished high school only. In Boston, 13 of 44 (30%) mothers had less than a high school diploma, 23 (52%) had finished high school only. Mother versus technician paired swabs (n = 62) had similar pathogen yield (paired t-test and Wilcoxon signed rank test p-values = 0.62 and 0.63, respectively; 95% confidence interval of the difference between the two measurements = − 0.45–0.75). Median Ct value for RNP was 22.6 (interquartile range, IQR = 2.04) for mother-collected and 22.4 (IQR = 2.39) for technician-collected swabs (p = 0.62). Agreement on pathogen yield between samples collected by mothers vs. technicians was higher for viruses than for bacterial pathogens, with high concordance for rhinovirus/enterovirus, human metapneumovirus, and adenovirus (Cohen’s kappa coefficients ≥80%, p < 0.0001). For bacterial pathogens, concordance was lower to moderate, except for Chlamydia pneumoniae, for which kappa coefficient indicated perfect agreement. Conclusion Mothers with a range of education levels from low-income communities were able to swab their children equally well as technicians. Home-swabbing using dry tubes, and less invasive collection procedures, could enhance respiratory disease surveillance. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12523-3.
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Affiliation(s)
- Sandra S Chaves
- CDC, National Center for Immunization and Respiratory Diseases, Influenza Division, Atlanta, USA.
| | - Ju-Hyeong Park
- CDC, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, USA
| | - Mila M Prill
- CDC, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, USA
| | - Brett Whitaker
- CDC, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, USA
| | - Reena Park
- Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Ginger L Chew
- CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta, USA
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11
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Sprungl K, Arena H, Reynolds S, Whitaker B. 170 Acetylation patterns of histone H3K27 in aged pig oocytes. Reprod Fertil Dev 2021; 34:323. [PMID: 35231380 DOI: 10.1071/rdv34n2ab170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- K Sprungl
- University of Findlay, Findlay, OH, USA
| | - H Arena
- University of Findlay, Findlay, OH, USA
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12
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Reynolds S, Springl K, Arena H, Whitaker B. 149 Effects of quisqualic acid and L-α-amino butyrate supplementation during in vitro oocyte maturation on embryonic development in pigs. Reprod Fertil Dev 2021; 34:312-313. [PMID: 35231356 DOI: 10.1071/rdv34n2ab149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- S Reynolds
- The University of Findlay, Findlay, OH, USA
| | - K Springl
- The University of Findlay, Findlay, OH, USA
| | - H Arena
- The University of Findlay, Findlay, OH, USA
| | - B Whitaker
- The University of Findlay, Findlay, OH, USA
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13
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Killerby ME, Ata Ur Rasheed M, Tamin A, Harcourt JL, Abedi GR, Lu X, Kujawski S, Shah MM, Kirking HL, Gold JAW, Salvatore PP, Coughlin MM, Whitaker B, Tate JE, Watson JT, Lindstrom S, Hall AJ, Fry AM, Gerber SI, Midgley CM, Thornburg NJ. Shedding of Culturable Virus, Seroconversion, and 6-Month Follow-up Antibody Responses in the First 14 Confirmed Cases of Coronavirus Disease 2019 in the United States. J Infect Dis 2021; 224:771-776. [PMID: 33693830 PMCID: PMC7989348 DOI: 10.1093/infdis/jiab125] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/05/2021] [Indexed: 11/13/2022] Open
Abstract
We aimed to characterize presence of culturable virus in clinical specimens during acute illness, and antibody kinetics up to 6 months after symptom onset, among 14 early patients with coronavirus disease 2019 in the United States. We isolated viable severe acute respiratory syndrome coronavirus 2 from real-time reverse-transcription polymerase chain reaction-positive respiratory specimens collected during days 0-8 after onset, but not after. All 13 patients with 2 or more serum specimens developed anti-spike antibodies; 12 developed detectable neutralizing antibodies. We did not isolate virus after detection of neutralizing antibodies. Eight participants provided serum at 6 months after onset; all retained detectable anti-spike immunoglobulin G, and half had detectable neutralizing antibodies. Two participants reported not feeling fully recovered at 6 months.
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Affiliation(s)
- Marie E Killerby
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Azaibi Tamin
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer L Harcourt
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Glen R Abedi
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xiaoyan Lu
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stephanie Kujawski
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melisa M Shah
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hannah L Kirking
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeremy A W Gold
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Phillip P Salvatore
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa M Coughlin
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brett Whitaker
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jacqueline E Tate
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John T Watson
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stephen Lindstrom
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aron J Hall
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alicia M Fry
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan I Gerber
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Claire M Midgley
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie J Thornburg
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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14
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Ford L, Lee C, Pray IW, Cole D, Bigouette JP, Abedi GR, Bushman D, Delahoy MJ, Currie DW, Cherney B, Kirby MK, Fajardo GC, Caudill M, Langolf K, Kahrs J, Zochert T, Kelly P, Pitts C, Lim A, Aulik N, Tamin A, Harcourt JL, Queen K, Zhang J, Whitaker B, Browne H, Medrzycki M, Shewmaker PL, Bonenfant G, Zhou B, Folster JM, Bankamp B, Bowen MD, Thornburg NJ, Goffard K, Limbago B, Bateman A, Tate JE, Gieryn D, Kirking HL, Westergaard RP, Killerby ME. Epidemiologic Characteristics Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antigen-Based Test Results, Real-Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) Cycle Threshold Values, Subgenomic RNA, and Viral Culture Results From University Testing. Clin Infect Dis 2021; 73:e1348-e1355. [PMID: 33846714 PMCID: PMC8083323 DOI: 10.1093/cid/ciab303] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Real-time reverse transcription polymerase chain reaction (rRT-PCR) and antigen tests are important diagnostics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sensitivity of antigen tests has been shown to be lower than that of rRT-PCR; however, data to evaluate epidemiologic characteristics that affect test performance are limited. METHODS Paired mid-turbinate nasal swabs were collected from university students and staff and tested for SARS-CoV-2 using both Quidel Sofia SARS Antigen Fluorescent Immunoassay (FIA) and rRT-PCR assay. Specimens positive by either rRT-PCR or antigen FIA were placed in viral culture and tested for subgenomic RNA (sgRNA). Logistic regression models were used to evaluate characteristics associated with antigen results, rRT-PCR cycle threshold (Ct) values, sgRNA, and viral culture. RESULTS Antigen FIA sensitivity was 78.9% and 43.8% among symptomatic and asymptomatic participants, respectively. Among rRT-PCR positive participants, negative antigen results were more likely among asymptomatic participants (odds ratio [OR] 4.6, 95% confidence interval [CI]: 1.3-15.4) and less likely among participants reporting nasal congestion (OR 0.1, 95% CI: .03-.8). rRT-PCR-positive specimens with higher Ct values (OR 0.5, 95% CI: .4-.8) were less likely, and specimens positive for sgRNA (OR 10.2, 95% CI: 1.6-65.0) more likely, to yield positive virus isolation. Antigen testing was >90% positive in specimens with Ct values < 29. Positive predictive value of antigen test for positive viral culture (57.7%) was similar to that of rRT-PCR (59.3%). CONCLUSIONS SARS-CoV-2 antigen test advantages include low cost, wide availability and rapid turnaround time, making them important screening tests. The performance of antigen tests may vary with patient characteristics, so performance characteristics should be accounted for when designing testing strategies and interpreting results.
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Affiliation(s)
- Laura Ford
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Christine Lee
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Laboratory Leadership Service, CDC, Atlanta, Georgia, USA
| | - Ian W Pray
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA.,Wisconsin Department of Health Services, Madison, Wisconsin, USA
| | - Devlin Cole
- Wisconsin Department of Health Services, Madison, Wisconsin, USA.,School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - John Paul Bigouette
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Glen R Abedi
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Dena Bushman
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Miranda J Delahoy
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Dustin W Currie
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Blake Cherney
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Marie K Kirby
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Geroncio C Fajardo
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Motria Caudill
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.,Agency for Toxic Substances and Disease Registry, CDC, Atlanta, Georgia, USA
| | | | - Juliana Kahrs
- University of Wisconsin-Oshkosh, Oshkosh, Wisconsin, USA
| | - Tara Zochert
- University of Wisconsin-Oshkosh, Oshkosh, Wisconsin, USA
| | - Patrick Kelly
- University Health Services, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Collin Pitts
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.,University Health Services, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ailam Lim
- Wisconsin Veterinary Diagnostic Laboratory University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nicole Aulik
- Wisconsin Veterinary Diagnostic Laboratory University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Azaibi Tamin
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jennifer L Harcourt
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Krista Queen
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jing Zhang
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Brett Whitaker
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Hannah Browne
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Magdalena Medrzycki
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Patricia L Shewmaker
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Gaston Bonenfant
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Bin Zhou
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jennifer M Folster
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Bettina Bankamp
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Michael D Bowen
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Natalie J Thornburg
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Kimberly Goffard
- Winnebago County (WI) Health Department, Oshkosh, Wisconsin, USA
| | - Brandi Limbago
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Allen Bateman
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Wisconsin State Laboratory of Hygiene, Madison, Wisconsin, USA
| | - Jacqueline E Tate
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Douglas Gieryn
- Winnebago County (WI) Health Department, Oshkosh, Wisconsin, USA
| | - Hannah L Kirking
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Ryan P Westergaard
- Wisconsin Department of Health Services, Madison, Wisconsin, USA.,School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Marie E Killerby
- COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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15
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Kumar R, Dar L, Amarchand R, Saha S, Lafond KE, Purakayastha DR, Kumar R, Choudekar A, Gopal G, Dhakad S, Narayan VV, Wahi A, Chhokar R, Lindstrom S, Whitaker B, Choudhary A, Dey AB, Krishnan A. Incidence, risk factors, and viral etiology of community-acquired acute lower respiratory tract infection among older adults in rural north India. J Glob Health 2021; 11:04027. [PMID: 33880179 PMCID: PMC8035979 DOI: 10.7189/jogh.11.04027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There are limited data on incidence, risk factors and etiology of acute lower respiratory tract infection (LRTI) among older adults in low- and middle-income countries. METHODS We established a cohort of community dwelling older adults ≥60 years and conducted weekly follow-up for acute respiratory infections (ARI) during 2015-2017. Nurses assessed ARI cases for LRTI, collecting combined nasal/throat swabs from all LRTI cases and an equal number of age- and sex-matched asymptomatic neighbourhood controls. Swabs were tested for influenza viruses, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and parainfluenza viruses (PIV) using polymerase chain reaction. LRTI and virus-specific LRTI incidence was calculated per 1000 person-years. We estimated adjusted incidence rate ratios (IRR) for risk factors using Poisson regression and calculated etiologic fractions (EF) using adjusted odds ratios for detection of viral pathogens in LRTI cases vs controls. RESULTS We followed 1403 older adults for 2441 person-years. LRTI and LRTI-associated hospitalization incidences were 248.3 (95% confidence interval (CI) = 229.3-268.8) and 12.7 (95% CI = 8.9-18.1) per 1000 person-years. Persons with pre-existing chronic bronchitis as compared to those without (incidence rate ratio (IRR) = 4.7, 95% CI = 3.9-5.6); aged 65-74 years (IRR = 1.6, 95% CI = 1.3-2.0) and ≥75 years (IRR = 1.8, 95% CI = 1.4-2.4) as compared to 60-64 years; and persons in poorest wealth quintile (IRR = 1.4, 95% CI = 1.1-1.8); as compared to those in wealthiest quintile were at higher risk for LRTI. Virus was detected in 10.1% of LRTI cases, most commonly influenza (3.8%) and RSV (3.0%). EF for RSV and influenza virus was 83.9% and 83.6%, respectively. CONCLUSION In this rural cohort of older adults, the incidence of LRTI was substantial. Chronic bronchitis was an important risk factor; influenza virus and RSV were major viral pathogens.
