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Health Protection Agency (HPA) UK Novel Coronavirus Investigation team. Evidence of person-to-person transmission within a family cluster of novel coronavirus infections, United Kingdom, February 2013. ACTA ACUST UNITED AC 2013; 18:20427. [PMID: 23517868 DOI: 10.2807/ese.18.11.20427-en] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In February 2013, novel coronavirus (nCoV) infection was diagnosed in an adult male in the United Kingdom with severe respiratory illness, who had travelled to Pakistan and Saudi Arabia 10 days before symptom onset. Contact tracing identified two secondary cases among family members without recent travel: one developed severe respiratory illness and died, the other an influenza-like illness. No other severe cases were identified or nCoV detected in respiratory samples among 135 contacts followed for 10 days.
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Kim SJ, Lee JH, Lee ES, Kim IH, Park HJ, Shin C, Kim JH. A case of secondary syphilis presenting as multiple pulmonary nodules. Korean J Intern Med 2013; 28:231-5. [PMID: 23526483 PMCID: PMC3604614 DOI: 10.3904/kjim.2013.28.2.231] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 05/12/2011] [Accepted: 06/22/2011] [Indexed: 11/27/2022] Open
Abstract
Syphilis is a sexually transmitted disease caused by Treponema pallidum. The prevalence of this disease has recently increased worldwide. However, pulmonary involvement in secondary syphilis is extremely rare. A 51-year-old heterosexual male patient presented with multiple pulmonary nodules with reactive serology from the Venereal Disease Research Laboratory test and positive fluorescent treponemal antibody absorption testing. A hematogenous metastatic malignancy was suspected and an excisional lung biopsy was performed. Histopathological examination showed only central necrosis with abscess and plasma cell infiltration, but no malignant cells. The patient reported sexual contact with a prostitute 8 weeks previously and a penile lesion 6 weeks earlier. Physical examination revealed an erythematous papular rash on the trunk. Secondary syphilis with pulmonary nodules was suspected, and benzathine penicillin G, 2.4 million units, was administered. Subsequently, the clinical signs of syphilis improved and the pulmonary nodules resolved. The final diagnosis was secondary syphilis with pulmonary nodular involvement.
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Affiliation(s)
- Se Joong Kim
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ju-Han Lee
- Department of Pathology, Korea University Ansan Hospital, Ansan, Korea
| | - Eung-Seok Lee
- Department of Pathology, Korea University Ansan Hospital, Ansan, Korea
| | - Il-Hwan Kim
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Hyung Joo Park
- Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chol Shin
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Je Hyeong Kim
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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Malik M, Mahjour J, Opoka M, Mafi AR. Emergence of novel human coronavirus: public health implications in the Eastern Mediterranean Region. East Mediterr Health J 2013; 18:1084-5. [PMID: 23301367 DOI: 10.26719/2012.18.11.1084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Seto WH, Conly JM, Pessoa-Silva CL, Malik M, Eremin S. Infection prevention and control measures for acute respiratory infections in healthcare settings: an update. East Mediterr Health J 2013; 19 Suppl 1:S39-S47. [PMID: 23888794] [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: 06/02/2023]
Abstract
Viruses account for the majority of the acute respiratory tract infections (ARIs) globally with a mortality exceeding 4 million deaths per year. The most commonly encountered viruses, in order of frequency, include influenza, respiratory syncytial virus, parainfluenza and adenovirus. Current evidence suggests that the major mode of transmission of ARls is through large droplets, but transmission through contact (including hand contamination with subsequent self-inoculation) and infectious respiratory aerosols of various sizes and at short range (coined as "opportunistic" airborne transmission) may also occur for some pathogens. Opportunistic airborne transmission may occur when conducting highrisk aerosol generating procedures and airborne precautions will be required in this setting. General infection control measures effective for all respiratory viral infections are reviewed and followed by discussion on some of the common viruses, including severe acute respiratory syndrome (SARS) coronavirus and the recently discovered novel coronavirus.
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Affiliation(s)
- W H Seto
- Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China
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Al-Tawfiq JA, Smallwood CAH, Arbuthnott KG, Malik MSK, Barbeschi M, Memish ZA. Emerging respiratory and novel coronavirus 2012 infections and mass gatherings. East Mediterr Health J 2013; 19 Suppl 1:S48-S54. [PMID: 23888795] [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: 06/02/2023]
Abstract
Mass gatherings are attended by an increasingly global audience and thus raise the concern of possible acute public health risks not normally encountered by the host population. The potential acute risks to individual and population health include communicable diseases. The communicable disease risks include emerging and re-emerging diseases in host and visiting populations. In this review, we provide an overview ofthe literature on respiratory infections at mass gatherings, then describe the impact of novel coronavirus 2012 (nCoV), an emerging respiratory disease virus, on the preparations for mass gathering. Although, nCoV emerged prior to the 2012 Hajj pilgrimage season, Muslims completed their religious duty without acquiring infections by nCoV. Clearly, the global nature of mass gatherings and their potential risks to international health make it imperative that research on such events and guidelines produced for their management are relevant to diverse contexts and are a collaborative effort between global experts.
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Affiliation(s)
- J A Al-Tawfiq
- Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia
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Ren H, Yuan ZA, Gu ZR, Hu JY, Wang Y, Li YT. [Study and application of transmission tracking analysis technique during incubation period of respiratory infectious diseases]. Zhonghua Yu Fang Yi Xue Za Zhi 2013; 47:63-66. [PMID: 23601526] [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: 06/02/2023]
Abstract
OBJECTIVE To develop a new transmission tracking analysis technique during incubation period of respiratory infectious diseases, and to discuss its practical value in the field survey of infectious diseases. METHODS The classical epidemiological theory was integrated with geographic information system. The transmission tracking analysis technique was established based on the modeling platform ArcGIS Engine Developer Kit 9.3, using the techniques of address matching, shortest path analysis and buffer analysis, and programming by Visual C++. Eight serious sever acute respiratory syndrome (SARS) cases in Shanghai in year 2003 were then chose as prototype to set up the test cases A-H. The electronic map and population density data were separately collected from Institute of Surveying and Mapping in Shanghai and Shanghai statistical yearbook 2003, to calculate and explore the parameters as length of transmission path, area of buffer zone and key departments by single and multi case analysis module. RESULTS The single case transmission tracking analysis showed that the length of transmission track of case A was 129.89 km during April 25th to 29th in 2003, including 12 tracing point and 108 intimate contacts, and the total area of buffer zone was 7.11 km(2) including 81 important institutes, naming 72 schools, 6 kindergartens and 3 gerocomiums. The multi-case transmission tracking analysis showed that the 8 cases shared 5 tracks without any temporal communication. However, there was a spatial communication whose length was 1.42 km and area was 0.60 km(2). There were no important institutes found in this communication area. CONCLUSION Transmission tracking technique is practicable and efficient to trace the source of infection, analyze the transmission tracks, establish the isolation buffer area and explore the important geographic positions in epidemiological investigation.
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Affiliation(s)
- Hong Ren
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
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Affiliation(s)
- Chad J. Roy
- Tulane National Primate Research Center, Tulane School of MedicineCovington, LA, USA
- *Correspondence:
| | - Doug S. Reed
- Center for Vaccine Research, University of PittsburghPittsburgh, PA, USA
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Chevillotte J. [Updating recommendations for acute respiratory tract infection in nursing homes]. Rev Infirm 2012:6. [PMID: 23316575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Puleston R, Beck C, Tahir M, Bardhan M, Charlemagne P, Alves C, Ladhani S, Watson C, Ramsay M, Kaczmarksi E, Borrow R, Gray S, Hadlington D, Weinbren M, Bhattacharjee D, Inglis N. An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012. Euro Surveill 2012; 17:20308. [PMID: 23137486] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- R Puleston
- Health Protection Agency, Nottingham, United Kingdom.
