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Meier-Stephenson V, Drebot MA, Dimitrova K, DiQuinzio M, Fonseca K, Forrest D, Hatchette T, Morshed M, Patriquin G, Poliquin G, Saxinger L, Serhir B, Tellier R, Therrien C, Vrbova L, Wood H. Case Series of Jamestown Canyon Virus Infections with Neurologic Outcomes, Canada, 2011-2016. Emerg Infect Dis 2024; 30:874-881. [PMID: 38666581 PMCID: PMC11060468 DOI: 10.3201/eid3005.221258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
Jamestown Canyon virus (JCV) is a mosquitoborne orthobunyavirus in the California serogroup that circulates throughout Canada and the United States. Most JCV exposures result in asymptomatic infection or a mild febrile illness, but JCV can also cause neurologic diseases, such as meningitis and encephalitis. We describe a case series of confirmed JCV-mediated neuroinvasive disease among persons from the provinces of British Columbia, Alberta, Quebec, and Nova Scotia, Canada, during 2011-2016. We highlight the case definitions, epidemiology, unique features and clinical manifestations, disease seasonality, and outcomes for those cases. Two of the patients (from Quebec and Nova Scotia) might have acquired JCV infections during travel to the northeastern region of the United States. This case series collectively demonstrates JCV's wide distribution and indicates the need for increased awareness of JCV as the underlying cause of meningitis/meningoencephalitis during mosquito season.
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Veroniki AA, Tricco AC, Watt J, Tsokani S, Khan PA, Soobiah C, Negm A, Doherty-Kirby A, Taylor P, Lunny C, McGowan J, Little J, Mallon P, Moher D, Wong S, Dinnes J, Takwoingi Y, Saxinger L, Chan A, Isaranuwatchai W, Lander B, Meyers A, Poliquin G, Straus SE. Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2: a rapid review with network meta-analysis of diagnostic test accuracy studies. BMC Med 2023; 21:110. [PMID: 36978074 PMCID: PMC10049780 DOI: 10.1186/s12916-023-02810-0] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The global spread of COVID-19 created an explosion in rapid tests with results in < 1 hour, but their relative performance characteristics are not fully understood yet. Our aim was to determine the most sensitive and specific rapid test for the diagnosis of SARS-CoV-2. METHODS Design: Rapid review and diagnostic test accuracy network meta-analysis (DTA-NMA). ELIGIBILITY CRITERIA Randomized controlled trials (RCTs) and observational studies assessing rapid antigen and/or rapid molecular test(s) to detect SARS-CoV-2 in participants of any age, suspected or not with SARS-CoV-2 infection. INFORMATION SOURCES Embase, MEDLINE, and Cochrane Central Register of Controlled Trials, up to September 12, 2021. OUTCOME MEASURES Sensitivity and specificity of rapid antigen and molecular tests suitable for detecting SARS-CoV-2. Data extraction and risk of bias assessment: Screening of literature search results was conducted by one reviewer; data abstraction was completed by one reviewer and independently verified by a second reviewer. Risk of bias was not assessed in the included studies. DATA SYNTHESIS Random-effects meta-analysis and DTA-NMA. RESULTS We included 93 studies (reported in 88 articles) relating to 36 rapid antigen tests in 104,961 participants and 23 rapid molecular tests in 10,449 participants. Overall, rapid antigen tests had a sensitivity of 0.75 (95% confidence interval 0.70-0.79) and specificity of 0.99 (0.98-0.99). Rapid antigen test sensitivity was higher when nasal or combined samples (e.g., combinations of nose, throat, mouth, or saliva samples) were used, but lower when nasopharyngeal samples were used, and in those classified as asymptomatic at the time of testing. Rapid molecular tests may result in fewer false negatives than rapid antigen tests (sensitivity: 0.93, 0.88-0.96; specificity: 0.98, 0.97-0.99). The tests with the highest sensitivity and specificity estimates were the Xpert Xpress rapid molecular test by Cepheid (sensitivity: 0.99, 0.83-1.00; specificity: 0.97, 0.69-1.00) among the 23 commercial rapid molecular tests and the COVID-VIRO test by AAZ-LMB (sensitivity: 0.93, 0.48-0.99; specificity: 0.98, 0.44-1.00) among the 36 rapid antigen tests we examined. CONCLUSIONS Rapid molecular tests were associated with both high sensitivity and specificity, while rapid antigen tests were mainly associated with high specificity, according to the minimum performance requirements by WHO and Health Canada. Our rapid review was limited to English, peer-reviewed published results of commercial tests, and study risk of bias was not assessed. A full systematic review is required. REVIEW REGISTRATION PROSPERO CRD42021289712.
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Affiliation(s)
- Areti Angeliki Veroniki
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada.
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada
- Epidemiology Division & Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, Canada
| | - Jennifer Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada
| | - Sofia Tsokani
- School of Education, University of Ioannina, Ioannina, Greece
| | - Paul A Khan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada
| | - Charlene Soobiah
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Ahmed Negm
- University of Alberta, Edmonton, AB, Canada
| | - Amanda Doherty-Kirby
- Patient Partner, Strategy for Patient Oriented-Research Evidence Alliance (SPOR EA), Toronto, Canada
| | - Paul Taylor
- Patient Partner, Strategy for Patient Oriented-Research Evidence Alliance (SPOR EA), Toronto, Canada
| | - Carole Lunny
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada
| | - Jessie McGowan
- University of Ottawa/Université d'Ottawa, Ottawa, ON, Canada
| | - Julian Little
- University of Ottawa/Université d'Ottawa, Ottawa, ON, Canada
| | | | - David Moher
- Ottawa Hospital Research Institute/Institut de Recherche de L'Hôpital d'Ottawa, Ottawa, ON, Canada
| | - Sabrina Wong
- University of British Columbia, Vancouver, BC, Canada
| | | | | | | | | | | | - Bryn Lander
- Health Canada (Ottawa)/Santé Canada (Ottawa), Ottawa, ON, Canada
| | - Adrienne Meyers
- Public Health Agency of Canada/Agence de La Santé Publique du Canada, Ottawa, ON, Canada
| | - Guillaume Poliquin
- Public Health Agency of Canada/Agence de La Santé Publique du Canada, Ottawa, ON, Canada
| | - Sharon E Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, ON, Canada
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Garnett L, Tse C, Funk D, Dust K, Tran KN, Hedley A, Poliquin G, Bullard J, Strong JE. Differential Infectivity of Original and Delta Variants of SARS-CoV-2 in Children Compared to Adults. Microbiol Spectr 2022; 10:e0039522. [PMID: 35972128 PMCID: PMC9602606 DOI: 10.1128/spectrum.00395-22] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
Although children of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, they have not been implicated as major drivers of transmission thus far. However, it is still unknown if this finding holds true with new variants of concern (VOC), such as Delta (B.1.617.2). This study aimed to examine differences in both viral RNA (as measured by cycle threshold [CT]) and viable-virus levels from children infected with Delta and those infected with original variants (OV). Furthermore, we aimed to compare the pediatric population infection trends to those in adults. We obtained 690 SARS-CoV-2 RT-PCR positive nasopharyngeal swabs from across Manitoba, Canada, which were further screened for mutations characteristic of VOC. Aliquots of sample were then provided for TCID50 (50% tissue culture infective dose) assays to determine infectious titers. Using a variety of statistical analyses we compared CT and infectivity of VOC in different age demographics. Comparing 122 Delta- to 175 OV-positive nasopharyngeal swab samples from children, we found that those infected with Delta are 2.7 times more likely to produce viable SARS-CoV-2 with higher titers (in TCID50 per milliliter), regardless of viral RNA levels. Moreover, comparing the pediatric samples to 130 OV- and 263 Delta-positive samples from adults, we found only that the Delta pediatric culture-positive samples had titers (TCID50 per milliliter) similar to those of culture-positive adult samples. IMPORTANCE These important findings show that children may play a larger role in viral transmission of Delta than for previously circulating SARS-CoV-2 variants. Additionally, they may suggest a mechanism for why Delta has evolved to be the predominant circulating variant.