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Affiliation(s)
- Rakesh Kumar
- All India Institute of Medical Sciences, New Delhi
| | - Lalit Dar
- All India Institute of Medical Sciences, New Delhi
| | | | - Siddhartha Saha
- Influenza Division, Centers for Disease Control and Prevention- India Country Office, New Delhi, India
| | - Kathryn E Lafond
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Ramesh Kumar
- All India Institute of Medical Sciences, New Delhi
| | | | | | | | - Venkatesh Vinayak Narayan
- Influenza Division, Centers for Disease Control and Prevention- India Country Office, New Delhi, India
| | | | | | | | - Brett Whitaker
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - A B Dey
- All India Institute of Medical Sciences, New Delhi
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16
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Owusu D, Pomeroy MA, Lewis NM, Wadhwa A, Yousaf AR, Whitaker B, Dietrich E, Hall AJ, Chu V, Thornburg N, Christensen K, Kiphibane T, Willardson S, Westergaard R, Dasu T, Pray IW, Bhattacharyya S, Dunn A, Tate JE, Kirking HL, Matanock A. Persistent SARS-CoV-2 RNA Shedding without Evidence of Infectiousness: A Cohort Study of Individuals with COVID-19. J Infect Dis 2021; 224:1362-1371. [PMID: 33649773 PMCID: PMC7989388 DOI: 10.1093/infdis/jiab107] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background To better understand SARS-CoV-2 shedding duration and infectivity, we estimated SARS-CoV-2 RNA shedding duration, described characteristics associated with viral RNA shedding resolution1, and determined if replication-competent viruses could be recovered ≥10 days after symptom onset among individuals with mild to moderate COVID-19. Methods We collected serial nasopharyngeal specimens at various time points from 109 individuals with rRT-PCR-confirmed COVID-19 in Utah and Wisconsin. We calculated probability of viral RNA shedding resolution using the Kaplan-Meier estimator and evaluated characteristics associated with shedding resolution using Cox proportional hazards regression. We attempted viral culture for 35 rRT-PCR-positive nasopharyngeal specimens collected ≥10 days after symptom onset. Results The likelihood of viral RNA shedding resolution at 10 days after symptom onset was approximately 3%. Time to shedding resolution was shorter among participants aged <18 years (adjusted hazards ratio [aHR]: 3.01; 95% CI: 1.6–5.6) and longer among those aged ≥50 years (aHR: 0.50; 95% CI: 0.3–0.9) compared to participants aged 18–49 years. No replication-competent viruses were recovered. Conclusions Although most patients were positive for SARS-CoV-2 for ≥10 days after symptom onset, our findings suggest that individuals with mild to moderate COVID-19 are unlikely to be infectious ≥10 days after symptom onset.
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Affiliation(s)
- Daniel Owusu
- COVID-19 Response Team and Epidemic Intelligence Service, CDC, Atlanta, USA
| | - Mary A Pomeroy
- COVID-19 Response Team and Epidemic Intelligence Service, CDC, Atlanta, USA
| | - Nathaniel M Lewis
- Epidemic Intelligence Service, CDC, and Utah Department of Health, Salt Lake City, USA
| | - Ashutosh Wadhwa
- COVID-19 Response Team and Laboratory Leadership Service, CDC, Atlanta, USA
| | - Anna R Yousaf
- COVID-19 Response Team and Epidemic Intelligence Service, CDC, Atlanta, USA
| | | | | | | | - Victoria Chu
- COVID-19 Response Team and Epidemic Intelligence Service, CDC, Atlanta, USA
| | | | | | - Tair Kiphibane
- Salt Lake County (UT) Health Department, Salt Lake City, USA
| | | | | | | | - Ian W Pray
- Epidemic Intelligence Service, CDC, and Wisconsin Department of Health Services, Madison, USA
| | | | - Angela Dunn
- Utah Department of Health, Salt Lake City, USA
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17
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Surie D, Huang JY, Brown AC, Gable P, Biedron C, Gilbert SE, Garner K, Bollinger S, Gulley T, Haney T, Lyons AK, Beshearse E, Gregory CJ, Sabour S, Clemmons NS, James AE, Tamin A, Reese N, Perry-Dow KA, Brown R, Harcourt JL, Campbell D, Houston H, Chakravorty R, Paulick A, Whitaker B, Murdoch J, Spicer L, Stumpf MM, Mills L, Coughlin MM, Higdem P, Rasheed MAU, Lonsway D, Bhatnagar A, Kothari A, Anderson K, Thornburg NJ, Breaker E, Adamczyk M, McAllister GA, Halpin AL, Seely KA, Patil N, McDonald LC, Kutty PK. Infectious Period of Severe Acute Respiratory Syndrome Coronavirus 2 in 17 Nursing Home Residents-Arkansas, June-August 2020. Open Forum Infect Dis 2021; 8:ofab048. [PMID: 33723510 PMCID: PMC7928697 DOI: 10.1093/ofid/ofab048] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background To estimate the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older adults with underlying conditions, we assessed duration of coronavirus disease 2019 (COVID-19) symptoms, reverse-transcription polymerase chain reaction (RT-PCR) positivity, and culture positivity among nursing home residents. Methods We enrolled residents within 15 days of their first positive SARS-CoV-2 test (diagnosis) at an Arkansas facility from July 7 to 15, 2020 and instead them for 42 days. Every 3 days for 21 days and then weekly, we assessed COVID-19 symptoms, collected specimens (oropharyngeal, anterior nares, and saliva), and reviewed medical charts. Blood for serology was collected on days 0, 6, 12, 21, and 42. Infectivity was defined by positive culture. Duration of culture positivity was compared with duration of COVID-19 symptoms and RT-PCR positivity. Data were summarized using measures of central tendency, frequencies, and proportions. Results We enrolled 17 of 39 (44%) eligible residents. Median participant age was 82 years (range, 58–97 years). All had ≥3 underlying conditions. Median duration of RT-PCR positivity was 22 days (interquartile range [IQR], 8–31 days) from diagnosis; median duration of symptoms was 42 days (IQR, 28–49 days). Of 9 (53%) participants with any culture-positive specimens, 1 (11%) severely immunocompromised participant remained culture-positive 19 days from diagnosis; 8 of 9 (89%) were culture-positive ≤8 days from diagnosis. Seroconversion occurred in 12 of 12 (100%) surviving participants with ≥1 blood specimen; all participants were culture-negative before seroconversion. Conclusions Duration of infectivity was considerably shorter than duration of symptoms and RT-PCR positivity. Severe immunocompromise may prolong SARS-CoV-2 infectivity. Seroconversion indicated noninfectivity in this cohort.
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Affiliation(s)
- Diya Surie
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Y Huang
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Allison C Brown
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Paige Gable
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Caitlin Biedron
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sarah E Gilbert
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kelley Garner
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | - Susan Bollinger
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Trent Gulley
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | - Tafarra Haney
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | - Amanda K Lyons
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Beshearse
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christopher J Gregory
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sarah Sabour
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nakia S Clemmons
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Allison E James
- Arkansas Department of Health, Little Rock, Arkansas, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Azaibi Tamin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natashia Reese
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - K Allison Perry-Dow
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robin Brown
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | - Jennifer L Harcourt
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Davina Campbell
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hollis Houston
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Ashley Paulick
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brett Whitaker
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jordan Murdoch
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | - Lori Spicer
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Megan M Stumpf
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lisa Mills
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa M Coughlin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Pamela Higdem
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | | | - David Lonsway
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amelia Bhatnagar
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Atul Kothari
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | - Karen Anderson
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie J Thornburg
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Erin Breaker
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michelle Adamczyk
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gillian A McAllister
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alison L Halpin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Naveen Patil
- Arkansas Department of Health, Little Rock, Arkansas, USA
| | - L Clifford McDonald
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Preeta K Kutty
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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18
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Wallace M, James AE, Silver R, Koh M, Tobolowsky FA, Simonson S, Gold JAW, Fukunaga R, Njuguna H, Bordelon K, Wortham J, Coughlin M, Harcourt JL, Tamin A, Whitaker B, Thornburg NJ, Tao Y, Queen K, Uehara A, Paden CR, Zhang J, Tong S, Haydel D, Tran H, Kim K, Fisher KA, Marlow M, Tate JE, Doshi RH, Sokol T, Curran KG. Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May-June, 2020. Emerg Infect Dis 2021; 27:421-429. [PMID: 33395380 PMCID: PMC7853536 DOI: 10.3201/eid2702.204158] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
To assess transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a detention facility experiencing a coronavirus disease outbreak and evaluate testing strategies, we conducted a prospective cohort investigation in a facility in Louisiana, USA. We conducted SARS-CoV-2 testing for detained persons in 6 quarantined dormitories at various time points. Of 143 persons, 53 were positive at the initial test, and an additional 58 persons were positive at later time points (cumulative incidence 78%). In 1 dormitory, all 45 detained persons initially were negative; 18 days later, 40 (89%) were positive. Among persons who were SARS-CoV-2 positive, 47% (52/111) were asymptomatic at the time of specimen collection; 14 had replication-competent virus isolated. Serial SARS-CoV-2 testing might help interrupt transmission through medical isolation and quarantine. Testing in correctional and detention facilities will be most effective when initiated early in an outbreak, inclusive of all exposed persons, and paired with infection prevention and control.
