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Updates on Coronavirus-Related Ocular Manifestations: From the Past to COVID-19 Pandemic. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2022. [DOI: 10.5812/pedinfect-117176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Context: Coronaviruses are the largest RNA viruses associated with some ocular manifestations. There are various contradictory reports about the ocular manifestations of coronaviruses in humans. Different ocular tissues can affect coronavirus-associated infectious diseases. Evidence Acquisition: All manuscripts were collected from PubMed, Google Scholar, and other relevant databases. All searches were done by specific keywords, including "coronavirus," "ocular disease," and "eye." Results: There are various contradictory reports about the ocular effects of coronaviruses in humans. Different ocular tissues are involved in coronavirus-associated infectious diseases. The ductal connection between the upper respiratory tract and eye mucosa through the nasolacrimal duct can be an entrance to respiratory viruses, such as coronaviruses. The coronavirus can infect the retina, conjunctiva, cornea, and uvea of the eye. The primary SARS-CoV-2 receptor, ACE2, is mainly expressed in the posterior tissues of the eye, such as the retina and RPE. Feline CoV, SARS-CoV, MERS-CoV, and infectious bronchitis virus (IBV) are responsible for conjunctiva involvement in coronavirus-related ocular pathogenesis. Also, various studies are held on COVID-19 and the impact of the conjunctiva on diagnosis and medical complications. Given that the cornea has an acceptable expression of ACE2 and TMPRSS2 genes compared to lung tissue, some studies were done on the impact of the cornea in COVID-19. Feline infectious peritonitis virus (FIPV) is also related to uvea complications. The experiments of human and animal models on the effects of coronaviruses on the retina and cornea in the event of various epidemics of coronaviruses and new and unknown ocular complications can be of great help to future studies. Conclusions: Given the importance of investigating the pathogenesis and other routes of SARS-CoV-2 infection, especially in areas other than the respiratory tract, this report attempts to highlight the importance of eye infections caused by the virus, its role in maintaining the virus transmission chain, and its impact on public health.
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Amin MA, Nahin S, Dola TA, Afrin S, Hawlader MDH. Retinal hemorrhage of late post‐COVID‐19 and post‐vaccine‐related pathogenic mechanisms: A new challenge for ophthalmologist in COVID era. Clin Case Rep 2022; 10:e05471. [PMID: 35223021 PMCID: PMC8850941 DOI: 10.1002/ccr3.5471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/06/2022] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mohammad Ashraful Amin
- Department of Public Health North South University Dhaka Bangladesh
- Public Health Professional Development Society (PPDS) Dhaka Bangladesh
| | - Sabrina Nahin
- Department of Physiology Green Life Medical College Hospital Dhaka Bangladesh
| | - Taslima Ahmed Dola
- Department of Community Medicine East West Medical College and Hospital Dhaka Bangladesh
| | - Sadia Afrin
- Department of Public Health North South University Dhaka Bangladesh
- Public Health Professional Development Society (PPDS) Dhaka Bangladesh
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Olguín-Manríquez F, Cernichiaro-Espinosa L, Olguín-Manríquez A, Manríquez-Arias R, Flores-Villalobos EO, Kawakami-Campos PA. Unilateral acute posterior multifocal placoid pigment epitheliopathy in a convalescent COVID-19 patient. Int J Retina Vitreous 2021; 7:41. [PMID: 34034832 PMCID: PMC8148402 DOI: 10.1186/s40942-021-00312-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/18/2021] [Indexed: 12/20/2022] Open
Abstract
Background To report a case of unilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in a Hispanic convalescent COVID-19 female patient. Case presentation A 35-year-old Hispanic female with exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was evaluated due to unilateral visual loss. Ophthalmic examination and diagnostic tests were consistent with APMPPE. Discussion Ocular changes can be observed in patients with COVID-19. A complete ophthalmic evaluation must be performed in patients with low vision after SARS-CoV-2 infection.
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Affiliation(s)
- Francisco Olguín-Manríquez
- Retina Department, Oftal Unidad Médica, Mexico city, Mexico. .,Retina Service, Oftal Unidad Médica, Av. Paseo de la Reforma 155, Colonia Lomas de Chapultepec, Alcaldía Miguel Hidalgo, 11000, Mexico City, CP, Mexico.
