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Venâncio LGA, Muniz LF, Hora LCDD, Silva JDD, Cavalcanti GST, Leal MDC, Caldas Neto SDS. Does a patient with acquired arbovirus infection have a hearing impairment? A scoping review of hearing changes in an adult with Dengue, Chikungunya, and Zika. Braz J Otorhinolaryngol 2024; 90:101342. [PMID: 37879254 PMCID: PMC10598399 DOI: 10.1016/j.bjorl.2023.101342] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/30/2023] [Accepted: 09/30/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVES To identify and understand the evidence regarding hearing changes related to acquired Dengue, Chikungunya, and Zika virus infection in adult individuals. METHODS A scoping review was performed according to the recommendations of The Joanna Briggs Institute and guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in the Embase, PubMed/Medline, ScienceDirect, Scopus, and Web of Science databases without restriction on language and year of publication. Case studies, observational studies, and clinical trials reporting hearing loss in adult subjects (>18-60 years of age) of both sexes with DENV, CHIKV, or ZIKV diagnosed by positive molecular/serological examination by RT-PCR or IgM/IgG by ELISA method were included. RESULTS Thirteen studies met the inclusion criteria and were selected for review. The occurrence of auditory symptoms caused by arboviroses and the presence of permanent or transient sensorineural hearing loss was variable in adults. CONCLUSIONS Dengue, Chikungunya, and Zika infections in adults are associated with a variety of auditory symptoms. The frequency of permanent or transient sensorineural hearing loss is low but not negligible.
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Karimi-Boroujeni M, Zahedi-Amiri A, Coombs KM. Embryonic Origins of Virus-Induced Hearing Loss: Overview of Molecular Etiology. Viruses 2021; 13:71. [PMID: 33419104 PMCID: PMC7825458 DOI: 10.3390/v13010071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022] Open
Abstract
Hearing loss, one of the most prevalent chronic health conditions, affects around half a billion people worldwide, including 34 million children. The World Health Organization estimates that the prevalence of disabling hearing loss will increase to over 900 million people by 2050. Many cases of congenital hearing loss are triggered by viral infections during different stages of pregnancy. However, the molecular mechanisms by which viruses induce hearing loss are not sufficiently explored, especially cases that are of embryonic origins. The present review first describes the cellular and molecular characteristics of the auditory system development at early stages of embryogenesis. These developmental hallmarks, which initiate upon axial specification of the otic placode as the primary root of the inner ear morphogenesis, involve the stage-specific regulation of several molecules and pathways, such as retinoic acid signaling, Sonic hedgehog, and Wnt. Different RNA and DNA viruses contributing to congenital and acquired hearing loss are then discussed in terms of their potential effects on the expression of molecules that control the formation of the auditory and vestibular compartments following otic vesicle differentiation. Among these viruses, cytomegalovirus and herpes simplex virus appear to have the most effect upon initial molecular determinants of inner ear development. Moreover, of the molecules governing the inner ear development at initial stages, SOX2, FGFR3, and CDKN1B are more affected by viruses causing either congenital or acquired hearing loss. Abnormalities in the function or expression of these molecules influence processes like cochlear development and production of inner ear hair and supporting cells. Nevertheless, because most of such virus-host interactions were studied in unrelated tissues, further validations are needed to confirm whether these viruses can mediate the same effects in physiologically relevant models simulating otic vesicle specification and growth.
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Affiliation(s)
- Maryam Karimi-Boroujeni
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Ali Zahedi-Amiri
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
| | - Kevin M. Coombs
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
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Wang C, Liu X, Wang S, Zhang W, Wang H, Ma W, Meng X, Xu X, Li Z, Pan QS, Wang P, Lin Q, Wang X, Amin M, Dollard S, Xu A, Chung W. Late-onset Hearing Loss From Congenital Cytomegalovirus Infection After Newborn Period in a Highly Immune Population in China. Pediatr Infect Dis J 2021; 40:70-73. [PMID: 33284252 PMCID: PMC8383185 DOI: 10.1097/inf.0000000000002922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
After following 141 children with likely asymptomatic congenital cytomegalovirus infection in a highly immune population in China, four children (2.8%) were found to have late-onset hearing loss. No maternal or childhood factors, except higher saliva cytomegalovirus viral load at birth (P = 0.03), were associated with increased risk of developing a hearing loss.
