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Bahadir Z, Narayan P, Wolters R, Permar SR, Fouda G, Hessell AJ, Haigwood NL. Monoclonal Antibodies for Pediatric Viral Disease Prevention and Treatment. Pediatrics 2025; 155:e2024068690. [PMID: 40174915 DOI: 10.1542/peds.2024-068690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 02/27/2025] [Indexed: 04/04/2025] Open
Abstract
Medical advancements over the last century have improved our ability to treat pediatric infectious diseases, significantly reducing associated morbidity and mortality worldwide. Although vaccines have been pivotal in this progress, many viral pathogens still do not currently have effective vaccines. The COVID-19 pandemic highlighted the need for rapid responses to emerging viral pathogens and introduced new tools to combat them. This review addresses human monoclonal antibodies (mAbs) as a strategy for treating and preventing viral infections in pediatric populations. We discuss previously used and currently available mAbs and advancements in mAb discovery. We address the future of mAb therapy by describing novel approaches in drug production and delivery platforms in addition to alternative antibody classes. Finally, we review the challenges and limitations of mAb therapy development for newborns and children.
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Affiliation(s)
- Zeynep Bahadir
- Department of Pediatrics, Weill Cornell Medicine, Cornell University, New York, New York
| | - Priyanka Narayan
- Department of Pediatrics, Weill Cornell Medicine, Cornell University, New York, New York
| | - Rachael Wolters
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| | - Sallie R Permar
- Department of Pediatrics, Weill Cornell Medicine, Cornell University, New York, New York
| | - Genevieve Fouda
- Department of Pediatrics, Weill Cornell Medicine, Cornell University, New York, New York
| | - Ann J Hessell
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| | - Nancy L Haigwood
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
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Koureas M, Nasika A, Lianos AG, Vontas A, Kyritsi MA, Voulgaridi I, Matziri A, Bogogiannidou Z, Kalala F, Mouchtouri VA, Speletas M, Hadjichristodoulou C. Seroprevalence of West Nile virus, Greece, 2020. Euro Surveill 2025; 30:2400487. [PMID: 40248889 PMCID: PMC12007402 DOI: 10.2807/1560-7917.es.2025.30.15.2400487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 10/21/2024] [Indexed: 04/19/2025] Open
Abstract
BackgroundWest Nile virus (WNV) is a growing public health concern in Europe. Greece is one of the most affected countries in Europe, with the highest annual incidences.AimWe aimed at assessing IgG antibodies to WNV in the Greek population and compared the results with a nationwide survey conducted in the period 2012-2013.MethodsIn a geographically stratified sampling, 4,416 serum samples were collected and analysed for WNV-specific IgG antibodies using ELISA. Samples positive for WNV IgG were further tested with a WNV serum neutralisation test to detect false positives.ResultsThe weighted seroprevalence, adjusted for age, sex and region, was 2.83% (95% confidence interval (CI): 2.32-3.44) in the 4,416 samples tested, significantly higher than in the 2012-2013 survey (1.55%; 95% CI: 1.17-2.04). The seropositivity increased with age with the highest seroprevalence in persons aged ≥ 80 years (6.04%; 95% CI: 3.28-10.88). No significant differences in seropositivity were observed between sexes or regions. We estimated that 312 (95% CI: 256-379) persons had a WNV infection per a case of West Nile neuroinvasive disease (WNND). A certain degree of discordance was observed between areas with increased seroprevalence and those with an increased incidence of WNND.ConclusionOur study reveals a wider geographical spread of WNV infections in Greece compared with previous investigations. The nearly twofold increase in seroprevalence highlights the need for ongoing monitoring and preventive measures to mitigate the impact of WNV on public health in Greece.
