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McMahon DE, Schuetz AN, Kovarik CL. Emerging infectious diseases of the skin: a review of clinical and histologic findings. Hum Pathol 2023; 140:196-213. [PMID: 37454994 DOI: 10.1016/j.humpath.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Emerging infectious diseases are of great importance to public health and clinical practice. This review aims to characterize the clinical and histopathologic features of emerging infectious diseases with cutaneous manifestations in order to increase awareness of these entities among dermatologists, pathologists, and dermatopathologists.
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Affiliation(s)
- Devon E McMahon
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Audrey N Schuetz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Carrie L Kovarik
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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2
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Bao M, Waitkus J, Liu L, Chang Y, Xu Z, Qin P, Chen J, Du K. Micro- and nanosystems for the detection of hemorrhagic fever viruses. LAB ON A CHIP 2023; 23:4173-4200. [PMID: 37675935 DOI: 10.1039/d3lc00482a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Hemorrhagic fever viruses (HFVs) are virulent pathogens that can cause severe and often fatal illnesses in humans. Timely and accurate detection of HFVs is critical for effective disease management and prevention. In recent years, micro- and nano-technologies have emerged as promising approaches for the detection of HFVs. This paper provides an overview of the current state-of-the-art systems for micro- and nano-scale approaches to detect HFVs. It covers various aspects of these technologies, including the principles behind their sensing assays, as well as the different types of diagnostic strategies that have been developed. This paper also explores future possibilities of employing micro- and nano-systems for the development of HFV diagnostic tools that meet the practical demands of clinical settings.
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Affiliation(s)
- Mengdi Bao
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Jacob Waitkus
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Li Liu
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Yu Chang
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Zhiheng Xu
- Department of Industrial Engineering, Rochester Institute of Technology, Rochester, NY, USA
| | - Peiwu Qin
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Juhong Chen
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Ke Du
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
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3
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Mane Manohar MP, Lee VJ, Chinedum Odunukwe EU, Singh PK, Mpofu BS, Oxley Md C. Advancements in Marburg (MARV) Virus Vaccine Research With Its Recent Reemergence in Equatorial Guinea and Tanzania: A Scoping Review. Cureus 2023; 15:e42014. [PMID: 37593293 PMCID: PMC10430785 DOI: 10.7759/cureus.42014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
Given the recent outbreaks of the Marburg (MARV) virus within the first quarter of the year 2023, interest in the MARV virus has been re-ignited given its shared phylogeny with the dreadful Ebola virus. This relation gives some insight into its virulence, associated morbidities, and mortality rates. The first outbreak of MARV recorded was in Germany, in 1967, of which seven died out of 31 reported cases. Ever since, subsequent cases have been reported all over Africa, a continent replete with failing healthcare systems. This reality impresses a need for a contemporary and concise revision of the MARV virus existing publications especially in the areas of vaccine research. A functional MARV vaccine will serve as a panacea to ailing communities within the African healthcare landscape. The objective of this scoping review is to provide pertinent information relating to MARV vaccine research beginning with an outline of MARV's pathology and pathogenesis in addition to the related morbidities, existing therapies, established outbreak protocols as well as areas of opportunities.
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Affiliation(s)
| | - Vivian J Lee
- Medicine, Avalon University School of Medicine, Willemstad, CUW
| | | | - Pratik K Singh
- Medicine, Aureus University School of Medicine, Oranjestad, ABW
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4
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Lee JH, Calcagno C, Feuerstein IM, Solomon J, Mani V, Huzella L, Castro MA, Laux J, Reeder RJ, Kim DY, Worwa G, Thomasson D, Hagen KR, Ragland DR, Kuhn JH, Johnson RF. Magnetic Resonance Imaging for Monitoring of Hepatic Disease Induced by Ebola Virus: a Nonhuman Primate Proof-of-Concept Study. Microbiol Spectr 2023; 11:e0353822. [PMID: 37184428 PMCID: PMC10269877 DOI: 10.1128/spectrum.03538-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 04/14/2023] [Indexed: 05/16/2023] Open
Abstract
Severe liver impairment is a well-known hallmark of Ebola virus disease (EVD). However, the role of hepatic involvement in EVD progression is understudied. Medical imaging in established animal models of EVD (e.g., nonhuman primates [NHPs]) can be a strong complement to traditional assays to better investigate this pathophysiological process in vivo and noninvasively. In this proof-of-concept study, we used longitudinal multiparametric magnetic resonance imaging (MRI) to characterize liver morphology and function in nine rhesus monkeys after exposure to Ebola virus (EBOV). Starting 5 days postexposure, MRI assessments of liver appearance, morphology, and size were consistently compatible with the presence of hepatic edema, inflammation, and congestion, leading to significant hepatomegaly at necropsy. MRI performed after injection of a hepatobiliary contrast agent demonstrated decreased liver signal on the day of euthanasia, suggesting progressive hepatocellular dysfunction and hepatic secretory impairment associated with EBOV infection. Importantly, MRI-assessed deterioration of biliary function was acute and progressed faster than changes in serum bilirubin concentrations. These findings suggest that longitudinal quantitative in vivo imaging may be a useful addition to standard biological assays to gain additional knowledge about organ pathophysiology in animal models of EVD. IMPORTANCE Severe liver impairment is a well-known hallmark of Ebola virus disease (EVD), but the contribution of hepatic pathophysiology to EVD progression is not fully understood. Noninvasive medical imaging of liver structure and function in well-established animal models of disease may shed light on this important aspect of EVD. In this proof-of-concept study, we used longitudinal magnetic resonance imaging (MRI) to characterize liver abnormalities and dysfunction in rhesus monkeys exposed to Ebola virus. The results indicate that in vivo MRI may be used as a noninvasive readout of organ pathophysiology in EVD and may be used in future animal studies to further characterize organ-specific damage of this condition, in addition to standard biological assays.
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Affiliation(s)
- Ji Hyun Lee
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Claudia Calcagno
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Irwin M. Feuerstein
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Jeffrey Solomon
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, Maryland, USA
| | - Venkatesh Mani
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Louis Huzella
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Marcelo A. Castro
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Joseph Laux
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Rebecca J. Reeder
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Dong-Yun Kim
- Office of Biostatistics Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Gabriella Worwa
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - David Thomasson
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Katie R. Hagen
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Danny R. Ragland
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Jens H. Kuhn
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Reed F. Johnson
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
- Emerging Viral Pathogens Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
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5
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Spengler JR, Welch SR, Ritter JM, Harmon JR, Coleman-McCray JD, Genzer SC, Seixas JN, Scholte FEM, Davies KA, Bradfute SB, Montgomery JM, Spiropoulou CF. Mouse models of Ebola virus tolerance and lethality: characterization of CD-1 mice infected with wild-type, guinea pig-adapted, or mouse-adapted virus. Antiviral Res 2023; 210:105496. [PMID: 36567020 DOI: 10.1016/j.antiviral.2022.105496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Development of lethal models of Ebola virus disease has been achieved by the serial passage of virus isolates from human cases in mice and guinea pigs. Use of mice infected with non-adapted virus has been limited due to the absence of overt clinical disease. In recent years, newly recognized sequelae identified in human cases has highlighted the importance of continued investigations of non-lethal infection both in humans and animal models. Here, we revisit the use of rodent-adapted and non-adapted Ebola virus (EBOV) in mice to investigate infection tolerance and future utility of these models in pathogenesis and therapeutic intervention studies. We found that like non-adapted wild-type EBOV, guinea pig-adapted EBOV resulted in widespread tissue infection, variably associated with tissue pathology, and alterations in clinical and immunological analytes in the absence of overt disease. Notably, infection with either non-lethal variant did not greatly differ from lethal mouse-adapted EBOV until near the time end-point criteria are reached in these mice. These data support future investigations of pathogenesis, convalescence, and sequelae in mouse models of virus tolerance.
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Affiliation(s)
- Jessica R Spengler
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stephen R Welch
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jana M Ritter
- Infectious Disease Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica R Harmon
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - JoAnn D Coleman-McCray
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah C Genzer
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Josilene N Seixas
- Infectious Disease Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Florine E M Scholte
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine A Davies
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Steven B Bradfute
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Joel M Montgomery
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
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6
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Gourronc FA, Rebagliati M, Kramer-Riesberg B, Fleck AM, Patten JJ, Geohegan-Barek K, Messingham KN, Davey RA, Maury W, Klingelhutz AJ. Adipocytes are susceptible to Ebola Virus infection. Virology 2022; 573:12-22. [DOI: 10.1016/j.virol.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/23/2022]
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7
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Abir MH, Rahman T, Das A, Etu SN, Nafiz IH, Rakib A, Mitra S, Emran TB, Dhama K, Islam A, Siyadatpanah A, Mahmud S, Kim B, Hassan MM. Pathogenicity and virulence of Marburg virus. Virulence 2022; 13:609-633. [PMID: 35363588 PMCID: PMC8986239 DOI: 10.1080/21505594.2022.2054760] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Marburg virus (MARV) has been a major concern since 1967, with two major outbreaks occurring in 1998 and 2004. Infection from MARV results in severe hemorrhagic fever, causing organ dysfunction and death. Exposure to fruit bats in caves and mines, and human-to-human transmission had major roles in the amplification of MARV outbreaks in African countries. The high fatality rate of up to 90% demands the broad study of MARV diseases (MVD) that correspond with MARV infection. Since large outbreaks are rare for MARV, clinical investigations are often inadequate for providing the substantial data necessary to determine the treatment of MARV disease. Therefore, an overall review may contribute to minimizing the limitations associated with future medical research and improve the clinical management of MVD. In this review, we sought to analyze and amalgamate significant information regarding MARV disease epidemics, pathophysiology, and management approaches to provide a better understanding of this deadly virus and the associated infection.