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Affiliation(s)
- Chengbin Wang
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xiaolin Liu
- Academy of Preventive Medicine, Shandong University
- Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong
| | - Shiwen Wang
- Chinese Center for Disease Control and Prevention, Beijing
| | - Wenqiang Zhang
- Academy of Preventive Medicine, Shandong University
- Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong
| | - Haiyan Wang
- Academy of Preventive Medicine, Shandong University
- Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong
| | - Wei Ma
- School of Public Health, Shandong University, Jinan
| | - Xiangxin Meng
- Pingyin County Center for Disease Control and Prevention, Pingyin
| | - Xingqu Xu
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Zhan Li
- Academy of Preventive Medicine, Shandong University
| | - Qiang Shuxia Pan
- Linyi Municipal Center for Disease Control and Prevention, Linyi
- Pingyin County Maternal and Children Healthcare and Family Planning Service Center, Pingyin
| | - Ping Wang
- Yinan County Maternal and Children Healthcare Center, Yinan
| | - Qian Lin
- Jinan Municipal Maternal and Children Healthcare Center, Jinan, Shandong, China
| | - Xiaofang Wang
- Chinese Center for Disease Control and Prevention, Beijing
| | - Minal Amin
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sheila Dollard
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aiqiang Xu
- Academy of Preventive Medicine, Shandong University
- Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong
| | - Winnie Chung
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Chen K, Zhong Y, Gu Y, Sharma R, Li M, Zhou J, Wu Y, Gao Y, Qin G. Estimated Cost-effectiveness of Newborn Screening for Congenital Cytomegalovirus Infection in China Using a Markov Model. JAMA Netw Open 2020; 3:e2023949. [PMID: 33275150 PMCID: PMC7718603 DOI: 10.1001/jamanetworkopen.2020.23949] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IMPORTANCE Congenital cytomegalovirus infection (cCMVi) is one of the most common infections associated with childhood hearing loss. Prevention and mitigation of cCMVi-related hearing loss will require an increase in newborn screening, which is not yet available in China. OBJECTIVE To estimate the cost-effectiveness of newborn screening strategies for cCMVi from the perspective of the Chinese health care system. DESIGN, SETTING, AND PARTICIPANTS A decision tree for a simulated cohort population of 15 000 000 live births was developed to compare the costs and health effects of 3 mutually exclusive interventions: (1) no screening, (2) targeted screening using CMV polymerase chain reaction assay for newborns who fail a universal hearing screening, and (3) universal screening for CMV among all newborns. Markov diagrams were used to evaluate the lifetime horizon (76 years). MAIN OUTCOMES AND MEASURES Cost, hearing-related health outcomes, and incremental cost-effectiveness ratios (ICERs) were estimated based on a direct medical costs perspective. Costs and ICERs were reported in 2018 US dollars. RESULTS Incidence of cCMVi among newborns was reported to be approximately 0.7% in China. Targeted screening was less costly but also less effective than universal screening, identifying 41% of cases needing antiviral treatment and preventing nearly half of less severe or profound hearing loss. To avoid 1 CMV-related severe or profound hearing loss, 13 and 16 newborns need to be treated by targeted and universal screening, respectively. The ICERs of targeted and universal screening vs no screening were $79 and $2087 per quality-adjusted life-year gained, respectively, at the discounted rate of 3.5%. Both screening options were cost-effective for the Chinese health care system based on the willingness-to-pay threshold of 3 × gross domestic product per capita. The sensitivity analysis showed that the prevalence of cCMVi, as well as diagnosis and treatment costs, were key factors that may be associated with decision-making. CONCLUSIONS AND RELEVANCE To achieve cost-effectiveness and best health outcomes, universal screening could be considered for the Chinese population. While the results are specific to China, the model may easily be adapted for other countries.
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Affiliation(s)
- Kai Chen
- Department of Internal Medicine, Nantong University Medical School, Nantong, Jiangsu, China
| | - Yaqin Zhong
- Department of Health Management, Nantong University School of Public Health, Nantong, Jiangsu, China
| | - Yuanyuan Gu
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | - Rajan Sharma
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | - Muting Li
- Department of Health Management, Nantong University School of Public Health, Nantong, Jiangsu, China
| | - Jinjun Zhou
- Department of Pediatrics, Nantong Maternal and Child Health Hospital, Nantong University, Nantong, Jiangsu, China
| | - Youjia Wu
- Department of Pediatrics, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Yuexia Gao
- Department of Health Management, Nantong University School of Public Health, Nantong, Jiangsu, China
| | - Gang Qin
- Department of Infectious Diseases, Nantong Third People’s Hospital Affiliated to Nantong University, Nantong, Jiangsu, China
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Ficenec SC, Percak J, Arguello S, Bays A, Goba A, Gbakie M, Shaffer JG, Emmett SD, Schieffelin JS, Bausch D. Lassa Fever Induced Hearing Loss: The Neglected Disability of Hemorrhagic Fever. Int J Infect Dis 2020; 100:82-87. [PMID: 32795603 PMCID: PMC7807889 DOI: 10.1016/j.ijid.2020.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/27/2020] [Accepted: 08/07/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Lassa fever (LF) a hemorrhagic fever endemic to Western has an incidence of approximately 500,000 cases per year. Here, we evaluate hearing loss and other sequelae following LF. METHODS This case-control study enrolled laboratory confirmed LF survivors, non-LF Febrile controls and Matched Community controls with no history of LF or recent hospitalization for a febrile illness. Study participants completed a symptom questionnaire. Pure-tone audiometry was completed by a subset of participants. RESULTS One hundred forty-seven subjects were enrolled aged from 3-66 years (mean = 23.3). LF survivors were significantly more likely to report balance difficulties (55% vs 20%, p < 0.001), hair loss (32% vs 7%, p < 0.001), difficulty speaking (19% vs 1%, p < 0.001), social isolation (50% vs 0%, p < 0.001), and hearing loss (17% vs 1%, p = 0.002) in comparison to Matched-Community Controls. Similar trends were noted in comparison to Febrile Controls, although these findings were non-significant. Fifty subjects completed audiometry. Audiometry found that LF survivors had significantly more bilateral hearing loss in comparison to Matched-Community Controls (30% vs 4%, p = 0.029). CONCLUSION This study characterizes the sequelae of LF and highlights the need for increased access to hearing care in West Africa.