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Pseudomonas aeruginosa respiratory tract infections associated with contaminated ultrasound gel used for transesophageal echocardiography—Michigan, December 2011–January 2012. Clin Infect Dis 2012; 55:ii. [PMID: 22912968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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Centers for Disease Control and Prevention (CDC). Pseudomonas aeruginosa respiratory tract infections associated with contaminated ultrasound gel used for transesophageal echocardiography - Michigan, December 2011-January 2012. MMWR Morb Mortal Wkly Rep 2012; 61:262-4. [PMID: 22513528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In late December 2011, the Department of Epidemiology at Beaumont Health System (BHS) in Royal Oak, Michigan, noted an increase in the number of positive respiratory cultures in one surgical intensive-care unit (ICU), prompting further investigation. The increase in positive cultures was attributed entirely to Pseudomonas aeruginosa. Investigation by BHS staff members found that all of these positive cultures were related to use of ultrasound transmission gel from a single manufacturer during transesophageal echocardiography. Seven patients were infected with P. aeruginosa based on National Healthcare Safety Network (NHSN) criteria, and nine were colonized. Cultures from one open and one unopened bottle of the gel grew P. aeruginosa closely related to the outbreak strain based on molecular typing via repetitive extragenic palindromic polymerase chain reaction (rep-PCR). The Oakland County Health Department, the Michigan Department of Community Health, and the Food and Drug Administration (FDA) were notified of the findings. On January 23, all implicated ultrasound gel in multiuse bottles was removed from BHS facilities and replaced with a single-use, sterile ultrasound gel for all potentially invasive procedures. On April 18, FDA issued a Safety Communication* advising health-care professionals and facilities not to use certain lot numbers of the ultrasound transmission gel and further advising that the only ultrasound gel that is sterile is unopened gel in containers labeled as sterile. To date, no further respiratory cultures have been positive for P. aeruginosa.
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Abstract
The recent emergence of virulent respiratory infectious diseases such as Severe Acute Respiratory Syndrome (SARS) and Influenza A/H1N1 viruses predisposes nurses to occupational risks. This qualitative study investigated how Chinese Singaporean nurses perceived the risks of exposure to these infectious diseases and the factors that influenced this risk perception. Data were collected through face-to-face interviews and were analyzed using Braun and Clarke's process of thematic analysis. Three themes emerged: living with risk; the experience of SARS; and acceptance of risk. The nature of nursing work was perceived to place participants at risk of infection. Another significant finding of this study is that the government's, organizations' and nurses' perceptions of new emerging respiratory infectious diseases were influenced by their previous experience with SARS. Similar to previous studies, nurses working at the 'front line' believed that infection from these diseases was an unavoidable occupational hazard.
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Affiliation(s)
- Yiwen Koh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Zayas G, Chiang MC, Wong E, MacDonald F, Lange CF, Senthilselvan A, King M. Cough aerosol in healthy participants: fundamental knowledge to optimize droplet-spread infectious respiratory disease management. BMC Pulm Med 2012; 12:11. [PMID: 22436202 PMCID: PMC3331822 DOI: 10.1186/1471-2466-12-11] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [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: 09/08/2011] [Accepted: 03/21/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Influenza A H1N1 virus can be transmitted via direct, indirect, and airborne route to non-infected subjects when an infected patient coughs, which expels a number of different sized droplets to the surrounding environment as an aerosol. The objective of the current study was to characterize the human cough aerosol pattern with the aim of developing a standard human cough bioaerosol model for Influenza Pandemic control. METHOD 45 healthy non-smokers participated in the open bench study by giving their best effort cough. A laser diffraction system was used to obtain accurate, time-dependent, quantitative measurements of the size and number of droplets expelled by the cough aerosol. RESULTS Voluntary coughs generated droplets ranging from 0.1 - 900 microns in size. Droplets of less than one-micron size represent 97% of the total number of measured droplets contained in the cough aerosol. Age, sex, weight, height and corporal mass have no statistically significant effect on the aerosol composition in terms of size and number of droplets. CONCLUSIONS We have developed a standard human cough aerosol model. We have quantitatively characterized the pattern, size, and number of droplets present in the most important mode of person-to-person transmission of IRD: the cough bioaerosol. Small size droplets (< 1 μm) predominated the total number of droplets expelled when coughing. The cough aerosol is the single source of direct, indirect and/or airborne transmission of respiratory infections like the Influenza A H1N1 virus. STUDY DESIGN Open bench, Observational, Cough, Aerosol study.
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Affiliation(s)
- Gustavo Zayas
- Mucophysiology Laboratory, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ming C Chiang
- Mucophysiology Laboratory, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Eric Wong
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Fred MacDonald
- Centre for Lung Health, Northern Lung Function Laboratory, Edmonton General Hospital, Edmonton, AB, Canada
| | - Carlos F Lange
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Ambikaipakan Senthilselvan
- Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Malcolm King
- Mucophysiology Laboratory, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Cohen NJ, Callahan DB, Gonzalez V, Balaban V, Wang RT, Pordell P, Beato R, Oyervides O, Huang WT, Massoudi MS. Respiratory illness in households of school-dismissed students during pandemic (H1N1) 2009. Emerg Infect Dis 2012; 17:1756-7. [PMID: 21888814 PMCID: PMC3322060 DOI: 10.3201/eid1709.101589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bolton KJ, McCaw JM, Forbes K, Nathan P, Robins G, Pattison P, Nolan T, McVernon J. Influence of contact definitions in assessment of the relative importance of social settings in disease transmission risk. PLoS One 2012; 7:e30893. [PMID: 22359553 PMCID: PMC3281034 DOI: 10.1371/journal.pone.0030893] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 12/23/2011] [Indexed: 11/18/2022] Open
Abstract
Background Realistic models of disease transmission incorporating complex population heterogeneities require input from quantitative population mixing studies. We use contact diaries to assess the relative importance of social settings in respiratory pathogen spread using three measures of person contact hours (PCH) as proxies for transmission risk with an aim to inform bipartite network models of respiratory pathogen transmission. Methods and Findings Our survey examines the contact behaviour for a convenience sample of 65 adults, with each encounter classified as occurring in a work, retail, home, social, travel or “other” setting. The diary design allows for extraction of PCH-interaction (cumulative time in face-face conversational or touch interaction with contacts) – analogous to the contact measure used in several existing surveys – as well as PCH-setting (product of time spent in setting and number of people present) and PCH-reach (product of time spent in setting and number of people in close proximity). Heterogeneities in day-dependent distribution of risk across settings are analysed using partitioning and cluster analyses and compared between days and contact measures. Although home is typically the highest-risk setting when PCH measures isolate two-way interactions, its relative importance compared to social and work settings may reduce when adopting a more inclusive contact measure that considers the number and duration of potential exposure events. Conclusions Heterogeneities in location-dependent contact behaviour as measured by contact diary studies depend on the adopted contact definition. We find that contact measures isolating face-face conversational or touch interactions suggest that contact in the home dominates, whereas more inclusive contact measures indicate that home and work settings may be of higher importance. In the absence of definitive knowledge of the contact required to facilitate transmission of various respiratory pathogens, it is important for surveys to consider alternative contact measures.
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Affiliation(s)
- Kirsty J Bolton
- Vaccine and Immunisation Research Group, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria, Australia.