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19
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Pray IW, Ford L, Cole D, Lee C, Bigouette JP, Abedi GR, Bushman D, Delahoy MJ, Currie D, Cherney B, Kirby M, Fajardo G, Caudill M, Langolf K, Kahrs J, Kelly P, Pitts C, Lim A, Aulik N, Tamin A, Harcourt JL, Queen K, Zhang J, Whitaker B, Browne H, Medrzycki M, Shewmaker P, Folster J, Bankamp B, Bowen MD, Thornburg NJ, Goffard K, Limbago B, Bateman A, Tate JE, Gieryn D, Kirking HL, Westergaard R, Killerby M. Performance of an Antigen-Based Test for Asymptomatic and Symptomatic SARS-CoV-2 Testing at Two University Campuses — Wisconsin, September–October 2020. MMWR Morb Mortal Wkly Rep 2021; 69:1642-1647. [PMID: 33382679 PMCID: PMC9191905 DOI: 10.15585/mmwr.mm695152a3] [Citation(s) in RCA: 191] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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20
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Jones JM, Kracalik I, Rana MM, Nguyen A, Keller BC, Mishkin A, Hoopes C, Kaleekal T, Humar A, Vilaro J, Im G, Smith L, Justice A, Leaumont C, Lindstrom S, Whitaker B, La Hoz RM, Michaels MG, Klassen D, Kuhnert W, Basavaraju SV. SARS-CoV-2 Infections among Recent Organ Recipients, March-May 2020, United States. Emerg Infect Dis 2020; 27:552-555. [PMID: 33327990 PMCID: PMC7853574 DOI: 10.3201/eid2702.204046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
We conducted public health investigations of 8 organ transplant recipients who tested positive for severe acute respiratory syndrome coronavirus 2 infection. Findings suggest the most likely source of transmission was community or healthcare exposure, not the organ donor. Transplant centers should educate transplant candidates and recipients about infection prevention recommendations.
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21
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Wilmont S, Neu N, Hill-Ricciuti A, Alba L, Prill MM, Whitaker B, Garg S, Stone ND, Lu X, Kim L, Gerber SI, Larson E, Saiman L. Active surveillance for acute respiratory infections among pediatric long-term care facility staff. Am J Infect Control 2020; 48:1474-1477. [PMID: 32593809 PMCID: PMC7316056 DOI: 10.1016/j.ajic.2020.06.190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
Staff at pediatric long-term care facilities (pLTCF) were responsive to electronic messages asking about acute respiratory illness symptoms. Staff in pLTCFs had respiratory viruses detected during acute respiratory infections and while asymptomatic. Contagious presenteeism occurred as some participants with ARIs worked while symptomatic. Staff with ARI may pose a risk of transmitting respiratory viral infections to frail and medically complex pLTCF residents.
Background Transmission of respiratory viruses between staff and residents of pediatric long-term care facilities (pLTCFs) can occur. We assessed the feasibility of using text or email messages to perform surveillance for acute respiratory infections (ARIs) among staff. Methods From December 7, 2016 to May 7, 2017, 50 staff participants from 2 pLTCFs received weekly text or email requests to report the presence or absence of ARI symptoms. Those who fulfilled the ARI case definition (≥2 symptoms) had respiratory specimens collected to detect viruses by reverse transcriptase polymerase chain reaction assays. Pre- and postsurveillance respiratory specimens were collected to assess subclinical viral shedding. Results The response rate to weekly electronic messages was 93%. Twenty-one ARIs reported from 20 (40%) participants fulfilled the case definition. Respiratory viruses were detected in 29% (5/17) of specimens collected at symptom onset (influenza B, respiratory syncytial virus, coronavirus [CoV] 229E, rhinovirus [RV], and dual detection of CoV OC43 and bocavirus). Four participants had positive presurveillance (4 RV), and 6 had positive postsurveillance specimens (3 RV, 2 CoV NL63, and 1 adenovirus). Conclusions Electronic messaging to conduct ARI surveillance among pLTCF staff was feasible.
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Affiliation(s)
- Sibyl Wilmont
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Natalie Neu
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | | | - Luis Alba
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Mila M Prill
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Brett Whitaker
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA; Influenza Division, United States Public Health Service, Rockville, MD
| | - Nimalie D Stone
- Division of Healthcare Quality and Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Xiaoyan Lu
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lindsay Kim
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA; Influenza Division, United States Public Health Service, Rockville, MD
| | - Susan I Gerber
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Lisa Saiman
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY; Department of Infection Prevention & Control, NewYork-Presbyterian Hospital, New York, NY.
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22
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Milucky J, Pondo T, Gregory CJ, Iuliano D, Chaves SS, McCracken J, Mansour A, Zhang Y, Aleem MA, Wolff B, Whitaker B, Whistler T, Onyango C, Lopez MR, Liu N, Rahman MZ, Shang N, Winchell J, Chittaganpitch M, Fields B, Maldonado H, Xie Z, Lindstrom S, Sturm-Ramirez K, Montgomery J, Wu KH, Van Beneden CA. The epidemiology and estimated etiology of pathogens detected from the upper respiratory tract of adults with severe acute respiratory infections in multiple countries, 2014-2015. PLoS One 2020; 15:e0240309. [PMID: 33075098 PMCID: PMC7571682 DOI: 10.1371/journal.pone.0240309] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/24/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction Etiology studies of severe acute respiratory infections (SARI) in adults are limited. We studied potential etiologies of SARI among adults in six countries using multi-pathogen diagnostics. Methods We enrolled both adults with SARI (acute respiratory illness onset with fever and cough requiring hospitalization) and asymptomatic adults (adults hospitalized with non-infectious illnesses, non-household members accompanying SARI patients, adults enrolled from outpatient departments, and community members) in each country. Demographics, clinical data, and nasopharyngeal and oropharyngeal specimens were collected from both SARI patients and asymptomatic adults. Specimens were tested for presence of 29 pathogens utilizing the Taqman® Array Card platform. We applied a non-parametric Bayesian regression extension of a partially latent class model approach to estimate proportions of SARI caused by specific pathogens. Results We enrolled 2,388 SARI patients and 1,135 asymptomatic adults from October 2013 through October 2015. We detected ≥1 pathogen in 76% of SARI patients and 67% of asymptomatic adults. Haemophilus influenzae and Streptococcus pneumoniae were most commonly detected (≥23% of SARI patients and asymptomatic adults). Through modeling, etiology was attributed to a pathogen in most SARI patients (range among countries: 57.3–93.2%); pathogens commonly attributed to SARI etiology included influenza A (14.4–54.4%), influenza B (1.9–19.1%), rhino/enterovirus (1.8–42.6%), and RSV (3.6–14.6%). Conclusions Use of multi-pathogen diagnostics and modeling enabled attribution of etiology in most adult SARI patients, despite frequent detection of multiple pathogens in the upper respiratory tract. Seasonal flu vaccination and development of RSV vaccine would likely reduce the burden of SARI in these populations.
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Affiliation(s)
- Jennifer Milucky
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
- * E-mail:
| | - Tracy Pondo
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
| | - Christopher J. Gregory
- Division of Global Health Protection, Centers for Disease Control and Prevention, Thailand Ministry of Public Health, Thailand
| | - Danielle Iuliano
- Influenza Division, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
| | - Sandra S. Chaves
- Influenza Division, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, CDC Kenya Office, Kenya
| | - John McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Adel Mansour
- Division of Global Health Protection, Centers for Disease Control and Prevention, Egypt
| | - Yuzhi Zhang
- Division of Global Health Protection, Centers for Disease Control and Prevention, China
| | | | - Bernard Wolff
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
| | - Brett Whitaker
- Division of Viral Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
| | - Toni Whistler
- Division of Global Health Protection, Centers for Disease Control and Prevention, Thailand Ministry of Public Health, Thailand
| | - Clayton Onyango
- Kenya Medical Research Institute/Centers for Disease Control and Prevention Public Health Collaboration, Kisumu, Kenya
| | - Maria Renee Lopez
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Na Liu
- China Centers for Disease Control and Prevention, National Institute for Viral Disease, Beijing, China
| | | | - Nong Shang
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
| | - Jonas Winchell
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
| | | | - Barry Fields
- Division of Global Health Protection, Centers for Disease Control and Prevention, Kenya
| | - Herberth Maldonado
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Zhiping Xie
- China Centers for Disease Control and Prevention, National Institute for Viral Disease, Beijing, China
| | - Stephen Lindstrom
- Division of Viral Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
| | - Katherine Sturm-Ramirez
- Influenza Division, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, CDC Bangladesh Office, Bangladesh
| | - Joel Montgomery
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kai-Hui Wu
- Influenza Division, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, CDC Bangladesh Office, Bangladesh
| | - Chris A. Van Beneden
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, United States of America
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23
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Lu X, Wang L, Sakthivel SK, Whitaker B, Murray J, Kamili S, Lynch B, Malapati L, Burke SA, Harcourt J, Tamin A, Thornburg NJ, Villanueva JM, Lindstrom S. US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis 2020; 26:1654-1665. [PMID: 32396505 PMCID: PMC7392423 DOI: 10.3201/eid2608.201246] [Citation(s) in RCA: 397] [Impact Index Per Article: 99.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the etiologic agent associated with coronavirus disease, which emerged in late 2019. In response, we developed a diagnostic panel consisting of 3 real-time reverse transcription PCR assays targeting the nucleocapsid gene and evaluated use of these assays for detecting SARS-CoV-2 infection. All assays demonstrated a linear dynamic range of 8 orders of magnitude and an analytical limit of detection of 5 copies/reaction of quantified RNA transcripts and 1 x 10-1.5 50% tissue culture infectious dose/mL of cell-cultured SARS-CoV-2. All assays performed comparably with nasopharyngeal and oropharyngeal secretions, serum, and fecal specimens spiked with cultured virus. We obtained no false-positive amplifications with other human coronaviruses or common respiratory pathogens. Results from all 3 assays were highly correlated during clinical specimen testing. On February 4, 2020, the Food and Drug Administration issued an Emergency Use Authorization to enable emergency use of this panel.