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Affiliation(s)
- Lauren Garnett
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carmen Tse
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Duane Funk
- Departments of Anaesthesiology and Medicine, Section of Critical Care, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kerry Dust
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
| | - Kaylie N. Tran
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Adam Hedley
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
| | - Guillaume Poliquin
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jared Bullard
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James E. Strong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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Hua N, Corsten M, Bello A, Bhatt M, Milwid R, Champredon D, Turgeon P, Zemek R, Dawson L, Mitsakakis N, Webster R, Caulley L, Angel JB, Bastien N, Poliquin G, Johnson-Obaseki S. Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study. CMAJ Open 2022; 10:E981-E987. [PMID: 36347561 PMCID: PMC9648623 DOI: 10.9778/cmajo.20210279] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate and timely testing for SARS-CoV-2 in the pediatric population is crucial to control the COVID-19 pandemic; saliva testing has been proposed as a less invasive alternative to nasopharyngeal swabs. We sought to compare the detection of SARS-CoV-2 using saliva versus nasopharyngeal swab in the pediatric population, and to determine the optimum time of testing for SARS-CoV-2 using saliva. METHODS We conducted a longitudinal diagnostic study in Ottawa, Canada, from Jan. 19 to Mar. 26, 2021. Children aged 3-17 years were eligible if they exhibited symptoms of COVID-19, had been identified as a high-risk or close contact to someone confirmed positive for SARS-CoV-2 or had travelled outside Canada in the previous 14 days. Participants provided both nasopharyngeal swab and saliva samples. Saliva was collected using a self-collection kit (DNA Genotek, OM-505) or a sponge-based kit (DNA Genotek, ORE-100) if they could not provide a saliva sample into a tube. RESULTS Among 1580 paired nasopharyngeal and saliva tests, 60 paired samples were positive for SARS-CoV-2. Forty-four (73.3%) were concordant-positive results and 16 (26.6%) were discordant, among which 8 were positive only on nasopharyngeal swab and 8 were positive only on saliva testing. The sensitivity of saliva was 84.6% (95% confidence interval 71.9%-93.1%). INTERPRETATION Salivary testing for SARS-CoV-2 in the pediatric population is less invasive and shows similar detection of SARS-CoV-2 to nasopharyngeal swabs. It may therefore provide a feasible alternative for diagnosis of SARS-CoV-2 infection in children.
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Affiliation(s)
- Nadia Hua
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Martin Corsten
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Alexander Bello
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Maala Bhatt
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Rachael Milwid
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - David Champredon
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Patricia Turgeon
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Roger Zemek
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Lauren Dawson
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Nicholas Mitsakakis
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Richard Webster
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Lisa Caulley
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Jonathan B Angel
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Nathalie Bastien
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Guillaume Poliquin
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man.
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Funk DJ, Bullard J, Lother S, Grande GV, Garnett L, Doan K, Dust K, Kumar A, Poliquin G, Strong J. Persistence of live virus in critically ill patients infected with SARS-COV-2: a prospective observational study. Crit Care 2022; 26:10. [PMID: 34983614 PMCID: PMC8724747 DOI: 10.1186/s13054-021-03884-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/04/2021] [Accepted: 12/27/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Research on the duration of infectivity of ICU patients with COVID-19 has been sparse. Tests based on Reverse Transcriptase polymerase chain reaction (RT-PCR) detect both live virus and non-infectious viral RNA. We aimed to determine the duration of infectiousness based on viral culture of nasopharyngeal samples of patients with COVID-19. METHODS Prospective observational study in adult intensive care units with a diagnosis of COVID-19 Pneumonia. Patients had repeated nasopharyngeal sampling performed after day 10 of ICU admission. Culture positive rate (based on viral culture on Vero cells in a level 4 lab) and Cycle threshold from RT-PCR were measured. RESULTS Nine patients of the 108 samples (8.3%, 95% CI 3.9-15.2%) grew live virus at a median of 13 days (interquartile range 11-19) after their initial positive test. 74.1% of patients were RT-PCR positive but culture negative, and the remaining (17.6%) were RT-PCR and culture negative. Cycle threshold showed excellent ability to predict the presence of live virus, with a Ct < 25 with an AUC of 0.90 (95% CI 0.83-0.97, p < 0.001). The specificity of a Ct > 25 to predict negative viral culture was 100% (95% CI 70-100%). CONCLUSION 8.3% of our ICU patients with COVID-19 grew live virus at a median of 13 days post-initial positive RT-PCR test. Severity of illness, use of mechanical ventilation, and time between tests did not predict the presence of live virus. Cycle threshold of > 25 had the best ability to determine the lack of live virus in these patents.