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MacIntyre CR, Ridda I, Seale H, Gao Z, Ratnamohan VM, Donovan L, Zeng F, Dwyer DE. Respiratory viruses transmission from children to adults within a household. Vaccine 2011; 30:3009-14. [PMID: 22119589 PMCID: PMC7115576 DOI: 10.1016/j.vaccine.2011.11.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 11/08/2011] [Accepted: 11/11/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND The aim of this study was to examine the rate of transmission of influenza and other respiratory viruses from children attending an Emergency Department to their family members in the household using active surveillance. METHODS A prospective hospital-based study was conducted over three consecutive winters (2006-2008) in children aged <1-15 years presenting with influenza-like illness (ILI). 168 children with ILI and their healthy families were recruited over three winter seasons. RESULTS Respiratory viruses were detected in 101 (60.8%) children with ILI; in 91/166 (54.8%) a single pathogen was detected, and in the remaining 10 children more than one virus was detected concurrently. Influenza was the most common virus detected (34/101), followed by rhinoviruses (22/101) and adenoviruses (14/101). Of influenza viruses, 21/34 were influenza A and 13/34 influenza B. Meeting the clinical definition of ILI did not differentiate between influenza and other viruses. Clinical ILI developed within one week of follow up in 12% (26/205) of the family members who were swabbed. Viral pathogens were detected in 42.3% (11/26) of the symptomatic family members. In 6/11 cases the same virus was detected in the adult and child. The lower estimate of the household risk of transmission of respiratory viruses, based on concordant proven infection in both child and adult, from a single sick child to adult household contacts is therefore 3% per week. CONCLUSION This study provides quantitative, prospective data on rates of household transmission of infection from children to adults.
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Belser JA, Snider CB, Cox NJ, Hayden FG. XIth International Symposium on Respiratory Viral Infections. Influenza Other Respir Viruses 2011; 5:443-52, e455-7. [PMID: 21668671 PMCID: PMC5780661 DOI: 10.1111/j.1750-2659.2011.00255.x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Please cite this paper as: Belser et al. (2011) XIth International Symposium on Respiratory Viral Infections. Influenza and Other Respiratory Viruses 5(6), 443–e457.
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Affiliation(s)
- Jessica A Belser
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30033, USA.
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Abdelzaher AM, Wright ME, Ortega C, Hasan AR, Shibata T, Solo-Gabriele HM, Kish J, Withum K, He G, Elmir SM, Bonilla JA, Bonilla TD, Palmer CJ, Scott TM, Lukasik J, Harwood VJ, McQuaig S, Sinigalliano CD, Gidley ML, Wanless D, Plano LRW, Garza AC, Zhu X, Stewart JR, Dickerson JW, Yampara-Iquise H, Carson C, Fleisher JM, Fleming LE. Daily measures of microbes and human health at a non-point source marine beach. J Water Health 2011; 9:443-57. [PMID: 21976192 DOI: 10.2166/wh.2011.146] [Citation(s) in RCA: 21] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Studies evaluating the relationship between microbes and human health at non-point source beaches are necessary for establishing criteria which would protect public health while minimizing economic burdens. The objective of this study was to evaluate water quality and daily cumulative health effects (gastrointestinal, skin, and respiratory illnesses) for bathers at a non-point source subtropical marine recreational beach in order to better understand the inter-relationships between these factors and hence improve monitoring and pollution prevention techniques. Daily composite samples were collected, during the Oceans and Human Health Beach Exposure Assessment and Characterization Health Epidemiologic Study conducted in Miami (Florida, USA) at a non-point source beach, and analyzed for several pathogens, microbial source tracking markers, indicator microbes, and environmental parameters. Analysis demonstrated that rainfall and tide were more influential, when compared to other environmental factors and source tracking markers, in determining the presence of both indicator microbes and pathogens. Antecedent rainfall and F+ coliphage detection in water should be further assessed to confirm their possible association with skin and gastrointestinal (GI) illness outcomes, respectively. The results of this research illustrate the potential complexity of beach systems characterized by non-point sources, and how more novel and comprehensive approaches are needed to assess beach water quality for the purpose of protecting bather health.
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Affiliation(s)
- Amir M Abdelzaher
- NSF, NIEHS Oceans and Human Health Center, University of Miami, 4600 Rickenbacker Causeway Miami, FL 33149, USA
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Stehlé J, Voirin N, Barrat A, Cattuto C, Isella L, Pinton JF, Quaggiotto M, Van den Broeck W, Régis C, Lina B, Vanhems P. High-resolution measurements of face-to-face contact patterns in a primary school. PLoS One 2011; 6:e23176. [PMID: 21858018 PMCID: PMC3156713 DOI: 10.1371/journal.pone.0023176] [Citation(s) in RCA: 262] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 07/07/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little quantitative information is available on the mixing patterns of children in school environments. Describing and understanding contacts between children at school would help quantify the transmission opportunities of respiratory infections and identify situations within schools where the risk of transmission is higher. We report on measurements carried out in a French school (6-12 years children), where we collected data on the time-resolved face-to-face proximity of children and teachers using a proximity-sensing infrastructure based on radio frequency identification devices. METHODS AND FINDINGS Data on face-to-face interactions were collected on Thursday, October 1(st) and Friday, October 2(nd) 2009. We recorded 77,602 contact events between 242 individuals (232 children and 10 teachers). In this setting, each child has on average 323 contacts per day with 47 other children, leading to an average daily interaction time of 176 minutes. Most contacts are brief, but long contacts are also observed. Contacts occur mostly within each class, and each child spends on average three times more time in contact with classmates than with children of other classes. We describe the temporal evolution of the contact network and the trajectories followed by the children in the school, which constrain the contact patterns. We determine an exposure matrix aimed at informing mathematical models. This matrix exhibits a class and age structure which is very different from the homogeneous mixing hypothesis. CONCLUSIONS We report on important properties of the contact patterns between school children that are relevant for modeling the propagation of diseases and for evaluating control measures. We discuss public health implications related to the management of schools in case of epidemics and pandemics. Our results can help define a prioritization of control measures based on preventive measures, case isolation, classes and school closures, that could reduce the disruption to education during epidemics.