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Affiliation(s)
- Mehedy Hasan Abir
- Faculty of Food Science and Technology, Chattogram Veterinary and Animal Sciences University, Chittagong, Bangladesh
| | - Tanjilur Rahman
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, University of Chittagong, Chittagong, Bangladesh
| | - Ayan Das
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, University of Chittagong, Chittagong, Bangladesh
| | - Silvia Naznin Etu
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chittagong, Bangladesh
| | - Iqbal Hossain Nafiz
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, University of Chittagong, Chittagong, Bangladesh
| | - Ahmed Rakib
- Department of Pharmacy, Faculty of Biological Sciences, University of Chittagong, Chittagong, Bangladesh
| | - Saikat Mitra
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Ariful Islam
- EcoHealth Alliance, New York, NY, USA.,Centre for Integrative Ecology, School of Life and Environmental Science, Deakin University, Victoria, Australia
| | - Abolghasem Siyadatpanah
- Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Shafi Mahmud
- Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, Bangladesh
| | - Bonlgee Kim
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Mohammad Mahmudul Hassan
- Queensland Alliance for One Health Sciences, School of Veterinary Sciences, The University of Queensland, Gatton, Australia.,Department of Physiology, Biochemistry and Pharmacology, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Chattogram, Bangladesh
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8
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Oumarou Hama H, Aboudharam G, Barbieri R, Lepidi H, Drancourt M. Immunohistochemical diagnosis of human infectious diseases: a review. Diagn Pathol 2022; 17:17. [PMID: 35094696 PMCID: PMC8801197 DOI: 10.1186/s13000-022-01197-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/18/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Immunohistochemistry (IHC) using monoclonal and polyclonal antibodies is a useful diagnostic method for detecting pathogen antigens in fixed tissues, complementing the direct diagnosis of infectious diseases by PCR and culture on fresh tissues. It was first implemented in a seminal publication by Albert Coons in 1941. MAIN BODY Of 14,198 publications retrieved from the PubMed, Google, Google Scholar and Science Direct databases up to December 2021, 230 were selected for a review of IHC techniques, protocols and results. The methodological evolutions of IHC and its application to the diagnosis of infectious diseases, more specifically lice-borne diseases, sexually transmitted diseases and skin infections, were critically examined. A total of 59 different pathogens have been detected once in 22 different tissues and organs; and yet non-cultured, fastidious and intracellular pathogens accounted for the vast majority of pathogens detected by IHC. Auto-IHC, incorporating patient serum as the primary antibody, applied to diseased heart valves surgically collected from blood culture-negative endocarditis patients, detected unidentified Gram-positive cocci and microorganisms which were subsequently identified as Coxiella burnetii, Bartonella quintana, Bartonella henselae and Tropheryma whipplei. The application of IHC to ancient tissues dated between the ends of the Ptolemaic period to over 70 years ago, have also contributed to paleomicrobiology diagnoses. CONCLUSION IHC plays an important role in diagnostic of infectious diseases in tissue samples. Paleo-auto-IHC derived from auto-IHC, is under development for detecting non-identified pathogens from ancient specimens.
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Affiliation(s)
- Hamadou Oumarou Hama
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Gérard Aboudharam
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- Aix-Marseille-Univ., Ecole de Médecine Dentaire, Marseille, France
| | - Rémi Barbieri
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Hubert Lepidi
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- Laboratoire d'Histologie, Faculté de Médecine, Université de la Méditerranée, Marseille, France
| | - Michel Drancourt
- IHU Méditerranée Infection, Marseille, France.
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France.
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9
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Clinicopathologic features among different viral epidemic outbreaks involving the skin. Clin Dermatol 2022; 40:573-585. [PMID: 36509508 PMCID: PMC8219845 DOI: 10.1016/j.clindermatol.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The current coronavirus disease 2019 pandemic has exceeded any epidemiologic prevision, but increasing information suggests some analogies with the major viral outbreaks in the last century, and a general warning has been issued on the possibility that coinfections can make the differential diagnosis and treatment difficult, especially in tropical countries. Some reports have noted that the presence of high dengue antibodies can give a false-negative result when testing for severe acute respiratory syndrome coronavirus 2. Mucocutaneous manifestations are very frequent, with an apparent overlap among different pathogens. However, strong clinicopathologic correlation might provide some clues to address differentials. Waiting for laboratory and instrumental results, the timing and distribution of skin lesions is often pathognomonic. Histopathologic findings characterize certain reaction patterns and provide insights on pathogenetic mechanisms. Unfortunately, skin assessment, especially invasive examinations such as biopsy, takes a back seat in severely ill patients. A literature retrieval was performed to collect information from other epidemics to counteract what has become the most frightening disease of our time.
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Key Words
- (covid-19), coronavirus 2019 disease
- (who), world health organization
- (sars), severe acute respiratory syndrome coronavirus
- (sars-cov-2), novel coronavirus
- (mers), middle east respiratory syndrome
- (r0), basic reproductive number
- (mis), multisystem inflammatory syndrome
- (iga), immunoglobulin a
- (ace-2), angiotensin‐converting enzyme 2
- (dengv), dengue virus
- (ttp), thrombotic thrombocytopenic purpura
- (vwf), von willebrand factor
- (cd1a), cluster of diffentiation 1-a
- (rt-pcr), reverse transcription polymerase chain reaction
- (chikv), chikungunya virus
- (e1, e2), envelope glycoprotein
- (ifn-i), interferon-type-i
- (zikv), zika virus
- (ebov), ebola virus
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10
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Bassat Q, Varo R, Hurtado JC, Marimon L, Ferrando M, Ismail MR, Carrilho C, Fernandes F, Castro P, Maixenchs M, Rodrigo-Calvo MT, Guerrero J, Martínez A, Lacerda MVG, Mandomando I, Menéndez C, Martinez MJ, Ordi J, Rakislova N. Minimally Invasive Tissue Sampling as an Alternative to Complete Diagnostic Autopsies in the Context of Epidemic Outbreaks and Pandemics: The Example of Coronavirus Disease 2019 (COVID-19). Clin Infect Dis 2021; 73:S472-S479. [PMID: 34910176 PMCID: PMC8672745 DOI: 10.1093/cid/ciab760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Infectious diseases’ outbreak investigation requires, by definition, conducting a thorough epidemiological assessment while simultaneously obtaining biological samples for an adequate screening of potential responsible pathogens. Complete autopsies remain the gold-standard approach for cause-of-death evaluation and characterization of emerging diseases. However, for highly transmissible infections with a significant associated lethality, such as COVID-19, complete autopsies are seldom performed due to biosafety challenges, especially in low-resource settings. Minimally invasive tissue sampling (MITS) is a validated new approach based on obtaining postmortem samples from key organs and body fluids, a procedure that does not require advanced biosafety measures or a special autopsy room. Methods We aimed to review the use of MITS or similar procedures for outbreak investigation up to 27 March 2021 and their performance for evaluating COVID-19 deaths. Results After a literature review, we analyzed in detail the results of 20 studies conducted at international sites, whereby 216 COVID-19–related deaths were investigated. MITS provided a general and more granular understanding of the pathophysiological changes secondary to the infection and high-quality samples where the extent and degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related damage could be evaluated. Conclusions MITS is a useful addition in the investigation and surveillance of infections occurring in outbreaks or epidemics. Its less invasive nature makes the tool more acceptable and feasible and reduces the risk of procedure-associated contagion, using basic biosafety measures. Standardized approaches protocolizing which samples should be collected—and under which exact biosafety measures—are necessary to facilitate and expand its use globally.
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Affiliation(s)
- Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ICREA, Catalan Institution for Research and Advanced Studies, Barcelona, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Rosauro Varo
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Juan Carlos Hurtado
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Lorena Marimon
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Melania Ferrando
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Mamudo R Ismail
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Carla Carrilho
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Fabiola Fernandes
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clínic, Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Maria Maixenchs
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - José Guerrero
- Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Antonio Martínez
- Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Marcus V G Lacerda
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil.,Fundação Oswaldo Cruz, Instituto Leônidas e Maria Deane-ILMD, Manaus, Brazil
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | - Clara Menéndez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Miguel J Martinez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Jaume Ordi
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Natalia Rakislova
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
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Yamaoka S, Ebihara H. Pathogenicity and Virulence of Ebolaviruses with Species- and Variant-specificity. Virulence 2021; 12:885-901. [PMID: 33734027 PMCID: PMC7993122 DOI: 10.1080/21505594.2021.1898169] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/10/2021] [Accepted: 02/19/2021] [Indexed: 01/05/2023] Open
Abstract
Ebola virus (EBOV), belonging to the species Zaire ebolavirus in the genus Ebolavirus, causes a severe febrile illness in humans with case fatality rates (CFRs) up to 90%. While there have been six virus species classified, which each have a single type virus in the genus Ebolavirus, CFRs of ebolavirus infections vary among viruses belonging to each distinct species. In this review, we aim to define the ebolavirus species-specific virulence on the basis of currently available laboratory and experimental findings. In addition, this review will also cover the variant-specific virulence of EBOV by referring to the unique biological and pathogenic characteristics of EBOV variant Makona, a new EBOV variant isolated from the 2013-2016 EBOV disease outbreak in West Africa. A better definition of species-specific and variant-specific virulence of ebolaviruses will facilitate our comprehensive knowledge on genus Ebolavirus biology, leading to the development of therapeutics against well-focused pathogenic mechanisms of each Ebola disease.
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Affiliation(s)
- Satoko Yamaoka
- Department of Molecular Medicine, Mayo Clinic, Rochester, USA
| | - Hideki Ebihara
- Department of Molecular Medicine, Mayo Clinic, Rochester, USA
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Atzori L, Ferreli C, Mateeva V, Vassileva S, Rongioletti F. Clinicopathologic features between different viral epidemic outbreaks involving the skin. Clin Dermatol 2021; 39:405-417. [PMID: 34517998 PMCID: PMC8071581 DOI: 10.1016/j.clindermatol.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The current coronavirus disease 2019 pandemic has exceeded any epidemiologic prevision, but increasing information suggests some analogies with the major viral outbreaks of the last century. A general warning has been issued on the possibility that coinfections can make differential diagnosis and treatment difficult, especially in tropical countries. Some reports have pointed out that the presence of high Dengue antibodies can give a false-negative result for severe acute respiratory syndrome coronavirus 2. Mucocutaneous manifestations are very frequent, with an apparent overlap among different pathogens. A strong clinicopathologic correlation, however, may provide some clues to address the differential. Waiting for laboratory and instrumental results, the timing and distribution of skin lesions is often pathognomonic. Histopathologic findings characterize certain reaction patterns and provide insights on pathogenetic mechanisms. Unfortunately, skin assessments, especially invasive exams such as biopsy, are less important in severely ill patients. A literature review was performed to collect information from other epidemics to counteract what has become the most frightening disease of our time.
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Affiliation(s)
- Laura Atzori
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Valeria Mateeva
- Department of Dermatology, Sofia University of Medicine, Sofia, Bulgaria
| | - Snejina Vassileva
- Department of Dermatology, Sofia University of Medicine, Sofia, Bulgaria
| | - Franco Rongioletti
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Vita-SaluteS.Raffaele University, Milan, Italy
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Dixon RV, Skaria E, Lau WM, Manning P, Birch-Machin MA, Moghimi SM, Ng KW. Microneedle-based devices for point-of-care infectious disease diagnostics. Acta Pharm Sin B 2021; 11:2344-2361. [PMID: 34150486 PMCID: PMC8206489 DOI: 10.1016/j.apsb.2021.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/25/2020] [Accepted: 01/28/2021] [Indexed: 02/08/2023] Open
Abstract
Recent infectious disease outbreaks, such as COVID-19 and Ebola, have highlighted the need for rapid and accurate diagnosis to initiate treatment and curb transmission. Successful diagnostic strategies critically depend on the efficiency of biological sampling and timely analysis. However, current diagnostic techniques are invasive/intrusive and present a severe bottleneck by requiring specialist equipment and trained personnel. Moreover, centralised test facilities are poorly accessible and the requirement to travel may increase disease transmission. Self-administrable, point-of-care (PoC) microneedle diagnostic devices could provide a viable solution to these problems. These miniature needle arrays can detect biomarkers in/from the skin in a minimally invasive manner to provide (near-) real-time diagnosis. Few microneedle devices have been developed specifically for infectious disease diagnosis, though similar technologies are well established in other fields and generally adaptable for infectious disease diagnosis. These include microneedles for biofluid extraction, microneedle sensors and analyte-capturing microneedles, or combinations thereof. Analyte sampling/detection from both blood and dermal interstitial fluid is possible. These technologies are in their early stages of development for infectious disease diagnostics, and there is a vast scope for further development. In this review, we discuss the utility and future outlook of these microneedle technologies in infectious disease diagnosis.