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Affiliation(s)
- Duane J Funk
- Departments of Anesthesiology and Medicine, Section of Critical Care, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada. .,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
| | - Jared Bullard
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, MB, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Sylvan Lother
- Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada
| | - Gloria Vazquez Grande
- Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada
| | - Lauren Garnett
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Kaylie Doan
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Kerry Dust
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Anand Kumar
- Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada
| | - Guillaume Poliquin
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Jim Strong
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
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6
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Nourbakhsh S, Shoukat A, Zhang K, Poliquin G, Halperin D, Sheffield H, Halperin SA, Langley JM, Moghadas SM. Effectiveness and cost-effectiveness of RSV infant and maternal immunization programs: A case study of Nunavik, Canada. EClinicalMedicine 2021; 41:101141. [PMID: 34622186 PMCID: PMC8479643 DOI: 10.1016/j.eclinm.2021.101141] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite passive immunization with palivizumab to select high-risk children under two years of age, the health and economic burden of respiratory syncytial virus (RSV) remains substantial. We evaluated the effectiveness and cost-effectiveness of immunization programs with new generations of RSV prophylactics, including long-acting monoclonal antibodies (LAMA) and maternal vaccines, in terms of reducing hospitalizations in Nunavik, a Canadian Arctic region. METHODS We developed an agent-based model of RSV transmission and parameterized it with the demographics and burden of RSV in Nunavik, Québec. We compared various immunization strategies, taking into account the costs associated with program delivery and calculating the incremental cost-effectiveness ratio (ICER) using quality-adjusted life-years (QALYs) gained as a measure of effectiveness. Scenario analyses included immunization with palivizumab and LAMA for infants under one year of age, and maternal vaccination in mild, moderate, and severe RSV seasons. Data were analysed from November 1, 2019 to May 1, 2021. FINDINGS We found that a Nunavik pilot program with palivizumab which included healthy full-term infants aged 0-2 months in addition to those considered high-risk for complicated RSV disease is not cost-effective, compared to offering palivizumab only to preterm/chronically ill infants under 1 year of age. Using LAMA as prophylaxis produces ICER values of CAD $39,414/QALY (95% Credible Interval [CrI]: $39,314-$40,017) in a mild season (moderately cost-effective) and CAD $5,255/QALY (95% CrI: $5,222-$5,307) in a moderate season (highly cost-effective). LAMA was a dominant (cost-saving with negative incremental costs and positive incremental effects) strategy in a severe RSV season. Maternal vaccination combined with immunization of preterm/chronically ill infants 3-11 months was also a dominant (cost-saving) strategy in all seasons. INTERPRETATION The switch from palivizumab in RSV immunization programs to new prophylactics would lead to significant savings, with LAMA being an effective strategy without compromising benefits in terms of reducing hospitalizations.
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Affiliation(s)
- Shokoofeh Nourbakhsh
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario M3J 1P3, Canada
| | - Affan Shoukat
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario M3J 1P3, Canada
| | - Kevin Zhang
- Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Guillaume Poliquin
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 0J9, Canada
- Office of the Scientific Director, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Donna Halperin
- School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Holden Sheffield
- Department of Paediatrics, Qikiqtani General Hospital, Iqaluit, Nunavut X0A 0H0, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia B3K 6R8, Canada
| | - Joanne M Langley
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia B3K 6R8, Canada
| | - Seyed M Moghadas
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario M3J 1P3, Canada
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7
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Griffin BD, Chan M, Tailor N, Mendoza EJ, Leung A, Warner BM, Duggan AT, Moffat E, He S, Garnett L, Tran KN, Banadyga L, Albietz A, Tierney K, Audet J, Bello A, Vendramelli R, Boese AS, Fernando L, Lindsay LR, Jardine CM, Wood H, Poliquin G, Strong JE, Drebot M, Safronetz D, Embury-Hyatt C, Kobasa D. SARS-CoV-2 infection and transmission in the North American deer mouse. Nat Commun 2021; 12:3612. [PMID: 34127676 PMCID: PMC8203675 DOI: 10.1038/s41467-021-23848-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [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: 08/03/2020] [Accepted: 05/17/2021] [Indexed: 01/08/2023] Open
Abstract
Widespread circulation of SARS-CoV-2 in humans raises the theoretical risk of reverse zoonosis events with wildlife, reintroductions of SARS-CoV-2 into permissive nondomesticated animals. Here we report that North American deer mice (Peromyscus maniculatus) are susceptible to SARS-CoV-2 infection following intranasal exposure to a human isolate, resulting in viral replication in the upper and lower respiratory tract with little or no signs of disease. Further, shed infectious virus is detectable in nasal washes, oropharyngeal and rectal swabs, and viral RNA is detectable in feces and occasionally urine. We further show that deer mice are capable of transmitting SARS-CoV-2 to naïve deer mice through direct contact. The extent to which these observations may translate to wild deer mouse populations remains unclear, and the risk of reverse zoonosis and/or the potential for the establishment of Peromyscus rodents as a North American reservoir for SARS-CoV-2 remains unknown.
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Affiliation(s)
- Bryan D Griffin
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Mable Chan
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Nikesh Tailor
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Emelissa J Mendoza
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Anders Leung
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Bryce M Warner
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ana T Duggan
- Science Technology Cores and Services, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Estella Moffat
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, MB, Canada
| | - Shihua He
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Lauren Garnett
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Kaylie N Tran
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Logan Banadyga
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Alixandra Albietz
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Kevin Tierney
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Jonathan Audet
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Alexander Bello
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Robert Vendramelli
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Amrit S Boese
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Lisa Fernando
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - L Robbin Lindsay
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Entomology, University of Manitoba, Winnipeg, MB, Canada
| | - Claire M Jardine
- Department of Pathobiology, Canadian Wildlife Health Cooperative, Department of Pathobiology, University of Guelph, Guelph, ON, Canada
| | - Heidi Wood
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Guillaume Poliquin
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Office of the Scientific Director, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - James E Strong
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Michael Drebot
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - David Safronetz
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Carissa Embury-Hyatt
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, MB, Canada
| | - Darwyn Kobasa
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
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8
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Bullard J, Funk D, Dust K, Garnett L, Tran K, Bello A, Strong JE, Lee SJ, Waruk J, Hedley A, Alexander D, Van Caeseele P, Loeppky C, Poliquin G. Comparaison de l’infectivité du coronavirus du syndrome respiratoire aigu sévère 2 chez les enfants et les adultes. CMAJ 2021; 193:E870-E877. [PMID: 34099475 PMCID: PMC8203260 DOI: 10.1503/cmaj.210263-f] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 12/11/2022] Open
Abstract
CONTEXTE: Le rôle des enfants dans la propagation et la transmission communautaire du coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) est encore mal compris. Nous visons à quantifier l’infectivité du SRAS-CoV-2 d’échantillons nasopharyngés provenant d’enfants comparativement à ceux provenant d’adultes. MÉTHODES: Nous avons obtenu des écouvillons nasopharyngés de cas adultes et pédiatriques de la maladie à coronavirus 2019 (COVID-19) ainsi que de leurs contacts qui ont obtenu un résultat positif à la présence du SRAS-CoV-2 lors d’un test de dépistage au Manitoba entre les mois de mars et décembre 2020. Nous avons comparé la croissance virale en culture cellulaire, les valeurs de cycle seuil de test d’amplification en chaîne par polymérase couplé à une transcription inverse (RT-PCR) de l’enveloppe (E) du gène du SRAS-CoV-2 et de la dose infectieuse pour 50 % de la culture tissulaire (DICT50/mL) entre les adultes et les enfants. RÉSULTATS: Parmi les 305 échantillons positifs à la présence du SRAS-CoV-2 validés par RT-PCR, 97 échantillons provenaient d’enfants de 10 ans et moins, 78 échantillons d’enfants de 11–17 ans et 130 échantillons d’adultes (≥ 18 ans). On a observé une croissance virale en culture dans 31 % des échantillons, dont 18 (19 %) échantillons d’enfants de 10 ans et moins, 18 (23 %) d’enfants de 11–17 ans et 57 (44 %) d’adultes (enfants c. adultes, rapport de cotes 0,45; intervalle de confiance [IC] à 95 % 0,28–0,72). Le cycle seuil était de 25,1 (IC à 95 % 17,7–31,3) chez les enfants de 10 ans et moins, 22,2 (IC à 95 % 18,3–29,0) chez les enfants de 11–17 ans et 18,7 (IC à 95 % 17,9–30,4) chez les adultes (p < 0,001). La DICT50/mL médiane était considérablement plus faible chez les enfants de 11–17 ans (316, écart interquartile [EI] 178–2125) que chez les adultes (5620, EI 1171–17 800, p < 0,001). Le cycle seuil était un indicateur exact d’une culture positive chez les enfants et les adultes (aire sous la courbe de la fonction d’efficacité du récepteur, 0,87, IC à 95 % 0,81–0,93 c. 0,89, IC à 95 % 0,83–0,96, p = 0,6). INTERPRÉTATION: Comparés aux adultes, les enfants qui ont obtenu un résultat positif à un test de dépistage du SRAS-CoV-2 à l’aide d’un écouvillon nasopharyngé étaient moins susceptibles de présenter une croissance du virus en culture et obtenaient un cycle seuil plus élevé et une concentration virale moins élevée, indiquant que les enfants ne sont pas les principaux vecteurs de la transmission du SRAS-CoV-2.