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Affiliation(s)
- Juliette Stehlé
- Centre de Physique Théorique de Marseille, CNRS UMR 6207, Marseille, France
| | - Nicolas Voirin
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hygiène, Epidémiologie et Prévention, Lyon, France
- Université de Lyon, Université Lyon 1, CNRS UMR 5558, Laboratoire de Biométrie et de Biologie Evolutive, Equipe Epidémiologie et Santé Publique, Lyon, France
| | - Alain Barrat
- Centre de Physique Théorique de Marseille, CNRS UMR 6207, Marseille, France
- Data Science Laboratory, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
- * E-mail:
| | - Ciro Cattuto
- Data Science Laboratory, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | - Lorenzo Isella
- Data Science Laboratory, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | - Jean-François Pinton
- Laboratoire de Physique de l'Ecole Normale Supérieure de Lyon, CNRS UMR 5672, Lyon, France
| | - Marco Quaggiotto
- Data Science Laboratory, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | - Wouter Van den Broeck
- Data Science Laboratory, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | - Corinne Régis
- Université de Lyon, Université Lyon 1, CNRS UMR 5558, Laboratoire de Biométrie et de Biologie Evolutive, Equipe Epidémiologie et Santé Publique, Lyon, France
| | - Bruno Lina
- Hospices Civils de Lyon, National Influenza Centre, Laboratory of Virology, Lyon, France
- VIRPATH, CNRS FRE 3011, UCBL, Université de Lyon, Faculté de Médecine RTH Laennec, Lyon, France
| | - Philippe Vanhems
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hygiène, Epidémiologie et Prévention, Lyon, France
- Université de Lyon, Université Lyon 1, CNRS UMR 5558, Laboratoire de Biométrie et de Biologie Evolutive, Equipe Epidémiologie et Santé Publique, Lyon, France
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Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al‐Ansary LA, Bawazeer GA, van Driel ML, Nair NS, Jones MA, Thorning S, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2011; 2011:CD006207. [PMID: 21735402 PMCID: PMC6993921 DOI: 10.1002/14651858.cd006207.pub4] [Citation(s) in RCA: 242] [Impact Index Per Article: 18.6] [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: 11/06/2022]
Abstract
BACKGROUND Viral epidemics or pandemics of acute respiratory infections like influenza or severe acute respiratory syndrome pose a global threat. Antiviral drugs and vaccinations may be insufficient to prevent their spread. OBJECTIVES To review the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. SEARCH STRATEGY We searched The Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL 2010, Issue 3), which includes the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to October 2010), OLDMEDLINE (1950 to 1965), EMBASE (1990 to October 2010), CINAHL (1982 to October 2010), LILACS (2008 to October 2010), Indian MEDLARS (2008 to October 2010) and IMSEAR (2008 to October 2010). SELECTION CRITERIA In this update, two review authors independently applied the inclusion criteria to all identified and retrieved articles and extracted data. We scanned 3775 titles, excluded 3560 and retrieved full papers of 215 studies, to include 66 papers of 67 studies. We included physical interventions (screening at entry ports, isolation, quarantine, social distancing, barriers, personal protection, hand hygiene) to prevent respiratory virus transmission. We included randomised controlled trials (RCTs), cohorts, case-controls, before-after and time series studies. DATA COLLECTION AND ANALYSIS We used a standardised form to assess trial eligibility. We assessed RCTs by randomisation method, allocation generation, concealment, blinding and follow up. We assessed non-RCTs for potential confounders and classified them as low, medium and high risk of bias. MAIN RESULTS We included 67 studies including randomised controlled trials and observational studies with a mixed risk of bias. A total number of participants is not included as the total would be made up of a heterogenous set of observations (participant people, observations on participants and countries (object of some studies)). The risk of bias for five RCTs and most cluster-RCTs was high. Observational studies were of mixed quality. Only case-control data were sufficiently homogeneous to allow meta-analysis. The highest quality cluster-RCTs suggest respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children. Benefit from reduced transmission from children to household members is broadly supported also in other study designs where the potential for confounding is greater. Nine case-control studies suggested implementing transmission barriers, isolation and hygienic measures are effective at containing respiratory virus epidemics. Surgical masks or N95 respirators were the most consistent and comprehensive supportive measures. N95 respirators were non-inferior to simple surgical masks but more expensive, uncomfortable and irritating to skin. Adding virucidals or antiseptics to normal handwashing to decrease respiratory disease transmission remains uncertain. Global measures, such as screening at entry ports, led to a non-significant marginal delay in spread. There was limited evidence that social distancing was effective, especially if related to the risk of exposure. AUTHORS' CONCLUSIONS Simple and low-cost interventions would be useful for reducing transmission of epidemic respiratory viruses. Routine long-term implementation of some measures assessed might be difficult without the threat of an epidemic.
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Affiliation(s)
- Tom Jefferson
- University of OxfordCentre for Evidence Based MedicineOxfordUKOX2 6GG
| | - Chris B Del Mar
- Bond UniversityCentre for Research in Evidence‐Based Practice (CREBP)University DriveGold CoastQueenslandAustralia4229
| | - Liz Dooley
- Bond UniversityFaculty of Health Sciences and MedicineGold CoastQueenslandAustralia4229
| | - Eliana Ferroni
- Regional Center for Epidemiology, Veneto RegionEpidemiological System of the Veneto RegionPassaggio Gaudenzio 1PadovaItaly35131
| | - Lubna A Al‐Ansary
- World Health OrganizationDepartment of Health Metrics and MeasurementGenevaSwitzerland
| | - Ghada A Bawazeer
- King Saud UniversityDepartment of Clinical Pharmacy, College of PharmacyP.O. Box 22452RiyadhSaudi Arabia11495
| | - Mieke L van Driel
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineBrisbaneQueenslandAustralia4029
- Ghent UniversityDepartment of Public Health and Primary CareCampus UZ 6K3, Corneel Heymanslaan 10GhentBelgium9000
| | - N Sreekumaran Nair
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) (Institution of National Importance Under Ministry of Health and Family Welfare, Government of India)Department of Medical Biometrics & Informatics (Biostatistics)4th Floor, Administrative BlockDhanvantri NagarPuducherryIndia605006
| | - Mark A Jones
- Bond UniversityInstitute for Evidence‐Based Healthcare11 University DriveRobinaGold CoastQueenslandAustralia4226
| | - Sarah Thorning
- Gold Coast Hospital and Health ServiceGCUH LibraryLevel 1, Block E, GCUHSouthportQueenslandAustralia4215
| | - John M Conly
- Foothills Medical Centre, Room 930, North Tower1403‐29th St NWCalgaryABCanadaT2N 2T9
- WHO. Infection Prevention and Control in Health CareDepartment of Global Alert and Response ‐ Health Security and EnvironmentOffice L420, 20, Avenue AppiaGenevaSwitzerlandCH‐1211
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122
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Reich NG, Perl TM, Cummings DAT, Lessler J. Visualizing clinical evidence: citation networks for the incubation periods of respiratory viral infections. PLoS One 2011; 6:e19496. [PMID: 21559339 PMCID: PMC3084881 DOI: 10.1371/journal.pone.0019496] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [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: 11/02/2010] [Accepted: 04/08/2011] [Indexed: 12/01/2022] Open
Abstract
Simply by repetition, medical facts can become enshrined as truth even when there
is little empirical evidence supporting them. We present an intuitive and clear
visual design for tracking the citation history of a particular scientific fact
over time. We apply this method to data from a previously published literature
review on the incubation period of nine respiratory viral infections. The
resulting citation networks reveal that the conventional wisdom about the
incubation period for these diseases was based on a small fraction of available
data and in one case, on no retrievable empirical evidence. Overall, 50%
of all incubation period statements did not provide a source for their estimate
and 65% of original sources for incubation period data were not
incorporated into subsequent publications. More standardized and widely
available methods for visualizing these histories of medical evidence are needed
to ensure that conventional wisdom cannot stray too far from empirically
supported knowledge.
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Affiliation(s)
- Nicholas G Reich
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
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123
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Abstract
Health care-associated viral respiratory infections, common among hospitalized children, also occur among adults and institutionalized persons and result in increased patient morbidity, mortality, and health care costs. Approximately 20% of patients with healthcare-associated pneumonia have viral respiratory infections, with 70% of these infections caused by adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV). These infections typically reflect the level of viral activity within the community. This article focuses on the epidemiology, transmission, and control of health care-associated RSV and influenza virus.