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Key Words
- AC, alternating current
- APCs, antigen-presenting cells
- ASSURED, affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free and deliverable to end-users
- Biomarker detection
- Biosensor
- CMOS, complementary metal-oxide semiconductor
- COVID, coronavirus disease
- COVID-19
- CSF, cerebrospinal fluid
- CT, computerised tomography
- CV, cyclic voltammetry
- DC, direct current
- DNA, deoxyribonucleic acid
- DPV, differential pulse voltammetry
- EBV, Epstein–Barr virus
- EDC/NHS, 1-ethyl-3-(3-dimethylaminoproply) carbodiimide/N-hydroxysuccinimide
- ELISA, enzyme-linked immunosorbent assay
- GOx, glucose oxidase
- HIV, human immunodeficiency virus
- HPLC, high performance liquid chromatography
- HRP, horseradish peroxidase
- IP, iontophoresis
- ISF, interstitial fluid
- IgG, immunoglobulin G
- Infectious disease
- JEV, Japanese encephalitis virus
- MN, microneedle
- Microneedle
- NA, nucleic acid
- OBMT, one-touch-activated blood multidiagnostic tool
- OPD, o-phenylenediamine
- PCB, printed circuit board
- PCR, polymerase chain reaction
- PDMS, polydimethylsiloxane
- PEDOT, poly(3,4-ethylenedioxythiophene)
- PNA, peptide nucleic acid
- PP, polyphenol
- PPD, poly(o-phenylenediamine)
- PoC, point-of-care
- Point-of-care diagnostics (PoC)
- SALT, skin-associated lymphoid tissue
- SAM, self-assembled monolayer
- SEM, scanning electron microscope
- SERS, surface-enhanced Raman spectroscopy
- SWV, square wave voltammetry
- Skin
- TB, tuberculosis
- UV, ultraviolet
- VEGF, vascular endothelial growth factor
- WHO, World Health Organisation
- cfDNA, cell-free deoxyribonucleic acid
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Affiliation(s)
- Rachael V. Dixon
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
| | - Eldhose Skaria
- Wellcome Trust Centre for Cell-Matrix Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PT, UK
| | - Wing Man Lau
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
| | - Philip Manning
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
| | - Mark A. Birch-Machin
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
| | - S. Moein Moghimi
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
| | - Keng Wooi Ng
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
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Shao Y, Saredy J, Xu K, Sun Y, Saaoud F, Drummer C, Lu Y, Luo JJ, Lopez-Pastrana J, Choi ET, Jiang X, Wang H, Yang X. Endothelial Immunity Trained by Coronavirus Infections, DAMP Stimulations and Regulated by Anti-Oxidant NRF2 May Contribute to Inflammations, Myelopoiesis, COVID-19 Cytokine Storms and Thromboembolism. Front Immunol 2021; 12:653110. [PMID: 34248940 PMCID: PMC8269631 DOI: 10.3389/fimmu.2021.653110] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/12/2021] [Indexed: 12/13/2022] Open
Abstract
To characterize transcriptomic changes in endothelial cells (ECs) infected by coronaviruses, and stimulated by DAMPs, the expressions of 1311 innate immune regulatomic genes (IGs) were examined in 28 EC microarray datasets with 7 monocyte datasets as controls. We made the following findings: The majority of IGs are upregulated in the first 12 hours post-infection (PI), and maintained until 48 hours PI in human microvascular EC infected by middle east respiratory syndrome-coronavirus (MERS-CoV) (an EC model for COVID-19). The expressions of IGs are modulated in 21 human EC transcriptomic datasets by various PAMPs/DAMPs, including LPS, LPC, shear stress, hyperlipidemia and oxLDL. Upregulation of many IGs such as nucleic acid sensors are shared between ECs infected by MERS-CoV and those stimulated by PAMPs and DAMPs. Human heart EC and mouse aortic EC express all four types of coronavirus receptors such as ANPEP, CEACAM1, ACE2, DPP4 and virus entry facilitator TMPRSS2 (heart EC); most of coronavirus replication-transcription protein complexes are expressed in HMEC, which contribute to viremia, thromboembolism, and cardiovascular comorbidities of COVID-19. ECs have novel trained immunity (TI), in which subsequent inflammation is enhanced. Upregulated proinflammatory cytokines such as TNFα, IL6, CSF1 and CSF3 and TI marker IL-32 as well as TI metabolic enzymes and epigenetic enzymes indicate TI function in HMEC infected by MERS-CoV, which may drive cytokine storms. Upregulated CSF1 and CSF3 demonstrate a novel function of ECs in promoting myelopoiesis. Mechanistically, the ER stress and ROS, together with decreased mitochondrial OXPHOS complexes, facilitate a proinflammatory response and TI. Additionally, an increase of the regulators of mitotic catastrophe cell death, apoptosis, ferroptosis, inflammasomes-driven pyroptosis in ECs infected with MERS-CoV and the upregulation of pro-thrombogenic factors increase thromboembolism potential. Finally, NRF2-suppressed ROS regulate innate immune responses, TI, thrombosis, EC inflammation and death. These transcriptomic results provide novel insights on the roles of ECs in coronavirus infections such as COVID-19, cardiovascular diseases (CVD), inflammation, transplantation, autoimmune disease and cancers.
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Affiliation(s)
- Ying Shao
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Jason Saredy
- Metabolic Disease Research, Thrombosis Research, Departments of Pharmacology, Microbiology and Immunology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Keman Xu
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Yu Sun
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Fatma Saaoud
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Charles Drummer
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Yifan Lu
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Jin J Luo
- Neurology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Jahaira Lopez-Pastrana
- Psychiatry and Behavioral Science, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Eric T Choi
- Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Xiaohua Jiang
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States.,Metabolic Disease Research, Thrombosis Research, Departments of Pharmacology, Microbiology and Immunology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Hong Wang
- Metabolic Disease Research, Thrombosis Research, Departments of Pharmacology, Microbiology and Immunology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Xiaofeng Yang
- Centers of Cardiovascular Research, Inflammation, Translational & Clinical Lung Research, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States.,Metabolic Disease Research, Thrombosis Research, Departments of Pharmacology, Microbiology and Immunology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
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15
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Cornish NE, Anderson NL, Arambula DG, Arduino MJ, Bryan A, Burton NC, Chen B, Dickson BA, Giri JG, Griffith NK, Pentella MA, Salerno RM, Sandhu P, Snyder JW, Tormey CA, Wagar EA, Weirich EG, Campbell S. Clinical Laboratory Biosafety Gaps: Lessons Learned from Past Outbreaks Reveal a Path to a Safer Future. Clin Microbiol Rev 2021; 34:e0012618. [PMID: 34105993 PMCID: PMC8262806 DOI: 10.1128/cmr.00126-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Patient care and public health require timely, reliable laboratory testing. However, clinical laboratory professionals rarely know whether patient specimens contain infectious agents, making ensuring biosafety while performing testing procedures challenging. The importance of biosafety in clinical laboratories was highlighted during the 2014 Ebola outbreak, where concerns about biosafety resulted in delayed diagnoses and contributed to patient deaths. This review is a collaboration between subject matter experts from large and small laboratories and the federal government to evaluate the capability of clinical laboratories to manage biosafety risks and safely test patient specimens. We discuss the complexity of clinical laboratories, including anatomic pathology, and describe how applying current biosafety guidance may be difficult as these guidelines, largely based on practices in research laboratories, do not always correspond to the unique clinical laboratory environments and their specialized equipment and processes. We retrospectively describe the biosafety gaps and opportunities for improvement in the areas of risk assessment and management; automated and manual laboratory disciplines; specimen collection, processing, and storage; test utilization; equipment and instrumentation safety; disinfection practices; personal protective equipment; waste management; laboratory personnel training and competency assessment; accreditation processes; and ethical guidance. Also addressed are the unique biosafety challenges successfully handled by a Texas community hospital clinical laboratory that performed testing for patients with Ebola without a formal biocontainment unit. The gaps in knowledge and practices identified in previous and ongoing outbreaks demonstrate the need for collaborative, comprehensive solutions to improve clinical laboratory biosafety and to better combat future emerging infectious disease outbreaks.
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Affiliation(s)
- Nancy E. Cornish
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Nancy L. Anderson
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Diego G. Arambula
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Matthew J. Arduino
- Centers for Disease Control and Prevention, National Center for Emerging & Zoonotic Infectious Diseases (NCEZID), Atlanta, Georgia, USA
| | - Andrew Bryan
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Nancy C. Burton
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
| | - Bin Chen
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Beverly A. Dickson
- Department of Clinical Pathology, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Judith G. Giri
- Centers for Disease Control and Prevention, Center for Global Health (CGH), Atlanta, Georgia, USA
| | | | | | - Reynolds M. Salerno
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Paramjit Sandhu
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - James W. Snyder
- Department of Pathology and Laboratory Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Christopher A. Tormey
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
- Pathology & Laboratory Medicine Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Elizabeth A. Wagar
- Department of Laboratory Medicine, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Elizabeth G. Weirich
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Sheldon Campbell
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
- Pathology & Laboratory Medicine Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
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16
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Early Transcriptional Changes within Liver, Adrenal Gland, and Lymphoid Tissues Significantly Contribute to Ebola Virus Pathogenesis in Cynomolgus Macaques. J Virol 2020; 94:JVI.00250-20. [PMID: 32213610 DOI: 10.1128/jvi.00250-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/11/2020] [Indexed: 01/05/2023] Open
Abstract
Ebola virus (EBOV) continues to pose a significant threat to human health, as evidenced by the 2013-2016 epidemic in West Africa and the ongoing outbreak in the Democratic Republic of the Congo. EBOV causes hemorrhagic fever, organ damage, and shock culminating in death, with case fatality rates as high as 90%. This high lethality combined with the paucity of licensed medical countermeasures makes EBOV a critical human pathogen. Although EBOV infection results in significant damage to the liver and the adrenal glands, little is known about the molecular signatures of injury in these organs. Moreover, while changes in peripheral blood cells are becoming increasingly understood, the host responses within organs and lymphoid tissues remain poorly characterized. To address this knowledge gap, we tracked longitudinal transcriptional changes in tissues collected from EBOV-Makona-infected cynomolgus macaques. Following infection, both liver and adrenal glands exhibited significant and early downregulation of genes involved in metabolism, coagulation, hormone synthesis, and angiogenesis; upregulated genes were associated with inflammation. Analysis of lymphoid tissues showed early upregulation of genes that play a role in innate immunity and inflammation and downregulation of genes associated with cell cycle and adaptive immunity. Moreover, transient activation of innate immune responses and downregulation of humoral immune responses in lymphoid tissues were confirmed with flow cytometry. Together, these data suggest that the liver, adrenal gland, and lymphatic organs are important sites of EBOV infection and that dysregulating the function of these vital organs contributes to the development of Ebola virus disease.IMPORTANCE Ebola virus (EBOV) remains a high-priority pathogen since it continues to cause outbreaks with high case fatality rates. Although it is well established that EBOV results in severe organ damage, our understanding of tissue injury in the liver, adrenal glands, and lymphoid tissues remains limited. We begin to address this knowledge gap by conducting longitudinal gene expression studies in these tissues, which were collected from EBOV-infected cynomolgus macaques. We report robust and early gene expression changes within these tissues, indicating they are primary sites of EBOV infection. Furthermore, genes involved in metabolism, coagulation, and adaptive immunity were downregulated, while inflammation-related genes were upregulated. These results indicate significant tissue damage consistent with the development of hemorrhagic fever and lymphopenia. Our study provides novel insight into EBOV-host interactions and elucidates how host responses within the liver, adrenal glands, and lymphoid tissues contribute to EBOV pathogenesis.