| | | | - Arturo Olguín-Manríquez
- Cornea and Anterior Segment Department, Oftal Unidad Médica, Pachuca de Soto, Hidalgo, Mexico
| | | | | | - Perla Ayumi Kawakami-Campos
- Retina Department, Instituto Nacional de Ciencias Médicas Y Nutrición "Salvador Zubirán", Mexico City, Mexico
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Durán C SC, Mayorga G DC. The eye: "An organ that must not be forgotten in coronavirus disease 2019 (COVID-2019) pandemic". JOURNAL OF OPTOMETRY 2021; 14:114-119. [PMID: 32763128 PMCID: PMC7362814 DOI: 10.1016/j.optom.2020.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/30/2020] [Accepted: 07/04/2020] [Indexed: 06/11/2023]
Abstract
The coronavirus family is a group of zoonotic viruses with some recognized reservoirs particularly some bats. A novel coronavirus emerged in the province of Wuhan (China) in December of 2019.The number of infected patient with serious respiratory infection quickly spread around the world to become a global pandemic. The clinical presentation and viral pathogenesis of the coronavirus disease named COVID-19 indicated that the virus is transmitted from person to person through infected droplets entering the respiratory mucosa. Close contact with infected individuals particularly in crowded environments has characterized the rapid spread of the infection. Clinical manifestations of the viral infection have mentioned the presence of some ocular findings such as conjunctival congestion, conjunctivitis and even corneal injury associated with the classical COVID-19 infection. Some animal models of different coronaviruses eye infections have described the viral pathogenesis through tear and conjunctival sampling. On the other hand, we are recommended protective measure to prevent contagion and limit the spread of the virus in health care professionals and contact lenses wearers.
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Affiliation(s)
- Sandra C Durán C
- La Salle University, Health and Sciences Faculty, Optometry Program, Primary Eye Care Group, Bogotá, Colombia.
| | - Diana C Mayorga G
- National University of Colombia, Pharmacy Faculty, Cancer Pharmacogenetics Group, Bogotá, Colombia
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Stanescu-Segall D, Zarka J, Pedinielli A, Gaudric A, Bodaghi B, Touhami S. Bilateral cystoid maculopathy as first manifestation of SARS-CoV-2 infection. J Fr Ophtalmol 2021; 44:e249-e251. [PMID: 33840494 PMCID: PMC7997302 DOI: 10.1016/j.jfo.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 11/24/2022]
Affiliation(s)
- D Stanescu-Segall
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France.
| | - J Zarka
- CHIC: Centre hospitalier intercommunal de Creteil, 40, avenue de Verdun, 94000 Créteil, France
| | - A Pedinielli
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - A Gaudric
- CIL, 11, rue Antoine-Bourdelle, 75015 Paris, France
| | - B Bodaghi
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - S Touhami
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France
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Lani-Louzada R, Ramos CDVF, Cordeiro RM, Sadun AA. Retinal changes in COVID-19 hospitalized cases. PLoS One 2020; 15:e0243346. [PMID: 33270751 PMCID: PMC7714146 DOI: 10.1371/journal.pone.0243346] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/19/2020] [Indexed: 12/30/2022] Open
Abstract
The main objective of this study was to evaluate the retinas of severely or critically ill COVID-19 patients during their hospital stay, at varying time points after symptoms onset. This was a case series observed during May 2020 in two referral centers for COVID-19 treatment in Rio de Janeiro, Brazil. 47 eyes from 25 hospitalized patients with severe or critical confirmed illness were evaluated. A handheld retinal camera was used to acquire bilateral fundus images at several time points after symptoms onset. Electronic health records were retrospectively analyzed and clinical data collected. Severe and critical diseases were noticed in 52% (13/25) and 48% (12/25) of enrolled patients, respectively. Retinal changes were present in 12% (3/25) of patients: a 35 year-old male demonstrated bilateral nerve fiber layer infarcts and microhemorrhages in the papillomacular bundle, but required mechanical ventilation and developed severe anemia and systemic hypotension, acute kidney injury and neurologic symptoms during the course of the disease (critical illness); a 56 year-old male, who required full enoxaparin anticoagulation due to particularly elevated D-dimer (>5.0 mcg/mL), demonstrated unilateral and isolated flame-shaped hemorrhages; and a 49 year-old hypertensive male showed bilateral and discrete retinal dot and blot microhemorrhages. The other 22 patients evaluated did not demonstrate convincing retinal changes upon examination. There was no correlation between disease severity and admission serum levels of CRP, D-dimer and ferritin. This was the first study to show that vascular retinal changes may be present in not insignificant numbers of severe or critical COVID-19 inpatients. These retinal changes, only seen after morbid developments, were likely secondary to clinical intercurrences or comorbidities instead of a direct damage by SARS-CoV-2, and may be important and easily accessible outcome measures of therapeutic interventions and sentinels of neurologic and systemic diseases during COVID-19 pandemic.