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24
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Harcourt J, Tamin A, Lu X, Kamili S, Sakthivel SK, Murray J, Queen K, Tao Y, Paden CR, Zhang J, Li Y, Uehara A, Wang H, Goldsmith C, Bullock HA, Wang L, Whitaker B, Lynch B, Gautam R, Schindewolf C, Lokugamage KG, Scharton D, Plante JA, Mirchandani D, Widen SG, Narayanan K, Makino S, Ksiazek TG, Plante KS, Weaver SC, Lindstrom S, Tong S, Menachery VD, Thornburg NJ. Severe Acute Respiratory Syndrome Coronavirus 2 from Patient with Coronavirus Disease, United States. Emerg Infect Dis 2020; 26:1266-1273. [PMID: 32160149 PMCID: PMC7258473 DOI: 10.3201/eid2606.200516] [Citation(s) in RCA: 431] [Impact Index Per Article: 107.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The etiologic agent of an outbreak of pneumonia in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 in January 2020. A patient in the United States was given a diagnosis of infection with this virus by the state of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens from this patient and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into 2 virus repositories, making it broadly available to the public health and research communities. We hope that open access to this reagent will expedite development of medical countermeasures.
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25
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Kujawski SA, Wong KK, Collins JP, Epstein L, Killerby ME, Midgley CM, Abedi GR, Ahmed NS, Almendares O, Alvarez FN, Anderson KN, Balter S, Barry V, Bartlett K, Beer K, Ben-Aderet MA, Benowitz I, Biggs H, Binder AM, Black SR, Bonin B, Brown CM, Bruce H, Bryant-Genevier J, Budd A, Buell D, Bystritsky R, Cates J, Charles EM, Chatham-Stephens K, Chea N, Chiou H, Christiansen D, Chu V, Cody S, Cohen M, Conners E, Curns A, Dasari V, Dawson P, DeSalvo T, Diaz G, Donahue M, Donovan S, Duca LM, Erickson K, Esona MD, Evans S, Falk J, Feldstein LR, Fenstersheib M, Fischer M, Fisher R, Foo C, Fricchione MJ, Friedman O, Fry AM, Galang RR, Garcia MM, Gerber SI, Gerrard G, Ghinai I, Gounder P, Grein J, Grigg C, Gunzenhauser JD, Gutkin GI, Haddix M, Hall AJ, Han G, Harcourt J, Harriman K, Haupt T, Haynes A, Holshue M, Hoover C, Hunter JC, Jacobs MW, Jarashow C, Jhung MA, Joshi K, Kamali T, Kamili S, Kim L, Kim M, King J, Kirking HL, Kita-Yarbro A, Klos R, Kobayashi M, Kocharian A, Komatsu KK, Koppaka R, Layden JE, Li Y, Lindquist S, Lindstrom S, Link-Gelles R, Lively J, Livingston M, Lo K, Lo J, Lu X, Lynch B, Madoff L, Malapati L, Marks G, Marlow M, Mathisen GE, McClung N, McGovern O, McPherson TD, Mehta M, Meier A, Mello L, Moon SS, Morgan M, Moro RN, Murray J, Murthy R, Novosad S, Oliver SE, O'Shea J, Pacilli M, Paden CR, Pallansch MA, Patel M, Patel S, Pedraza I, Pillai SK, Pindyck T, Pray I, Queen K, Quick N, Reese H, Rha B, Rhodes H, Robinson S, Robinson P, Rolfes M, Routh J, Rubin R, Rudman SL, Sakthivel SK, Scott S, Shepherd C, Shetty V, Smith EA, Smith S, Stierman B, Stoecker W, Sunenshine R, Sy-Santos R, Tamin A, Tao Y, Terashita D, Thornburg NJ, Tong S, Traub E, Tural A, Uehara A, Uyeki TM, Vahey G, Verani JR, Villarino E, Wallace M, Wang L, Watson JT, Westercamp M, Whitaker B, Wilkerson S, Woodruff RC, Wortham JM, Wu T, Xie A, Yousaf A, Zahn M, Zhang J. Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States. Nat Med 2020; 26:861-868. [PMID: 32327757 DOI: 10.1101/2020.03.09.20032896] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 04/06/2020] [Indexed: 05/28/2023]
Abstract
Data on the detailed clinical progression of COVID-19 in conjunction with epidemiological and virological characteristics are limited. In this case series, we describe the first 12 US patients confirmed to have COVID-19 from 20 January to 5 February 2020, including 4 patients described previously1-3. Respiratory, stool, serum and urine specimens were submitted for SARS-CoV-2 real-time reverse-transcription polymerase chain reaction (rRT-PCR) testing, viral culture and whole genome sequencing. Median age was 53 years (range: 21-68); 8 patients were male. Common symptoms at illness onset were cough (n = 8) and fever (n = 7). Patients had mild to moderately severe illness; seven were hospitalized and demonstrated clinical or laboratory signs of worsening during the second week of illness. No patients required mechanical ventilation and all recovered. All had SARS-CoV-2 RNA detected in respiratory specimens, typically for 2-3 weeks after illness onset. Lowest real-time PCR with reverse transcription cycle threshold values in the upper respiratory tract were often detected in the first week and SARS-CoV-2 was cultured from early respiratory specimens. These data provide insight into the natural history of SARS-CoV-2. Although infectiousness is unclear, highest viral RNA levels were identified in the first week of illness. Clinicians should anticipate that some patients may worsen in the second week of illness.
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26
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Harcourt J, Tamin A, Lu X, Kamili S, Sakthivel SK, Murray J, Queen K, Tao Y, Paden CR, Zhang J, Li Y, Uehara A, Wang H, Goldsmith C, Bullock HA, Wang L, Whitaker B, Lynch B, Gautam R, Schindewolf C, Lokugamage KG, Scharton D, Plante JA, Mirchandani D, Widen SG, Narayanan K, Makino S, Ksiazek TG, Plante KS, Weaver SC, Lindstrom S, Tong S, Menachery VD, Thornburg NJ. Isolation and characterization of SARS-CoV-2 from the first US COVID-19 patient. bioRxiv 2020:2020.03.02.972935. [PMID: 32511316 PMCID: PMC7239045 DOI: 10.1101/2020.03.02.972935] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The etiologic agent of the outbreak of pneumonia in Wuhan China was identified as severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) in January, 2020. The first US patient was diagnosed by the State of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens, and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into two virus repositories, making it broadly available to the public health and research communities. We hope that open access to this important reagent will expedite development of medical countermeasures.
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Affiliation(s)
| | - Azaibi Tamin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xiaoyan Lu
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Krista Queen
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ying Tao
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clinton R Paden
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Yan Li
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | | | - Brett Whitaker
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Rashi Gautam
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Craig Schindewolf
- Department of Microbiology and Immunology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Kumari G Lokugamage
- Department of Microbiology and Immunology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Dionna Scharton
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Jessica A Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Divya Mirchandani
- Department of Microbiology and Immunology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Steven G Widen
- Department of Biochemistry & Molecular Biology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Krishna Narayanan
- Department of Microbiology and Immunology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Shinji Makino
- Department of Microbiology and Immunology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Thomas G Ksiazek
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
- Department of Pathology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Kenneth S Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | - Scott C Weaver
- Department of Microbiology and Immunology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
- Department of Pathology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
| | | | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vineet D Menachery
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
- Department of Pathology, Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston TX, USA
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27
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Alroy KA, Gwom LC, Ndongo CB, Kenmoe S, Monamele G, Clara A, Whitaker B, Manga H, Tayimetha CY, Tseuko D, Etogo B, Pasi O, Etoundi AG, Seukap E, Njouom R, Balajee A. Strengthening timely detection and reporting of unusual respiratory events from health facilities in Yaoundé, Cameroon. Influenza Other Respir Viruses 2020; 14:122-128. [PMID: 31923349 PMCID: PMC7040971 DOI: 10.1111/irv.12684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The International Health Regulations state that early detection and immediate reporting of unusual health events is important for early warning and response systems. OBJECTIVE To describe a pilot surveillance program established in health facilities in Yaoundé, Cameroon in 2017 which aimed to enable detection and reporting of public health events. METHODS Cameroon's Ministry of Health, in partnership with the US Centers for Disease Control and Prevention, Cameroon Pasteur Center, and National Public Health Laboratory, implemented event-based surveillance (EBS) in nine Yaoundé health facilities. Four signals were defined that could indicate possible public health events, and a reporting, triage, and verification system was established among partner organizations. A pre-defined laboratory algorithm was defined, and a series of workshops trained health facilities, laboratory, and public health staff for surveillance implementation. RESULTS From May 2017 to January 2018, 30 signals were detected, corresponding to 15 unusual respiratory events. All health facilities reported a signal at least once, and more than three-quarters of health facilities reported ≥2 times. Among specimens tested, the pathogens detected included Klebsiella pneumoniae, Moraxella catarrhalis, Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus, Pneumocystis jiroveci, influenza A (H1N1) virus, rhinovirus, and adenovirus. CONCLUSIONS The events detected in this pilot were caused by routine respiratory bacteria and viruses, and no novel influenza viruses or other emerging respiratory threats were identified. The surveillance system, however, strengthened relationships and communication linkages between health facilities and public health authorities. Astute clinicians can play a critical role in early detection and EBS is one approach that may enable reporting of emerging outbreaks and public health events.