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Affiliation(s)
- Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Asimina Nasika
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Athanasios G Lianos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Maria A Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Ioanna Voulgaridi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Alexia Matziri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Zacharoula Bogogiannidou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Fani Kalala
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Varvara A Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
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Tuncel G, Akan G, Kalaycı M, Baddal B, Bostancı A, Suer K, Özverel CS, Şanlıdağ T. Efficient Detection of West Nile Virus in Urine Specimens by a Novel In-House RT-qPCR Detection Kit. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2025; 2025:6513971. [PMID: 39816187 PMCID: PMC11732278 DOI: 10.1155/cjid/6513971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 11/23/2024] [Indexed: 01/18/2025]
Abstract
West Nile Virus (WNV) infection represents a major global public health challenge. Even though most of the patients are asymptomatic, some cases progress to critical condition which may be fatal. Diagnosis traditionally relies on serological methods, but their limitations, including cross-reactivity, highlight the need for alternative approaches. Here, we present the development and validation of a novel RT-qPCR assay for precise and rapid detection of WNV RNA in urine, emerging as a promising specimen due to its noninvasive collection and high viral load. The assay demonstrates high efficiency and sensitivity, with a detection limit comparable to commercially available kits. This study highlights the importance of in-house kit design as a diagnostic tool in regions affected by emerging tropical infections, such as WNV, exemplified Cyprus. It emphasizes the critical role of low-cost, early detection with high sensitivity and specificity in infection control and surveillance efforts.
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Affiliation(s)
- Gülten Tuncel
- DESAM Research Institute, Near East University, Nicosia, Cyprus
| | - Gökçe Akan
- DESAM Research Institute, Near East University, Nicosia, Cyprus
- Biochemistry Department, MUHAS Genetics Laboratory, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Melis Kalaycı
- DESAM Research Institute, Near East University, Nicosia, Cyprus
| | - Buket Baddal
- DESAM Research Institute, Near East University, Nicosia, Cyprus
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | | | - Kaya Suer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | | | - Tamer Şanlıdağ
- DESAM Research Institute, Near East University, Nicosia, Cyprus
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4
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Vilibic-Cavlek T, Bogdanic M, Savic V, Hruskar Z, Barbic L, Stevanovic V, Antolasic L, Milasincic L, Sabadi D, Miletic G, Coric I, Mrzljak A, Listes E, Savini G. Diagnosis of West Nile virus infections: Evaluation of different laboratory methods. World J Virol 2024; 13:95986. [PMID: 39722752 PMCID: PMC11551685 DOI: 10.5501/wjv.v13.i4.95986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 08/14/2024] [Accepted: 08/27/2024] [Indexed: 10/18/2024] Open
Abstract
BACKGROUND The diagnosis of West Nile virus (WNV) is challenging due to short-term and low-level viremia, flavivirus cross-reactivity, and long immunoglobulin M (IgM) persistence. AIM To evaluate different methods for WNV detection [reverse transcription-polymerase chain reaction (RT-PCR), IgM/IgG antibodies, IgG avidity] in serum, cerebrospinal fluid (CSF), and urine samples of patients with confirmed WNV infection. METHODS The study included patients with confirmed WNV neuroinvasive infection (n = 62), asymptomatic WNV seropositive individuals (n = 22), and individuals with false-positive WNV IgM antibodies (n = 30). WNV RNA was detected using RT-PCR. A commercial ELISA was used to detect WNV IgM/IgG antibodies with confirmation of cross-reactive samples using a virus neutralization test (VNT). IgG-positive samples were tested for IgG avidity. RESULTS The WNV-RNA detection rates were significantly higher in the urine (54.5%)/serum (46.4%) than in CSF (32.2%). According to the sampling time, the WNV-RNA detection rates in urine collected within 7 days/8-14/≥ 15 days were 29.4/66.6/62.5% (P = 0.042). However, these differences were not observed in the CSF. The median RT-PCR cycle threshold values were significantly lower in urine (32.5, IQR = 28-34) than in CSF (34.5, IQR = 33-36). The frequency of positive WNV IgM and IgG significantly differed according to the sampling time in serum but not in CSF. Positive IgM/IgG antibodies were detected in 84.3/9.3% of serum samples collected within 7 days, 100/71.1% of samples collected 8-14, and 100% samples collected after ≥ 15 days. Recent WNV infection was confirmed by low/borderline avidity index (AI) in 13.6% of asymptomatic individuals. A correlation between ELISA and AI was strong negative for IgM and strong positive for IgG. No significant correlation between ELISA IgG and VNT was found. CONCLUSION The frequency of WNV RNA and antibody detection depends on the sampling time and type of clinical samples. IgG avidity could differentiate recent WNV infections from long-persisting IgM antibodies.
