scholarly journals Rotavirus A in Brazil: Molecular Epidemiology and Surveillance during 2018–2019

Pathogens ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 515 ◽  
Author(s):  
Meylin Bautista Gutierrez ◽  
Alexandre Madi Fialho ◽  
Adriana Gonçalves Maranhão ◽  
Fábio Correia Malta ◽  
Juliana da Silva Ribeiro de Andrade ◽  
...  
Keyword(s):  
Viral Load ◽  
Severe Disease ◽  
Emergency Department Visits ◽  
Childhood Mortality ◽  
Epidemiological Surveillance ◽  
Nucleotide Sequencing ◽  
Mortality And Morbidity ◽  
Rotavirus A ◽  
Stool Samples ◽  
The Impact

Rotavirus A (RVA) vaccines succeeded in lowering the burden of acute gastroenteritis (AGE) worldwide, especially preventing severe disease and mortality. In 2019, Brazil completed 13 years of RVA vaccine implementation (Rotarix™) within the National Immunization Program (NIP), and as reported elsewhere, the use of Rotarix™ in the country has reduced childhood mortality and morbidity due to AGE. Even though both marketed vaccines are widely distributed, the surveillance of RVA causing AGE and the monitoring of circulating genotypes are important tools to keep tracking the epidemiological scenario and vaccines impact. Thus, our study investigated RVA epidemiological features, viral load and G and P genotypes circulation in children and adults presenting AGE symptoms in eleven states from three out of five regions in Brazil. By using TaqMan®-based one-step RT-qPCR, we investigated a total of 1536 stool samples collected from symptomatic inpatients, emergency department visits and outpatients from January 2018 to December 2019. G and P genotypes of RVA-positive samples were genetically characterized by multiplex RT-PCR or by nearly complete fragment sequencing. We detected RVA in 12% of samples, 10.5% in 2018 and 13.7% in 2019. A marked winter/spring seasonality was observed, especially in Southern Brazil. The most affected age group was children aged >24–60 months, with a positivity rate of 18.8% (p < 0.05). Evaluating shedding, we found a statistically lower RVA viral load in stool samples collected from children aged up to six months compared to the other age groups (p < 0.05). The genotype G3P[8] was the most prevalent during the two years (83.7% in 2018 and 65.5% in 2019), and nucleotide sequencing of some strains demonstrated that they belonged to the emergent equine-like G3P[8] genotype. The dominance of an emergent genotype causing AGE reinforces the need for continuous epidemiological surveillance to assess the impact of mass RVA immunization as well as to monitor the emergence of novel genotypes.

scholarly journals Production of Noncapped Genomic RNAs Is Critical to Sindbis Virus Disease and Pathogenicity

mBio ◽  
2020 ◽  
Vol 11 (6) ◽  
Author(s):  
Autumn T. LaPointe ◽  
V Douglas Landers ◽  
Claire E. Westcott ◽  
Kevin J. Sokoloski
Keyword(s):  
Sindbis Virus ◽  
Virus Disease ◽  
Severe Disease ◽  
Wild Type Virus ◽  
Wild Type ◽  
Genomic Rnas ◽  
Mortality And Morbidity ◽  
The Impact