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Affiliation(s)
- Karen A. Alroy
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Luc Christian Gwom
- Division for the Fight against Disease, Epidemics and PandemicsMinistry of HealthYaoundéCameroon
| | | | | | | | - Alexey Clara
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Brett Whitaker
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Henri Manga
- National Public Health LaboratoryMinistry of HealthYaoundéCameroon
| | | | - Dorine Tseuko
- National Public Health LaboratoryMinistry of HealthYaoundéCameroon
| | - Bienvenu Etogo
- National Public Health LaboratoryMinistry of HealthYaoundéCameroon
| | - Omer Pasi
- Division of Global Health ProtectionCenter for Global HealthAtlantaGAUSA
| | - Alain Georges Etoundi
- Division for the Fight against Disease, Epidemics and PandemicsMinistry of HealthYaoundéCameroon
| | - Elise Seukap
- Division for the Fight against Disease, Epidemics and PandemicsMinistry of HealthYaoundéCameroon
| | | | - Arunmozhi Balajee
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
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Whitaker B, Alroy KA, Guthrie E, Schildecker S, Hiers S, Woodard J, Balajee SA. Strengthening laboratory capacity for detection of respiratory viral pathogens through the Global Health Security Agenda (GHSA) framework. Afr J Lab Med 2019; 8:861. [PMID: 31392168 PMCID: PMC6676779 DOI: 10.4102/ajlm.v8i1.861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/17/2019] [Indexed: 11/26/2022] Open
Abstract
Background Endemic and emerging respiratory viruses are a threat to public health, and a robust public health laboratory system is essential to ensure global health security. Objective This program sought to expand molecular laboratory testing capacity to detect a broad range of respiratory pathogens in clinical respiratory specimens collected during disease surveillance and outbreak investigations. Methods As a part of the Global Health Security Agenda (GHSA), the United States Centers for Disease Control and Prevention utilised the equipment and training infrastructure already in place at the World Health Organization National Influenza Centers to expand testing capacity for respiratory viruses in laboratories in GHSA partner countries. This was done through the provision of quality assured reagents, including multiplex platforms and technical guidance for laboratory staff, as well as the assessment of laboratory testing accuracy. Conclusion Early findings illustrated that GHSA laboratories have been able to expand testing capacity using specimens from routine surveillance, as well as from outbreak situations.
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Affiliation(s)
- Brett Whitaker
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Karen A Alroy
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Erica Guthrie
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Sarah Schildecker
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Susan Hiers
- Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Jill Woodard
- Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - S Arunmozhi Balajee
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
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Krishnan A, Kumar R, Broor S, Gopal G, Saha S, Amarchand R, Choudekar A, Purkayastha DR, Whitaker B, Pandey B, Narayan VV, Kabra SK, Sreenivas V, Widdowson MA, Lindstrom S, Lafond KE, Jain S. Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children. J Glob Health 2019; 9:010433. [PMID: 31131104 PMCID: PMC6513504 DOI: 10.7189/jogh.09.010433] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background In India, community-based acute lower respiratory infections (ALRI) burden studies are limited, hampering development of prevention and control strategies. Methods We surveyed children <10 years old at home weekly from August 2012-August 2014, for cough, sore throat, rhinorrhoea, ear discharge, and shortness of breath. Symptomatic children were assessed for ALRI using World Health Organization definitions. Nasal and throat swabs were obtained from all ALRI cases and asymptomatic controls and tested using polymerase chain reaction for respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza viruses (PIV), and influenza viruses (IV). We estimated adjusted odds ratios (aOR) using logistic regression to calculate etiologic fractions (EF). We multiplied agent-specific ALRI incidence rates by EF to calculate the adjusted incidence as episodes per child-year. Results ALRI incidence was 0.19 (95% confidence interval (CI) = 0.18-0.20) episode per child-year. Association between virus and ALRI was strongest for RSV (aOR = 15.9; 95% CI = 7.3-34.7; EF = 94%) and least for IV (aOR = 4.6; 95% CI = 2.0-10.6; EF = 78%). Adjusted agent-specific ALRI incidences were RSV (0.03, 95% CI = 0.02-0.03), hMPV (0.02, 95% CI = 0.01-0.02), PIV (0.02, 95% CI = 0.01-0.02), and IV (0.01, 95% CI = 0.01-0.01) episode per child-year. Conclusions ALRI among children in rural India was high; RSV was a significant contributor.
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Affiliation(s)
- Anand Krishnan
- All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- All India Institute of Medical Sciences, New Delhi, India
| | - Shobha Broor
- SGT Medical College, Hospital & Research Institute, Gurgaon, India
| | - Giridara Gopal
- All India Institute of Medical Sciences, New Delhi, India
| | - Siddhartha Saha
- Influenza Division, US Centers for Disease Control and Prevention- India country office, New Delhi, India
| | | | | | | | - Brett Whitaker
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bharti Pandey
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Sushil K Kabra
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Marc-Alain Widdowson
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Stephen Lindstrom
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathryn E Lafond
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Seema Jain
- Influenza Division, US Centers for Disease Control and Prevention- India country office, New Delhi, India.,US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Kenmoe S, Tcharnenwa C, Monamele GC, Kengne CN, Ripa MN, Whitaker B, Alroy KA, Balajee SA, Njouom R. Comparison of FTD® respiratory pathogens 33 and a singleplex CDC assay for the detection of respiratory viruses: A study from Cameroon. Diagn Microbiol Infect Dis 2019; 94:236-242. [PMID: 30738690 PMCID: PMC7127211 DOI: 10.1016/j.diagmicrobio.2019.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 12/04/2022]
Abstract
Introduction: This study compares the detection of 14 common respiratory viruses by two different real-time reverse transcription polymerase chain reaction (rRT-PCR) methods: in house singleplex tests developed by the Centers for Disease Control and Prevention and the commercially available Fast Track Diagnostic (FTD®) Respiratory Pathogens 33 multiplex test. Methods: A total of 217 nasopharyngeal swabs were analyzed using CDC singleplex rRT-PCR and FTD® Respiratory Pathogens 33 multiplex assays, for the detection of 14 respiratory viruses. Results: The results showed that 179/217 (82.5%) samples were positive with the singleplex method and 183/217 (84.3%) with the FTD® Respiratory Pathogens 33 multiplex test. Excellent or satisfactory agreement was obtained for all viruses (k > 0.6) except Parainfluenzavirus 4 (k = 0.24) and influenza B (k = 0.51). Conclusion: Although the multiplex FTD kits were more expensive than the singleplex assay, the FTD kits yielded rapid results in a shorter timeframe, increasing efficiency of diagnosis.
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Affiliation(s)
- Sebastien Kenmoe
- Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Clarisse Tcharnenwa
- Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon; Department of Microbiology, Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Gwladys C Monamele
- Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon; Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | | | - Mohamadou Njankouo Ripa
- Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Brett Whitaker
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karen A Alroy
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Arunmozhi Balajee
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Njouom
- Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon.
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Mentler M, Current J, Whitaker B. 170 The effects of linoleic and linolenic acid supplementation on the in vitro maturation of pig oocytes in a heat-stressed environment. Reprod Fertil Dev 2019. [DOI: 10.1071/rdv31n1ab170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Elevated environmental temperatures induce heat stress, which can cause a depression in fertility and early embryonic development. Fatty acids initiate an endergonic reaction that is able to absorb cellular heat, causing a decrease in intracellular temperature. Supplementing linoleic and linolenic acids to the maturation medium of pig oocytes at elevated temperatures reduces the effects of heat stress-induced damage during fertilization and embryonic development. However, the mechanism of action of fatty acids during oocyte maturation is unknown. Therefore, the objective of this study was to minimize heat stress-induced damage and characterise the intracellular oocyte mechanisms. Oocyte maturation media was supplemented with linoleic and linolenic acid during oocyte maturation at either 38.5 or 41.5°C. Oocytes (n=3094, r=5) were supplemented with 50μM linoleic acid, 50μM linolenic acid, 25μM of both, or 50μM of both during 40 to 44h of maturation and then evaluated for the formation of reactive oxygen species (n=239), intracellular glutathione concentrations (n=1005), glutathione peroxidase (n=1005), catalase (n=987), and superoxide dismutase (n=863) activities. Data were analysed using ANOVA with the main effects including treatment, well, and replicate. There were no significant differences between the treatment groups matured at 38.5°C when comparing reactive oxygen species generation. Supplementation of linoleic or linolenic acid significantly decreased (P<0.05) reactive oxygen species generation in oocytes matured at 41.5°C compared with no supplementation at the same temperature. Supplementation of linoleic or linolenic acid or both significantly increased (P<0.05) intracellular glutathione concentrations compared with no supplementation at 38.5°C (23.37±1.23 pmol/oocyte) and 41.5°C (10.42±1.01 pmol/oocyte). There were no significant differences between the treatment groups matured at 38.5°C or 41.5°C when comparing glutathione peroxidase activity. Supplementation of linoleic or linolenic acid or both significantly increased (P<0.05) catalase and superoxide dismutase activities compared with no supplementation at 38.5°C and at 41.5°C. Superoxide dismutase activity was significantly higher (P<0.05) in oocytes matured at 41.5°C compared with those matured at 38.5°C. These results indicate that supplementing linoleic and linolenic acid to the maturation medium of pig oocytes at an elevated temperature reduces the effects of heat stress-induced damage by increasing intracellular glutathione concentrations and catalase and superoxide dismutase activities.