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Affiliation(s)
- Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Vladimir Savic
- Poultry Center, Croatian Veterinary Institute, Zagreb 10000, Croatia
| | - Zeljka Hruskar
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine University of Zagreb, Zagreb 10000, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine University of Zagreb, Zagreb 10000, Croatia
| | - Ljiljana Antolasic
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
| | - Ljiljana Milasincic
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
| | - Dario Sabadi
- Department of Infectious Diseases, Clinical Hospital Center Osijek, Osijek 31000, Croatia
- Medical Faculty, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Gorana Miletic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine University of Zagreb, Zagreb 10000, Croatia
| | - Ivona Coric
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine University of Zagreb, Zagreb 10000, Croatia
| | - Anna Mrzljak
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
- Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb 10000, Croatia
| | - Eddy Listes
- Croatian Veterinary Institute, Veterinary Institute Split, Split 21000, Croatia
| | - Giovanni Savini
- OIE Reference Center for West Nile Disease, Istituto Zooprofilattico Sperimentale, G. Caporale, Teramo 64100, Italy
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Vo HM, Sheppard JM. Cholecystitis and Cardiomyopathy in an Immunocompetent Patient With Cytomegalovirus Infection: A Case Report. Cureus 2024; 16:e65418. [PMID: 39071074 PMCID: PMC11274759 DOI: 10.7759/cureus.65418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/25/2024] [Indexed: 07/30/2024] Open
Abstract
In this case report, we present a 53-year-old immunocompetent male exhibiting cholecystitis and cardiomyopathy related to cytomegalovirus (CMV) infection. The initial presentation pointed toward cholecystitis, including epigastric pain, chronic dysgeusia, dyspepsia, and cholelithiasis on ultrasound. A cholecystectomy was performed, and tissue analysis showed subacute cholecystitis. Postsurgical daily fever spikes prompted subsequent evaluation, which revealed CMV infection along with cardiomyopathy as evidenced by a reduced left ventricular ejection fraction, despite no suggestive clinical symptoms. Gastrointestinal symptoms, along with elevated liver enzymes, indicated possible congestive hepatopathy. Preceding symptoms also suggested a viral etiology, including a protracted fever and a possible transient Bell's palsy. Medical management for viral myocarditis was initiated, and the patient has been followed closely after discharge. The case emphasizes the importance of considering viral etiology with comprehensive cardiac workup, even in the absence of overt cardiac symptoms but with abnormal liver enzymes. Surprisingly, the infectious workup showed positive West Nile virus (WNV) and Epstein-Barr virus (EBV) serology, indicating possible co-infection or cross-reactivity.
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Affiliation(s)
- Hieu M Vo
- Internal Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Jerry M Sheppard
- Internal Medicine, Mississippi Baptist Medical Center, Jackson, USA
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Pavesi A, Tiecco G, Rossi L, Sforza A, Ciccarone A, Compostella F, Lovatti S, Tomasoni LR, Castelli F, Quiros-Roldan E. Inflammatory Response Associated with West Nile Neuroinvasive Disease: A Systematic Review. Viruses 2024; 16:383. [PMID: 38543749 PMCID: PMC10976239 DOI: 10.3390/v16030383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND West Nile virus (WNV) infection is a seasonal arbovirosis with the potential to cause severe neurological disease. Outcomes of the infection from WNV depend on viral factors (e.g., lineage) and host-intrinsic factors (e.g., age, sex, immunocompromising conditions). Immunity is essential to control the infection but may also prove detrimental to the host. Indeed, the persistence of high levels of pro-inflammatory cytokines and chemokines is associated with the development of blood-brain barrier (BBB) damage. Due to the importance of the inflammatory processes in the development of West Nile neuroinvasive disease (WNND), we reviewed the available literature on the subject. METHODS According to the 2020 updated PRISMA guidelines, all peer-reviewed articles regarding the inflammatory response associated with WNND were included. RESULTS One hundred and thirty-six articles were included in the data analysis and sorted into three groups (in vitro on-cell cultures, in vivo in animals, and in humans). The main cytokines found to be increased during WNND were IL-6 and TNF-α. We highlighted the generally small quantity and heterogeneity of information about the inflammatory patterns associated with WNND. CONCLUSIONS Further studies are needed to understand the pathogenesis of WNND and to investigate the extent and the way the host inflammatory response either helps in controlling the infection or in worsening the outcomes. This might prove useful both for the development of target therapies and for the development of molecular markers allowing early identification of patients displaying an inflammatory response that puts them at a higher risk of developing neuroinvasive disease and who might thus benefit from early antiviral therapies.