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Affiliation(s)
| | - Jeffrey Percak
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Sara Arguello
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Alison Bays
- Division of Rheumatology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | | | | | - Jeffrey G Shaffer
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Susan D Emmett
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
| | | | - Daniel Bausch
- Tulane Viral Hemorrhagic Fever Research Program, Kenema Government Hospital, Kenema, Sierra Leone
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Sattler RA, Maruyama J, Shehu NY, Makishima T, Paessler S. Current small animal models for LASV hearing loss. Curr Opin Virol 2019; 37:118-122. [PMID: 31479989 DOI: 10.1016/j.coviro.2019.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 11/20/2022]
Abstract
Lassa virus (LASV) is endemic in West Africa, causing an estimated 100000-300000 new infections and up to 5000-10000 deaths yearly. There are no vaccines and therapeutics are extremely limited. Typical case fatality rates are ∼1%, although a recent 2018 Nigerian outbreak featured an unprecedented 25.4% case fatality rate. Survivors of infection suffer a lifetime of sequelae with sudden onset sensorineural hearing loss (SNHL) being the most prevalent. The cause of this hearing loss remains unknown, and there is a critical need for further research on its mechanisms and potential therapeutics. The objective of this review is to outline the only currently available small animal model for LASV-induced hearing loss and to identify potential surrogate models.
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Affiliation(s)
- Rachel A Sattler
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Nathan Y Shehu
- Department of Medicine, Infectious Disease Unit, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA.
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Leal MC, Muniz LF, Ferreira TSA, Santos CM, Almeida LC, Van Der Linden V, Ramos RCF, Rodrigues LC, Neto SSC. Hearing Loss in Infants with Microcephaly and Evidence of Congenital Zika Virus Infection - Brazil, November 2015-May 2016. MMWR Morb Mortal Wkly Rep 2016; 65:917-9. [PMID: 27585248 DOI: 10.15585/mmwr.mm6534e3] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Congenital infection with Zika virus causes microcephaly and other brain abnormalities (1). Hearing loss associated with other congenital viral infections is well described; however, little is known about hearing loss in infants with congenital Zika virus infection. A retrospective assessment of a series of 70 infants aged 0-10 months with microcephaly and laboratory evidence of Zika virus infection was conducted by the Hospital Agamenon Magalhães in Brazil and partners. The infants were enrolled during November 2015-May 2016 and had screening and diagnostic hearing tests. Five (7%) infants had sensorineural hearing loss, all of whom had severe microcephaly; however, one child was tested after receiving treatment with an ototoxic antibiotic. If this child is excluded, the prevalence of sensorineural hearing loss was 5.8% (four of 69), which is similar to that seen in association with other congenital viral infections. Additional information is needed to understand the prevalence and spectrum of hearing loss in children with congenital Zika virus infection; all infants born to women with evidence of Zika virus infection during pregnancy should have their hearing tested, including infants who appear normal at birth.
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8
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Li X, Shi X, Wang C, Niu H, Zeng L, Qiao Y, Xu K. Pathological changes of the inner ear cochlea in different time windows of murine cytomegalovirus-induced hearing loss in a mouse model. Acta Otolaryngol 2015; 135:536-41. [PMID: 25761153 DOI: 10.3109/00016489.2014.995830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Murine congenital cytomegalovirus (CMV) (MCMV) infection of the inner ear cochlea, which caused continuous pathological change, occurred on the third day after intracerebral injection and persisted for a very long time. OBJECTIVE Our study used the MCMV-induced hearing loss neonatal mouse model to investigate the pathological changes of the cochlea in different time windows. METHODS Sixty newborn BALB/c mice were randomly and equally divided into the experimental group (MCMV intracerebral injection) and control group (normal saline intracerebral injection). At 1, 3, 5, 7, and 21 days after intracerebral injection, cochleas were extracted and evaluated by MCMV-DNA PCR analysis and histopathological examination. RESULTS Two mice died before the end of the experiment in the experimental group, while there were no deaths in the control group. In the experimental group, the MCMV-DNA PCR samples did not show positive results in the gel electrophoresis until the 3-21 days after intracerebral injection, while no positive result was found in the control group. Pathological changes including hemorrhage and inflammatory cell infiltration of the scala vestibule and scala tympani began on the third day, spiral ganglion cell gap widening and cell thinning began on the seventh day, and scala tympani fibrosis began on the 14th day.