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Hicks E, Winn E, Whitaker B. 146 Quercetin supplementation during boar semen thawing and incubation improves the in vitro production of pig embryos. Reprod Fertil Dev 2019. [DOI: 10.1071/rdv31n1ab146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Elevated levels of reactive oxygen species in the in vitro environment cause oxidative stress, which leads to membrane damage, decreased fertility, and morphological deformities of spermatozoa. Antioxidants, such as quercetin (a polyphenol flavonoid), are often supplemented to reduce the effects of oxidative stress on spermatozoa. Supplementing frozen-thawed boar semen with quercetin improves sperm forward progressive motility, viability and lipid peroxidation up to 10h after thawing. However, the effects of fertilizing with quercetin-supplemented sperm are unknown. Therefore, the objective of this study was to determine the effects of supplementing quercetin (0.25, 0.50, 0.75mM) during the thawing and incubation of frozen-thawed boar semen on oocyte fertilization characteristics (n=400) and subsequent embryonic development (n=1340) at 48 and 144h for cleavage and blastocyst formation, respectively. Oocytes from aspired aspirated mature follicles (3-6mm diameter) were obtained from a local abattoir and matured in medium 199 for 40 to 44h at 38.5°C in an atmosphere of 5% CO2. Fertilization was performed using pooled frozen-thawed semen from 3 different boars, and co-incubation of the sperm (2×105 sperm mL−1) and oocytes (30 oocytes/well) lasted for 6 to 8h at 38.5°C in an atmosphere of 5% CO2. Data were analysed using ANOVA with the main effects including treatment, well and replicate. Chi-squared analysis was used to determine percentages of embryos reaching the different developmental stages for each treatment. There were no differences in penetration rates and male pronuclear formation between treatment groups; however, supplementation of 0.25 (18.18±10.63%), 0.50 (20.93±9.89%) and 0.75mM (18.07±12.02%) quercetin significantly decreased (P<0.05) polyspermic penetration rates compared with no supplementation (40.00±11.34%). Embryos produced from frozen-thawed boar sperm supplemented with 0.25 and 0.50mM quercetin had a significantly higher percentage (P<0.05) of embryos reaching the 2-cell stage of development by 48h after IVF (75.00±7.89%, 68.75±2.23%, respectively) compared with 0.75mM quercetin supplementation (64.62±3.88%) and no supplementation (62.97±4.11%). Supplementation of 0.25 (44.12±6.23%), 0.50 (43.75±7.02%) and 0.75mM (43.08±2.98%) quercetin to the sperm significantly increased (P<0.05) the percentage of embryos reaching the blastocyst stage of development by 144h after IVF compared with no supplementation (28.27±8.07%). These results indicate that supplementing frozen-thawed boar semen with quercetin decreases the incidence of polyspermic penetration and improves early embryonic development in pigs.
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Gaur B, Saha S, Iuliano AD, Rai SK, Krishnan A, Jain S, Whitaker B, Winchell J, Lal RB, Broor S. Use of TaqMan Array card for the detection of respiratory viral pathogens in children under 5 years old hospitalised with acute medical illness in Ballabgarh, Haryana, India. Indian J Med Microbiol 2019; 37:105-108. [PMID: 31424019 PMCID: PMC9257431 DOI: 10.4103/ijmm.ijmm_18_146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Historical specimens collected from hospitalized children were tested for the following 13 viruses: influenza A and B; respiratory syncytial virus (RSV); parainfluenza viruses 1-3; human metapneumovirus; rhinovirus; coronaviruses 229E, OC43, NL63 and HKU1 and Adenovirus using monoplex real-time reverse transcriptase polymerase chain reaction (rRT-PCR). They were retested using TaqMan Array Card (TAC), a micro-fluidic system, capable of simultaneous multi-pathogen testing, to evaluate its sensitivity and specificity against monoplex rRT-PCR. TAC showed high sensitivity (71%-100%) and specificity (98%-100%) for these viruses in comparison to monoplex rRT-PCR. Multi-specimen detection with high sensitivity and specificity makes TAC a potentially useful tool for both surveillance and outbreak investigations.
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Affiliation(s)
- Bharti Gaur
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - Siddhartha Saha
- Influenza Division, Centers for Disease Control and Prevention, U.S Embassy, New Delhi, India
| | - A Danielle Iuliano
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sanjay K Rai
- Centre for Community Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Anand Krishnan
- Centre for Community Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Seema Jain
- Influenza Division, Centers for Disease Control and Prevention, U.S Embassy, New Delhi, India
| | - Brett Whitaker
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonas Winchell
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Renu B Lal
- Influenza Division, Centers for Disease Control and Prevention, U.S Embassy, New Delhi, India
| | - Shobha Broor
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
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Alroy KA, Do TT, Tran PD, Dang TQ, Vu LN, Le NTH, Dang AD, Ngu ND, Ngo TH, Hoang PVM, Phan LT, Nguyen TV, Nguyen LT, Nguyen TV, Vien MQ, Le HX, Dao AT, Nguyen TB, Pham DT, Nguyen VTT, Pham TN, Phan BH, Whitaker B, Do TTT, Dao PA, Balajee SA, Mounts AW. Expanding severe acute respiratory infection (SARI) surveillance beyond influenza: The process and data from 1 year of implementation in Vietnam. Influenza Other Respir Viruses 2018; 12:632-642. [PMID: 29754431 PMCID: PMC6086843 DOI: 10.1111/irv.12571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In 2016, as a component of the Global Health Security Agenda, the Vietnam Ministry of Health expanded its existing influenza sentinel surveillance for severe acute respiratory infections (SARI) to include testing for 7 additional viral respiratory pathogens. This article describes the steps taken to implement expanded SARI surveillance in Vietnam and reports data from 1 year of expanded surveillance. METHODS The process of expanding the suite of pathogens for routine testing by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) included laboratory trainings, procurement/distribution of reagents, and strengthening and aligning SARI surveillance epidemiology practices at sentinel sites and regional institutes (RI). RESULTS Surveillance data showed that of 4003 specimens tested by the RI laboratories, 20.2% (n = 810) were positive for influenza virus. Of the 3193 influenza-negative specimens, 41.8% (n = 1337) were positive for at least 1 non-influenza respiratory virus, of which 16.2% (n = 518), 13.4% (n = 428), and 9.6% (n = 308) tested positive for respiratory syncytial virus, rhinovirus, and adenovirus, respectively. CONCLUSIONS The Government of Vietnam has demonstrated that expanding respiratory viral surveillance by strengthening and building upon an influenza platform is feasible, efficient, and practical.
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Affiliation(s)
- Karen A. Alroy
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Trang Thuy Do
- Division of Global Health ProtectionCenter for Global HealthCenters for Disease Control and PreventionHanoiVietnam
| | - Phu Dac Tran
- General Department of Preventive MedicineMinistry of HealthHanoiVietnam
| | - Tan Quang Dang
- General Department of Preventive MedicineMinistry of HealthHanoiVietnam
| | - Long Ngoc Vu
- General Department of Preventive MedicineMinistry of HealthHanoiVietnam
| | - Nga Thi Hang Le
- General Department of Preventive MedicineMinistry of HealthHanoiVietnam
| | - Anh Duc Dang
- National Institute of Hygiene and EpidemiologyHanoiVietnam
| | - Nghia Duy Ngu
- National Institute of Hygiene and EpidemiologyHanoiVietnam
| | - Tu Huy Ngo
- National Institute of Hygiene and EpidemiologyHanoiVietnam
| | | | - Lan Trong Phan
- Pasteur Institute in Ho Chi Minh CityHo Chi Minh CityVietnam
| | | | | | | | | | - Huy Xuan Le
- Pasteur Institute in Nha TrangKhanh HoaVietnam
| | - Anh The Dao
- Pasteur Institute in Nha TrangKhanh HoaVietnam
| | | | - Duoc Tho Pham
- Tay Nguyen Institute of Hygiene and EpidemiologyDak LakVietnam
| | | | - Thanh Ngoc Pham
- Tay Nguyen Institute of Hygiene and EpidemiologyDak LakVietnam
| | - Binh Hai Phan
- Tay Nguyen Institute of Hygiene and EpidemiologyDak LakVietnam
| | - Brett Whitaker
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Thuy Thi Thu Do
- Division of Global Health ProtectionCenter for Global HealthCenters for Disease Control and PreventionHanoiVietnam
| | - Phuong Anh Dao
- Division of Global Health ProtectionCenter for Global HealthCenters for Disease Control and PreventionHanoiVietnam
| | - S. Arunmozhi Balajee
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Anthony W. Mounts
- Division of Global Health ProtectionCenter for Global HealthCenters for Disease Control and PreventionHanoiVietnam
- Division of Global Health ProtectionCenter for Global HealthCenters for Disease Control and PreventionAtlantaGAUSA
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Thomazelli LM, Oliveira DBD, Durigon GS, Whitaker B, Kamili S, Berezin EN, Durigon EL. Human parainfluenza virus surveillance in pediatric patients with lower respiratory tract infections: a special view of parainfluenza type 4. Jornal de Pediatria (Versão em Português) 2018. [DOI: 10.1016/j.jpedp.2017.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Thomazelli LM, Oliveira DBLD, Durigon GS, Whitaker B, Kamili S, Berezin EN, Durigon EL. Human parainfluenza virus surveillance in pediatric patients with lower respiratory tract infections: a special view of parainfluenza type 4. J Pediatr (Rio J) 2018; 94:554-558. [PMID: 28963878 DOI: 10.1016/j.jped.2017.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Characterize the role of human parainfluenza virus and its clinical features in Brazilian children under 2 years of age presenting with acute lower respiratory tract infections. METHODS Real-time assays were used to identify strains of human parainfluenza virus and other common respiratory viruses in nasopharyngeal aspirates. One thousand and two children presenting with acute lower respiratory tract illnesses were enrolled from February 2008 to August 2010. RESULTS One hundred and four (10.4%) patients were human parainfluenza virus positive, of whom 60 (57.7%) were positive for human parainfluenza virus-3, 30 (28.8%) for human parainfluenza virus-4, 12 (11.5%) for human parainfluenza virus-1, and two (1.9%) for human parainfluenza virus-2. Seven (6.7%) patients had more than one strain of human parainfluenza virus detected. The most frequent symptoms were tachypnea and cough, similar to other viral respiratory infections. Clinical manifestations did not differ significantly between human parainfluenza virus-1, -2, -3, and -4 infections. Human parainfluenza virus-1, -3, and -4 were present in the population studied throughout the three years of surveillance, with human parainfluenza virus-3 being the predominant type identified in the first two years. CONCLUSION Human parainfluenza viruses contribute substantially to pediatric acute respiratory illness (ARI) in Brazil, with nearly 30% of this contribution attributable to human parainfluenza virus-4.