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Affiliation(s)
- Alessandro Pavesi
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Giorgio Tiecco
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Luca Rossi
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Anita Sforza
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Andrea Ciccarone
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Federico Compostella
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Sofia Lovatti
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Lina Rachele Tomasoni
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili di Brescia, 25123 Brescia, Italy;
| | - Francesco Castelli
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
| | - Eugenia Quiros-Roldan
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (A.P.); (G.T.); (L.R.); (A.S.); (A.C.); (F.C.); (S.L.); (F.C.)
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MacIntyre C, Lourens C, Mendes A, de Villiers M, Avenant T, du Plessis NM, Leendertz FH, Venter M. West Nile Virus, an Underdiagnosed Cause of Acute Fever of Unknown Origin and Neurological Disease among Hospitalized Patients in South Africa. Viruses 2023; 15:2207. [PMID: 38005884 PMCID: PMC10674603 DOI: 10.3390/v15112207] [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: 09/29/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
West Nile virus (WNV), a mosquito-borne flavivirus, is endemic to South Africa. However, its contribution to acute febrile and neurological disease in hospitalized patients in South Africa is unknown. This study examined two patient cohorts for WNV using molecular testing and IgM serology with confirmation of serological results by viral neutralization tests (VNT) to address this knowledge gap. Univariate analysis was performed using collected demographic and clinical information to identify risk factors. In the first cohort, 219 cerebrospinal fluid (CSF) specimens from patients with acute neurological disease in Gauteng hospitals collected in January to June 2017 were tested for WNV. The study identified WNV in 8/219 (3.65%, 95.00% CI (1.59-7.07)) patients with unsolved neurological infections. The second cohort, from 2019 to 2021, included 441 patients enrolled between January and June with acute febrile or neurological disease from urban and rural sites in Gauteng and Mpumalanga provinces. West Nile virus was diagnosed in 40/441 (9.07%, 95.00% CI (6.73-12.12)) of patients, of which 29/40 (72.50%, 95.00% CI (56.11-85.40)) had neurological signs, including headaches, encephalitis, meningitis, and acute flaccid paralysis (AFP). Notably, most of the cases were identified in children although adolescents and senior adults had a significantly higher risk of testing WNV positive. This suggests a previously underestimated disease burden and that WNV might be underrecognized as a cause of febrile and neurological diseases in hospitalized patients in South Africa, especially in children. This emphasizes the importance of further research and awareness regarding arboviruses of public health concern.
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Affiliation(s)
- Caitlin MacIntyre
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Carla Lourens
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Adriano Mendes
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Maryke de Villiers
- Department of Internal Medicine, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa;
| | - Theunis Avenant
- Department of Pediatrics, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (T.A.); (N.M.d.P.)
| | - Nicolette M. du Plessis
- Department of Pediatrics, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (T.A.); (N.M.d.P.)