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Affiliation(s)
- Xuanyi Li
- Department of Otolaryngology, Affiliated Hospital of Xuzhou Medical College
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Bradford RD, Yoo YG, Golemac M, Pugel EP, Jonjic S, Britt WJ. Murine CMV-induced hearing loss is associated with inner ear inflammation and loss of spiral ganglia neurons. PLoS Pathog 2015; 11:e1004774. [PMID: 25875183 PMCID: PMC4395355 DOI: 10.1371/journal.ppat.1004774] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 03/02/2015] [Indexed: 01/22/2023] Open
Abstract
Congenital human cytomegalovirus (HCMV) occurs in 0.5–1% of live births and approximately 10% of infected infants develop hearing loss. The mechanism(s) of hearing loss remain unknown. We developed a murine model of CMV induced hearing loss in which murine cytomegalovirus (MCMV) infection of newborn mice leads to hematogenous spread of virus to the inner ear, induction of inflammatory responses, and hearing loss. Characteristics of the hearing loss described in infants with congenital HCMV infection were observed including, delayed onset, progressive hearing loss, and unilateral hearing loss in this model and, these characteristics were viral inoculum dependent. Viral antigens were present in the inner ear as were CD3+ mononuclear cells in the spiral ganglion and stria vascularis. Spiral ganglion neuron density was decreased after infection, thus providing a mechanism for hearing loss. The lack of significant inner ear histopathology and persistence of inflammation in cochlea of mice with hearing loss raised the possibility that inflammation was a major component of the mechanism(s) of hearing loss in MCMV infected mice. Congenital infection with human cytomegalovirus (HCMV) is the most common viral infection of the fetus and occurs in 0.5–2.0% of all live births in most regions in the world. Infection of the fetus can result in a spectrum of end-organ disease, including long term damage to the central nervous system (CNS). Although less than 10% of infected infants exhibit clinical evidence of end-organ disease, up to 10% of the total number of infected infants develop hearing loss. Mechanisms of disease leading to hearing loss are poorly understood because of the limited availability of pathological specimens and accessibility of the inner ear. Existing small animal models fail to recapitulate many features of this infection of the inner ear. In this report we describe a mouse model in which newborn animals infected peripherally with murine CMV develop hearing loss following hematogenous spread of virus to the inner ear. Hearing loss occurs in 30–50% of animals and characteristics of hearing loss in infants with congenital HCMV infection, including delayed onset of hearing loss, progressive hearing loss, and unilateral hearing loss were present in infected mice. Our findings suggest that host derived inflammatory responses and not direct virus-mediated cytopathology are responsible for hearing loss. Findings from this study provide insight into potential mechanisms of hearing loss in infants with congenital HCMV infection.
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Affiliation(s)
- Russell D. Bradford
- Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama, United States of America
| | - Young-Gun Yoo
- Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama, United States of America
| | - Mijo Golemac
- Department of Histology and Embryology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Ester Pernjak Pugel
- Department of Histology and Embryology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Stipan Jonjic
- Department of Histology and Embryology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - William J. Britt
- Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama, United States of America
- Department of Microbiology, University of Alabama School of Medicine, Birmingham, Alabama, United States of America
- Department of Neurobiology, University of Alabama School of Medicine, Birmingham, Alabama, United States of America
- * E-mail:
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Royackers L, Rector E, Verhaert N, Desloovere C. Long-term audiological follow-up of children with congenital cytomegalovirus. B-ENT 2013; Suppl 21:57-64. [PMID: 24383224] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To evaluate the audiological outcome of children with congenital cytomegalovirus infection. METHODOLOGY In a prospective study, the hearing of 98 congenitally cytomegalovirus-infected children born between January 2003 and July 2009 was systematically evaluated until the age of six using the Flemish CMV protocol. Symptomatic children with hearing loss at birth were treated with ganciclovir, if parents consented. RESULTS Seventy children passed initial screening, 28 had unilateral or bilateral hearing loss. In the normal hearing group, one asymptomatic and two symptomatic children developed late-onset hearing loss. Eight children in the group with hearing loss at birth received ganciclovir. Nine symptomatic and 11 asymptomatic children did not receive ganciclovir. In the treated group, 37.5% of the children had stable hearing loss, and 37.5% had progressive and/or fluctuating hearing loss. First progression or fluctuation always occurred after the age of one year. The hearing threshold improved in 25.0%. The improvement took place during or shortly after treatment. Hearing loss remained stable in 33.3% of the untreated symptomatic children, while progression or fluctuation occurred in 55.5%. In the asymptomatic group, hearing loss was most commonly stable (63.6%). The first change in the hearing threshold was almost always detected before the age of one year in both untreated groups. CONCLUSIONS Hearing loss caused by congenital cytomegalovirus infection cannot be defined unequivocally either with respect to the level of hearing loss or its evolution over time. Treating symptomatic children with ganciclovir leads to a better prognosis during the first year of life, after which progression or fluctuation again becomes more likely. However, overall, progression is more common in the untreated symptomatic group. Asymptomatic children with SNHL are more likely to have a stable hearing status.