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Masys AJ, Izurieta R, Reina Ortiz M. The Emerging Threat of Ebola. ADVANCED SCIENCES AND TECHNOLOGIES FOR SECURITY APPLICATIONS 2020. [PMCID: PMC7123219 DOI: 10.1007/978-3-030-23491-1_6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ebola is one of the deadliest infectious disease of the modern era. Over 50% of those infected die. Prior to 1976, the disease was unknown. No one knows exactly where it came from, but it is postulated that a mutation in an animal virus allowed it to jump species and infect humans. In 1976 simultaneous outbreaks of Ebola occurred in what is now South Sudan and the Democratic Republic of the Congo (DRC). For 20 years, only sporadic cases were seen, but in 1995 a new outbreak occurred killing hundreds in the DRC. Since that time the frequency of these outbreaks has been increasing. It is uncertain why this is occurring, but many associate it with increasing human encroachment into forested areas bringing people and animals into more intimate contact and increased mobility of previously remote population. This chapter will navigate Ebola in the context of global health and security. There are multiple objectives of this chapter. First is to provide a basic understanding of Ebola disease processes and outbreak patterns. Second, is to explore the interplay between social determinants of health and Ebola. The role of technology in spreading Ebola outbreaks will be explained as will Ebola’s potential as a bioweapon. Readers will gain understanding of the link between environmental degradation and Ebola outbreaks. This chapter will be divided into five main sections. These are (1) a case study; (2) Ebola Disease process; (3) Social determinants of health and Ebola; (4) Ebola in the modern era, and (5) the link between Ebola and environmental degradation.
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Affiliation(s)
- Anthony J. Masys
- College of Public Health, University of South Florida, Tampa, FL USA
| | - Ricardo Izurieta
- College of Public Health, University of South Florida, Tampa, FL USA
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Afzal A, Kaplan H, Motazedi T, Qureshi T, Woc-Colburn L. Diagnostics: The Role of the Laboratory. HIGHLY INFECTIOUS DISEASES IN CRITICAL CARE 2020:37-68. [DOI: 10.1007/978-3-030-33803-9_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Duarte-Neto AN. Pathology of infectious diseases: new agents, opportunistic, neglectable, emergent, reemergent diseases and why not super resistant nosocomial bacteria? AUTOPSY AND CASE REPORTS 2019; 9:e2019126. [PMID: 31641650 PMCID: PMC6768261 DOI: 10.4322/acr.2019.126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Indexed: 01/05/2023] Open
Affiliation(s)
- Amaro Nunes Duarte-Neto
- Universidade de São Paulo (USP), Faculty of Medicine, Hospital das Clínicas. São Paulo, SP, Brazil
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McElroy AK, Shrivastava-Ranjan P, Harmon JR, Martines RB, Silva-Flannery L, Flietstra TD, Kraft CS, Mehta AK, Lyon GM, Varkey JB, Ribner BS, Nichol ST, Zaki SR, Spiropoulou CF. Macrophage Activation Marker Soluble CD163 Associated with Fatal and Severe Ebola Virus Disease in Humans 1. Emerg Infect Dis 2019; 25:290-298. [PMID: 30666927 PMCID: PMC6346465 DOI: 10.3201/eid2502.181326] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Ebola virus disease (EVD) is associated with elevated cytokine levels, and hypercytokinemia is more pronounced in fatal cases. This type of hyperinflammatory state is reminiscent of 2 rheumatologic disorders known as macrophage activation syndrome and hemophagocytic lymphohistiocytosis, which are characterized by macrophage and T-cell activation. An evaluation of 2 cohorts of patients with EVD revealed that a marker of macrophage activation (sCD163) but not T-cell activation (sCD25) was associated with severe and fatal EVD. Furthermore, substantial immunoreactivity of host tissues to a CD163-specific antibody, predominantly in areas of extensive immunostaining for Ebola virus antigens, was observed in fatal cases. These data suggest that host macrophage activation contributes to EVD pathogenesis and that directed antiinflammatory therapies could be beneficial in the treatment of EVD.
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MESH Headings
- Antigens, CD/blood
- Antigens, Differentiation, Myelomonocytic/blood
- Biomarkers
- Ebolavirus/immunology
- Hemorrhagic Fever, Ebola/blood
- Hemorrhagic Fever, Ebola/diagnosis
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/virology
- Humans
- Immunoassay
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Liver/immunology
- Liver/metabolism
- Liver/pathology
- Macrophage Activation/immunology
- Macrophages/immunology
- Macrophages/metabolism
- Receptors, Cell Surface/blood
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21
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Brunton B, Rogers K, Phillips EK, Brouillette RB, Bouls R, Butler NS, Maury W. TIM-1 serves as a receptor for Ebola virus in vivo, enhancing viremia and pathogenesis. PLoS Negl Trop Dis 2019; 13:e0006983. [PMID: 31242184 PMCID: PMC6615641 DOI: 10.1371/journal.pntd.0006983] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 07/09/2019] [Accepted: 05/17/2019] [Indexed: 01/11/2023] Open
Abstract
Background T cell immunoglobulin mucin domain-1 (TIM-1) is a phosphatidylserine (PS) receptor, mediating filovirus entry into cells through interactions with PS on virions. TIM-1 expression has been implicated in Ebola virus (EBOV) pathogenesis; however, it remains unclear whether this is due to TIM-1 serving as a filovirus receptor in vivo or, as others have suggested, TIM-1 induces a cytokine storm elicited by T cell/virion interactions. Here, we use a BSL2 model virus that expresses EBOV glycoprotein to demonstrate the importance of TIM-1 as a virus receptor late during in vivo infection. Methodology/Principal findings Infectious, GFP-expressing recombinant vesicular stomatitis virus encoding either full length EBOV glycoprotein (EBOV GP/rVSV) or mucin domain deleted EBOV glycoprotein (EBOV GPΔO/rVSV) was used to assess the role of TIM-1 during in vivo infection. GFP-expressing rVSV encoding its native glycoprotein G (G/rVSV) served as a control. TIM-1-sufficient or TIM-1-deficient BALB/c interferon α/β receptor-/- mice were challenged with these viruses. While G/rVSV caused profound morbidity and mortality in both mouse strains, TIM-1-deficient mice had significantly better survival than TIM-1-expressing mice following EBOV GP/rVSV or EBOV GPΔO/rVSV challenge. EBOV GP/rVSV or EBOV GPΔO/rVSV in spleen of infected animals was high and unaffected by expression of TIM-1. However, infectious virus in serum, liver, kidney and adrenal gland was reduced late in infection in the TIM-1-deficient mice, suggesting that virus entry via this receptor contributes to virus load. Consistent with higher virus loads, proinflammatory chemokines trended higher in organs from infected TIM-1-sufficient mice compared to the TIM-1-deficient mice, but proinflammatory cytokines were more modestly affected. To assess the role of T cells in EBOV GP/rVSV pathogenesis, T cells were depleted in TIM-1-sufficient and -deficient mice and the mice were challenged with virus. Depletion of T cells did not alter the pathogenic consequences of virus infection. Conclusions Our studies provide evidence that at late times during EBOV GP/rVSV infection, TIM-1 increased virus load and associated mortality, consistent with an important role of this receptor in virus entry. This work suggests that inhibitors which block TIM-1/virus interaction may serve as effective antivirals, reducing virus load at late times during EBOV infection. T cell immunoglobulin mucin domain-1 (TIM-1) is one of a number of phosphatidylserine (PS) receptors that mediate clearance of apoptotic bodies by binding PS on the surface of dead or dying cells. Enveloped viruses mimic apoptotic bodies by exposing PS on the outer leaflet of the viral membrane. While TIM-1 has been shown to serve as an adherence factor/receptor for filoviruses in tissue culture, limited studies have investigated the role of TIM-1 as a receptor in vivo. Here, we sought to determine if TIM-1 was critical for Ebola virus glycoprotein-mediated infection using a BSL2 model virus. We demonstrate that loss of TIM-1 expression results in decreased virus load late during infection and significantly reduced virus-elicited mortality. These findings provide evidence that TIM-1 serves as an important receptor for Ebola virus in vivo. Blocking TIM-1/EBOV interactions may be effective antiviral strategy to reduce viral load and pathogenicity at late times of EBOV infection.
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Affiliation(s)
- Bethany Brunton
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, United States of America
| | - Kai Rogers
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, United States of America
| | - Elisabeth K. Phillips
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, United States of America
| | - Rachel B. Brouillette
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, United States of America
| | - Ruayda Bouls
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, United States of America
| | - Noah S. Butler
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, United States of America
| | - Wendy Maury
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, United States of America
- * E-mail:
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22
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Clinical, Histopathologic, and Immunohistochemical Characterization of Experimental Marburg Virus Infection in A Natural Reservoir Host, the Egyptian Rousette Bat ( Rousettus aegyptiacus). Viruses 2019; 11:v11030214. [PMID: 30832364 PMCID: PMC6466277 DOI: 10.3390/v11030214] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 01/22/2023] Open
Abstract
Egyptian rousette bats (Rousettus aegyptiacus) are natural reservoir hosts of Marburg virus (MARV), and Ravn virus (RAVV; collectively called marburgviruses) and have been linked to human cases of Marburg virus disease (MVD). We investigated the clinical and pathologic effects of experimental MARV infection in Egyptian rousettes through a serial euthanasia study and found clear evidence of mild but transient disease. Three groups of nine, captive-born, juvenile male bats were inoculated subcutaneously with 10,000 TCID50 of Marburg virus strain Uganda 371Bat2007, a minimally passaged virus originally isolated from a wild Egyptian rousette. Control bats (n = 3) were mock-inoculated. Three animals per day were euthanized at 3, 5⁻10, 12 and 28 days post-inoculation (DPI); controls were euthanized at 28 DPI. Blood chemistry analyses showed a mild, statistically significant elevation in alanine aminotransferase (ALT) at 3, 6 and 7 DPI. Lymphocyte and monocyte counts were mildly elevated in inoculated bats after 9 DPI. Liver histology revealed small foci of inflammatory infiltrate in infected bats, similar to lesions previously described in wild, naturally-infected bats. Liver lesion severity scores peaked at 7 DPI, and were correlated with both ALT and hepatic viral RNA levels. Immunohistochemical staining detected infrequent viral antigen in liver (3⁻8 DPI, n = 8), spleen (3⁻7 DPI, n = 8), skin (inoculation site; 3⁻12 DPI, n = 20), lymph nodes (3⁻10 DPI, n = 6), and oral submucosa (8⁻9 DPI, n = 2). Viral antigen was present in histiocytes, hepatocytes and mesenchymal cells, and in the liver, antigen staining co-localized with inflammatory foci. These results show the first clear evidence of very mild disease caused by a filovirus in a reservoir bat host and provide support for our experimental model of this virus-reservoir host system.