| | - Fabian H. Leendertz
- Helmholtz Institute for One Health and University of Greifswald, 17489 Greifswald, Germany;
| | - Marietjie Venter
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
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8
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Lin SC, Zhao FR, Janova H, Gervais A, Rucknagel S, Murray KO, Casanova JL, Diamond MS. Blockade of interferon signaling decreases gut barrier integrity and promotes severe West Nile virus disease. Nat Commun 2023; 14:5973. [PMID: 37749080 PMCID: PMC10520062 DOI: 10.1038/s41467-023-41600-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023] Open
Abstract
The determinants of severe disease caused by West Nile virus (WNV) and why only ~1% of individuals progress to encephalitis remain poorly understood. Here, we use human and mouse enteroids, and a mouse model of pathogenesis, to explore the capacity of WNV to directly infect gastrointestinal (GI) tract cells and contribute to disease severity. At baseline, WNV poorly infects human and mouse enteroid cultures and enterocytes in mice. However, when STAT1 or type I interferon (IFN) responses are absent, GI tract cells become infected, and this is associated with augmented GI tract and blood-brain barrier (BBB) permeability, accumulation of gut-derived molecules in the brain, and more severe WNV disease. The increased gut permeability requires TNF-α signaling, and is absent in WNV-infected IFN-deficient germ-free mice. To link these findings to human disease, we measured auto-antibodies against type I IFNs in serum from WNV-infected human cohorts. A greater frequency of auto- and neutralizing antibodies against IFN-α2 or IFN-ω is present in patients with severe WNV infection, whereas virtually no asymptomatic WNV-infected subjects have such antibodies (odds ratio 24 [95% confidence interval: 3.0 - 192.5; P = 0.003]). Overall, our experiments establish that blockade of type I IFN signaling extends WNV tropism to enterocytes, which correlates with increased gut and BBB permeability, and more severe disease.
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Affiliation(s)
- Shih-Ching Lin
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Fang R Zhao
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Hana Janova
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Adrian Gervais
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) U1163, Necker Hospital for Sick Children, Paris, EU, 75015, France
- Paris Cité University, Imagine Institute, Paris, EU, 75015, France
| | - Summer Rucknagel
- Gnotobiotic Research, Education, and Transgenic Center, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Kristy O Murray
- Department of Pediatrics, Section of Pediatric Tropical Medicine, William T. Shearer Center for Human Immunobiology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, 77030, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) U1163, Necker Hospital for Sick Children, Paris, EU, 75015, France
- Paris Cité University, Imagine Institute, Paris, EU, 75015, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, 10065, USA
- Howard Hughes Medical Institute, New York, NY, 10065, USA
- Department of Paediatrics, Necker Hospital for Sick Children, Paris, EU, 75015, France
| | - Michael S Diamond
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Andrew M. and Jane M. Bursky the Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, MO, 63110, USA.
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Broban A, Olive MM, Tantely ML, Dorsemans AC, Rakotomanana F, Ravalohery JP, Rogier C, Heraud JM, Andriamandimby SF. Seroprevalence of IgG Antibodies Directed against Dengue, Chikungunya and West Nile Viruses and Associated Risk Factors in Madagascar, 2011 to 2013. Viruses 2023; 15:1707. [PMID: 37632049 PMCID: PMC10458928 DOI: 10.3390/v15081707] [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: 07/21/2023] [Revised: 08/02/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
Arboviruses have been shown to circulate in Madagascar, including West Nile, dengue, and chikungunya viruses, though the extent of their circulation remains poorly documented. We estimated the seroprevalence of these three arboviruses in Madagascar and determined risk factors associated with seropositivity. Serum samples obtained from 1680 individuals surrounding the Sentinel Health Centers network in all regions of the country were analyzed using ELISA and hemagglutination inhibition assays for dengue, chikungunya, and West Nile viruses IgG antibodies, and multivariate logistic regression models were run. Overall, 6.5% [IC 95% 3.2-9.9] were seropositive for dengue virus, predominantly of Dengue serotype 1, 13.7% [IC 95% 6.5-20.9] for chikungunya virus, and 12.7% [IC 95% 9.0-16.5] for West Nile virus. There was no association with age, showing that dengue and chikungunya viruses were likely recently introduced. Eastern and Northern parts were more affected by dengue and chikungunya viruses, while West Nile virus seemed to circulate in all parts of the country. Dengue and chikungunya seropositivity were notably associated with high levels of vegetation, as well as frequent work in the forest, and West Nile seropositivity with the presence of cultivated areas, as well as standard of living. This analysis gives a new insight into arboviruses circulation and transmission patterns in Madagascar.
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Affiliation(s)
- Anaïs Broban
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (A.B.); (M.-M.O.); (A.-C.D.); (J.-P.R.); (S.F.A.)