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Affiliation(s)
- Jared Bullard
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man.
| | - Duane Funk
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Kerry Dust
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Lauren Garnett
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Kaylie Tran
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Alex Bello
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - James E Strong
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Santina J Lee
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Jillian Waruk
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Adam Hedley
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - David Alexander
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Paul Van Caeseele
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Carla Loeppky
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
| | - Guillaume Poliquin
- Laboratoire provincial Cadham (Bullard, Dust, Hedley, Alexander, Van Caeseele), Santé Manitoba, Département de pédiatrie et de santé de l'enfant (Bullard, Strong, Lee, Van Caeseele, Poliquin), Université du Manitoba; Laboratoire national de microbiologie (Funk, Garnett, Tran, Bello, Strong, Poliquin), Agence de la santé publique du Canada; Département d'anesthésiologie et de médecine (Funk), section des soins intensifs, Université du Manitoba; Département de microbiologie médicale et des maladies infectieuses (Garnett, Tran, Bello, Alexander), Université du Manitoba; Contrôle des maladies transmissibles, Santé publique (Lee), Santé Manitoba; Unité d'épidémiologie et de surveillance (Waruk, Loeppky), Santé Manitoba; Département des sciences en santé communautaire (Loeppky), University of Manitoba, Winnipeg, Man
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9
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Vesikari T, Langley JM, Segall N, Ward BJ, Cooper C, Poliquin G, Smith B, Gantt S, McElhaney JE, Dionne M, van Damme P, Leroux-Roels I, Leroux-Roels G, Machluf N, Spaans JN, Yassin-Rajkumar B, Anderson DE, Popovic V, Diaz-Mitoma F. Immunogenicity and safety of a tri-antigenic versus a mono-antigenic hepatitis B vaccine in adults (PROTECT): a randomised, double-blind, phase 3 trial. Lancet Infect Dis 2021; 21:1271-1281. [PMID: 33989539 DOI: 10.1016/s1473-3099(20)30780-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/31/2020] [Accepted: 09/25/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The seroprotection rate (SPR) of hepatitis B vaccination in adults is suboptimal. The aim of this study was to compare the SPR of a tri-antigenic hepatitis B vaccine (TAV), with a mono-antigenic vaccine (MAV) in adults of all ages. METHODS This was a multicentre, double-blind, phase 3, randomised controlled trial (PROTECT) comparing the immunogenicity and safety of TAV with MAV in 28 community and hospital sites in the USA, Finland, Canada, and Belgium. Adults (aged ≥18 years) seronegative for hepatitis B virus (HBV), including those with well-controlled common chronic conditions, were randomly assigned (1:1) and stratified by study centre and age according to a web-based permuted blocked randomisation. Participants received either TAV or MAV which were administered as an intramuscular dose (1 mL) of TAV (10 μg; Sci-B-Vac, VBI Vaccines [SciVac, Rehovot, Israel]) or MAV (20 μg; Engerix-B [GlaxoSmithKline Biologicals, Rixensart, Belgium]) on days 0, 28, and 168 with six study visits and 24 weeks of follow-up after the third vaccination. Participants, investigators, and those assessing outcomes were masked to group assignment. The co-primary outcomes were to show non-inferiority of the SPRs 4 weeks after the third vaccination with TAV versus MAV in adults aged 18 years and older, as well as superiority in adults aged 45 years and older. SPR was defined as the percentage of participants attaining anti-HBs titres of 10 mIU/mL or higher. Non-inferiority of TAV to MAV was concluded if the lower limit of the 95% CI for the between-group difference was greater than -5%. Non-inferiority was assessed in the per-protocol set of participants (aged ≥18 years) and superiority was assessed in all participants (aged ≥45 years) who received at least one vaccination and had at least one evaluable immunogenicity sample after baseline (full analysis set). Safety analyses were a secondary outcome and included all participants who received at least one injection. This trial is registered at Clinicaltrials.gov (NCT03393754) and EudraCT (2017-001819-36) and is closed to new participants. FINDINGS Between Dec 13, 2017, and April 8, 2019, 1607 participants (796 allocated to TAV and 811 allocated to MAV) were randomly assigned and distributed across age cohorts of 18-44 years (299 of 1607; 18·6%), 45-64 years (716 of 1607; 44·6%), and 65 years and older (592 of 1607; 36·8%). In participants aged 18 years and older, SPR was 91·4% (656 of 718) in the TAV group versus 76·5% (553 of 723) in the MAV group (difference 14·9%, 95% CI 11·2-18·6), showing non-inferiority in the per-protocol set. In participants aged 45 years and older, SPR was 89·4% (559 of 625) in the TAV group versus 73·1% (458 of 627) in the MAV group (difference 16·4%, 95% CI 12·2-20·7), showing superiority in the full analysis set. TAV was associated with higher rates of mild or moderate injection site pain (63·2% [503 of 796] in TAV vs 36·3% [294 of 811] in MAV), tenderness (60·8% [484 of 796] in TAV vs 34·8% [282 of 811] in MAV), and myalgia (34·7% [276 of 796] vs 24·3% [197 of 811] in MAV). Otherwise, the safety profile of TAV was similar to that of MAV. INTERPRETATION The safety and efficacy of TAV shows its usefulness for the prevention of HBV infection in adults, including those with stable and controlled chronic conditions. FUNDING VBI Vaccines.