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Affiliation(s)
- L Royackers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - E Rector
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - N Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - C Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
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11
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Torre P, Zeldow B, Hoffman HJ, Buchanan A, Siberry GK, Rice M, Sirois PA, Williams PL. Hearing loss in perinatally HIV-infected and HIV-exposed but uninfected children and adolescents. Pediatr Infect Dis J 2012; 31:835-41. [PMID: 22549437 PMCID: PMC3410657 DOI: 10.1097/inf.0b013e31825b9524] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about hearing loss in children with HIV infection (HIV+). We examined the prevalence of hearing loss in perinatally HIV+ and HIV-exposed but uninfected (HEU) children, compared these with the percentage with hearing loss in the general population and evaluated possible risk factors for hearing loss in HIV+ and HEU children. METHODS Audiometric examinations were completed in children who met any prespecified criteria for possible hearing loss. The hearing examination consisted of a tympanogram in each ear and pure-tone air-conduction threshold testing from 500 through 4000 Hz. Hearing loss was defined as the pure-tone average over these frequencies ≥ 20 dB hearing level. The associations of demographic variables, parent/caregiver, HIV disease and HIV treatment with hearing loss were evaluated with univariate and multivariable logistic regression models. RESULTS Hearing testing was completed in 231 children (145 HIV+ and 86 HEU). Hearing loss occurred in 20.0% of HIV+ children and 10.5% of HEU children. After adjusting for caregiver education level, HIV infection was associated with increased odds of hearing loss (adjusted odds ratio = 2.13, 95% confidence interval: 0.95-4.76, P = 0.07). Among HIV+ children, those with a Centers for Disease Control and Prevention class C diagnosis had over twice the odds of hearing loss (adjusted odds ratio = 2.47, 95% confidence interval: 1.04-5.87, P = 0.04). The prevalence of hearing loss was higher in both HIV+ and HEU children compared with National Health and Nutrition Examination Survey III children. CONCLUSIONS Hearing loss was more common in both HIV+ and HEU children than in children from a US population sample. More advanced HIV illness increased the risk of hearing loss in HIV+ children.
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Affiliation(s)
- Peter Torre
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA 92182-1518, USA.
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12
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Nigro G, Adler SP, Parruti G, Anceschi MM, Coclite E, Pezone I, Di Renzo GC. Immunoglobulin therapy of fetal cytomegalovirus infection occurring in the first half of pregnancy--a case-control study of the outcome in children. J Infect Dis 2011; 205:215-27. [PMID: 22140265 DOI: 10.1093/infdis/jir718] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Primary cytomegalovirus (CMV) infection early in gestation causes severe disease. METHODS Case patients were 32 congenitally infected children aged 1-5 years who had either hearing deficit and/or psychomotor retardation and whose mothers had a confirmed or probable primary CMV infection at ≤ 20 weeks' gestation. Control subjects were 32 congenitally infected normal children whose mothers had a confirmed primary infection at ≤ 20 weeks' gestation. Case patients and control subjects were matched by the weeks of maternal gestation (± 1 week) at the mother's infection and by the child's age (± 1 year) at evaluation. RESULTS For the case patients and control subjects, the mean age was 3.0 years. The mean number of weeks of gestation at maternal infection was 11 weeks. The only risk factor for an affected child was the mother not receiving immunoglobulin (P = .001). Of the 32 case patients, only 4 mothers received CMV immunoglobulin, compared with 27 of the 32 mothers of control infants (adjusted odds ratio, 14 [95% confidence interval, 1.7-110]). The rate of both psychomotor retardation and hearing deficit decreased with immunoglobulin. CONCLUSIONS These results support the efficacy of immunoglobulins for decreasing the severity of disabilities caused by fetal CMV infection after a primary maternal infection during pregnancy.
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Affiliation(s)
- Giovanni Nigro
- Maternal-Infant Department, University and San Salvatore Hospital of L'Aquila, Italy.