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Affiliation(s)
- William P. Goins
- Division of Infectious Diseases, Department of Medicine, Baylor College of Medicine, 1709 Dryden Road, BCM 620, Suite 6.15, Houston, TX 77030, USA
| | - H. Keipp Talbot
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, 1161 21st Avenue South, A–2200 MCN, Nashville, TN 37232, USA
| | - Thomas R. Talbot
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, 1161 21st Avenue South, A–2200 MCN, Nashville, TN 37232, USA
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124
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Robinson CM, Singh G, Henquell C, Walsh MP, Peigue-Lafeuille H, Seto D, Jones MS, Dyer DW, Chodosh J. Computational analysis and identification of an emergent human adenovirus pathogen implicated in a respiratory fatality. Virology 2011; 409:141-7. [PMID: 21056888 PMCID: PMC3006489 DOI: 10.1016/j.virol.2010.10.020] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 09/29/2010] [Accepted: 10/13/2010] [Indexed: 11/30/2022]
Abstract
Adenoviral infections are typically acute, self-limiting, and not associated with death. However, we present the genomic and bioinformatics analysis of a novel recombinant human adenovirus (HAdV-D56) isolated in France that caused a rare neonatal fatality, and keratoconjunctivitis in three health care workers who cared for the neonate. Whole genome alignments revealed the expected diversity in the penton base, hexon, E3, and fiber coding regions, and provided evidence for extensive recombination. Bootscan analysis confirmed recombination between HAdV-D9, HAdV-D26, HAdV-D15, and HAdV-D29 in the penton base and hexon proteins, centered around hypervariable loops within the putative proteins. Protein structure analysis of the fiber coding region revealed similarity with HAdV-D8, HAdV-D9, and HAdV-D53, possibly accounting for the ocular tropism of the virus. Based on these data, this virus appears to be a new HAdV-D type (HAdV-D56), underscoring the importance of recombination events in human adenovirus evolution and the emergence of new adenovirus pathogens.
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MESH Headings
- Adenoviruses, Human/genetics
- Adenoviruses, Human/isolation & purification
- Adenoviruses, Human/pathogenicity
- Amino Acid Sequence
- Cluster Analysis
- Computational Biology
- DNA, Viral/chemistry
- DNA, Viral/genetics
- Evolution, Molecular
- Fatal Outcome
- France
- Genome, Viral
- Humans
- Infant, Newborn
- Keratoconjunctivitis/virology
- Molecular Sequence Data
- Phylogeny
- Recombination, Genetic
- Respiratory Tract Infections/mortality
- Respiratory Tract Infections/transmission
- Respiratory Tract Infections/virology
- Sequence Alignment
- Sequence Analysis, DNA
- Viral Proteins/genetics
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Affiliation(s)
- Christopher M. Robinson
- Howe Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, Massachusetts, 02114, USA
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, 975 N.E. 10, Oklahoma City, Oklahoma, 73104, USA
| | - Gurdeep Singh
- Howe Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, Massachusetts, 02114, USA
| | - Cécile Henquell
- CHU Clermont-Ferrand, Laboratoire de Virologie, Hôpital Gabriel Montpied, France, Université d'Auvergne, EA-3843, France
| | - Michael P. Walsh
- Department of Bioinformatics and Computational Biology, George Mason University, 10900 University Blvd., MSN 5B3, Manassas, VA, 20110, USA
| | - Hélène Peigue-Lafeuille
- CHU Clermont-Ferrand, Laboratoire de Virologie, Hôpital Gabriel Montpied, France, Université d'Auvergne, EA-3843, France
| | - Donald Seto
- Department of Bioinformatics and Computational Biology, George Mason University, 10900 University Blvd., MSN 5B3, Manassas, VA, 20110, USA
| | - Morris S. Jones
- Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Circle Travis AFB, California, 94535, USA
| | - David W. Dyer
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, 975 N.E. 10, Oklahoma City, Oklahoma, 73104, USA
| | - James Chodosh
- Howe Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, Massachusetts, 02114, USA
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125
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Troko J, Myles P, Gibson J, Hashim A, Enstone J, Kingdon S, Packham C, Amin S, Hayward A, Nguyen Van-Tam J. Is public transport a risk factor for acute respiratory infection? BMC Infect Dis 2011. [PMID: 21235795 DOI: 10.1186/1471-2334-11-16] [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: 04/21/2023] Open
Abstract
BACKGROUND The relationship between public transport use and acquisition of acute respiratory infection (ARI) is not well understood but potentially important during epidemics and pandemics. METHODS A case-control study performed during the 2008/09 influenza season. Cases (n = 72) consulted a General Practitioner with ARI, and controls with another non-respiratory acute condition (n = 66). Data were obtained on bus or tram usage in the five days preceding illness onset (cases) or the five days before consultation (controls) alongside demographic details. Multiple logistic regression modelling was used to investigate the association between bus or tram use and ARI, adjusting for potential confounders. RESULTS Recent bus or tram use within five days of symptom onset was associated with an almost six-fold increased risk of consulting for ARI (adjusted OR = 5.94 95% CI 1.33-26.5). The risk of ARI appeared to be modified according to the degree of habitual bus and tram use, but this was not statistically significant (1-3 times/week: adjusted OR = 0.54 (95% CI 0.15-1.95; >3 times/week: 0.37 (95% CI 0.13-1.06). CONCLUSIONS We found a statistically significant association between ARI and bus or tram use in the five days before symptom onset. The risk appeared greatest among occasional bus or tram users, but this trend was not statistically significant. However, these data are plausible in relation to the greater likelihood of developing protective antibodies to common respiratory viruses if repeatedly exposed. The findings have differing implications for the control of seasonal acute respiratory infections and for pandemic influenza.
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Affiliation(s)
- Joy Troko
- University of Nottingham, City Hospital, UK
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126
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Scheidemandel V. [Do not cough with the hand! Elbow is better]. MMW Fortschr Med 2010; 152:17. [PMID: 21294364 DOI: 10.1007/bf03367559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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127
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Hall DP, Scott DHT. The risks of acquiring hospital-acquired infections from wet breathing systems. Expert Rev Anti Infect Ther 2010; 8:1071-3. [PMID: 20954870 DOI: 10.1586/eri.10.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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128
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129
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Abstract
UNLABELLED Infection risk assessment is very useful in understanding the transmission dynamics of infectious diseases and in predicting the risk of these diseases to the public. Quantitative infection risk assessment can provide quantitative analysis of disease transmission and the effectiveness of infection control measures. The Wells-Riley model has been extensively used for quantitative infection risk assessment of respiratory infectious diseases in indoor premises. Some newer studies have also proposed the use of dose-response models for such purpose. This study reviews and compares these two approaches to infection risk assessment of respiratory infectious diseases. The Wells-Riley model allows quick assessment and does not require interspecies extrapolation of infectivity. Dose-response models can consider other disease transmission routes in addition to airborne route and can calculate the infectious source strength of an outbreak in terms of the quantity of the pathogen rather than a hypothetical unit. Spatial distribution of airborne pathogens is one of the most important factors in infection risk assessment of respiratory disease. Respiratory deposition of aerosol induces heterogeneous infectivity of intake pathogens and randomness on the intake dose, which are not being well accounted for in current risk models. Some suggestions for further development of the risk assessment models are proposed. PRACTICAL IMPLICATIONS This review article summarizes the strengths and limitations of the Wells-Riley and the dose-response models for risk assessment of respiratory diseases. Even with many efforts by various investigators to develop and modify the risk assessment models, some limitations still persist. This review serves as a reference for further development of infection risk assessment models of respiratory diseases. The Wells-Riley model and dose-response model offer specific advantages. Risk assessors can select the approach that is suitable to their particular conditions to perform risk assessment.