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23
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Malvy D, McElroy AK, de Clerck H, Günther S, van Griensven J. Ebola virus disease. Lancet 2019; 393:936-948. [PMID: 30777297 DOI: 10.1016/s0140-6736(18)33132-5] [Citation(s) in RCA: 237] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/12/2018] [Accepted: 11/28/2018] [Indexed: 12/17/2022]
Abstract
Ebolaviruses are pathogenic agents associated with a severe, potentially fatal, systemic disease in man and great apes. Four species of ebolaviruses have been identified in west or equatorial Africa. Once the more virulent forms enter the human population, transmission occurs primarily through contact with infected body fluids and can result in major epidemics in under-resourced settings. These viruses cause a disease characterised by systemic viral replication, immune suppression, abnormal inflammatory responses, major fluid and electrolyte losses, and high mortality. Despite recent progress on vaccines, and with no licensed prophylaxis or treatment available, case management is essentially supportive with management of severe multiple organ failure resulting from immune-mediated cell damage. The 2013-16 outbreak was classified by WHO as a Public Health Emergency of International Concern, which drew attention to the challenges of diseases caused by infections with ebolaviruses and questioned scientific, clinical, and societal preparation to handle future epidemics.
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Affiliation(s)
- Denis Malvy
- Department for Infectious and Tropical Diseases, University Hospital Centre of Bordeaux, Bordeaux, France; INSERM 1219, University of Bordeaux, Bordeaux, France.
| | - Anita K McElroy
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Stephan Günther
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
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24
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Ning YJ, Kang Z, Xing J, Min YQ, Liu D, Feng K, Wang M, Deng F, Zhou Y, Hu Z, Wang H. Ebola virus mucin-like glycoprotein (Emuc) induces remarkable acute inflammation and tissue injury: evidence for Emuc pathogenicity in vivo. Protein Cell 2019; 9:389-393. [PMID: 28956289 PMCID: PMC5876185 DOI: 10.1007/s13238-017-0471-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Yun-Jia Ning
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Zhenyu Kang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jingjun Xing
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuan-Qin Min
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Dan Liu
- School of Medicine, Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Kuan Feng
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Manli Wang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Fei Deng
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Yiwu Zhou
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhihong Hu
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Hualin Wang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
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25
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Rogers KJ, Maury W. The role of mononuclear phagocytes in Ebola virus infection. J Leukoc Biol 2018; 104:717-727. [PMID: 30095866 DOI: 10.1002/jlb.4ri0518-183r] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/17/2022] Open
Abstract
The filovirus, Zaire Ebolavirus (EBOV), infects tissue macrophages (Mϕs) and dendritic cells (DCs) early during infection. Viral infection of both cells types is highly productive, leading to increased viral load. However, virus infection of these two cell types results in different consequences for cellular function. Infection of Mϕs stimulates the production of proinflammatory and immunomodulatory cytokines and chemokines, leading to the production of a cytokine storm, while simultaneously increasing tissue factor production and thus facilitating disseminated intravascular coagulation. In contrast, EBOV infection of DCs blocks DC maturation and antigen presentation rendering these cells unable to communicate with adaptive immune response elements. Details of the known interactions of these cells with EBOV are reviewed here. We also identify a number of unanswered questions that remain about interactions of filoviruses with these cells.
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Affiliation(s)
- Kai J Rogers
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
| | - Wendy Maury
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
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26
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Hsu PC, Chiou BH, Huang CM. On revealing the gene targets of Ebola virus microRNAs involved in the human skin microbiome. PeerJ 2018; 6:e4138. [PMID: 29312814 PMCID: PMC5757418 DOI: 10.7717/peerj.4138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 11/15/2017] [Indexed: 01/23/2023] Open
Abstract
Ebola virus, a negative-sense single-stranded RNA virus, causes severe viral hemorrhagic fever and has a high mortality rate. Histopathological and immunopathological analyses of Ebola virus have revealed that histopathological changes in skin tissue are associated with various degrees of endothelial cell swelling and necrosis. The interactions of microbes within or on a host are a crucial for the skin immune shield. The discovery of microRNAs (miRNAs) in Ebola virus implies that immune escape, endothelial cell rupture, and tissue dissolution during Ebola virus infection are a result of the effects of Ebola virus miRNAs. Keratinocytes obtained from normal skin can attach and spread through expression of the thrombospondin family of proteins, playing a role in initiation of cell-mediated immune responses in the skin. Several miRNAs have been shown to bind the 3′ untranslated region of thrombospondin mRNA, thereby controlling its stability and translational activity. In this study, we discovered short RNA sequences that may act as miRNAs from Propionibacterium acnes using a practical workflow of bioinformatics methods. Subsequently, we deciphered the common target gene. These RNA sequences tended to bind to the same thrombospondin protein, THSD4, emphasizing the potential importance of the synergistic binding of miRNAs from Ebola virus, Propionibacterium acnes, and humans to the target. These results provide important insights into the molecular mechanisms of thrombospondin proteins and miRNAs in Ebola virus infection.
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Affiliation(s)
- Pei-Chun Hsu
- Department of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Bin-Hao Chiou
- Department of Systems Biology and Bioinformatics, National Central University, Jhongli, Taiwan
| | - Chun-Ming Huang
- Department of Medicine, Division of Dermatology, University of California, San Diego, CA, United States of America
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27
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Singh RK, Dhama K, Malik YS, Ramakrishnan MA, Karthik K, Khandia R, Tiwari R, Munjal A, Saminathan M, Sachan S, Desingu PA, Kattoor JJ, Iqbal HMN, Joshi SK. Ebola virus - epidemiology, diagnosis, and control: threat to humans, lessons learnt, and preparedness plans - an update on its 40 year's journey. Vet Q 2017; 37:98-135. [PMID: 28317453 DOI: 10.1080/01652176.2017.1309474] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are underway for testing against EBOV. In the absence of any effective control measure, the adaptation of high standards of biosecurity measures, strict sanitary and hygienic practices, strengthening of surveillance and monitoring systems, imposing appropriate quarantine checks and vigilance on trade, transport, and movement of visitors from EVD endemic countries remains the answer of choice for tackling the EBOV spread. Herein, we converse with the current scenario of EBOV giving due emphasis on animal and veterinary perspectives along with advances in diagnosis and control strategies to be adopted, lessons learned from the recent outbreaks and the global preparedness plans. To retrieve the evolutionary information, we have analyzed a total of 56 genome sequences of various EBOV species submitted between 1976 and 2016 in public databases.
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Affiliation(s)
- Raj Kumar Singh
- a ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Kuldeep Dhama
- b Division of Pathology, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Yashpal Singh Malik
- c Division of Biological Standardization, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | | | - Kumaragurubaran Karthik
- e Divison of Bacteriology and Mycology, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Rekha Khandia
- f Department of Biochemistry and Genetics , Barkatullah University , Bhopal , India
| | - Ruchi Tiwari
- g Department of Veterinary Microbiology and Immunology , College of Veterinary Sciences, Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU) , Mathura , India
| | - Ashok Munjal
- f Department of Biochemistry and Genetics , Barkatullah University , Bhopal , India
| | - Mani Saminathan
- b Division of Pathology, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Swati Sachan
- h Immunology Section, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | | | - Jobin Jose Kattoor
- c Division of Biological Standardization, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Hafiz M N Iqbal
- i School of Engineering and Science, Tecnologico de Monterrey , Monterrey , Mexico
| | - Sunil Kumar Joshi
- j Cellular Immunology Lab , Frank Reidy Research Center for Bioelectrics , School of Medical Diagnostics & Translational Sciences, Old Dominion University , Norfolk , VA , USA
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28
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Hidalgo J, Richards GA, Jiménez JIS, Baker T, Amin P. Viral hemorrhagic fever in the tropics: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care 2017; 42:366-372. [PMID: 29128377 DOI: 10.1016/j.jcrc.2017.11.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 12/01/2022]
Abstract
Viral hemorrhagic fevers (VHFs) are a group of illnesses caused by four families of viruses namely Arenaviruses, Filoviruses, Bunyaviruses, and Flaviviruses. Humans are not the natural reservoir for any of these organisms and acquire the disease through vectors from animal reservoirs. In some conditions human to human transmission is possible increasing the risk to healthy individuals in the vicinity, more so to Health Care Workers (HCW). The pathogenesis of VHF, though poorly understood, varies according to the viruses involved. The resultant microvascular damage leads to increased vascular permeability, organ dysfunction and even death. The management is generally supportive but antiviral agents are of benefit in certain circumstances.
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Affiliation(s)
- Jorge Hidalgo
- Division of Critical Care, Karl Heusner Memorial Hospital, Belize Healthcare Partners Belize, Central America
| | - Guy A Richards
- Division of Critical Care, Charlotte Maxeke Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Tim Baker
- Department of Anaesthesia & Intensive Care, Queen Elizabeth Central Hospital, Blantyre, Malawi; Global Health - Health Systems & Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Pravin Amin
- Department of Critical Care Medicine, Bombay Hospital Institute of Medical Sciences, Mumbai, India.
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29
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Coarsey CT, Esiobu N, Narayanan R, Pavlovic M, Shafiee H, Asghar W. Strategies in Ebola virus disease (EVD) diagnostics at the point of care. Crit Rev Microbiol 2017; 43:779-798. [PMID: 28440096 PMCID: PMC5653233 DOI: 10.1080/1040841x.2017.1313814] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/21/2016] [Accepted: 03/25/2017] [Indexed: 12/13/2022]
Abstract
Ebola virus disease (EVD) is a devastating, highly infectious illness with a high mortality rate. The disease is endemic to regions of Central and West Africa, where there is limited laboratory infrastructure and trained staff. The recent 2014 West African EVD outbreak has been unprecedented in case numbers and fatalities, and has proven that such regional outbreaks can become a potential threat to global public health, as it became the source for the subsequent transmission events in Spain and the USA. The urgent need for rapid and affordable means of detecting Ebola is crucial to control the spread of EVD and prevent devastating fatalities. Current diagnostic techniques include molecular diagnostics and other serological and antigen detection assays; which can be time-consuming, laboratory-based, often require trained personnel and specialized equipment. In this review, we discuss the various Ebola detection techniques currently in use, and highlight the potential future directions pertinent to the development and adoption of novel point-of-care diagnostic tools. Finally, a case is made for the need to develop novel microfluidic technologies and versatile rapid detection platforms for early detection of EVD.