ABSTRACT Alphaviruses are positive-sense RNA viruses that utilize a 5′ cap structure to facilitate translation of viral proteins and to protect the viral RNA genome. Nonetheless, significant quantities of viral genomic RNAs that lack a canonical 5′ cap structure are produced during alphaviral replication and packaged into viral particles. However, the role/impact of the noncapped genomic RNA (ncgRNA) during alphaviral infection in vivo has yet to be characterized. To determine the importance of the ncgRNA in vivo, the previously described D355A and N376A nsP1 mutations, which increase or decrease nsP1 capping activity, respectively, were incorporated into the neurovirulent AR86 strain of Sindbis virus to enable characterization of the impact of altered capping efficiency in a murine model of infection. Mice infected with the N376A nsP1 mutant exhibited slightly decreased rates of mortality and delayed weight loss and neurological symptoms, although levels of inflammation in the brain were similar to those of wild-type infection. Although the D355A mutation resulted in decreased antiviral gene expression and increased resistance to interferon in vitro, mice infected with the D355A mutant showed significantly reduced mortality and morbidity compared to mice infected with wild-type virus. Interestingly, expression of proinflammatory cytokines was found to be significantly decreased in mice infected with the D355A mutant, suggesting that capping efficiency and the production of ncgRNA are vital to eliciting pathogenic levels of inflammation. Collectively, these data indicate that the ncgRNA have important roles during alphaviral infection and suggest a novel mechanism by which noncapped viral RNAs aid in viral pathogenesis. IMPORTANCE Mosquito-transmitted alphaviruses have been the cause of widespread outbreaks of disease that can range from mild illness to lethal encephalitis or severe polyarthritis. There are currently no safe and effective vaccines or therapeutics with which to prevent or treat alphaviral disease, highlighting the need to better understand alphaviral pathogenesis to develop novel antiviral strategies. This report reveals production of noncapped genomic RNAs (ncgRNAs) to be a novel determinant of alphaviral virulence and offers insight into the importance of inflammation to pathogenesis. Taken together, the findings reported here suggest that the ncgRNAs contribute to alphaviral pathogenesis through the sensing of the ncgRNAs during alphaviral infection and are necessary for the development of severe disease.

scholarly journals Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study

BMJ ◽  
2020 ◽  
pp. m1443 ◽  
Author(s):  
Shufa Zheng ◽  
Jian Fan ◽  
Fei Yu ◽  
Baihuan Feng ◽  
Bin Lou ◽  
...  
Keyword(s):  
Viral Load ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
Zhejiang Province ◽  
Serum Samples ◽  
Viral Loads ◽  
Mild Disease ◽  
Stool Samples ◽  
Serum And Urine ◽  
Serum And Urine Samples

AbstractObjectiveTo evaluate viral loads at different stages of disease progression in patients infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first four months of the epidemic in Zhejiang province, China.DesignRetrospective cohort study.SettingA designated hospital for patients with covid-19 in Zhejiang province, China.Participants96 consecutively admitted patients with laboratory confirmed SARS-CoV-2 infection: 22 with mild disease and 74 with severe disease. Data were collected from 19 January 2020 to 20 March 2020.Main outcome measuresRibonucleic acid (RNA) viral load measured in respiratory, stool, serum, and urine samples. Cycle threshold values, a measure of nucleic acid concentration, were plotted onto the standard curve constructed on the basis of the standard product. Epidemiological, clinical, and laboratory characteristics and treatment and outcomes data were obtained through data collection forms from electronic medical records, and the relation between clinical data and disease severity was analysed.Results3497 respiratory, stool, serum, and urine samples were collected from patients after admission and evaluated for SARS-CoV-2 RNA viral load. Infection was confirmed in all patients by testing sputum and saliva samples. RNA was detected in the stool of 55 (59%) patients and in the serum of 39 (41%) patients. The urine sample from one patient was positive for SARS-CoV-2. The median duration of virus in stool (22 days, interquartile range 17-31 days) was significantly longer than in respiratory (18 days, 13-29 days; P=0.02) and serum samples (16 days, 11-21 days; P<0.001). The median duration of virus in the respiratory samples of patients with severe disease (21 days, 14-30 days) was significantly longer than in patients with mild disease (14 days, 10-21 days; P=0.04). In the mild group, the viral loads peaked in respiratory samples in the second week from disease onset, whereas viral load continued to be high during the third week in the severe group. Virus duration was longer in patients older than 60 years and in male patients.ConclusionThe duration of SARS-CoV-2 is significantly longer in stool samples than in respiratory and serum samples, highlighting the need to strengthen the management of stool samples in the prevention and control of the epidemic, and the virus persists longer with higher load and peaks later in the respiratory tissue of patients with severe disease.