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Affiliation(s)
- G. N. Sze To
- Department of Mechanical Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - C. Y. H. Chao
- Department of Mechanical Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
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130
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Jefferson T, Del Mar C, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, van Driel ML, Nair S, Foxlee R, Rivetti A. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2010:CD006207. [PMID: 20091588 DOI: 10.1002/14651858.cd006207.pub3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [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: 11/08/2022]
Abstract
BACKGROUND Viral epidemics or pandemics of acute respiratory infections like influenza or severe acute respiratory syndrome pose a world-wide threat. Antiviral drugs and vaccinations may be insufficient to prevent catastrophe. OBJECTIVES To systematically review the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, issue 2); MEDLINE (1966 to May 2009); OLDMEDLINE (1950 to 1965); EMBASE (1990 to May 2009); and CINAHL (1982 to May 2009). SELECTION CRITERIA We scanned 2958 titles, excluded 2790 and retrieved the full papers of 168 trials, to include 59 papers of 60 studies. We included any physical interventions (isolation, quarantine, social distancing, barriers, personal protection and hygiene) to prevent transmission of respiratory viruses. We included the following study designs: randomised controlled trials (RCTs), cohorts, case controls, cross-over, before-after, and time series studies. DATA COLLECTION AND ANALYSIS We used a standardised form to assess trial eligibility. RCTs were assessed by: randomisation method; allocation generation; concealment; blinding; and follow up. Non-RCTs were assessed for the presence of potential confounders, and classified into low, medium, and high risks of bias. MAIN RESULTS The risk of bias for the four RCTs, and most cluster RCTs, was high. The observational studies were of mixed quality. Only case-control data were sufficiently homogeneous to allow meta-analysis.The highest quality cluster RCTs suggest respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children. Additional benefit from reduced transmission from children to other household members is broadly supported in results of other study designs, where the potential for confounding is greater. Six case-control studies suggested that implementing barriers to transmission, isolation, and hygienic measures are effective at containing respiratory virus epidemics. We found limited evidence that N95 respirators were superior to simple surgical masks, but were more expensive, uncomfortable, and caused skin irritation. The incremental effect of adding virucidals or antiseptics to normal handwashing to decrease respiratory disease remains uncertain. Global measures, such as screening at entry ports, were not properly evaluated. There was limited evidence that social distancing was effective especially if related to the risk of exposure. AUTHORS' CONCLUSIONS Many simple and probably low-cost interventions would be useful for reducing the transmission of epidemic respiratory viruses. Routine long-term implementation of some of the measures assessed might be difficult without the threat of a looming epidemic.
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Affiliation(s)
- Tom Jefferson
- Vaccines Field, The Cochrane Collaboration, Via Adige 28a, Anguillara Sabazia, Roma, Italy, 00061
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131
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Vergeĭchik GI, Sitnikov BP. [Papillomavirus infection of the upper respiratory tract and anogenital region in children. Transmission routes and possibilities for prevention]. Vestn Otorinolaringol 2010:74-78. [PMID: 20527093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This review of present-day knowledge of etiology of laryngeal papillomatosis is focused on transition routes of papillomavirus infection in children and possibilities for its prevention.
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132
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Gould D, Drey N. Preventing the spread of acute respiratory viral infections. Nurs Stand 2009; 24:44-49. [PMID: 19899337 DOI: 10.7748/ns2009.10.24.5.44.c7318] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Acute respiratory tract infections (ARIs) caused by viruses are not easily treated, so public health measures to prevent transmission are important. Most ARIs cause only mild, self-limiting illnesses. Nevertheless, they account for considerable loss of time from school and work, disrupting education and affecting the economy. The role of hygiene, especially handwashing in reducing the risk of infection, was established in research studies in the 1970s, but few members of the public or health professionals appear to recognise the importance of hand hygiene. The emergence of new, more serious ARIs may renew interest in hygiene, particularly hand hygiene, as an important preventive measure.
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133
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Abstract
There are no unique boxing diseases but certain factors contributing to the spread of illnesses apply strongly to the boxer, coach, and the training facility. This article examines the nature of the sport of boxing and its surrounding environment, and the likelihood of spread of infection through airborne, contact, or blood-borne routes of transmission. Evidence from other sports such as running, wrestling, and martial arts is included to help elucidate the pathophysiologic elements that could be identified in boxers.
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Affiliation(s)
- Osric S King
- Hospital for Special Surgery, 535 East 70th Street New York, NY 10021, USA.
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134
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Winther L, Andersen RM, Baptiste KE, Aalbæk B, Guardabassi L. Association of Stenotrophomonas maltophilia infection with lower airway disease in the horse: a retrospective case series. Vet J 2009; 186:358-63. [PMID: 19758829 DOI: 10.1016/j.tvjl.2009.08.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 08/18/2009] [Accepted: 08/19/2009] [Indexed: 11/17/2022]
Abstract
Stenotrophomonas maltophilia is being reported with increasing frequency as a human nosocomial pathogen, especially among immuno-compromised patients. To the authors' knowledge, this pathogen has not previously been associated with lower airway disease in the horse. In this paper the clinical findings, laboratory diagnosis and response to treatment of seven cases of respiratory infection with S. maltophilia in horses, presented at three equine referral hospitals in Denmark in 2007, are described. In all cases there was a clinical history of chronic coughing and abundant mucopurulent exudate was observed in the lower trachea on endoscopy. On culture of tracheal aspirate, grey, slow-growing colonies, identified as S. maltophilia by both API 20NE identification and 16s ribosomal DNA sequencing, were identified. All isolates had a similar antibiotic susceptibility pattern characterised by resistance to all penicillins and cephalosporins, and to imipenem, gentamicin, amikacin and rifampicin. Ribotyping and pulsed-field gel electrophoresis of the S. maltophilia isolates from different patients indicated that they were either indistinguishable or closely related. This study indicates that S. maltophilia can be associated with chronic lower airway disease in the horse and provides useful initial insights into the diagnosis, therapy and epidemiology of this novel condition.
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Affiliation(s)
- Lotte Winther
- Department of Large Animal Sciences, Faculty of Life Sciences, University of Copenhagen, Denmark.
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136
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HOFSTAD T, VOGELSANG TM. Pathogenic Staphylococci in the Upper Respiratory Tract Their occurrence in patients in a medical department. ACTA ACUST UNITED AC 2009; 167:279-85. [PMID: 14402467 DOI: 10.1111/j.0954-6820.1960.tb03547.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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137
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Qin L, Masaki H, Gotoh K, Furumoto A, Terada M, Watanabe K, Watanabe H. Molecular epidemiological study of Moraxella catarrhalis isolated from nosocomial respiratory infection patients in a community hospital in Japan. Intern Med 2009; 48:797-803. [PMID: 19443974 DOI: 10.2169/internalmedicine.48.2036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/06/2022] Open
Abstract
BACKGROUND Moraxella catarrhalis, occasionally, plays the essential role in nosocomial respiratory infection (NRI). Few studies have reported the route by which this organism spreads in a nosocomial infection outbreak. We identified characteristics of the strains isolated from NRI and attempted to reveal the potential nosocomial transmission routes. METHODS A follow-up study has been performed in a Japanese community hospital between July 2002 and January 2003. M. catarrhalis clinical isolates were identified and beta-lactamase production test as well as the minimal inhibitory concentrations (MICs) have been examined. Pulsed-field gel electrophoresis (PFGE) and the multi locus sequence typing method (MLST) have been introduced as the effective "fingerprinting" methods. RESULTS A total of 29 strains were isolated from 17 participants; 7 independent DNA fragment patterns were detected by PFGE. Pattern B (defined in this study) was dominant, and was detected both in strains from a health care worker (HCW) and inpatients. In the 9 selected strains analyzed by MLST, 7 unique MLST types were identified, which showed the congruence with the results of PFGE results. CONCLUSION Epidemiological analysis proved the transmission route from patient to patient, and suggested that more studies should be focused on identifying the possible transmission route between HCWs and inpatients.
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Affiliation(s)
- Liang Qin
- Division of Infectious Diseases, Department of Infectious Medicine, Kurume University School of Medicine, Kurume.