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Affiliation(s)
- Luciano M Thomazelli
- Universidade de São Paulo (USP), Instituto de Ciências Biomédicas, São Paulo, SP, Brazil.
| | | | - Giuliana S Durigon
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Brett Whitaker
- Center for Disease Control and Prevention, Atlanta, United States
| | - Shifaq Kamili
- Center for Disease Control and Prevention, Atlanta, United States
| | - Eitan N Berezin
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Edison L Durigon
- Universidade de São Paulo (USP), Instituto de Ciências Biomédicas, São Paulo, SP, Brazil
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Al-Abdallat MM, Rha B, Alqasrawi S, Payne DC, Iblan I, Binder AM, Haddadin A, Nsour MA, Alsanouri T, Mofleh J, Whitaker B, Lindstrom SL, Tong S, Ali SS, Dahl RM, Berman L, Zhang J, Erdman DD, Gerber SI. Acute respiratory infections among returning Hajj pilgrims-Jordan, 2014. J Clin Virol 2017; 89:34-37. [PMID: 28226273 PMCID: PMC7106359 DOI: 10.1016/j.jcv.2017.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/09/2017] [Accepted: 01/30/2017] [Indexed: 01/31/2023]
Abstract
Surveillance for respiratory illness in Hajj pilgrims took place in Jordan in 2014. 58% of the 125 subjects returning from Hajj tested positive for at least one virus. Rhino/enterovirus was the most commonly detected viral pathogen (47% of subjects). No cases of Middle East Respiratory Syndrome coronavirus were detected.
Background The emergence of Middle East Respiratory Syndrome coronavirus (MERS-CoV) has prompted enhanced surveillance for respiratory infections among pilgrims returning from the Hajj, one of the largest annual mass gatherings in the world. Objectives To describe the epidemiology and etiologies of respiratory illnesses among pilgrims returning to Jordan after the 2014 Hajj. Study design Surveillance for respiratory illness among pilgrims returning to Jordan after the 2014 Hajj was conducted at sentinel health care facilities using epidemiologic surveys and molecular diagnostic testing of upper respiratory specimens for multiple respiratory pathogens, including MERS-CoV. Results Among the 125 subjects, 58% tested positive for at least one virus; 47% tested positive for rhino/enterovirus. No cases of MERS-CoV were detected. Conclusions The majority of pilgrims returning to Jordan from the 2014 Hajj with respiratory illness were determined to have a viral etiology, but none were due to MERS-CoV. A greater understanding of the epidemiology of acute respiratory infections among returning travelers to other countries after Hajj should help optimize surveillance systems and inform public health response practices.
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Affiliation(s)
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sultan Alqasrawi
- Communicable Diseases Directorate, Jordan Ministry of Health, Amman, Jordan
| | - Daniel C Payne
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ibrahim Iblan
- Jordan Field Epidemiology Training Program, Amman, Jordan
| | - Alison M Binder
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Aktham Haddadin
- Directorate of Laboratories, Jordan Ministry of Health, Amman, Jordan
| | | | - Tarek Alsanouri
- Directorate of Laboratories, Jordan Ministry of Health, Amman, Jordan
| | - Jawad Mofleh
- Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Brett Whitaker
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephen L Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sami Sheikh Ali
- Communicable Diseases Directorate, Jordan Ministry of Health, Amman, Jordan
| | | | - LaShondra Berman
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jing Zhang
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dean D Erdman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Wolff BJ, Bramley AM, Thurman KA, Whitney CG, Whitaker B, Self WH, Arnold SR, Trabue C, Wunderink RG, McCullers J, Edwards KM, Jain S, Winchell JM. Improved Detection of Respiratory Pathogens by Use of High-Quality Sputum with TaqMan Array Card Technology. J Clin Microbiol 2017; 55:110-121. [PMID: 27795345 PMCID: PMC5228222 DOI: 10.1128/jcm.01805-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/12/2016] [Indexed: 11/20/2022] Open
Abstract
New diagnostic platforms often use nasopharyngeal or oropharyngeal (NP/OP) swabs for pathogen detection for patients hospitalized with community-acquired pneumonia (CAP). We applied multipathogen testing to high-quality sputum specimens to determine if more pathogens can be identified relative to NP/OP swabs. Children (<18 years old) and adults hospitalized with CAP were enrolled over 2.5 years through the Etiology of Pneumonia in the Community (EPIC) study. NP/OP specimens with matching high-quality sputum (defined as ≤10 epithelial cells/low-power field [lpf] and ≥25 white blood cells/lpf or a quality score [q-score] definition of 2+) were tested by TaqMan array card (TAC), a multipathogen real-time PCR detection platform. Among 236 patients with matched specimens, a higher proportion of sputum specimens had ≥1 pathogen detected compared with NP/OP specimens in children (93% versus 68%; P < 0.0001) and adults (88% versus 61%; P < 0.0001); for each pathogen targeted, crossing threshold (CT) values were earlier in sputum. Both bacterial (361 versus 294) and viral detections (245 versus 140) were more common in sputum versus NP/OP specimens, respectively, in both children and adults. When available, high-quality sputum may be useful for testing in hospitalized CAP patients.
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Affiliation(s)
- Bernard J Wolff
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anna M Bramley
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen A Thurman
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cynthia G Whitney
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brett Whitaker
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wesley H Self
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Sandra R Arnold
- University of Tennessee Health Science Center/Saint Thomas Health, Nashville, Tennessee, USA
- Le Bonheur Children's Hospital, Memphis, Tennessee, USA
| | - Christopher Trabue
- University of Tennessee Health Science Center/Saint Thomas Health, Nashville, Tennessee, USA
| | | | - Jon McCullers
- University of Tennessee Health Science Center/Saint Thomas Health, Nashville, Tennessee, USA
- Le Bonheur Children's Hospital, Memphis, Tennessee, USA
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Seema Jain
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonas M Winchell
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Schneider E, Chommanard C, Rudd J, Whitaker B, Lowe L, Gerber SI. Evaluation of Patients under Investigation for MERS-CoV Infection, United States, January 2013-October 2014. Emerg Infect Dis 2016; 21:1220-3. [PMID: 26079433 PMCID: PMC4480388 DOI: 10.3201/eid2107.141888] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Middle East respiratory syndrome (MERS) cases continue to be reported from the Middle East. Evaluation and testing of patients under investigation (PUIs) for MERS are recommended. In 2013-2014, two imported cases were detected among 490 US PUIs. Continued awareness is needed for early case detection and implementation of infection control measures.
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Harvey JJ, Chester S, Burke SA, Ansbro M, Aden T, Gose R, Sciulli R, Bai J, DesJardin L, Benfer JL, Hall J, Smole S, Doan K, Popowich MD, St George K, Quinlan T, Halse TA, Li Z, Pérez-Osorio AC, Glover WA, Russell D, Reisdorf E, Whyte T, Whitaker B, Hatcher C, Srinivasan V, Tatti K, Tondella ML, Wang X, Winchell JM, Mayer LW, Jernigan D, Mawle AC. Comparative analytical evaluation of the respiratory TaqMan Array Card with real-time PCR and commercial multi-pathogen assays. J Virol Methods 2015; 228:151-7. [PMID: 26640122 PMCID: PMC7113746 DOI: 10.1016/j.jviromet.2015.11.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/19/2015] [Accepted: 11/25/2015] [Indexed: 12/24/2022]
Abstract
Viral and bacterial real-time PCR oligonucleotides were spotted on TaqMan Array Cards. Analytical sensitivity was compared with standalone laboratory PCR assays. TaqMan Array Card sensitivity was generally one log lower. Reproducibility across six independent testing sites was within one log.
In this study, a multicenter evaluation of the Life Technologies TaqMan® Array Card (TAC) with 21 custom viral and bacterial respiratory assays was performed on the Applied Biosystems ViiA™ 7 Real-Time PCR System. The goal of the study was to demonstrate the analytical performance of this platform when compared to identical individual pathogen specific laboratory developed tests (LDTs) designed at the Centers for Disease Control and Prevention (CDC), equivalent LDTs provided by state public health laboratories, or to three different commercial multi-respiratory panels. CDC and Association of Public Health Laboratories (APHL) LDTs had similar analytical sensitivities for viral pathogens, while several of the bacterial pathogen APHL LDTs demonstrated sensitivities one log higher than the corresponding CDC LDT. When compared to CDC LDTs, TAC assays were generally one to two logs less sensitive depending on the site performing the analysis. Finally, TAC assays were generally more sensitive than their counterparts in three different commercial multi-respiratory panels. TAC technology allows users to spot customized assays and design TAC layout, simplify assay setup, conserve specimen, dramatically reduce contamination potential, and as demonstrated in this study, analyze multiple samples in parallel with good reproducibility between instruments and operators.
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Affiliation(s)
- John J Harvey
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA.