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Affiliation(s)
| | - Joanne M Langley
- Departments of Pediatrics and Community Health and Epidemiology, Canadian Center for Vaccinology, Halifax, NS, Canada
| | | | - Brian J Ward
- McGill University Health Centre-Vaccine Study Centre, Montreal, QC, Canada
| | - Curtis Cooper
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Guillaume Poliquin
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Bruce Smith
- Department of Mathematics and Statistics, Dalhousie University, Halifax, NS, Canada
| | - Soren Gantt
- BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | | | - Marc Dionne
- University of Laval, Quebec City, QC, Canada
| | - Pierre van Damme
- University of Antwerp-Center for the Evaluation of Vaccination, Universiteitsplein, Wilrijk, Belgium
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10
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Caulley L, Shaw J, Corsten M, Hua N, Angel JB, Poliquin G, Whelan J, Antonation K, Johnson-Obaseki S. Salivary testing of COVID-19: evaluation of serological testing following positive salivary results. BMC Infect Dis 2021; 21:410. [PMID: 33947347 PMCID: PMC8093594 DOI: 10.1186/s12879-021-06108-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Salivary detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been proposed as an alternative to nasopharyngeal or oropharyngeal swab testing. Our group previously published a study demonstrating that both testing methods identified SARS-CoV-2 using polymerase chain reaction (PCR)-based detection methodology. We therefore conducted a follow-up study using antibody testing to evaluate the accuracy of saliva versus swabs for COVID-19 detection and the durability of antibody response. Methods Venous blood samples were collected from consenting participants and the presence of serum antibodies for SARS-CoV-2 was evaluated on a large, automated immunoassay platform by the Roche anti-SARS-CoV-2 qualitative assay (Roche Diagnostics, Laval Quebec). Individuals with a serum antibody cut-off index (COI) ≥ 1.0 were considered positive. Results In asymptomatic and mildly symptomatic patients with a previously positive standard swab and/or saliva SARS-CoV-2 PCR-test, 42 demonstrated antibodies with 13 patients positive by swab alone, and 8 patients positive by saliva alone. Conclusions Despite their status as ‘current standard’ for COVID-19 testing, these findings highlight limitations of PCR-based tests.
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Affiliation(s)
- Lisa Caulley
- Department of Otolaryngology - Head and Neck Surgery, University of Ottawa, 501 Smyth Rd, Ottawa, K1H8L1, Canada
| | - Julie Shaw
- Department of Pathology and Laboratory Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H8L1, Canada
| | - Martin Corsten
- Division of Otolaryngology - Head and Neck Surgery, Dalhousie University, 6299 South St, Halifax, B3F4R2, Canada
| | - Nadia Hua
- Department of Otolaryngology - Head and Neck Surgery, University of Ottawa, 501 Smyth Rd, Ottawa, K1H8L1, Canada
| | - Jonathan B Angel
- Division of Infectious Diseases, University of Ottawa, 451 Smyth Road, Ottawa, K1H8L1, Canada.,Chronic Disease Program, Ottawa Hospital Research Institute, 1053 Carling Ave, Ottawa, K1H8L1, Canada
| | - Guillaume Poliquin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington St, Winnipeg, R3E3M4, Canada.,Department of Pediatrics & Child Health, University of Manitoba, 66 Chancellors Cir, Winnipeg, R3T2N2, Canada
| | - Jonathan Whelan
- Department of Undergraduate Medical Education, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H8L1, Canada
| | - Kym Antonation
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington St, Winnipeg, R3E3M4, Canada
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology - Head and Neck Surgery, University of Ottawa, 501 Smyth Rd, Ottawa, K1H8L1, Canada.
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11
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Bullard J, Funk D, Dust K, Garnett L, Tran K, Bello A, Strong JE, Lee SJ, Waruk J, Hedley A, Alexander D, Van Caeseele P, Loeppky C, Poliquin G. Infectivity of severe acute respiratory syndrome coronavirus 2 in children compared with adults. CMAJ 2021; 193:E601-E606. [PMID: 33837039 PMCID: PMC8101972 DOI: 10.1503/cmaj.210263] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: The role of children in the transmission and community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. We aimed to quantify the infectivity of SARS-CoV-2 in nasopharyngeal samples from children compared with adults. METHODS: We obtained nasopharyngeal swabs from adult and pediatric cases of coronavirus disease 2019 (COVID-19) and from their contacts who tested positive for SARS-CoV-2 in Manitoba between March and December 2020. We compared viral growth in cell culture, cycle threshold values from the reverse transcription polymerase chain reaction (RT-PCR) of the SARS-CoV-2 envelope (E) gene and the 50% tissue culture infective dose (TCID50/mL) between adults and children. RESULTS: Among 305 samples positive for SARS-CoV-2 by RT-PCR, 97 samples were from children aged 10 years or younger, 78 were from children aged 11–17 years and 130 were from adults (≥ 18 yr). Viral growth in culture was present in 31% of samples, including 18 (19%) samples from children 10 years or younger, 18 (23%) from children aged 11–17 years and 57 (44%) from adults (children v. adults, odds ratio 0.45, 95% confidence interval [CI] 0.28–0.72). The cycle threshold was 25.1 (95% CI 17.7–31.3) in children 10 years or younger, 22.2 (95% CI 18.3–29.0) in children aged 11–17 years and 18.7 (95% CI 17.9–30.4) in adults (p < 0.001). The median TCID50/mL was significantly lower in children aged 11–17 years (316, interquartile range [IQR] 178–2125) than adults (5620, IQR 1171 to 17 800, p < 0.001). Cycle threshold was an accurate predictor of positive culture in both children and adults (area under the receiver-operator curve, 0.87, 95% CI 0.81–0.93 v. 0.89, 95% CI 0.83–0.96, p = 0.6). INTERPRETATION: Compared with adults, children with nasopharyngeal swabs that tested positive for SARS-CoV-2 were less likely to grow virus in culture, and had higher cycle thresholds and lower viral concentrations, suggesting that children are not the main drivers of SARS-CoV-2 transmission.
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Affiliation(s)
- Jared Bullard
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man.