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13
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Li X, Chen YJ, Li LQ. [Relationship between viral burden in urine and hearing loss in neonates with cytomegalovirus infection]. Zhongguo Dang Dai Er Ke Za Zhi 2011; 13:617-620. [PMID: 21849108] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To determine the relationship between viral burden in urine and hearing loss in neonates with cytomegalovirus (CMV) infection. METHODS Twenty-two neonates with CMV infection between April 2006 and January 2010 were enrolled. Their viral burden in urine and hearing loss information were studied. The receiver operating characteristic curve (ROC) was constructed and the cutoff was determined based on their medical information. The hearing levels were evaluated by brain stem auditory evoked potential (BAEP) during the age of 3 to 6 months in 20 patients. RESULTS The viral burden in urine in neonates with abnormal BAEP was higher than that in neonates with normal BAEP (5.06 ± 1.50 vs 3.73 ± 0.86, P<0.05). Hearing loss was predicted with a sensitivity of 0.545 and a specificity of 1.0 by using ROC at the cutoff point of 5.1 which were defined after logarithmic conversion at 1.27×10(5) copies/mL of CMV burden in urine. The incidence of hearing loss during the age of 3 to 6 months was strikingly higher in high viral burden group than that in low viral load group (P<0.05). CONCLUSIONS The viral burden in urine can predict the possibility of hearing loss in neonates with CMV infection. Hearing loss is likely to be developed when viral burden in urine ≥1.27×10(5) copies/mL in neonates with CMV infection.
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Affiliation(s)
- Xiao Li
- Children's Hospital of Chongqing Medical University, Chongqing, China
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Schraff SA, Schleiss MR, Brown DK, Meinzen-Derr J, Choi KY, Greinwald JH, Choo DI. Macrophage inflammatory proteins in cytomegalovirus-related inner ear injury. Otolaryngol Head Neck Surg 2007; 137:612-8. [PMID: 17903579 DOI: 10.1016/j.otohns.2007.03.044] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Revised: 03/14/2007] [Accepted: 03/29/2007] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Inner ear inflammation triggered by CMV infection may play a role in CMV-related auditory pathogenesis. The purpose of the study was to determine if a virally encoded macrophage inflammatory protein played a role in CMV-related hearing loss. DESIGN Mutagenesis was performed with deletion of a guinea pig CMV macrophage inflammatory protein. Intracochlear inoculations were performed on three groups of animals (n = 18). Group 1 received sterile viral media, Group 2 received wild-type CMV virus, and Group 3 received "knockout" (KO) virus with a deleted immunomodulation gene. Baseline and postinoculation ABRs were obtained. ELISA and PCR were performed and temporal bones examined. SUBJECTS Eighteen guinea pigs. RESULTS The KO group had significantly better hearing than the WT group. There were no significant differences between the KO and sham groups. The WT group had significant hearing loss at all frequencies. Inflammation and fibrosis were noted in the WT temporal bones only. CONCLUSIONS Virally encoded macrophage inflammatory proteins appear to play a significant role in CMV-related hearing loss.
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Affiliation(s)
- Scott A Schraff
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
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15
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Dura B, Pawłowska M. [Mumps in patients hospitalized in Bydgoszcz in the years 1991-2003]. Przegl Epidemiol 2007; 61:43-9. [PMID: 17702438] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The case records of 1185 people, who were hospitalized because of epidemic parotitis at Department of Infectious Diseases in Bydgoszcz in the years 1991-2003 has been analyzed. An increase of the number of cases in the years: 1994, 1997/1998, 2003 has been indicated, especially in boys in the pre-school and school age. The most frequent complication in the course of mumps was meningitis, pancreatitis et orchitis. The only permament complication of the mumps was unilateral hypoacusis present in 5 patients. We observed that lumbar puncture is less frequently performed in cases of clinical mild neuroinfections in the course of mumps at the same we observed a tendency to shorten the time of hospitaliz ation to one week. In the light of conducted researches, the introduction of suggested vaccines against mumps does not seem to have had significant influence on the epidemiology of this disease.
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Affiliation(s)
- Barbara Dura
- Wojewódzki Szpital Obserwacyjno-Zakaźny w Bydgoszczy.