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Affiliation(s)
- Rafael Lani-Louzada
- Hospital Nossa Senhora da Saúde, Santa Casa da Misericórdia do Rio de Janeiro (Hospital da Gamboa), Instituto de Oftalmologia do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ricardo Mello Cordeiro
- Departamento de Clínica Médica, Hospital de Clínicas de Jacarepaguá, Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Clínica Médica, Hospital de Clínicas Mário Lioni, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alfredo A. Sadun
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Doheny Eye Institute, Los Angeles, California, United States of America
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The RPE Cell and the Immune System. RETINAL PIGMENT EPITHELIUM IN HEALTH AND DISEASE 2020. [PMCID: PMC7121222 DOI: 10.1007/978-3-030-28384-1_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The RPE cell plays a pivotal role in retinal immunity. In fact, the RPE cell orchestrates both innate and adaptive immunity and contains a plethora of factors to regulate the immune response. Many immunoregulatory activities of the RPE cell are accomplished through cytokine production, toll-like receptor (TLR) activation, complement regulation and antigen presentation. The RPE cells immune regulatory network plays an essential role in retinal immunity and autoimmunity, retinal infections and in a variety of retinal degenerative disorders. Understanding the immune regulatory properties of this cell may provide additional clues to disease mechanisms that may lead to future treatments for many human retinal diseases.
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Infections Associated with Retinal Autoimmunity. INFECTION AND AUTOIMMUNITY 2015. [PMCID: PMC7151837 DOI: 10.1016/b978-0-444-63269-2.00059-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Immune reactivity in the retina can be critically important in inflammation and infections, but regulation of this response is essential. The retinal pigment epithelial (RPE), a unique retinal cell, displays a number of essential functions to support the health of the retina. In this review, we highlight how the RPE cell plays a pivotal role in immune defense. The RPE cell orchestrates both innate and adaptive immunity since it expresses TLRs, complement components, MHC class I and II molecules, and serves as an antigen presenting cell. Moreover, both of these immune responses result in the production of a plethora of cytokines, mainly proinflammatory. In order to counteract these inflammatory factors and silence unwanted immune reactivity, the RPE cell also generates suppressive molecules. Recently, chronic immune reactivity has been implicated in a number of retinal diseases, such as age-related macular degeneration (AMD). Current evidence suggests that the generation of excessive retinal inflammation may be the consequence of a loss of RPE immunosuppressive factors. Herein, we summarize the varied interactions of the RPE cell with the immune response and highlight how the RPE cell survives and participates in this dynamic environment.
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Detrick B, Lee MT, Chin MS, Hooper LC, Chan CC, Hooks JJ. Experimental coronavirus retinopathy (ECOR): retinal degeneration susceptible mice have an augmented interferon and chemokine (CXCL9, CXCL10) response early after virus infection. J Neuroimmunol 2007; 193:28-37. [PMID: 18037505 PMCID: PMC2562577 DOI: 10.1016/j.jneuroim.2007.09.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Revised: 09/05/2007] [Accepted: 09/21/2007] [Indexed: 11/19/2022]
Abstract
Mouse hepatitis virus induces a biphasic disease in BALB/c mice that consists of an acute retinitis followed by progression to a chronic retinal degeneration with autoimmune reactivity. Retinal degeneration resistant CD-1 mice do not develop the late phase. What host factors contribute to the distinct responses to the virus are unknown. Herein, we show that IFN-α, IFN-β and IFN-γ act in concert as part of the innate immune response to the retinal infection. At day 2, high serum levels of IFN-γ, CXCL9 and CXCL10, were detected in BALB/c mice. Moreover, elevated levels of CXCL9 and CXCL10 gene expression were detected in retinal tissue. Although IFN-γ and the chemokines were detected in CD-1 mice, they were at significantly lower levels compared to BALB/c mice. These augmented innate responses observed correlated with the development of autoimmune reactivity and retinal degeneration and thus may contribute to the pathogenic processes.
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Affiliation(s)
- Barbara Detrick
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD 21287-7065, USA.
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Vinores SA, Wang Y, Vinores MA, Derevjanik NL, Shi A, Klein DA, Detrick B, Hooks JJ. Blood-retinal barrier breakdown in experimental coronavirus retinopathy: association with viral antigen, inflammation, and VEGF in sensitive and resistant strains. J Neuroimmunol 2001; 119:175-82. [PMID: 11585619 PMCID: PMC7119735 DOI: 10.1016/s0165-5728(01)00374-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Intraocular coronavirus inoculation results in a biphasic retinal disease in susceptible mice (BALB/c) characterized by an acute inflammatory response, followed by retinal degeneration associated with autoimmune reactivity. Resistant mice (CD-1), when similarly inoculated, only develop the early phase of the disease. Blood-retinal barrier (BRB) breakdown occurs in the early phase in both strains, coincident with the onset of inflammation. As the inflammation subsides, the extent of retinal vascular leakage is decreased, indicating that BRB breakdown in experimental coronavirus retinopathy (ECOR) is primarily due to inflammation rather than to retinal cell destruction. Vascular endothelial growth factor (VEGF) is upregulated only in susceptible mice during the secondary (retinal degeneration) phase.