scholarly journals DETERMINATION OF PREVALENCE RATE OF ENTAMOEBA HISTOLYTICA AMONG CHILDREN DIAGNOSED WITH ACUTE DIARRHEA IN KANO, NIGERIA

2021 ◽  
pp. 16-18
Author(s):  
JA’AFAR S ADAM ◽  
MUSA G YAHAYA ◽  
FAROUK S NAS ◽  
LURWAN MU’AZU ◽  
MUHAMMAD ALI
Keyword(s):  
Entamoeba Histolytica ◽  
Acute Diarrhea ◽  
Childhood Mortality ◽  
Personal Hygiene ◽  
Age Group ◽  
Mortality And Morbidity ◽  
Improved Sanitation ◽  
Stool Samples ◽  
Age Category

Background: Diarrhea is a major contributor to childhood mortality and morbidity in the developing world. Objective: The study was aimed to determine the prevalence of Entamoeba histolytica among children diagnosed with acute diarrhea in Kura General Hospital Kano, from February to August 2017. Methodology: A total of 236 stools samples were collected from children within the age group of 0 – 5 years diagnosed with acute diarrhea attending the Hospital. The stool samples were examined for Entamoeba Histolytica cysts and trophozoites using direct wet preparation and Formol Ether concentration techniques. Results: The result showed that 23 samples which accounted for 9.75% of the samples were found to be positive for the parasite. Highest incidence of the parasite was found among children within the age category of 4 - 5 years. The results also indicated that males (56.5%) were more infected than females (43.5%). However, there is no statistical difference in the rate of infection among the sex and age group of the patients at p< 0.05. Conclusion: In conclusion, maintenance of personal hygiene and improved sanitation of the environment will indeed prevent contamination of food and water sources.

scholarly journals The Prevalence of HBV Infection in Renal Transplant Recipients and the Impact of Infection on Graft Survival

2019 ◽  
Author(s):  
Nawfal R Hussein ◽  
Zana SM Saleem ◽  
Nashwan MR Ibrahim ◽  
Mahde Saleh Assafi ◽  
Shameran Daniel
Keyword(s):  
Viral Load ◽  
Renal Transplant ◽  
General Population ◽  
Serum Creatinine ◽  
Graft Function ◽  
Hbv Infection ◽  
Renal Transplant Recipients ◽  
Mortality And Morbidity ◽  
Hbsag Positivity ◽  
The Impact

Abstract- Hepatitis B virus infection (HBV) is a leading cause of increased mortality and morbidity in renal transplant subjects. The purpose of this project was to investigate the prevalence of HBV in patients with renal transplant and compare it with the general population in Duhok city, Iraq. Then, the impact of HBV infection on graft function was evaluated. A total of 560 renal transplant subjects and 2975 volunteers were recruited in this study. All subjects were examined for HB surface antigen (HBsAg) positivity. Then, all HBsAg positive subjects were tested for viral load, alanine transaminase (ALT), aspartate aminotransferase (AST), serum creatinine and HBV profile. All HBsAg positive renal transplant subjects received treatment and were followed up for 24 months. It was found that 6/560 (1.1%) of the renal transplant subjects were HBsAg positive while 30/2975 (1.09%) of the volunteers were positive for HBsAg (P>0.05). After initiation of medications, viral load became undetected within 6 months of treatment. Serum creatinine levels were normal at the end of the study. No major side effects were recorded. The prevalence of HBV in renal transplant subjects was similar to the prevalence in general population. HBV infection did not show any negative effect on the graft function. Further study is needed with a larger sample size to explore the long term effect of the infection on graft functionality.

scholarly journals 999Impact of Heatwaves on use of health services (GP and Emergency department visits)

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Blesson Varghese ◽  
Matt Beaty ◽  
Peng Bi ◽  
John Nairn
Keyword(s):  
Emergency Department ◽  
Health Services ◽  
Warm Season ◽  
Emergency Department Visits ◽  
Volume Depletion ◽  
Mortality And Morbidity ◽  
Low Intensity ◽  
Excess Heat Factor ◽  
Ed Visits ◽  
The Impact