| | - Stephanie Chester
- Association of Public Health Laboratories, Silver Spring, MD, 20904 USA
| | - Stephen A Burke
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Marisela Ansbro
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Tricia Aden
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Association of Public Health Laboratories, Silver Spring, MD, 20904 USA
| | - Remedios Gose
- Hawaii Department of Health State Laboratories, Pearl City, HI, 96782 USA
| | - Rebecca Sciulli
- Hawaii Department of Health State Laboratories, Pearl City, HI, 96782 USA
| | - Jing Bai
- Iowa State Hygienic Laboratory, Coralville, IA, 52241 USA
| | - Lucy DesJardin
- Iowa State Hygienic Laboratory, Coralville, IA, 52241 USA
| | | | - Joshua Hall
- William A. Hinton State Laboratory Institute, Jamaica Plain, MA, 02130 USA
| | - Sandra Smole
- William A. Hinton State Laboratory Institute, Jamaica Plain, MA, 02130 USA
| | - Kimberly Doan
- William A. Hinton State Laboratory Institute, Jamaica Plain, MA, 02130 USA
| | - Michael D Popowich
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Kirsten St George
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Tammy Quinlan
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Tanya A Halse
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Zhen Li
- Washington State Public Health Laboratories, Shoreline, WA, 98155-7224 USA
| | | | - William A Glover
- Washington State Public Health Laboratories, Shoreline, WA, 98155-7224 USA
| | - Denny Russell
- Washington State Public Health Laboratories, Shoreline, WA, 98155-7224 USA
| | - Erik Reisdorf
- Wisconsin State Laboratory of Hygiene, Madison, WI, USA
| | - Thomas Whyte
- Wisconsin State Laboratory of Hygiene, Madison, WI, USA
| | - Brett Whitaker
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Cynthia Hatcher
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Velusamy Srinivasan
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Kathleen Tatti
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Maria Lucia Tondella
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Xin Wang
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Jonas M Winchell
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Leonard W Mayer
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Daniel Jernigan
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Alison C Mawle
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
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Sarkar S, Justa S, Brucks M, Endres J, Fox DA, Zhou X, Alnaimat F, Whitaker B, Wheeler JC, Jones BH, Bommireddy SR. Interleukin (IL)-17A, F and AF in inflammation: a study in collagen-induced arthritis and rheumatoid arthritis. Clin Exp Immunol 2014; 177:652-61. [PMID: 24813051 PMCID: PMC4137849 DOI: 10.1111/cei.12376] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 12/17/2022] Open
Abstract
Interleukin (IL)-17 plays a critical role in inflammation. Most studies to date have elucidated the inflammatory role of IL-17A, often referred to as IL-17. IL-17F is a member of the IL-17 family bearing 50% homology to IL-17A and can also be present as heterodimer IL-17AF. This study elucidates the distribution and contribution of IL-17A, F and AF in inflammatory arthritis. Neutralizing antibody to IL-17A alone or IL-17F alone or in combination was utilized in the mouse collagen-induced arthritis (CIA) model to elucidate the contribution of each subtype in mediating inflammation. IL-17A, F and AF were all increased during inflammatory arthritis. Neutralization of IL-17A reduced the severity of arthritis, neutralization of IL-17A+IL-17F had the same effect as neutralizing IL-17A, while neutralization of IL-17F had no effect. Moreover, significantly higher levels of IL-17A and IL-17F were detected in peripheral blood mononuclear cells (PBMC) from patients with rheumatoid arthritis (RA) in comparison to patients with osteoarthritis (OA). IL-17A and AF were detected in synovial fluid mononuclear cells (SFMC) in RA and OA, with IL-17A being significantly higher in RA patients. Enriched CD3+ T cells from RA PBMCs produced singnificantly high levels of IL-17A and IL-17AF in comparison to OA peripheral blood CD3+ T cells. IL-17A, F and AF were undetectable in T cells from SFMCs from RA and OA. While IL-17A, F, and AF were all induced during CIA, IL-17A played a dominant role. Furthermore, production of IL-17A, and not IL-17F or IL-17AF, was elevated in PBMCs, SFMCs and enriched peripheral blood CD3+ T in RA.
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Affiliation(s)
- S Sarkar
- Section of Rheumatology, Department of Medicine, and the Arizona Arthritis Center, University of Arizona, Tucson, AZ, USA
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Whitaker B, Noren J, Chadderdon S, Wang W, Forber R, Selfridge R, Schultz S. Slab coupled optical fiber sensor calibration. Rev Sci Instrum 2013; 84:023108. [PMID: 23464196 DOI: 10.1063/1.4789766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper presents a method for calibrating slab coupled optical fiber sensors (SCOS). An automated system is presented for selecting the optimal laser wavelength for use in SCOS interrogation. The wavelength calibration technique uses a computer sound card for both the creation of the applied electric field and the signal detection. The method used to determine the ratio between the measured SCOS signal and the applied electric field is also described along with a demonstration of the calibrated SCOS involving measuring the dielectric breakdown of air.
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Affiliation(s)
- B Whitaker
- Department of Electrical and Computer Engineering, Brigham Young University, 464 CB, Provo, Utah 84602, USA
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Garner MM, Atkinson SD, Hallett SL, Bartholomew JL, Nordhausen RW, Reed H, Adams L, Whitaker B. Renal myxozoanosis in weedy sea dragons, Phyllopteryx taeniolatus (Lacepède), caused by Sinuolinea phyllopteryxa n. sp. J Fish Dis 2008; 31:27-35. [PMID: 18086032 DOI: 10.1111/j.1365-2761.2007.00862.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Renal myxozoanosis was diagnosed histologically in 11 captive, wild caught, adult weedy (common) sea dragons, Phyllopteryx taeniolatus, from three separate public aquaria in the United States. Myxozoan spores were visible in wet mounts of kidney tissue and were associated with renal tubular dilatation and tubular epithelial cell hypertrophy. Light and electron microscopy revealed spore morphology consistent with the genus Sinuolinea. Spores were spheroidal, slightly dorso-ventrally compressed, length (L) 17.1 x width (W) 16.4 x thickness (T) 15.6 microm, with two shell valves joined at a distinct, sinuous sutural ridge, and had two nearly spherical polar capsules, L 5.5 x W 5.0 microm, with five to seven turns of the polar filament. There were no extra-valvular ridges or protrusions. DNA sequencing required the design of three new primers that yielded 1740 bp of 18S ribosomal DNA sequence. The parasite was determined to be novel based on morphological and molecular data, and was given the name Sinuolinea phyllopteryxa after its vertebrate host.
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Affiliation(s)
- M M Garner
- Northwest ZooPath, Monroe, WA 98272, USA.
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Jacobson ER, Origgi F, Pessier AP, Lamirande EW, Walker I, Whitaker B, Stalis IH, Nordhausen R, Owens JW, Nichols DK, Heard D, Homer B. Paramyxovirus infection in caiman lizards (Draecena guianensis). J Vet Diagn Invest 2001; 13:143-51. [PMID: 11289210 DOI: 10.1177/104063870101300208] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Three separate epidemics occurred in caiman lizards (Dracaena guianensis) that were imported into the USA from Peru in late 1998 and early 1999. Histologic evaluation of tissues from necropsied lizards demonstrated a proliferative pneumonia. Electron microscopic examination of lung tissue revealed a virus that was consistent with members of the family Paramyxoviridae. Using a rabbit polyclonal antibody against an isolate of ophidian (snake) paramyxovirus, an immunoperoxidase staining technique demonstrated immunoreactivity within pulmonary epithelial cells of 1 lizard. Homogenates of lung, brain, liver, or kidney from affected lizards were placed in flasks containing monolayers of either terrapene heart cells or viper heart cells. Five to 10 days later, syncytial cells formed. When Vero cells were inoculated with supernatant of infected terrapene heart cells, similar syncytial cells developed. Electron microscopic evaluation of infected terrapene heart cells revealed intracytoplasmic inclusions consisting of nucleocapsid strands. Using negative-staining electron microscopy, abundant filamentous nucleocapsid material with a herringbone structure typical of the Paramyxoviridae was observed in culture medium of infected viper heart cells. Seven months following the initial epizootic, blood samples were collected from surviving group 1 lizards, and a hemagglutination inhibition assay was performed to determine presence of specific antibody against the caiman lizard isolate. Of the 17 lizards sampled, 7 had titers of < or =1:20 and 10 had titers of >1:20 and < or =1:80. This report is only the second of a paramyxovirus identified in a lizard and is the first to snow the relationship between histologic and ultrastructural findings and virus isolation.
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Affiliation(s)
- E R Jacobson
- College of Veterinary Medicine, University of Florida, Gainesville 32610, USA
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Abstract
BACKGROUND There are few published data on severe outcomes of the donation of blood for allogeneic or autologous use. It would be helpful if blood collectors could better characterize and/or predict the likelihood of significant complications of blood donation. STUDY DESIGN AND METHODS Very severe outcome (VSO) was defined as an event requiring hospitalization. Approximately 4.1 million American Red Cross whole-blood donation records (July 1993-March 1994) were reviewed for the incidence and type of VSO. RESULTS A total of 33 VSOs occurred for all donations. The incidence of VSOs for allogeneic donation was 1 (0.0005%) in 198,119 and that for autologous donation was 1 (0.006%) in 16,783 (p < 0.001). First-time donors were three times as likely to have a VSO. Donors > 40 years old had 87.9 percent of the VSOs, and donors > 60 years old had 48.5 percent. Vasovagal (66.7%) and anginal (12.1%) episodes were the most frequent complications, and 66.7 percent of reactions occurred at the blood collection site. The mean hospital stay was 1.9 days. CONCLUSION VSO is an infrequent complication of all types of blood donation, but its occurrence may be associated with significant morbidity and cost. VSO is nearly 12 times as likely in autologous blood donors.
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Affiliation(s)
- M A Popovsky
- American Red Cross Blood Services, Dedham, Massachusetts, USA
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Akiyama T, Whitaker B, Federspiel M, Hughes SH, Yamamoto H, Takeuchi T, Brumbaugh J. Tissue-specific expression of mouse tyrosinase gene in cultured chicken cells. Exp Cell Res 1994; 214:154-62. [PMID: 8082718 DOI: 10.1006/excr.1994.1244] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A mouse tyrosinase cDNA has been combined with different promoters and inserted into several replication-competent avian leukosis proviruses and the viruses were transferred into cultured albino chick cells by viral infection. Expression of the tyrosinase gene depended on one of four promoter sequences: the resident constitutive promoter (Rous sarcoma virus long-terminal repeat; RSV-LTR), 471 bp from the mouse tyrosinase gene-associated promoter, 519 bp from the Japanese quail tyrosinase gene associated promoter, or 369 bp from the quail tyrosinase promoter. The infected cells expressed tyrosinase and produced pigment which could be seen with the light microscope. Immunofluorescence microscopy, using an anti mouse tyrosinase T1-specific antibody, also showed the presence of mouse tyrosinase. When infected with the same viral titer, gene expression was highest with the constitutive LTR promoter. The quail tyrosinase promoter, while less efficient than the LTR, was more efficient than the other tyrosinase promoter. Fibroblasts and hepatocytes infected with the construct carrying the constitutive promoter or the truncated quail promoter expressed tyrosinase. The mouse and quail promoters appeared to show tissue-specific expression since fibroblasts and hepatocytes infected with viruses carrying these promoters did not express mouse tyrosinase. Toxicity is associated with constitutive expression of tyrosinase in nonmelanocytes. Therefore the viruses that carry the tissue specific promoters should be useful for in vivo studies.
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Affiliation(s)
- T Akiyama
- Department of Biology, Keio University, Yokohama, Japan
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Affiliation(s)
- B Whitaker
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
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