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138
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Chua KB, Voon K, Crameri G, Tan HS, Rosli J, McEachern JA, Suluraju S, Yu M, Wang LF. Identification and characterization of a new orthoreovirus from patients with acute respiratory infections. PLoS One 2008; 3:e3803. [PMID: 19030226 PMCID: PMC2583042 DOI: 10.1371/journal.pone.0003803] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Accepted: 10/23/2008] [Indexed: 01/19/2023] Open
Abstract
First discovered in the early 1950s, reoviruses (respiratory enteric orphan viruses) were not associated with any known disease, and hence named orphan viruses. Recently, our group reported the isolation of the Melaka virus from a patient with acute respiratory disease and provided data suggesting that this new orthoreovirus is capable of human-to-human transmission and is probably of bat origin. Here we report yet another Melaka-like reovirus (named Kampar virus) isolated from the throat swab of a 54 year old male patient in Kampar, Perak, Malaysia who was suffering from high fever, acute respiratory disease and vomiting at the time of virus isolation. Serological studies indicated that Kampar virus was transmitted from the index case to at least one other individual and caused respiratory disease in the contact case. Sequence analysis of the four small class genome segments indicated that Kampar and Melaka viruses are closely related. This was confirmed by virus neutralization assay, showing an effective two-way cross neutralization, i.e., the serum against one virus was able to neutralize the other. Although the exact origin of Kampar virus is unknown, epidemiological tracing revealed that the house of the index case is surrounded by fruit trees frequently visited by fruit bats. There is a high probability that Kampar virus originated from bats and was transmitted to humans via bat droppings or contaminated fruits. The discovery of Kampar virus highlights the increasing trend of emergence of bat zoonotic viruses and the need to expand our understanding of bats as a source of many unknown viruses.
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Affiliation(s)
- Kaw Bing Chua
- National Public Health Laboratory, Sg. Buloh, Selangor, Malaysia
- International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
- * E-mail: (KBC); (L-FW)
| | - Kenny Voon
- International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Gary Crameri
- CSIRO Livestock Industries, Australian Animal Health Laboratory and Australian Biosecurity Cooperative Research Center for Emerging Infectious Diseases, Geelong, Australia
| | - Hui Siu Tan
- Klinik Kesihatan Kampar, Jalan Degong, Perak, Malaysia
| | - Juliana Rosli
- National Public Health Laboratory, Sg. Buloh, Selangor, Malaysia
| | - Jennifer A. McEachern
- CSIRO Livestock Industries, Australian Animal Health Laboratory and Australian Biosecurity Cooperative Research Center for Emerging Infectious Diseases, Geelong, Australia
| | | | - Meng Yu
- CSIRO Livestock Industries, Australian Animal Health Laboratory and Australian Biosecurity Cooperative Research Center for Emerging Infectious Diseases, Geelong, Australia
| | - Lin-Fa Wang
- CSIRO Livestock Industries, Australian Animal Health Laboratory and Australian Biosecurity Cooperative Research Center for Emerging Infectious Diseases, Geelong, Australia
- * E-mail: (KBC); (L-FW)
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139
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Cheng FWT, Lee V, Shing MMK, Li CK. Prolonged shedding of respiratory syncytial virus in immunocompromised children: implication for hospital infection control. J Hosp Infect 2008; 70:383-5. [PMID: 18951664 DOI: 10.1016/j.jhin.2008.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 08/29/2008] [Indexed: 11/19/2022]
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Abstract
Chlamydiae are important intracellular bacterial pathogens of vertebrates. In the last years, novel members of this group have been discovered: Parachlamydia acanthamoebae and Simkania negevensis seems to be emerging respiratory human pathogens, while Waddlia chondrophila might be a new agent of bovine abortion. Various species have been showed to infect also the herpetofauna and fishes, and some novel chlamydiae are endosymbionts of arthropods. In addition, molecular studies evidenced a huge diversity of chlamydiae from both environmental and clinical samples, most of such a diversity could be formed by novel lineages of chlamydiae. Experimental studies showed that free-living amoebae may support multiplication of various chlamydiae, then could play an important role as reservoir/vector of chlamydial infections. Here we reviewed literature data concerning chlamydial infections, with a particular emphasis on the novely described chlamydial organisms.
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Affiliation(s)
- Daniele Corsaro
- Retrovirology Laboratory, Centre Hospitalier de Luxembourg, Luxembourg
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141
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Rees TM, Lubinski JL. Oral supplementation with L-lysine did not prevent upper respiratory infection in a shelter population of cats. J Feline Med Surg 2008; 10:510-3. [PMID: 18547855 DOI: 10.1016/j.jfms.2008.03.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2008] [Indexed: 11/18/2022]
Abstract
Cats in animal shelters are highly susceptible to infection by feline herpesvirus (FHV) by virtue of their stress and close proximity to other cats. Animal shelters take several different approaches to prevent FHV-related upper respiratory infections (URIs), including empirically treating all cats with L-lysine, a supplement believed to prevent the replication of FHV and, therefore, manifestations of herpesvirus infections. In this study we tested oral supplementation of L-lysine as a means to prevent URIs. One hundred and forty-four cats were treated with L-lysine in a small amount of canned food once daily. A 'no treatment' group of 147 cats received no lysine during the course of the study. The development of conjunctivitis or URI was tracked between the two groups. In all measures, there was no effect between the two groups, suggesting that lysine was not able to prevent URI or conjunctivitis in our shelter situation. Cats entering shelters encounter stressors that may make them more susceptible to FHV reactivation or infection. Infection control and control of fomite transmission are also key to keeping cats healthy in a group housing situation. The finding that lysine did not prevent URI in this animal shelter suggests that shelters may better use their resources by finding ways to decrease stress among their feline population, focusing on proper infection control measures, and limiting fomite transmission of disease.
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Affiliation(s)
- Tina M Rees
- Humane Society of Indianapolis, 7929 N Michigan Road, Indianapolis, IN 46268, USA.
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142
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Nicas M, Best D. A study quantifying the hand-to-face contact rate and its potential application to predicting respiratory tract infection. J Occup Environ Hyg 2008; 5:347-52. [PMID: 18357546 PMCID: PMC7196690 DOI: 10.1080/15459620802003896] [Citation(s) in RCA: 164] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
A substantial portion of human respiratory tract infection is thought to be transmitted via contaminated hand contact with the mouth, eyes, and/or nostrils. Thus, a key risk factor for infection transmission should be the rate of hand contact with these areas termed target facial membranes. A study was conducted in which 10 subjects were each videotaped for 3 hr while performing office-type work in isolation from other persons. The number of contacts to the eyes, nostrils, and lips was scored during subsequent viewing of the tapes. The total contacts per subject had sample mean x = 47 and sample standard deviation s = 34. The average total contact rate per hour was 15.7. The authors developed a relatively simple algebraic model for estimating the dose of pathogens transferred to target facial membranes during a defined exposure period. The model considers the rate of pathogen transfer to the hands via contact with contaminated environmental surfaces, and the rate of pathogen loss from the hands due to pathogen die-off and transfer from the hands to environmental surfaces and to target facial membranes during touching. The estimation of infection risk due to this dose also is discussed. A hypothetical but plausible example involving influenza A virus transmission is presented to illustrate the model.
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Affiliation(s)
- Mark Nicas
- School of Public Health, University of California, Berkeley, Berkeley, California 94720, USA.
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143
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Puro V, Fusco FM, Lanini S, Nisii C, Ippolito G. Risk management of febrile respiratory illness in emergency departments. New Microbiol 2008; 31:165-173. [PMID: 18623980] [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: 05/26/2023]
Abstract
Febrile Respiratory Illness (FRI) is defined as a new or worsening episode of either cough or shortness of breath, presenting with fever (temperature 38 degrees C or higher) or chills in the previous 24 hours. Some FRI could cause large outbreaks of potentially life-threatening diseases (multi- or extensively drug resistant MTB, SARS, pandemic influenza) if not adequately controlled. Emergency Departments (EDs) are preferential sites of disease transmission because of the presence of both infectious and susceptible patients in the same space, the lack of rapid isolation of infectious patients, and the frequent and close contacts among patients and HCWs often not protected by PPE. The management of risk of FRI transmission is thus extremely important in EDs, where all procedures of infection control should be in place and continually monitored and assessed. In this article the main procedures for the management of risk of FRI transmission in EDs are described and discussed.