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Affiliation(s)
- Chad T. Coarsey
- Department of Computer and Electrical Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
- Asghar-Lab: Micro and Nanotechnology in Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Nwadiuto Esiobu
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, FL, United States
| | - Ramswamy Narayanan
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, FL, United States
| | - Mirjana Pavlovic
- Department of Computer and Electrical Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Hadi Shafiee
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Waseem Asghar
- Department of Computer and Electrical Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
- Asghar-Lab: Micro and Nanotechnology in Medicine, Florida Atlantic University, Boca Raton, FL, United States
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, FL, United States
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30
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Lai CY, Strange DP, Wong TAS, Lehrer AT, Verma S. Ebola Virus Glycoprotein Induces an Innate Immune Response In vivo via TLR4. Front Microbiol 2017; 8:1571. [PMID: 28861075 PMCID: PMC5562721 DOI: 10.3389/fmicb.2017.01571] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 08/03/2017] [Indexed: 01/16/2023] Open
Abstract
Ebola virus (EBOV), a member of the Filoviridae family, causes the most severe form of viral hemorrhagic fever. Although no FDA licensed vaccine or treatment against Ebola virus disease (EVD) is currently available, Ebola virus glycoprotein (GP) is the major antigen used in all candidate Ebola vaccines. Recent reports of protection as quickly as within 6 days of administration of the rVSV-based vaccine expressing EBOV GP before robust humoral responses were generated suggests that the innate immune responses elicited early after vaccination may contribute to the protection. However, the innate immune responses induced by EBOV GP in the absence of viral vectors or adjuvants have not been fully characterized in vivo. Our recent studies demonstrated that immunization with highly purified recombinant GP in the absence of adjuvants induced a robust IgG response and partial protection against EBOV infection suggesting that GP alone can induce protective immunity. In this study we investigated the early immune response to purified EBOV GP alone in vitro and in vivo. We show that GP was efficiently internalized by antigen presenting cells and subsequently induced production of key inflammatory cytokines. In vivo, immunization of mice with EBOV GP triggered the production of key Th1 and Th2 innate immune cytokines and chemokines, which directly governed the recruitment of CD11b+ macrophages and CD11c+ dendritic cells to the draining lymph nodes (DLNs). Pre-treatment of mice with a TLR4 antagonist inhibited GP-induced cytokine production and recruitment of immune cells to the DLN. EBOV GP also upregulated the expression of costimulatory molecules in bone marrow derived macrophages suggesting its ability to enhance APC stimulatory capacity, which is critical for the induction of effective antigen-specific adaptive immunity. Collectively, these results provide the first in vivo evidence that early innate immune responses to EBOV GP are mediated via the TLR4 pathway and are able to modulate the innate-adaptive interface. These mechanistic insights into the adjuvant-like property of EBOV GP may help to develop a better understanding of how optimal prophylactic efficacy of EBOV vaccines can be achieved as well as further explore the potential post-exposure use of vaccines to prevent filoviral disease.
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Affiliation(s)
- Chih-Yun Lai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at ManoaHonolulu, HI, United States
| | - Daniel P Strange
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at ManoaHonolulu, HI, United States
| | - Teri Ann S Wong
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at ManoaHonolulu, HI, United States
| | - Axel T Lehrer
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at ManoaHonolulu, HI, United States
| | - Saguna Verma
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at ManoaHonolulu, HI, United States
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31
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Spengler JR, Prescott J, Feldmann H, Spiropoulou CF. Human immune system mouse models of Ebola virus infection. Curr Opin Virol 2017; 25:90-96. [PMID: 28810165 DOI: 10.1016/j.coviro.2017.07.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/10/2017] [Accepted: 07/25/2017] [Indexed: 11/28/2022]
Abstract
Human immune system (HIS) mice, immunodeficient mice engrafted with human cells (with or without donor-matched tissue), offer a unique opportunity to study pathogens that cause disease predominantly or exclusively in humans. Several HIS mouse models have recently been used to study Ebola virus (EBOV) infection and disease. The results of these studies are encouraging and support further development and use of these models in Ebola research. HIS mice provide a small animal model to study EBOV isolates, investigate early viral interactions with human immune cells, screen vaccines and therapeutics that modulate the immune system, and investigate sequelae in survivors. Here we review existing models, discuss their use in pathogenesis studies and therapeutic screening, and highlight considerations for study design and analysis. Finally, we point out caveats to current models, and recommend future efforts for modeling EBOV infection in HIS mice.
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Affiliation(s)
- Jessica R Spengler
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Joseph Prescott
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT 59840, USA
| | - Heinz Feldmann
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT 59840, USA
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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32
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Negredo A, de la Calle-Prieto F, Palencia-Herrejón E, Mora-Rillo M, Astray-Mochales J, Sánchez-Seco MP, Bermejo Lopez E, Menárguez J, Fernández-Cruz A, Sánchez-Artola B, Keough-Delgado E, Ramírez de Arellano E, Lasala F, Milla J, Fraile JL, Ordobás Gavín M, Martinez de la Gándara A, López Perez L, Diaz-Diaz D, López-García MA, Delgado-Jimenez P, Martín-Quirós A, Trigo E, Figueira JC, Manzanares J, Rodriguez-Baena E, Garcia-Comas L, Rodríguez-Fraga O, García-Arenzana N, Fernández-Díaz MV, Cornejo VM, Emmerich P, Schmidt-Chanasit J, Arribas JR. Autochthonous Crimean-Congo Hemorrhagic Fever in Spain. N Engl J Med 2017; 377:154-161. [PMID: 28700843 DOI: 10.1056/nejmoa1615162] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, viral, tickborne disease. In Europe, cases have been reported only in the southeastern part of the continent. We report two autochthonous cases in Spain. The index patient acquired the disease through a tick bite in the province of Ávila - 300 km away from the province of Cáceres, where viral RNA from ticks was amplified in 2010. The second patient was a nurse who became infected while caring for the index patient. Both were infected with the African 3 lineage of this virus. (Funded by Red de Investigación Cooperativa en Enfermedades Tropicales [RICET] and Efficient Response to Highly Dangerous and Emerging Pathogens at EU [European Union] Level [EMERGE].).
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Affiliation(s)
- Anabel Negredo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Fernando de la Calle-Prieto
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Eduardo Palencia-Herrejón
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Marta Mora-Rillo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jenaro Astray-Mochales
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - María P Sánchez-Seco
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Esther Bermejo Lopez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Javier Menárguez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Ana Fernández-Cruz
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Beatriz Sánchez-Artola
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Elena Keough-Delgado
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Eva Ramírez de Arellano
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Fátima Lasala
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jakob Milla
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jose L Fraile
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Maria Ordobás Gavín
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Amalia Martinez de la Gándara
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Lorenzo López Perez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Domingo Diaz-Diaz
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - M Aurora López-García
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Pilar Delgado-Jimenez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Alejandro Martín-Quirós
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Elena Trigo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Juan C Figueira
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jesús Manzanares
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Elena Rodriguez-Baena
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Luis Garcia-Comas
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Olaia Rodríguez-Fraga
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Nicolás García-Arenzana
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Maria V Fernández-Díaz
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Victor M Cornejo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Petra Emmerich
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jonas Schmidt-Chanasit
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jose R Arribas
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
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Baseler L, Chertow DS, Johnson KM, Feldmann H, Morens DM. The Pathogenesis of Ebola Virus Disease. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2017; 12:387-418. [DOI: 10.1146/annurev-pathol-052016-100506] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Laura Baseler
- Department of Veterinary Medicine and Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Daniel S. Chertow
- Critical Care Medicine Department, Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892
| | - Karl M. Johnson
- Founder, Special Pathogens Branch, Centers for Disease Control and Prevention, Placitas, New Mexico 87043
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana 59840
| | - David M. Morens
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892;
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Du K, Cai H, Park M, Wall TA, Stott MA, Alfson KJ, Griffiths A, Carrion R, Patterson JL, Hawkins AR, Schmidt H, Mathies RA. Multiplexed efficient on-chip sample preparation and sensitive amplification-free detection of Ebola virus. Biosens Bioelectron 2017; 91:489-496. [PMID: 28073029 DOI: 10.1016/j.bios.2016.12.071] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/26/2016] [Accepted: 12/30/2016] [Indexed: 12/23/2022]
Abstract
An automated microfluidic sample preparation multiplexer (SPM) has been developed and evaluated for Ebola virus detection. Metered air bubbles controlled by microvalves are used to improve bead-solution mixing thereby enhancing the hybridization of the target Ebola virus RNA with capture probes bound to the beads. The method uses thermally stable 4-formyl benzamide functionalized (4FB) magnetic beads rather than streptavidin coated beads with a high density of capture probes to improve the target capture efficiency. Exploiting an on-chip concentration protocol in the SPM and the single molecule detection capability of the antiresonant reflecting optical waveguide (ARROW) biosensor chip, a detection limit of 0.021pfu/mL for clinical samples is achieved without target amplification. This RNA target capture efficiency is two orders of magnitude higher than previous results using streptavidin beads and the limit of detection (LOD) improves 10×. The wide dynamic range of this technique covers the whole clinically applicable concentration range. In addition, the current sample preparation time is ~1h which is eight times faster than previous work. This multiplexed, miniaturized sample preparation microdevice establishes a key technology that intended to develop next generation point-of-care (POC) detection system.
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Affiliation(s)
- K Du
- Department of Chemistry, University of California at Berkeley, Berkeley, CA 94720, USA
| | - H Cai
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA 95064, USA
| | - M Park
- Department of Chemistry, University of California at Berkeley, Berkeley, CA 94720, USA
| | - T A Wall
- ECEn Department, Brigham Young University, 459 Clyde Building, Provo, UT 84602, USA
| | - M A Stott
- ECEn Department, Brigham Young University, 459 Clyde Building, Provo, UT 84602, USA
| | - K J Alfson
- Department of Virology and Immunology, Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX 78227, USA
| | - A Griffiths
- Department of Virology and Immunology, Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX 78227, USA
| | - R Carrion
- Department of Virology and Immunology, Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX 78227, USA
| | - J L Patterson
- Department of Virology and Immunology, Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX 78227, USA
| | - A R Hawkins
- ECEn Department, Brigham Young University, 459 Clyde Building, Provo, UT 84602, USA
| | - H Schmidt
- School of Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA 95064, USA.
| | - R A Mathies
- Department of Chemistry, University of California at Berkeley, Berkeley, CA 94720, USA.
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Olejnik J, Hume AJ, Leung DW, Amarasinghe GK, Basler CF, Mühlberger E. Filovirus Strategies to Escape Antiviral Responses. Curr Top Microbiol Immunol 2017; 411:293-322. [PMID: 28685291 DOI: 10.1007/82_2017_13] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This chapter describes the various strategies filoviruses use to escape host immune responses with a focus on innate immune and cell death pathways. Since filovirus replication can be efficiently blocked by interferon (IFN), filoviruses have evolved mechanisms to counteract both type I IFN induction and IFN response signaling pathways. Intriguingly, marburg- and ebolaviruses use different strategies to inhibit IFN signaling. This chapter also summarizes what is known about the role of IFN-stimulated genes (ISGs) in filovirus infection. These fall into three categories: those that restrict filovirus replication, those whose activation is inhibited by filoviruses, and those that have no measurable effect on viral replication. In addition to innate immunity, mammalian cells have evolved strategies to counter viral infections, including the induction of cell death and stress response pathways, and we summarize our current knowledge of how filoviruses interact with these pathways. Finally, this chapter delves into the interaction of EBOV with myeloid dendritic cells and macrophages and the associated inflammatory response, which differs dramatically between these cell types when they are infected with EBOV. In summary, we highlight the multifaceted nature of the host-viral interactions during filoviral infections.