- Epicentre, 75017 Paris, France
| | - Marie-Marie Olive
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (A.B.); (M.-M.O.); (A.-C.D.); (J.-P.R.); (S.F.A.)
| | | | - Anne-Claire Dorsemans
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (A.B.); (M.-M.O.); (A.-C.D.); (J.-P.R.); (S.F.A.)
| | - Fanjasoa Rakotomanana
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar;
| | - Jean-Pierre Ravalohery
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (A.B.); (M.-M.O.); (A.-C.D.); (J.-P.R.); (S.F.A.)
| | - Christophe Rogier
- Directorate, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar;
- Primum Vitare ! D’abord Prévenir !, 75015 Paris, France
| | - Jean-Michel Heraud
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (A.B.); (M.-M.O.); (A.-C.D.); (J.-P.R.); (S.F.A.)
| | - Soa Fy Andriamandimby
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (A.B.); (M.-M.O.); (A.-C.D.); (J.-P.R.); (S.F.A.)
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10
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Johnson SAM, Asmah R, Awuni JA, Tasiame W, Mensah GI, Paweska JT, Weyer J, Hellferscee O, Thompson PN. Evidence of Rift Valley Fever Virus Circulation in Livestock and Herders in Southern Ghana. Viruses 2023; 15:1346. [PMID: 37376647 DOI: 10.3390/v15061346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Rift Valley fever (RVF) is a re-emerging zoonotic disease of domestic ruminants and humans. While neighbouring countries have reported outbreaks of RVF, Ghana has not yet identified any cases. The aim of this study was to determine whether RVF virus (RVFV) was circulating in livestock and herders in the southern part of Ghana, to estimate its seroprevalence, and to identify associated risk factors. The study surveyed 165 livestock farms randomly selected from two districts in southern Ghana. Serum samples of 253 goats, 246 sheep, 220 cattle, and 157 herdsmen were tested to detect IgG and IgM antibodies against RVFV. The overall seroprevalence of anti-RVF antibodies in livestock was 13.1% and 30.9% of farms had RVFV seropositive animals. The species-specific prevalence was 24.1% in cattle, 8.5% in sheep, and 7.9% in goats. A RVFV IgG seroprevalence of 17.8% was found among the ruminant herders, with 8.3% of all herders being IgM positive. RVFV was shown, for the first time, to have been circulating in southern Ghana, with evidence of a recent outbreak in Kwahu East; however, it was clinically undetected despite significant recent human exposure. A One Health approach is recommended to better understand RVF epidemiology and socio-economic impact in Ghana.
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Affiliation(s)
- Sherry Ama Mawuko Johnson
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110, South Africa
- School of Veterinary Medicine, University of Ghana, Legon, Accra 00233, Ghana
| | - Richard Asmah
- School of Biomedical & Allied Health Sciences, University of Ghana, Accra 00233, Ghana
| | - Joseph Adongo Awuni
- Accra Veterinary Laboratory, Ministry of Food and Agriculture, Accra P.O. Box M161, Ghana
| | - William Tasiame
- School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Gloria Ivy Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana
| | - Janusz T Paweska
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2192, South Africa
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Jacqueline Weyer
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2192, South Africa
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Orienka Hellferscee
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2192, South Africa
- Department of Medical Virology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2050, South Africa
| | - Peter N Thompson
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110, South Africa
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11
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Tauekelova AT, Kalila Z, Bakhtiyar A, Sautbayeva Z, Len P, Sailybayeva A, Khamitov S, Kadroldinova N, Barteneva NS, Bekbossynova MS. Association of Lung Fibrotic Changes and Cardiological Dysfunction with Comorbidities in Long COVID-19 Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2567. [PMID: 36767932 PMCID: PMC9915134 DOI: 10.3390/ijerph20032567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/23/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Background. Long COVID-19 symptoms appeared in many COVID-19 survivors. However, the prevalence and symptoms associated with long COVID-19 and its comorbidities have not been established. Methods. In total, 312 patients with long COVID-19 from 21 primary care centers were included in the study. At the six-month follow-up, their lung function was assessed by computerized tomography (CT) and spirometry, whereas cardiac function was assessed by elec-trocardiogram (ECG), Holter ECG, echocardiography, 24 h blood pressure monitoring, and a six-minute walk test (6MWT). Results. Of the 312 persons investigated, significantly higher sys-tolic and diastolic blood pressure, left ventricular hypertrophy, and elevated NT-proBNP were revealed in participants with hypertension or type 2 diabetes. Left ventricular diastolic dysfunc-tion was more frequently present in patients with hypertension. The most common registered CT abnormalities were fibrotic changes (83, 36.6%) and mediastinal lymphadenopathy (23, 10.1%). Among the tested biochemical parameters, three associations were found in long COVID-19 patients with hypertension but not diabetes: increased hemoglobin, fibrinogen, and ferritin. Nine patients had persisting IgM antibodies to SARS-CoV-2. Conclusions. We demon-strated a strong association between signs of cardiac dysfunction and lung fibrotic changes with comorbidities in a cohort of long COVID-19 subjects.