Abstract Background Heatwaves are associated with increases in mortality and morbidity (mostly hospitalisations). However, evidence regarding heatwave impacts on the use of frontline health-services such as general practitioner (GP) consultations and emergency department (ED) services is limited. This study quantified the impact of heatwaves on the use of GP and ED services in Adelaide. Methods Data on GP services (2011-2016) from the Medicare Benefits Schedule and ED visits (2013-2018) were obtained from the Australian Bureau of Statistics and the Department of Health, respectively. Heatwaves were defined using Excess Heat Factor. Using time-stratified case-crossover models, we modelled heatwave-severity (low, severe/extreme) against the use of GP and ED services in the warm-season (October-March). Effect estimates are reported as relative risks (RRs). Results Total GP visits decreased during low-intensity heatwaves and increased during severe/extreme heatwaves (RR 1.14; 95%CI: 1.13-1.15). The highest increases during severe/extreme heatwaves were observed for respiratory (RR 1.36; 95%CI: 1.27-1.45) and psychiatric services. While ED visits decreased overall during low-intensity and severe/extreme heatwaves, those due to heat-light disorders (RR 4.23; 95%CI: 2.98-6.00), volume depletion, and respiratory diseases increased during severe/extreme heatwaves. Conclusions There were significant increases in the use of GP and specific ED services during heatwaves in Adelaide. Further research is needed to identify the intrinsic and extrinsic vulnerability factors contributing to these increases in Adelaide and other Australian cities. Key messages Impacts of heatwaves extend beyond mortality to include frontline health-services (GP/EDs) that are already challenged. Evidence presented may assist policymakers for resource allocation and healthcare workforce capacity building.

scholarly journals Respiratory and diarrhoeal pathogens in Malawian children hospitalized with diarrhoea and association with short-term growth

2021 ◽  
Author(s):  
Mphatso Nancy Chisala ◽  
Pui-Ying Iroh Tam ◽  
Wongani Nyangulu ◽  
James Nyirenda
Keyword(s):  
Childhood Mortality ◽  
Respiratory Pathogens ◽  
Short Term ◽  
Mortality And Morbidity ◽  
Z Scores ◽  
Repeated Analysis ◽  
Reverse Relationship ◽  
Stool Samples ◽  
Relationship Of

Background: Pneumonia and diarrhoea are the leading causes of childhood mortality and morbidity worldwide. Recurrence of these common infections are one of the immediate causes of malnutrition, which puts children at risk of further infection. While studies have focused on how gut microbiota is broadly protective against respiratory infection, there has been less attention paid to the reverse relationship, of respiratory microbiota and pathogens influencing the gut, and subsequent association with growth. Methods: In this sub-study of a prospective cohort study, 27 children (2-24 months) who tested positive for Cryptosporidium were followed up over 8 weeks. Respiratory and stool pathogens were detected using quantitative molecular methods. Nutritional outcomes were assessed as length-for-age (LAZ), weight-for-length (WLZ) and weight-for-age (WAZ) z-scores. Changes over the study period were compared using repeated analysis of variance and mixed effects model analysis. Results: In this period,104 sputum and stool samples were collected. All stool samples had at least one pathogen detected, with an average of 5.1 (SD 2.1) stool pathogens, compared to 84% of the sputum samples with an average 3.5 (SD1.8). Diarrhoeagenic E. coli were the most common stool pathogens (92%), followed by Cryptosporidium (52%) and Campylobacter pan (39%). In sputum, S. pneumoniae was most prevalent (84%), seconded by Rhinovirus (56%) and M. catarrhalis (50%). There was a significant change in WAZ over the follow-up period. Children who had ≥3 GI pathogens had significantly a lower LAZ mean score at enrollment (-1.8 (SD 1.4)) and across the follow-up period. No relationship between respiratory pathogens and short-term growth was observed. Out of 49 sputum samples that had ≥3 pathogens, 42 (85%) simultaneously had ≥3 GI pathogens. Conclusion: Among young children hospitalized with diarrhoea, multiple gut and respiratory pathogens were prevalent over an 8-week follow-up period. The presence of more GI, but not respiratory, pathogens was significantly associated with reduced short-term growth.