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Affiliation(s)
- S A Vinores
- 825 Maumenee Building, Wilmer Ophthalmologic Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287-9289, USA.
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Hooks JJ, Tso MO, Detrick B. Retinopathies associated with antiretinal antibodies. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:853-8. [PMID: 11527791 PMCID: PMC96159 DOI: 10.1128/cdli.8.5.853-858.2001] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J J Hooks
- Immunology and Virology Section, Laboratory of Immunology, National Eye Institute, Bldg. 10, National Institutes of Health, Bethesda, MD 20892, USA.
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Larcher C, Recheis H, Sgonc R, Göttinger W, Huemer HP, Irschick EU. Influence of viral infection on expression of cell surface antigens in human retinal pigment epithelial cells. Graefes Arch Clin Exp Ophthalmol 1997; 235:709-16. [PMID: 9407229 PMCID: PMC7087854 DOI: 10.1007/bf01880670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Subacute viral infection is known to change the phenotype of infected cells, thereby causing immune-mediated tissue damage. The aim of this study was to investigate the expression of different cell surface molecules on human retinal pigment epithelial cells (RPEC) following viral infection, with special emphasis on those having immune-regulatory functions. METHODS Cultured RPEC were infected with cytomegalovirus (CMV), coxsackie-virus B3 (CVB) or herpes simplex virus type I (HSV). Double-staining fluorescence technique was used for visualization of virus infection and cell surface markers in the same cells by laser microscopy. RESULTS CMV downregulated MHC class I antigens on RPEC, whereas CVB and HSV did not alter MHC class I antigen expression. No induction of class II antigens was observed in RPEC infected with CVB, HSV or CMV. The intercellular adhesion molecule ICAM-1 (CD54) was strongly expressed in uninfected RPEC, and a slight increase was observed after virus infection. Vascular cell adhesion molecule 1 (VCAM-1) was expressed in low amounts in both uninfected and infected RPEC. No expression of intercellular adhesion molecule 2 (ICAM-2), E-selectin ELAM-1 or lymphocyte-function-associated antigen 1 (LFA-1) was observed on RPEC before or after virus infection. CONCLUSION Downmodulation of immune-regulating cell surface antigens has been suggested to provide a means of long-term survival of viruses in the infected cell, favoring establishment of persistent infection. Our observation in cultured human RPEC indicates that this mechanism might indeed contribute to the development of disease affecting retinal tissue.
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Affiliation(s)
- C Larcher
- Institute of Hygiene, University of Innsbruck, Austria
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Huemer HP, Larcher C, Kirchebner W, Klingenschmid J, Göttinger W, Irschick EU. Susceptibility of human retinal pigment epithelial cells to different viruses. Graefes Arch Clin Exp Ophthalmol 1996; 234:177-85. [PMID: 8720717 PMCID: PMC7088335 DOI: 10.1007/bf00462030] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Different viruses have been reported to be involved in retinal diseases in animal systems. In humans, herpes simplex virus and cytomegalovirus have been found to cause retinal disease. Most of the studied viruses are neurotropic. In this study, the in vitro susceptibility of human retinal pigment epithelial cells (RPEC) to representative members of different groups of human pathogenic viruses was investigated. METHODS Early cultures of RPE C - after two or three passages - were infected with the following viruses: herpes simplex virus (HSV) type 1, human herpesvirus 6 (HHV-6), Epstein-Barr virus (EBV), cytomegalovirus (CMV), adenovirus types 1 and 7, measles virus, parainfluenza virus and coxsackie virus B3. RESULTS Cultures of RPE C could be infected with neurotropic viruses like HSV or measles virus as well as with typical respiratory viruses like parainfluenza or adenoviruses. Coxsackievirus, an enterovirus, replicated as well as human CMV, whereas EBV and HHV-6, two lymphotropic viruses, failed to infect RPE. CONCLUSION These findings suggest that a variety of viruses, including those causing rather common illnesses, might be capable of inducing retinal lesions under certain circumstances due to haematogenous spread during the course of viraemia.
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Affiliation(s)
- H P Huemer
- Institute for Hygiene, University of Innsbruck, Austria
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