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Affiliation(s)
- Vincenzo Puro
- Epidemiological and Pre-clinical Research Department, Istituto Nazionale per le Malattie Infettive L. Spallanzani, Rome, Italy.
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144
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Mossong J, Hens N, Jit M, Beutels P, Auranen K, Mikolajczyk R, Massari M, Salmaso S, Tomba GS, Wallinga J, Heijne J, Sadkowska-Todys M, Rosinska M, Edmunds WJ. Social contacts and mixing patterns relevant to the spread of infectious diseases. PLoS Med 2008; 5:e74. [PMID: 18366252 PMCID: PMC2270306 DOI: 10.1371/journal.pmed.0050074] [Citation(s) in RCA: 1693] [Impact Index Per Article: 105.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 02/15/2008] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Mathematical modelling of infectious diseases transmitted by the respiratory or close-contact route (e.g., pandemic influenza) is increasingly being used to determine the impact of possible interventions. Although mixing patterns are known to be crucial determinants for model outcome, researchers often rely on a priori contact assumptions with little or no empirical basis. We conducted a population-based prospective survey of mixing patterns in eight European countries using a common paper-diary methodology. METHODS AND FINDINGS 7,290 participants recorded characteristics of 97,904 contacts with different individuals during one day, including age, sex, location, duration, frequency, and occurrence of physical contact. We found that mixing patterns and contact characteristics were remarkably similar across different European countries. Contact patterns were highly assortative with age: schoolchildren and young adults in particular tended to mix with people of the same age. Contacts lasting at least one hour or occurring on a daily basis mostly involved physical contact, while short duration and infrequent contacts tended to be nonphysical. Contacts at home, school, or leisure were more likely to be physical than contacts at the workplace or while travelling. Preliminary modelling indicates that 5- to 19-year-olds are expected to suffer the highest incidence during the initial epidemic phase of an emerging infection transmitted through social contacts measured here when the population is completely susceptible. CONCLUSIONS To our knowledge, our study provides the first large-scale quantitative approach to contact patterns relevant for infections transmitted by the respiratory or close-contact route, and the results should lead to improved parameterisation of mathematical models used to design control strategies.
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Affiliation(s)
- Joël Mossong
- Microbiology Unit, Laboratoire National de Santé, Luxembourg, Luxembourg.
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145
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Abstract
Influenza virus infections are associated with high morbidity and mortality. Influenza activity varies worldwide, and regional detection is influenced by geographic conditions, demographic and patient-risk factors. We assessed influenza activity and patterns of seasonality during three consecutive years (2001-2003) in three risk groups in São Paulo city. Four-hundred-twelve outpatients with acute respiratory infection were subjected to epidemiological, clinical and laboratory investigations; these included community population (N=140), health-care workers (N=203), and renal-transplanted patients (N=69). Nasal wash samples were tested by direct fluorescent assay for influenza, parainfluenza, adenovirus, and respiratory syncytial virus. Overall Influenza positivity was 21%, and a progressive decline was observed in all groups over time. Influenza A and B co-circulated at the same time in 2001 and 2002, but not in 2003. Low influenza-vaccination rates (19%) were reported by health-care workers. Unexpected low levels of etiological agents were detected in renal-transplanted patients, and infected cases were less symptomatic than immunocompetent patients. Based on this study, we conclude that health-care worker-immunization programs should be implemented and the clinical patterns of infected influenza patients should be used as a guide for better case-definition criteria for adequate influenza surveillance, particularly for renal-transplant patients.
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Affiliation(s)
- Nancy Bellei
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, São Paulo Federal University, São Paulo, SP, Brazil.
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146
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Spencer B. OTC product: Kleenex Anti-Viral tissue. J Am Pharm Assoc (2003) 2008; 48:112. [PMID: 18192141 PMCID: PMC7172764 DOI: 10.1331/japha.2008.08503] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Beth Spencer
- School of Pharmacy, Wingate University, 316 N. Main St. Wingate, NC 28174, USA.
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147
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Ortolano GA, Schaffer J, McAlister MB, Stanchfield I, Hill E, Vandenburgh L, Lewis M, John S, Canonica FP, Cervia JS. Filters reduce the risk of bacterial transmission from contaminated heated humidifiers used with CPAP for obstructive sleep apnea. J Clin Sleep Med 2007; 3:700-705. [PMID: 18198803 PMCID: PMC2556912] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
RATIONALE The treatment of choice for obstructive sleep apnea (OSA) is nasal continuous positive airway pressure (nCPAP) during sleep, but dryness of the upper airway compromises compliance. Heated humidifiers may mitigate such noncompliance; however, recent observations suggest that their use, particularly if not cleaned, increases the risk of respiratory infections. Humidifier water may be contaminated, but the long-held view that passive humidifiers cannot aerosolize water may obscure the perception of risk of infection. OBJECTIVES This study challenges the long-held view that "passover" humidifiers do not aerosolize water. With such evidence, this study characterizes the performance of filters to reduce the potential risk of contamination. METHODS Heated humidifier water contaminated with bacteria was studied under conditions simulating week-long use of nCPAP for OSA. RESULTS Bacteria were recovered in 9 of 11 tests from the breathing tubes of CPAP devices fitted with heated humidifiers with water contaminated with Brevundimonas diminuta or Serratia marcescens. Recoverable bacteria ranged from tens to thousands of colony forming units when tested at air flow rates of 60 liters per minute for 90 minutes. Neither organism was recovered from the circuit tubing when a hydrophobic breathing-circuit filter was positioned between the humidifier and face-mask tubing with a commercially available nCPAP machine tested under simulated-use conditions. CONCLUSION Data suggest that patients with OSA being treated with nCPAP fitted with humidifiers may be aerosolizing bacteria, putting them at risk for developing respiratory infections and that the use of a hydrophobic filter may attenuate the passage of microbes from contaminated humidifier water.
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150
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Zutavern A, Rzehak P, Brockow I, Schaaf B, Bollrath C, von Berg A, Link E, Kraemer U, Borte M, Herbarth O, Wichmann HE, Heinrich J. Day care in relation to respiratory-tract and gastrointestinal infections in a German birth cohort study. Acta Paediatr 2007; 96:1494-9. [PMID: 17666100 DOI: 10.1111/j.1651-2227.2007.00412.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [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: 11/29/2022]
Abstract
AIM To describe day care attendance in Germany today (in former East and former West Germany). To investigate longitudinally whether children attending day care centres have an increased risk of acquiring common cold, bronchitis, pneumonia, otitis media or diarrhea. METHODS Questionnaire information was collected when the children in the cohort were 6, 12, 18, 24 months, and 4 and 6 years old. Day care within the first and first 2 years of life was investigated longitudinally with GEE (generalised estimating equations) methods in relation to common cold, bronchitis, pneumonia, otitis media and diarrhea within the first 6 years of life. RESULTS Day care centre attendance is more common in former East than in former West Germany; this difference is evident even 10-12 years after German reunification. Children attending a day care centre were more likely to have common cold, bronchitis, pneumonia, otitis media and diarrhea within the first 2-3 years of life. With the exception of common cold, from year 4 onwards these associations were not statistically significant anymore and even reversed for some of the infections. CONCLUSIONS Children attending day care centres were at an increased risk of respiratory and gastrointestinal infections within the first years of life. However, around school age these differences disappeared or even partly reversed.
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Affiliation(s)
- Anne Zutavern
- GSF-National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
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