| | - Duane Funk
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Kerry Dust
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Lauren Garnett
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Kaylie Tran
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Alex Bello
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - James E Strong
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Santina J Lee
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Jillian Waruk
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Adam Hedley
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - David Alexander
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Paul Van Caeseele
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Carla Loeppky
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
| | - Guillaume Poliquin
- Cadham Provincial Laboratory (Bullard, Dust, Hedley, Alexander, Van Caeseele), Manitoba Health; Department of Pediatrics & Child Health (Bullard, Strong, Lee, Van Caeseele, Poliquin), University of Manitoba; National Microbiology Laboratory (Funk, Garnett, Tran, Bello, Strong, Poliquin), Public Health Agency of Canada; Departments of Anesthesiology and Medicine (Funk), Section of Critical Care, University of Manitoba; Department of Medical Microbiology & Infectious Diseases (Garnett, Tran, Bello, Alexander), University of Manitoba; Communicable Disease Control, Public Health (Lee), Manitoba Health; Epidemiology and Surveillance Unit (Waruk, Loeppky), Manitoba Health; Department of Community Health Science (Loeppky), University of Manitoba. Winnipeg, Man
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12
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Bullard J, Dust K, Funk D, Strong JE, Alexander D, Garnett L, Boodman C, Bello A, Hedley A, Schiffman Z, Doan K, Bastien N, Li Y, Van Caeseele PG, Poliquin G. Predicting Infectious Severe Acute Respiratory Syndrome Coronavirus 2 From Diagnostic Samples. Clin Infect Dis 2021; 71:2663-2666. [PMID: 32442256 PMCID: PMC7314198 DOI: 10.1093/cid/ciaa638] [Citation(s) in RCA: 870] [Impact Index Per Article: 290.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/21/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Reverse-transcription polymerase chain reaction (RT-PCR) has become the primary method to diagnose viral diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). RT-PCR detects RNA, not infectious virus; thus, its ability to determine duration of infectivity of patients is limited. Infectivity is a critical determinant in informing public health guidelines/interventions. Our goal was to determine the relationship between E gene SARS-CoV-2 RT-PCR cycle threshold (Ct) values from respiratory samples, symptom onset to test (STT), and infectivity in cell culture. METHODS In this retrospective cross-sectional study, we took SARS-CoV-2 RT-PCR-confirmed positive samples and determined their ability to infect Vero cell lines. RESULTS Ninety RT-PCR SARS-CoV-2-positive samples were incubated on Vero cells. Twenty-six samples (28.9%) demonstrated viral growth. Median tissue culture infectious dose/mL was 1780 (interquartile range, 282-8511). There was no growth in samples with a Ct > 24 or STT > 8 days. Multivariate logistic regression using positive viral culture as a binary predictor variable, STT, and Ct demonstrated an odds ratio (OR) for positive viral culture of 0.64 (95% confidence interval [CI], .49-.84; P < .001) for every 1-unit increase in Ct. Area under the receiver operating characteristic curve for Ct vs positive culture was OR, 0.91 (95% CI, .85-.97; P < .001), with 97% specificity obtained at a Ct of > 24. CONCLUSIONS SARS-CoV-2 Vero cell infectivity was only observed for RT-PCR Ct < 24 and STT < 8 days. Infectivity of patients with Ct > 24 and duration of symptoms > 8 days may be low. This information can inform public health policy and guide clinical, infection control, and occupational health decisions. Further studies of larger size are needed.
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Affiliation(s)
- Jared Bullard
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Kerry Dust
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Canada
| | - Duane Funk
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Anaesthesiology and Medicine, Section of Critical Care, University of Manitoba, Winnipeg, Canada
| | - James E Strong
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - David Alexander
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Lauren Garnett
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Carl Boodman
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Alexander Bello
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Adam Hedley
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Canada
| | - Zachary Schiffman
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Kaylie Doan
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nathalie Bastien
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Yan Li
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Paul G Van Caeseele
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Guillaume Poliquin
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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13
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Affiliation(s)
- Lisa Caulley
- University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (L.C., J.B.A.)
| | - Martin Corsten
- Dalhousie University, Halifax, Nova Scotia, Canada (M.C.)
| | - Libni Eapen
- University of Ottawa, Ottawa, Ontario, Canada (L.E., J.W., S.J.)
| | - Jonathan Whelan
- University of Ottawa, Ottawa, Ontario, Canada (L.E., J.W., S.J.)
| | - Jonathan B Angel
- University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (L.C., J.B.A.)
| | - Kym Antonation
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada (K.A., N.B.)
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada (K.A., N.B.)
| | - Guillaume Poliquin
- National Microbiology Laboratory, Public Health Agency of Canada, and University of Manitoba, Winnipeg, Manitoba, Canada (G.P.)
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14
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Ranadheera C, Valcourt EJ, Warner BM, Poliquin G, Rosenke K, Frost K, Tierney K, Saturday G, Miao J, Westover JB, Gowen BB, Booth S, Feldmann H, Wang Z, Safronetz D. Characterization of a novel STAT 2 knock-out hamster model of Crimean-Congo hemorrhagic fever virus pathogenesis. Sci Rep 2020; 10:12378. [PMID: 32704046 PMCID: PMC7378551 DOI: 10.1038/s41598-020-69054-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Received: 05/12/2020] [Accepted: 06/30/2020] [Indexed: 01/30/2023] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne pathogen causing a febrile illness in humans, which can progress to hemorrhagic manifestations, multi-organ failure, and death. Current mouse models of CCHFV infection reliably succumb to virus challenge but vary in their ability to reflect signs of disease similar to humans. In this study, we established a signal transducer and activator of transcription 2 (STAT2) knockout hamster model to expand the repertoire of animal models of CCHFV pathogenesis that can be used for therapeutic development. These hamsters demonstrated a systemic and lethal disease in response to infection. Hallmarks of human disease were observed including petechial rash, blood coagulation dysfunction, and various biochemistry and blood cell count abnormalities. Furthermore, we also demonstrated the utility of this model for anti-CCHFV therapeutic evaluation. The STAT2 knock-out hamster model of CCHFV infection may provide some further insights into clinical disease, viral pathogenesis, and pave the way for testing of potential drug and vaccine candidates.
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Affiliation(s)
- Charlene Ranadheera
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada.,Bioforensics Assay Development and Diagnostics, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Emelissa J Valcourt
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Bryce M Warner
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada.,Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Guillaume Poliquin
- Office of the Scientific Director, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Kyle Rosenke
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Kathy Frost
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Kevin Tierney
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Greg Saturday
- Rocky Mountain Veterinary Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Jinxin Miao
- Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT, USA.,Department of Pathology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450066, People's Republic of China
| | - Jonna B Westover
- Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT, USA
| | - Brian B Gowen
- Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT, USA
| | - Stephanie Booth
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada.,Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Zhongde Wang
- Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT, USA
| | - David Safronetz
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratories, Public Health Agency of Canada, Winnipeg, MB, Canada. .,Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada.