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Affiliation(s)
- Judith Olejnik
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, 620 Albany Street, Boston, MA, 02118, USA
| | - Adam J Hume
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, 620 Albany Street, Boston, MA, 02118, USA
| | - Daisy W Leung
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Gaya K Amarasinghe
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Christopher F Basler
- Microbial Pathogenesis, Georgia State University, Institute for Biomedical Sciences, Atlanta, GA, 30303, USA
| | - Elke Mühlberger
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, 620 Albany Street, Boston, MA, 02118, USA.
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Abstract
Ebola is a viral illness of which the initial symptoms can include a sudden fever, intense weakness, muscle pain and a sore throat, according to the World Health Organization (WHO). Airborne transmission of Ebola virus has been hypothesized but not demonstrated in humans. Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. The disease infects humans through close contact with infected animals, including chimpanzees, fruit bats, and forest antelope. Ebola virus can be transmitted by direct contact with blood, bodily fluids, or skin of patients with or who died of Ebola virus disease. As of late October 2014, the World Health Organization reported 13,567 suspected cases and 4922 deaths, although the agency believes that this substantially understates the magnitude of the outbreak. Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.
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Leligdowicz A, Fischer WA, Uyeki TM, Fletcher TE, Adhikari NKJ, Portella G, Lamontagne F, Clement C, Jacob ST, Rubinson L, Vanderschuren A, Hajek J, Murthy S, Ferri M, Crozier I, Ibrahima E, Lamah MC, Schieffelin JS, Brett-Major D, Bausch DG, Shindo N, Chan AK, O'Dempsey T, Mishra S, Jacobs M, Dickson S, Lyon GM, Fowler RA. Ebola virus disease and critical illness. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:217. [PMID: 27468829 PMCID: PMC4965892 DOI: 10.1186/s13054-016-1325-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/26/2016] [Indexed: 12/26/2022]
Abstract
As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa. EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury. Hypoxia and ventilation failure occurs most often with severe illness and may be exacerbated by substantial fluid requirements for intravascular volume repletion and some degree of systemic capillary leak. Although minor bleeding manifestations are common, hypovolemic and septic shock complicated by multisystem organ dysfunction appear the most frequent causes of death. Males and females have been equally affected, with children (0–14 years of age) accounting for 19 %, young adults (15–44 years) 58 %, and older adults (≥45 years) 23 % of reported cases. While the current case fatality proportion in West Africa is approximately 40 %, it has varied substantially over time (highest near the outbreak onset) according to available resources (40–90 % mortality in West Africa compared to under 20 % in Western Europe and the USA), by age (near universal among neonates and high among older adults), and by Ebola viral load at admission. While there is no Ebola virus-specific therapy proven to be effective in clinical trials, mortality has been dramatically lower among EVD patients managed with supportive intensive care in highly resourced settings, allowing for the avoidance of hypovolemia, correction of electrolyte and metabolic abnormalities, and the provision of oxygen, ventilation, vasopressors, and dialysis when indicated. This experience emphasizes that, in addition to evaluating specific medical treatments, improving the global capacity to provide supportive critical care to patients with EVD may be the greatest opportunity to improve patient outcomes.
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Affiliation(s)
| | - William A Fischer
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Timothy M Uyeki
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Thomas E Fletcher
- Defence Medical Services, Whittington Barracks, Lichfield, UK.,Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Neill K J Adhikari
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Francois Lamontagne
- Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Shevin T Jacob
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Lewis Rubinson
- Department of Medicine, University of Maryland, Baltimore, MD, USA
| | - Abel Vanderschuren
- Centre de recherche de l'institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada
| | - Jan Hajek
- Division of Infectious Diseases, University of British Columbia, Vancouver, BC, Canada
| | - Srinivas Murthy
- Department of Paediatrics, University of British Columbia, Vancouver, BC, Canada
| | | | - Ian Crozier
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Elhadj Ibrahima
- Department of Infectious and Parasitic Diseases, Donka Hospital, Conakry, Guinea
| | - Marie-Claire Lamah
- Department of Infectious and Parasitic Diseases, Donka Hospital, Conakry, Guinea
| | - John S Schieffelin
- Department of Pediatrics, School of Medicine and School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - David Brett-Major
- Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD, USA
| | - Daniel G Bausch
- Department of Pandemic and Epidemic Diseases, World Health Organization, Geneva, Switzerland
| | - Nikki Shindo
- Department of Pandemic and Epidemic Diseases, World Health Organization, Geneva, Switzerland
| | - Adrienne K Chan
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Tim O'Dempsey
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Michael Jacobs
- Department of Infection, Royal Free London NHS Foundation Trust, London, UK
| | - Stuart Dickson
- Acute Medicine and Intensive Care, Derriford Hospital, Plymouth, UK
| | - G Marshall Lyon
- Department of Infectious Diseases, Emory University Hospital, Atlanta, Georgia, USA
| | - Robert A Fowler
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada. .,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
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Muehlenbachs A, de la Rosa Vázquez O, Bausch DG, Schafer IJ, Paddock CD, Nyakio JP, Lame P, Bergeron E, McCollum AM, Goldsmith CS, Bollweg BC, Prieto MA, Lushima RS, Ilunga BK, Nichol ST, Shieh WJ, Ströher U, Rollin PE, Zaki SR. Ebola Virus Disease in Pregnancy: Clinical, Histopathologic, and Immunohistochemical Findings. J Infect Dis 2016; 215:64-69. [PMID: 27226206 DOI: 10.1093/infdis/jiw206] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/09/2016] [Indexed: 01/23/2023] Open
Abstract
Here we describe clinicopathologic features of Ebola virus disease in pregnancy. One woman infected with Sudan virus in Gulu, Uganda, in 2000 had a stillbirth and survived, and another woman infected with Bundibugyo virus had a live birth with maternal and infant death in Isiro, the Democratic Republic of the Congo in 2012. Ebolavirus antigen was seen in the syncytiotrophoblast and placental maternal mononuclear cells by immunohistochemical analysis, and no antigen was seen in fetal placental stromal cells or fetal organs. In the Gulu case, ebolavirus antigen localized to malarial parasite pigment-laden macrophages. These data suggest that trophoblast infection may be a mechanism of transplacental ebolavirus transmission.
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Affiliation(s)
| | | | | | | | - Christopher D Paddock
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Andrea M McCollum
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology
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Dunn AC, Walker TA, Redd J, Sugerman D, McFadden J, Singh T, Jasperse J, Kamara BO, Sesay T, McAuley J, Kilmarx PH. Nosocomial transmission of Ebola virus disease on pediatric and maternity wards: Bombali and Tonkolili, Sierra Leone, 2014. Am J Infect Control 2016; 44:269-72. [PMID: 26521701 DOI: 10.1016/j.ajic.2015.09.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/11/2015] [Accepted: 09/14/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND In the largest Ebola virus disease (EVD) outbreak in history, nosocomial transmission of EVD increased spread of the disease. We report on 2 instances in Sierra Leone where patients unknowingly infected with EVD were admitted to a general hospital ward (1 pediatric ward and 1 maternity ward), exposing health care workers, caregivers, and other patients to EVD. Both patients died on the general wards, and were later confirmed as being infected with EVD. We initiated contact tracing and assessed risk factors for secondary infections to guide containment recommendations. METHODS We reviewed medical records to establish the index patients' symptom onset. Health care workers, patients, and caregivers were interviewed to determine exposures and personal protective equipment (PPE) use. Contacts were monitored daily for EVD symptoms. Those who experienced EVD symptoms were isolated and tested. RESULTS Eighty-two contacts were identified: 64 health care workers, 7 caregivers, 4 patients, 4 newborns, and 3 children of patients. Seven contacts became symptomatic and tested positive for EVD: 2 health care workers (1 nurse and 1 hospital cleaner), 2 caregivers, 2 newborns, and 1 patient. The infected nurse placed an intravenous catheter in the pediatric index patient with only short gloves PPE and the hospital cleaner cleaned the operating room of the maternity ward index patient wearing short gloves PPE. The maternity ward index patient's caregiver and newborn were exposed to her body fluids. The infected patient and her newborn shared the ward and latrine with the maternity ward index patient. Hospital staff members did not use adequate PPE. Caregivers were not offered PPE. CONCLUSIONS Delayed recognition of EVD and inadequate PPE likely led to exposures and secondary infections. Earlier recognition of EVD and adequate PPE might have reduced direct contact with body fluids. Limiting nonhealth-care worker contact, improving access to PPE, and enhancing screening methods for pregnant women, children, and inpatients may help decrease EVD transmission in general health care settings.
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Affiliation(s)
- Angela C Dunn
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA; CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone.
| | - Tiffany A Walker
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA; CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone
| | - John Redd
- CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone
| | - David Sugerman
- CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone
| | - Jevon McFadden
- CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone
| | - Tushar Singh
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA; CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone
| | | | - Brima Osaio Kamara
- Sierra Leone Ministry of Health and Sanitation, Tonkolili District, Sierra Leone
| | - Tom Sesay
- Sierra Leone Ministry of Health and Sanitation, Bombali District, Sierra Leone
| | - James McAuley
- CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone
| | - Peter H Kilmarx
- CDC Sierra Leone Ebola Response Team, Freetown, Sierra Leone
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40
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Visual detection of Ebola virus using reverse transcription loop-mediated isothermal amplification combined with nucleic acid strip detection. Arch Virol 2016; 161:1125-33. [DOI: 10.1007/s00705-016-2763-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 01/16/2016] [Indexed: 10/22/2022]
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Cobo F. Viruses Causing Hemorrhagic Fever. Safety Laboratory Procedures. Open Virol J 2016; 10:1-9. [PMID: 27014378 PMCID: PMC4780467 DOI: 10.2174/1874357901610010001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 11/18/2015] [Accepted: 11/27/2015] [Indexed: 11/22/2022] Open
Abstract
Viral hemorrhagic fevers are diseases caused by viruses which belong to different families, many of them causing severe diseases. These viruses may produce different symptomatology together with a severe multisystem syndrome, and the final result might be the production of hemorrhages in several sites of the body. The majority of them have no other treatment than supportive therapy, although some antiviral drugs can be used in some circumstances. Transmission of VHF has been demonstrated through contact with animal vectors or person-to-person through the contact with body fluids. No risk of transmission has been found during the incubation period, but when the viral load is high the risk of transmission is greatest. Both health care and clinical laboratory workers must safely handle patients and specimens by taking all required precautions during their management.