scholarly journals Molecular Characterization of Norovirus Strains Isolated from Older Children and Adults in Impoverished Communities of Vhembe District, South Africa

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
G. Mulondo ◽  
R. Khumela ◽  
J. P. Kabue ◽  
A. N. Traore ◽  
N. Potgieter
Keyword(s):  
Age Groups ◽  
Pcr Amplification ◽  
Limpopo Province ◽  
Epidemiological Surveillance ◽  
Nucleotide Sequencing ◽  
Older Children ◽  
Rt Pcr ◽  
Human Norovirus ◽  
Stool Samples ◽  
Vhembe District

Background. Human norovirus (NoV) is an etiological agent associated with acute gastroenteritis (AGE) in both children and adults worldwide. However, very few studies have been reported on the prevalence and genetic diversity of NoV strains in children older than 5 years of age and adults with little or inadequate water and sanitation conditions. Objectives. The aim of this study was assessing the prevalence of the human norovirus in older children and adults suffering with diarrhoea from rural communities in the Vhembe district, Limpopo province. Methods. Between August 2017 and October 2018, stool samples were collected from outpatients suffering from AGE and screened for NoV strains using the RIDA©GENE norovirus I and II real-time one-step RT-PCR. RNA extracts of NoV-positive samples were subjected to RT-PCR amplification and nucleotide sequencing to genotype the positive NoV strains. Results. Out of 80 collected stool samples, 13 (16%) were tested positive for norovirus. Genogroup GII was identified in 6/13 (46%) samples and genogroup GI in 7/13 (54%) samples. The sequence analyses showed multiple genotypes including GII.Pg, GII.1, GII.2, GII.4, and GI.3. Phylogenetic analysis revealed the relatedness of NoV genotypes identified with other strains reported globally. Conclusion. Continued systematic surveillance to evaluate norovirus association with diarrhoea is needed to assist with epidemiological surveillance and disease burden in people of all the age groups.

scholarly journals Persistent intestinal dysbiosis after SARS-CoV-2 infection in Brazilian patients

2021 ◽  
Author(s):  
Alexandre Soares Ferreira Junior ◽  
Tais Fernanda Borgonovi ◽  
Larissa Vedovato Vilela de Salis ◽  
Aline Zazeri Leite ◽  
Amanda Soares Dantas ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Intestinal Microbiota ◽  
Poor Prognosis ◽  
Immune Status ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Healthy Controls ◽  
Intestinal Dysbiosis ◽  
Stool Samples ◽  
The Impact

Abstract Background: The massive secretion of inflammatory cytokines is associated with the Coronavirus Disease 2019 (COVID-19) severity and poor prognosis, as well as, in long COVID, the pathophysiology seems to be related to immune deregulation. The patient's immune status can influence the response to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus infection, and this immunity is affected by the intestinal microbiota condition (eubiotic or dysbiotic). This study aimed to evaluate the intestinal microbiota of patients infected with SARS-CoV-2 with different clinical manifestations and post-COVID-19 (post-COV) periods, and correlate with the use of antibiotics during the acute disease. Results: According to the beta diversity, we observed significant differences between microbial communities in stool samples from post-COV patients when compared with healthy controls. Additionally, we detected four different clusters when we grouped patients into asymptomatic, mild, moderate, and severe disease. Patients who took antibiotics during the COVID-19 course showed decreased richness of the gut microbiota, even months after the disease resolution. We detected some genera possibly associated with the persistent post-COV dysbiosis, including increased Prevotella, Dialister, Haemophillus, Barnesiella, Desulfovibrio, Bilophila, Alistipes, Parabacteroides and Bacteroides, suggesting the impact of the disease in the gut microbiota. Besides that, we found some genera associated with antibiotic-induced dysbiosis in post-COV patients, including decreased Akkermansia and Bifidobacterium species. Conclusions: Therefore, we hypothesized that persistent dysbiosis and indiscriminate use of antibiotics during the COVID-19 pandemic may be associated with long COVID syndromes, suggesting the involvement of the gut-lung axis. These data suggest that intestinal microbiota modulation may represent a therapeutic approach for long COVID.