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15
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Poliquin G, Funk D, Jones S, Tran K, Ranadheera C, Hagan M, Tierney K, Grolla A, Dhaliwal A, Bello A, Leung A, Nakamura C, Kobasa D, Falzarano D, Garnett L, Bovendo HF, Feldmann H, Kesselman M, Hansen G, Gren J, Risi G, Biondi M, Mortimer T, Racine T, Deschambault Y, Aminian S, Edmonds J, Saurette R, Allan M, Rondeau L, Hadder S, Press C, DeGraff C, Kucas S, Cook BWM, Hancock BJ, Kumar A, Soni R, Schantz D, McKitrick J, Warner B, Griffin BD, Qiu X, Kobinger GP, Safronetz D, Stein D, Cutts T, Kenny J, Soule G, Kozak R, Theriault S, Menec L, Vendramelli R, Higgins S, Banadyga L, Liu G, Rahim MN, Kasloff S, Sloan A, He S, Tailor N, Albietz A, Pickering B, Wong G, Gray M, Strong JE. Correction to: Impact of intensive care unit supportive care on the physiology of Ebola virus disease in a universally lethal non-human primate model. Intensive Care Med Exp 2019; 7:66. [PMID: 31802320 PMCID: PMC6892986 DOI: 10.1186/s40635-019-0283-9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Guillaume Poliquin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Duane Funk
- Department of Anaesthesia and Medicine, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shane Jones
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Kaylie Tran
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Charlene Ranadheera
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Mable Hagan
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kevin Tierney
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Allen Grolla
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | | | - Alexander Bello
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Anders Leung
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Cory Nakamura
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Manitoba, Canada
| | - Darwyn Kobasa
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Darryl Falzarano
- Vaccine and Infectious Disease Organization-International Vaccine Centre, University of Saskatchewan, Saskatoon, Canada
| | - Lauren Garnett
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Hugues Fausther Bovendo
- Centre de Recherche en Infectiologie, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, USA
| | - Murray Kesselman
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gregory Hansen
- Faculty of Critical Care, Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Jason Gren
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - George Risi
- Infectious Disease Specialists, P.C., Missoula, MT, USA
| | - Mia Biondi
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Todd Mortimer
- Child & Women's Health Programme, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Trina Racine
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Centre de Recherche en Infectiologie, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Yvon Deschambault
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Sam Aminian
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Jocelyn Edmonds
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Ray Saurette
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Mark Allan
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Lauren Rondeau
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Sharron Hadder
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Christy Press
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Christine DeGraff
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Stephanie Kucas
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Bradley W M Cook
- Cytophage Technologies, Inc, St. Boniface Hospital, Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - B J Hancock
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Surgery, Division of Pediatric Surgery, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anand Kumar
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Reeni Soni
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Daryl Schantz
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jarrid McKitrick
- Regional Pharmacy, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Bryce Warner
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Bryan D Griffin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Xiangguo Qiu
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gary P Kobinger
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Centre de Recherche en Infectiologie, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Dave Safronetz
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Derek Stein
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Todd Cutts
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - James Kenny
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Geoff Soule
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Robert Kozak
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Steven Theriault
- Cytophage Technologies, Inc, St. Boniface Hospital, Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Liam Menec
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Robert Vendramelli
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Sean Higgins
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Logan Banadyga
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Guodong Liu
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Md Niaz Rahim
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Samantha Kasloff
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Angela Sloan
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Shihua He
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Nikesh Tailor
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Alixandra Albietz
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Brad Pickering
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Manitoba, Canada
| | - Gary Wong
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael Gray
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - James E Strong
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada. .,Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. .,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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16
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Poliquin G, Funk D, Jones S, Tran K, Ranadheera C, Hagan M, Tierney K, Grolla A, Dhaliwal A, Bello A, Leung A, Nakamura C, Kobasa D, Falzarano D, Garnett L, Bovendo HF, Feldmann H, Kesselman M, Hansen G, Gren J, Risi G, Biondi M, Mortimer T, Racine T, Deschambault Y, Aminian S, Edmonds J, Sourette R, Allan M, Rondeau L, Hadder S, Press C, DeGraff C, Kucas S, Cook BWM, Hancock BJ, Kumar A, Soni R, Schantz D, McKitrick J, Warner B, Griffin BD, Qiu X, Kobinger GP, Safronetz D, Stein D, Cutts T, Kenny J, Soule G, Kozak R, Theriault S, Menec L, Vendramelli R, Higgins S, Liu G, Rahim NM, Kasloff S, Sloan A, He S, Tailor N, Gray M, Strong JE. Impact of intensive care unit supportive care on the physiology of Ebola virus disease in a universally lethal non-human primate model. Intensive Care Med Exp 2019; 7:54. [PMID: 31520194 PMCID: PMC6744539 DOI: 10.1186/s40635-019-0268-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/23/2019] [Accepted: 08/28/2019] [Indexed: 11/26/2022] Open
Abstract
Background There are currently limited data for the use of specific antiviral therapies for the treatment of Ebola virus disease (EVD). While there is anecdotal evidence that supportive care may be effective, there is a paucity of direct experimental data to demonstrate a role for supportive care in EVD. We studied the impact of ICU-level supportive care interventions including fluid resuscitation, vasoactive medications, blood transfusion, hydrocortisone, and ventilator support on the pathophysiology of EVD in rhesus macaques infected with a universally lethal dose of Ebola virus strain Makona C07. Methods Four NHPs were infected with a universally lethal dose Ebola virus strain Makona, in accordance with the gold standard lethal Ebola NHP challenge model. Following infection, the following therapeutic interventions were employed: continuous bedside supportive care, ventilator support, judicious fluid resuscitation, vasoactive medications, blood transfusion, and hydrocortisone as needed to treat cardiovascular compromise. A range of physiological parameters were continuously monitored to gage any response to the interventions. Results All four NHPs developed EVD and demonstrated a similar clinical course. All animals reached a terminal endpoint, which occurred at an average time of 166.5 ± 14.8 h post-infection. Fluid administration may have temporarily blunted a rise in lactate, but the effect was short lived. Vasoactive medications resulted in short-lived improvements in mean arterial pressure. Blood transfusion and hydrocortisone did not appear to have a significant positive impact on the course of the disease. Conclusions The model employed for this study is reflective of an intramuscular infection in humans (e.g., needle stick) and is highly lethal to NHPs. Using this model, we found that the animals developed progressive severe organ dysfunction and profound shock preceding death. While the overall impact of supportive care on the observed pathophysiology was limited, we did observe some time-dependent positive responses. Since this model is highly lethal, it does not reflect the full spectrum of human EVD. Our findings support the need for continued development of animal models that replicate the spectrum of human disease as well as ongoing development of anti-Ebola therapies to complement supportive care. Electronic supplementary material The online version of this article (10.1186/s40635-019-0268-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guillaume Poliquin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Duane Funk
- Department of Anaesthesia and Medicine, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shane Jones
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Kaylie Tran
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Charlene Ranadheera
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Mable Hagan
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kevin Tierney
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Allen Grolla
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | | | - Alexander Bello
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Anders Leung
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Cory Nakamura
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Manitoba, Canada
| | - Darwyn Kobasa
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Darryl Falzarano
- Vaccine and Infectious Disease Organization-International Vaccine Centre, University of Saskatchewan, Saskatoon, Canada
| | - Lauren Garnett
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Hugues Fausther Bovendo
- Centre de Recherche en Infectiologie, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, USA
| | - Murray Kesselman
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gregory Hansen
- Faculty of Critical Care, Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Jason Gren
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - George Risi
- Infectious Disease Specialists, P.C., Missoula, MT, USA
| | - Mia Biondi
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada.,Child & Women's Health Programme, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Todd Mortimer
- Child & Women's Health Programme, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Trina Racine
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Centre de Recherche en Infectiologie, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Yvon Deschambault
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Sam Aminian
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Jocelyn Edmonds
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Ray Sourette
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Mark Allan
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Lauren Rondeau
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Sharron Hadder
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Christy Press
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Christine DeGraff
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Stephanie Kucas
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Bradley W M Cook
- Cytophage Technologies, Inc., St. Boniface Hospital, Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - B J Hancock
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Surgery, Division of Pediatric Surgery, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anand Kumar
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Reeni Soni
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Darryl Schantz
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jarrid McKitrick
- Regional Pharmacy, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Bryce Warner
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Bryan D Griffin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Xiangguo Qiu
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gary P Kobinger
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Centre de Recherche en Infectiologie, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Dave Safronetz
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Derek Stein
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Todd Cutts
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - James Kenny
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Geoff Soule
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Robert Kozak
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Steven Theriault
- Cytophage Technologies, Inc., St. Boniface Hospital, Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Liam Menec
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Robert Vendramelli
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Sean Higgins
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Guodong Liu
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Niaz Md Rahim
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Samantha Kasloff
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Angela Sloan
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Shihua He
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Nikesh Tailor
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Michael Gray
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - James E Strong
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 rue Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada. .,Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. .,Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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17
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Stein DR, Sroga P, Warner BM, Deschambault Y, Poliquin G, Safronetz D. Evaluating Temperature Sensitivity of Vesicular Stomatitis Virus-Based Vaccines. Emerg Infect Dis 2019; 25:1563-1566. [PMID: 31141474 PMCID: PMC6649338 DOI: 10.3201/eid2508.190281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/18/2022] Open
Abstract
Use of the vesicular stomatitis virus (VSV)-based Ebola virus vaccine during outbreaks and the potential use of a similar VSV-based Lassa virus vaccine has raised questions about the vaccines' stability should the cold chain fail. We demonstrated that current cold chain conditions might tolerate significant variances without affecting efficacy.