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Affiliation(s)
- Fernando Cobo
- Microbiology Section (Biotechnology Area) and Tropical Medicine Unit
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42
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Comparative Evaluation of the Diagnostic Performance of the Prototype Cepheid GeneXpert Ebola Assay. J Clin Microbiol 2015; 54:359-67. [PMID: 26637383 DOI: 10.1128/jcm.02724-15] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/20/2015] [Indexed: 11/20/2022] Open
Abstract
The Ebola virus disease (EVD) outbreak in West Africa has highlighted an urgent need for point-of-care (POC) assays for the diagnosis of this devastating disease in resource-limited African countries. The diagnostic performance characteristics of a prototype Cepheid GeneXpert Ebola POC used to detect Ebola virus (EBOV) in stored serum and plasma samples collected from suspected EVD cases in Sierra Leone in 2014 and 2015 was evaluated. The GeneXpert Ebola POC is a self-contained single-cartridge automated system that targets the glycoprotein (GP) and nucleoprotein (NP) genes of EBOV and yields results within 90 min. Results from 281 patient samples were compared to the results of a TaqMan real-time reverse transcription-PCR (RT-PCR) targeting the polymerase gene and performed on two real-time PCR machines. Agreement between the three platforms was 100% at cycle threshold (CT) values of ≤34.99, but discordant results were noted between CT values of 35 and 45.The diagnostic sensitivity of the three platforms was 100% in 91 patient samples that were confirmed to be infectious by virus isolation. All three molecular platforms detected viral EBOV RNA in additional samples that did not contain viable EBOV. The analytical sensitivity of the GeneXpert Ebola POC for the detection of NP was higher, and comparable to that of polymerase gene detection, than that for the detection of GP when using a titrated laboratory stock of EBOV. There was no detectable cross-reactivity with other hemorrhagic fever viruses or arboviruses. The GeneXpert Ebola POC offers an easy to operate and sensitive diagnostic tool that can be used for the rapid screening of suspected EVD cases in treatment or in holding centers during EVD outbreaks.
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43
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Li H, Wang X, Liu W, Wei X, Lin W, Li E, Li P, Dong D, Cui L, Hu X, Li B, Ma Y, Zhao X, Liu C, Yuan J. Survey and Visual Detection of Zaire ebolavirus in Clinical Samples Targeting the Nucleoprotein Gene in Sierra Leone. Front Microbiol 2015; 6:1332. [PMID: 26648918 PMCID: PMC4664619 DOI: 10.3389/fmicb.2015.01332] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 11/12/2015] [Indexed: 12/01/2022] Open
Abstract
Ebola virus (EBOV) can lead to severe hemorrhagic fever with a high risk of death in humans and other primates. To guide treatment and prevent spread of the viral infection, a rapid and sensitive detection method is required for clinical samples. Here, we described and evaluated a reverse transcription loop-mediated isothermal amplification (RT-LAMP) method to detect Zaire ebolavirus using the nucleoprotein gene (NP) as a target sequence. Two different techniques were used, a calcein/Mn2+ complex chromogenic method and real-time turbidity monitoring. The RT-LAMP assay detected the NP target sequence with a limit of 4.56 copies/μL within 45 min under 61°C, a similar even or increase in sensitivity than that of real-time reverse transcription-polymerase chain reaction (RT-PCR). Additionally, all pseudoviral particles or non- Zaire EBOV genomes were negative for LAMP detection, indicating that the assay was highly specific for EBOV. To appraise the availability of the RT-LAMP method for use in clinical diagnosis of EBOV, of 417 blood or swab samples collected from patients with clinically suspected infections in Sierra Leone, 307 were identified for RT-LAMP-based surveillance of EBOV. Therefore, the highly specific and sensitive RT-LAMP method allows the rapid detection of EBOV, and is a suitable tool for clinical screening, diagnosis, and primary quarantine purposes.
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Affiliation(s)
- Huan Li
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Xuesong Wang
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Wei Liu
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Xiao Wei
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Weishi Lin
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Erna Li
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Puyuan Li
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Derong Dong
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Lifei Cui
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Xuan Hu
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Boxing Li
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Yanyan Ma
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Xiangna Zhao
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Chao Liu
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
| | - Jing Yuan
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences Beijing, China
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Prescott J, Feldmann H. Humanized Mice--A Neoteric Animal Disease Model for Ebola Virus? J Infect Dis 2015; 213:691-3. [PMID: 26582953 DOI: 10.1093/infdis/jiv539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 11/11/2015] [Indexed: 12/19/2022] Open
Affiliation(s)
- Joseph Prescott
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana
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Bird BH, Spengler JR, Chakrabarti AK, Khristova ML, Sealy TK, Coleman-McCray JD, Martin BE, Dodd KA, Goldsmith CS, Sanders J, Zaki SR, Nichol ST, Spiropoulou CF. Humanized Mouse Model of Ebola Virus Disease Mimics the Immune Responses in Human Disease. J Infect Dis 2015; 213:703-11. [PMID: 26582961 DOI: 10.1093/infdis/jiv538] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/01/2015] [Indexed: 11/14/2022] Open
Abstract
Animal models recapitulating human Ebola virus disease (EVD) are critical for insights into virus pathogenesis. Ebola virus (EBOV) isolates derived directly from human specimens do not, without adaptation, cause disease in immunocompetent adult rodents. Here, we describe EVD in mice engrafted with human immune cells (hu-BLT). hu-BLT mice developed EVD following wild-type EBOV infection. Infection with high-dose EBOV resulted in rapid, lethal EVD with high viral loads, alterations in key human antiviral immune cytokines and chemokines, and severe histopathologic findings similar to those shown in the limited human postmortem data available. A dose- and donor-dependent clinical course was observed in hu-BLT mice infected with lower doses of either Mayinga (1976) or Makona (2014) isolates derived from human EBOV cases. Engraftment of the human cellular immune system appeared to be essential for the observed virulence, as nonengrafted mice did not support productive EBOV replication or develop lethal disease. hu-BLT mice offer a unique model for investigating the human immune response in EVD and an alternative animal model for EVD pathogenesis studies and therapeutic screening.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Cynthia S Goldsmith
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeanine Sanders
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherif R Zaki
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
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46
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Singh G, Kumar A, Singh K, Kaur J. Retracted: Ebola virus: an introduction and its pathology. Rev Med Virol 2015; 26:49-56. [PMID: 26558534 DOI: 10.1002/rmv.1863] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 11/10/2022]
Abstract
The Ebola viruses are causative agent of a severe Ebola virus disease (EVD) or Ebola hemorrhagic fever (EHF) in human and other primates. Transmission of EVD occurs through the contact of body fluids from infected persons or animals, making it one of the most epidemic diseases worldwide. Underestimating the Ebola virus has cost loss of precious human lives in recent years. Ebola virus outbreak in year 2014 created a history, affecting a larger population in a wide geographical region of African sub-continent. EVD outbreaks have a case fatality rate of up to 70%. Ebola viruses are endemic in regions of Africa. Ebola viruses mainly target the hepatocytes, endothelial, and macrophage-rich lymphoid tissues and are characterized by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems. This impairment leads to multifocal necrosis and multi organ failure, and thus, in some ways, resembling septic shock. Currently, neither a specific treatment nor a vaccine licensed for use in humans is available. This review is focused on general characteristic of Ebola viruses, its pathogenesis, immunological response of host, and recent approaches for vaccine development against EVD. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Gurpreet Singh
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - Arbind Kumar
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - Kashmir Singh
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - Jagdeep Kaur
- Department of Biotechnology, Panjab University, Chandigarh, India
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Messaoudi I, Amarasinghe GK, Basler CF. Filovirus pathogenesis and immune evasion: insights from Ebola virus and Marburg virus. Nat Rev Microbiol 2015; 13:663-76. [PMID: 26439085 DOI: 10.1038/nrmicro3524] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ebola viruses and Marburg viruses, members of the filovirus family, are zoonotic pathogens that cause severe disease in people, as highlighted by the latest Ebola virus epidemic in West Africa. Filovirus disease is characterized by uncontrolled virus replication and the activation of host responses that contribute to pathogenesis. Underlying these phenomena is the potent suppression of host innate antiviral responses, particularly the type I interferon response, by viral proteins, which allows high levels of viral replication. In this Review, we describe the mechanisms used by filoviruses to block host innate immunity and discuss the links between immune evasion and filovirus pathogenesis.
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Affiliation(s)
- Ilhem Messaoudi
- School of Medicine, University of California Riverside, Riverside, California 92521, USA
| | - Gaya K Amarasinghe
- The Division of Biology &Biomedical Sciences, Washington University in St. Louis, St. Louis, Missouri 63110, USA
| | - Christopher F Basler
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
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Woźniak-Kosek A, Kosek J, Mierzejewski J, Rapiejko P. Progress in the Diagnosis and Control of Ebola Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 857:19-24. [PMID: 25724796 DOI: 10.1007/5584_2015_123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Ebola hemorrhagic fever is one of numerous viral hemorrhagic fevers. It is a severe, often fatal disease in humans and nonhuman primates (gorillas and chimpanzees). This article discusses the history of Ebola disease, already known routes of infection together with defining prevention methods and treatment trials. The importance of increasing awareness of the risk of disease among people who do not inhabit endemic regions is emphasized. This risk is associated especially with the increasing popularity of tourism to African countries, even to those where the virus is endemic. The research conducted over the years shows that three species of frugivorous bats are subjected to contamination by Ebola, but the infection is asymptomatic in them. It is believed that the saliva of these mammals and other body fluids may be a potential source of infection for primates and humans. In the laboratory, infection through small-particle aerosols has been demonstrated in primates, and airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated. The importance of this route of transmission remains unclear. Poor hygienic conditions can aid the spread of the virus. These observations suggest approaches to the study of routes of transmission to and among humans.
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Affiliation(s)
- Agnieszka Woźniak-Kosek
- Epidemiological Response Center of Polish Armed Forces, 7 K. Leskiego St., 01-485, Warsaw, Poland,
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Jeong HS, Kang YJ. Study on Laboratory Diagnosis of the Ebola Virus and Its Current Trends. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2015. [DOI: 10.15324/kjcls.2015.47.3.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hye Seon Jeong
- Department of Laboratory Medicine , St. Vincent Hospital, The Catholic University of Korea, Suwon 16247, Korea
| | - Yun-Jung Kang
- Department of Health Science, Dankook University Graduate School, Cheonan 31116, Korea
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Racsa LD, Kraft CS, Olinger GG, Hensley LE. Viral Hemorrhagic Fever Diagnostics. Clin Infect Dis 2015; 62:214-9. [PMID: 26354968 DOI: 10.1093/cid/civ792] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 08/26/2015] [Indexed: 11/12/2022] Open
Abstract
There are 4 families of viruses that cause viral hemorrhagic fever (VHF), including Filoviridae. Ebola virus is one virus within the family Filoviridae and the cause of the current outbreak of VHF in West Africa. VHF-endemic areas are found throughout the world, yet traditional diagnosis of VHF has been performed in large reference laboratories centered in Europe and the United States. The large amount of capital needed, as well as highly trained and skilled personnel, has limited the availability of diagnostics in endemic areas except in conjunction with governmental and nongovernmental entities. However, rapid diagnosis of VHF is essential to efforts that will limit outbreaks. In addition, increased global travel suggests VHF diagnoses may be made outside of the endemic areas. Thus, understanding how to diagnose VHF is imperative for laboratories worldwide. This article reviews traditional and current diagnostic modalities for VHF.
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Affiliation(s)
- Lori D Racsa
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia
| | - Colleen S Kraft
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia
| | - Gene G Olinger
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Frederick, Maryland
| | - Lisa E Hensley
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Frederick, Maryland
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