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Abstract
OBJECTIVE To evaluate the utility of therapy with the cyclic cogener of the anti-cytomegalovirus (CMV) agent cidofovir against CMV-induced hearing loss in a guinea pig model. DESIGN Thirty-six guinea pigs were randomly divided into 4 groups of 9. All groups underwent auditory brainstem response testing on days 0, 4, 7, 14, 21, and 28. Group 1 received no intervention. Group 2 underwent sham surgery consisting of unilateral round window injection of 25 microL of sterile viral media on day 0. Groups 3 and 4 underwent round window injection of 1.7 x 10(5) plaque-forming units of guinea pig CMV on day 0. Group 4 received antiviral treatment with intraperitoneal injection of cidofovir (20 mg/kg) on days 1 and 5 after inoculation. SETTING An animal research facility. SUBJECTS Thirty-six weanling Hartley guinea pigs. RESULTS Of the animals who received guinea pig CMV and no cidofovir treatment, 4 of 9 (day 4) and 5 of 9 (days 7 and 28) demonstrated a hearing loss of at least 30 dB. In contrast, none of the animals in the untreated, sham surgery, or cidofovir-treated groups had a hearing loss of greater than 20 dB. This difference was statistically significant for day 4 (P = .04, 1-tailed Fisher exact test), day 7 (P = .01), and day 28 (P = .01). Histologic evaluation of hearing-impaired animals revealed inflammatory infiltrates, particularly in the scala tympani. Fibrosis of the basal turn of the cochlea was observed in 7 of 9 untreated animals and 1 of 9 treated animals. CONCLUSION Cidofovir therapy prevents CMV-induced hearing loss and associated histologic changes in guinea pigs.
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Affiliation(s)
- David R White
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, USA.
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17
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Ross SA, Fowler KB, Ashrith G, Stagno S, Britt WJ, Pass RF, Boppana SB. Hearing loss in children with congenital cytomegalovirus infection born to mothers with preexisting immunity. J Pediatr 2006; 148:332-6. [PMID: 16615962 DOI: 10.1016/j.jpeds.2005.09.003] [Citation(s) in RCA: 162] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2005] [Revised: 08/05/2005] [Accepted: 09/01/2005] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To define hearing outcomes in children with congenital cytomegalovirus (CMV) infection born to mothers with non-primary CMV infection. STUDY DESIGN A cohort of 300 children with congenital CMV infection identified by newborn virologic screening at the University of Alabama Hospital and a private community hospital in which the type of maternal infection could be classified constituted the study population. Maternal infections were categorized by analyzing serum samples. Children were followed prospectively and underwent serial audiologic evaluations. RESULTS The frequency of hearing loss was not different between children born to mothers with non-primary infection (10%) and those with primary infection (11%). Significantly more children in the primary infection group had progressive and severe/profound hearing loss compared with children in the non-primary group. The frequency of bilateral, delayed onset, high-frequency, and fluctuating hearing loss was not different between the 2 groups. The mean age of diagnosis of hearing loss was 39 +/- 53 months for children born to mothers with non-primary infection and 13 +/- 21 months for the primary infection group (P = .16). CONCLUSIONS Maternal preexisting seroimmunity to CMV does not provide complete protection against hearing loss in infants with congenital CMV infection.
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Affiliation(s)
- Shannon A Ross
- Department of Pediatrics, University of Alabama at Birmingham, 35233, USA.
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18
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Murakami S, Hamajima Y, Watanabe N. [Herpes virus infection in otolaryngology]. Nihon Rinsho 2006; 64 Suppl 3:69-72. [PMID: 16615442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Affiliation(s)
- Shingo Murakami
- Department of Otolaryngology, Nagoya City University Medical School
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Gundín G, Monedero G, Teba JM, Pérez Esteban L, Sanz R. Infección por herpes zoster con afectación cocleovestibular aislada (sin parálisis facial). Acta Otorrinolaringológica Española 2006; 57:189-92. [PMID: 16686230 DOI: 10.1016/s0001-6519(06)78690-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Otological complications of Ramsay Hunt syndrome include facial paralysis, tinnitus, hearing loss, vertigo, dysgeusia, and skin eruption. The lower cranial nerves sometimes are affected by this neuritis. A case is reported of a man without immune-system impairment who had a cranial mononeuritis with unilateral involment of the VIII and VII cranial nerves after infection with varicella-zoster without herpetic lesions.
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Affiliation(s)
- G Gundín
- Servicio de Otorrinolaringología, Hospital Universitario de Getafe, Madrid
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Ihara T. [Mumps vaccine]. Nihon Rinsho 2005; 63 Suppl 5:612-6. [PMID: 15954418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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21
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Bradford RD, Cloud G, Lakeman AD, Boppana S, Kimberlin DW, Jacobs R, Demmler G, Sanchez P, Britt W, Soong SJ, Whitley RJ. Detection of Cytomegalovirus (CMV) DNA by Polymerase Chain Reaction Is Associated with Hearing Loss in Newborns with Symptomatic Congenital CMV Infection Involving the Central Nervous System. J Infect Dis 2005; 191:227-33. [PMID: 15609232 DOI: 10.1086/426456] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2004] [Accepted: 07/26/2004] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The study sought to determine the relationship between cytomegalovirus (CMV) viremia during early infancy and clinical and laboratory outcome events, particularly hearing loss in infants with symptomatic congenital CMV infection involving the central nervous system (CNS). STUDY DESIGN A total of 147 infant patients were enrolled prospectively in 2 clinical trials evaluating ganciclovir for the treatment of symptomatic congenital CMV infection involving the CNS. Aliquots of serum collected at enrollment in either of the 2 trials were available from 50 of the infants, and the degree of viremia was determined by real-time quantitative polymerase chain reaction. RESULTS Of the 50 infants from whom serum samples were available, 37 had detectable CMV DNA in the serum sample collected at enrollment and were classified as viremic. Viremic infants were more likely to have (1) hearing loss both at enrollment (P = .045) and at the 6-month follow-up testing (P = .035) and (2) other indicators of active CMV disease, including elevated levels of alanine aminotransferase, petechial rash, and organomegaly. CONCLUSION In children with symptomatic congenital CMV infection involving the CNS, viremia during early infancy is associated with hearing loss and systemic CMV disease.