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18
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Warner BM, Stein DR, Griffin BD, Tierney K, Leung A, Sloan A, Kobasa D, Poliquin G, Kobinger GP, Safronetz D. Development and Characterization of a Sin Nombre Virus Transmission Model in Peromyscus maniculatus. Viruses 2019; 11:v11020183. [PMID: 30795592 PMCID: PMC6409794 DOI: 10.3390/v11020183] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 01/24/2019] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022] Open
Abstract
In North America, Sin Nombre virus (SNV) is the main cause of hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory disease with a fatality rate of 35–40%. SNV is a zoonotic pathogen carried by deer mice (Peromyscus maniculatus), and few studies have been performed examining its transmission in deer mouse populations. Studying SNV and other hantaviruses can be difficult due to the need to propagate the virus in vivo for subsequent experiments. We show that when compared with standard intramuscular infection, the intraperitoneal infection of deer mice can be as effective in producing SNV stocks with a high viral RNA copy number, and this method of infection provides a more reproducible infection model. Furthermore, the age and sex of the infected deer mice have little effect on viral replication and shedding. We also describe a reliable model of direct experimental SNV transmission. We examined the transmission of SNV between deer mice and found that direct contact between deer mice is the main driver of SNV transmission rather than exposure to contaminated excreta/secreta, which is thought to be the main driver of transmission of the virus to humans. Furthermore, increases in heat shock responses or testosterone levels in SNV-infected deer mice do not increase the replication, shedding, or rate of transmission. Here, we have demonstrated a model for the transmission of SNV between deer mice, the natural rodent reservoir for the virus. The use of this model will have important implications for further examining SNV transmission and in developing strategies for the prevention of SNV infection in deer mouse populations.
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Affiliation(s)
- Bryce M Warner
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
| | - Derek R Stein
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
| | - Bryan D Griffin
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
| | - Kevin Tierney
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
| | - Anders Leung
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
| | - Angela Sloan
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
| | - Darwyn Kobasa
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
| | - Guillaume Poliquin
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
| | - Gary P Kobinger
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
- Centre de Recherche en Infectiologie, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC G1V 0A6 Canada.
| | - David Safronetz
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E3R2, Canada.
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19
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Hamm C, El-Masri M, Poliquin G, Poliquin V, Mathews J, Kanjeekal S, Alam Y, Kulkarni S, Elfiki T. A single-centre chart review exploring the adjusted association between breast cancer phenotype and prognosis. ACTA ACUST UNITED AC 2011; 18:191-6. [PMID: 21874118 DOI: 10.3747/co.v18i4.815] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE AND METHODS Using a retrospective chart review, we investigated the differences in survival and prognostic factors between patients with triple-negative breast cancer (tnbc) and those with non-tnbc. The review included 1018 breast cancer patients who were diagnosed between 2000 and 2005 in Essex, Kent, and Lambton counties in Ontario, Canada. RESULTS Our findings indicate that, although the unadjusted results suggested that patients with tnbc were more likely than patients with non-tnbc to die [hazard ratio (hr): 2.29; 95% confidence interval (ci): 1.33 to 2.93], an adjusted survival analysis revealed no significant difference in overall survival between the groups (hr: 1.22; 95% ci: 0.63 to 2.39). The significant predictors of survival in the adjusted analysis were age, stage of cancer, and size of cancer. CONCLUSIONS Our findings support those of earlier reports, which suggest that presenting tumour size is the most important prognostic factor in tnbc. Investigations into unique screening methods to identify these tumours at an earlier stage and to prevent advanced-stage cancer in this patient subpopulation are necessary.
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Affiliation(s)
- C Hamm
- University of Western Ontario, London, ON
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20
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Hamm CM, Poliquin G, Poliquin V, El-masri M. Abstract P5-03-05: Triple Negative Breast Cancer: Prognosis Dependent on Presenting Stage Rather Than Receptor Status. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p5-03-05] [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: 11/16/2022]
Abstract
Abstract
Purpose: To investigate the differences in survival and prognostic factors such as age at diagnosis, stage, size of tumor, mode of identification, treatment and family history between patients that have triple negative breast cancer (TNBC) and those who are not (at least one positive marker).
Methods: a retrospective chart review was conducted on 1018 eligible breast cancer patients who were diagnosed between 2000 and 2005 in Essex, Kent, and Lambton counties in Ontario.
Results: Our demographic findings supported those of previous publications whereby age at diagnosis was younger for TNBC patients (53.2 vs 60.9 respectively; p < 0.001). The frequency of stage III cancer was higher among TNBC patients than that of other cancer patients (16.2% and
6.3%, respectively; p > 0.001). Frequency of self detection was higher among TNBC patients compared to patients with other cancers (76.8% and 56.4%, respectively; p <.001). Perhaps most importantly, while TNBC had had HR of 2.29 (95%CI = 1.33 - 2.93), the adjusted survival analysis suggested that there was no significant difference in the overall survival between the two groups (HR = 1.22; 95%CI = .63 - 2.39). The significant predictors of survival in the adjusted analysis were; age, stage of cancer, and size of cancer.
Conclusions: We believe that this is the first indication that patients with TNBC do as well as their non-TNBC cohorts when matched for stage at presentation. Future studies need to focus on identification of patients who are at increased risk of TNBC so appropriate screening tests can be obtained.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-03-05.
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Affiliation(s)
- CM Hamm
- University of Western Ontario, Windsor, Canada; University of Windsor, ON, Canada
| | - G Poliquin
- University of Western Ontario, Windsor, Canada; University of Windsor, ON, Canada
| | - V Poliquin
- University of Western Ontario, Windsor, Canada; University of Windsor, ON, Canada
| | - M. El-masri
- University of Western Ontario, Windsor, Canada; University of Windsor, ON, Canada
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