Key Aspects of Assessing Effectiveness and Efficiency of Implementation of the Federal Clean Air Project on the Example of the Comprehensive Emission Reduction Action Plan in Nizhny Tagil

2020 ◽  
pp. 48-60
Author(s):  
SV Yarushin ◽  
DV Kuzmin ◽  
AA Shevchik ◽  
TM Tsepilova ◽  
VB Gurvich ◽  
...  
Keyword(s):  
Emission Reduction ◽  
Action Plan ◽  
Local Population ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Mortality And Morbidity ◽  
Industrial Enterprises ◽  
Clean Air ◽  
Effectiveness And Efficiency ◽  
The Impact

Introduction: Key issues of assessing effectiveness and economic efficiency of implementing the Federal Clean Air Project by public health criteria are considered based on the example of the Comprehensive Emission Reduction Action Plan realized in the city of Nizhny Tagil, Sverdlovsk Region. Materials and methods: We elaborated method approaches and reviewed practical aspects of evaluating measures taken in 2018–2019 at key urban industrial enterprises accounting for 95 % of stationary source emissions. Results: Summary calculations of ambient air pollution and carcinogenic and non-carcinogenic inhalation health risks including residual risks, evaluation of the impact of air quality on urban mortality and morbidity rates, economic assessment of prevented morbidity and premature mortality cases have enabled us not only to estimate health effects but also to develop guidelines for development and implementation of actions aimed at enhancing effectiveness and efficiency of industrial emission reduction in terms of health promotion of the local population. Conclusions: We substantiate proposals for the necessity and sufficiency of taking remedial actions ensuring achievement of acceptable health risk levels as targets of the Comprehensive Emission Reduction Action Plan in Nizhny Tagil until 2024 and beyond.

scholarly journals Treatment of HIV-associated facial lipoatrophy: impact on infection progression assessed by viral load and CD4 count

2013 ◽  
Vol 88 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Flávia Machado Gonçalves Soares ◽  
Izelda Maria Carvalho Costa
Keyword(s):  
Viral Load ◽  
Disease Progression ◽  
Statistical Significance ◽  
Undetectable Viral Load ◽  
Fat Distribution ◽  
Cd4 Count ◽  
Before And After ◽  
Facial Lipoatrophy ◽  
A Prospective Study ◽  
The Impact

BACKGROUND: HIV/AIDS-Associated Lipodystrophy Syndrome includes changes in body fat distribution, with or without metabolic changes. The loss of fat from the face, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome.OBJECTIVES:To evaluate the effect of FL treatment using polymethylmethacrylate (PMMA) implants on disease progression, assessed by viral load and CD4 cell count.METHODS: This was a prospective study of 44 patients treated from July 2009 to December 2010. Male and female patients, aged over 18 years, with clinically detectable FL and who had never been treated were included in the study. PMMA implantation was done to fill atrophic areas. Laboratory tests were conducted to measure viral load and CD4 count before and after treatment.RESULTS: Of the 44 patients, 72.72% were male and 27.27% female, mean age of 44.38 years. Before treatment, 82% of patients had undetectable viral load, which increased to 88.6% after treatment, but without statistical significance (p = 0.67). CD4 count before treatment ranged from 209 to 1293, averaging 493.97. After treatment, the average increased to 548.61. The increase in CD4 count after treatment was statistically significant with p = 0.02.CONCLUSION: The treatment of FL with PMMA implants showed a statistically significant increase in CD4 count after treatment, revealing the impact of FL treatment on disease progression. Viral load before and after treatment did not vary significantly.

Sign in / Sign up

Export Citation Format

Share Document