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Affiliation(s)
- Russell D Bradford
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA
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22
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Abstract
Morbilliviruses are a group of viruses that belong to the family Paramyxoviridae. The most instantly recognizable member is measles virus (MV) and individuals acutely infected with the virus exhibit a wide range of clinical symptoms ranging from a characteristic mild self-limiting infection to death. Canine distemper virus (CDV) and rinderpest virus (RPV) cause a similar but distinctive pathology in dogs and cattle, respectively, and these, alongside experimental MV infection of primates, have been useful models for MV pathogenesis. Traditionally, viruses were identified because a distinctive disease was observed in man or animals; an infectious agent was subsequently isolated, cultured, and this could be used to recapitulate the disease in an experimentally infected host. Thus, satisfying Koch's postulates has been the norm. More recently, particularly due to the advent of exceedingly sensitive molecular biological assays, many researchers have looked for infectious agents in disease conditions for which a viral aetiology has not been previously established. For these cases, the modified Koch's postulates of Bradford Hill have been developed as criteria to link a virus to a specific disease. Only in a few cases have these conditions been fulfilled. Therefore, many viruses have over the years been definitely and tentatively linked to human diseases and in this respect the morbilliviruses are no different. In this review, human diseases associated with morbillivirus infection have been grouped into three broad categories: (1) those which are definitely caused by the infection; (2) those which may be exacerbated or facilitated by an infection; and (3) those which currently have limited, weak, unsubstantiated or no credible scientific evidence to support any link to a morbillivirus. Thus, an attempt has been made to clarify the published data and separate human diseases actually linked to morbilliviruses from those that are merely anecdotally associated.
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Affiliation(s)
- Bertus K Rima
- School of Biomedical Sciences and Centre for Cancer Research and Cell Biology, The Queen's University of Belfast, UK.
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Nagy A, Endreffy E, Streitman K, Pintér S, Pusztai R. Incidence and outcome of congenital cytomegalovirus infection in selected groups of preterm and full-term neonates under intensive care. In Vivo 2004; 18:819-23. [PMID: 15646827] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Congenital cytomegalovirus (CMV) infection is the leading cause of mental retardation and hearing impairment. Examination for the presence of CMV infection was carried out in a selected population of 70 neonates. Urine samples were tested for CMV by means of a nested polymerase chain reaction. CMV was detected in 6 (16.7%) of the 36 preterm newborns and in 5 (14.7%) of the 34 full-term newborns. One preterm neonate died and the remaining 10 newborns were followed up. Two children born at full-term did not excrete CMV at 2 years of age and were symptom-free. Of 8 CMV-excreting children (5 preterm and 3 full-term), 2 were symptom-free (1 preterm and 1 term). Symptomatic CMV disease developed in 6 children (4 preterm and 2 full-term), with mental retardation (n=4), hearing loss (n=1), strabismus (n=2) or bronchial asthma (n=1). Screening of such neonates is important; those identified as congenitally CMV-infected can be monitored to correct any sequelae immediately.
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Affiliation(s)
- Aranka Nagy
- Department of Paediatrics, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Centre, University of Szeged, Hungary
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Kepa L, Oczko-Grzesik B, Stolarz W, Sobala-Szczygieł B. [Extra-salivatory glands manifestations of mumps--own observations]. Przegl Epidemiol 2003; 56:391-8. [PMID: 12608088] [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] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
A total of 808 patients with extra-salivary glands manifestations of mumps were treated in the Department of Infectious Diseases, Bytom, Silesian University Medical School in the period of 1985-2001. Mumps meningitis, testicular involvement (epidydymo-orchitis), and mild mumps pancreatitis were diagnosed in 762 (529 male; 69.4%), 24, and 22 (14 male; 63.6%) patients respectively. The patients' age ranged from 2 to 53 years. Mumps virus infection was the reason of transient (behavior disorders, cognition functions impairment) and permanent (hypoacusis, deafness) sequelae of the disease.
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Affiliation(s)
- Lucjan Kepa
- Oddział Chorób Zakaźnych Slaskiej Akademii Medycznej w Bytomiu
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