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Affiliation(s)
| | - Zhanar Kalila
- National Research Center for Cardiac Surgery, Astana 010000, Kazakhstan
| | - Akerke Bakhtiyar
- National Research Center for Cardiac Surgery, Astana 010000, Kazakhstan
| | - Zarina Sautbayeva
- School of Sciences and Humanities, Nazarbayev University, Astana 010000, Kazakhstan
| | - Polina Len
- School of Sciences and Humanities, Nazarbayev University, Astana 010000, Kazakhstan
| | - Aliya Sailybayeva
- National Research Center for Cardiac Surgery, Astana 010000, Kazakhstan
| | - Sadyk Khamitov
- National Research Center for Cardiac Surgery, Astana 010000, Kazakhstan
| | | | - Natasha S. Barteneva
- School of Sciences and Humanities, Nazarbayev University, Astana 010000, Kazakhstan
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12
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Nwanosike H, Green FM, Murray KO, Weatherhead JE, Ronca SE. Protocol of Detection of West Nile Virus in Clinical Samples. Methods Mol Biol 2023; 2585:119-125. [PMID: 36331770 DOI: 10.1007/978-1-0716-2760-0_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
West Nile virus (WNV) is one of the leading causes of arboviral encephalitis in the United States but is often underdiagnosed. Despite the wide breadth of WNV-induced clinical disease syndromes, many of the symptoms associated with WNV are nonspecific at the time of presentation; thus, choosing the right diagnostic tool is essential to not only understand the true burden of disease but also provide pathogen-directed interventions for WNV-infected patients. In this chapter, we briefly discuss the three most common types of diagnostic methods for WNV in human clinical samples: nucleic acid detection, enzyme-linked immunoassay (ELISA), and plaque reduction neutralization test (PRNT) and present the method for PRNT.
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Affiliation(s)
- Hephzibah Nwanosike
- Baylor College of Medicine, National School of Tropical Medicine, Houston, TX, USA
| | - Freedom M Green
- Baylor College of Medicine, National School of Tropical Medicine, Houston, TX, USA
| | - Kristy O Murray
- Baylor College of Medicine, National School of Tropical Medicine, Houston, TX, USA
| | - Jill E Weatherhead
- Baylor College of Medicine, National School of Tropical Medicine, Houston, TX, USA
| | - Shannon E Ronca
- Baylor College of Medicine, National School of Tropical Medicine, Houston, TX, USA.
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13
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Singh T, Hwang KK, Miller AS, Jones RL, Lopez CA, Dulson SJ, Giuberti C, Gladden MA, Miller I, Webster HS, Eudailey JA, Luo K, Von Holle T, Edwards RJ, Valencia S, Burgomaster KE, Zhang S, Mangold JF, Tu JJ, Dennis M, Alam SM, Premkumar L, Dietze R, Pierson TC, Eong Ooi E, Lazear HM, Kuhn RJ, Permar SR, Bonsignori M. A Zika virus-specific IgM elicited in pregnancy exhibits ultrapotent neutralization. Cell 2022; 185:4826-4840.e17. [PMID: 36402135 PMCID: PMC9742325 DOI: 10.1016/j.cell.2022.10.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 08/23/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022]
Abstract
Congenital Zika virus (ZIKV) infection results in neurodevelopmental deficits in up to 14% of infants born to ZIKV-infected mothers. Neutralizing antibodies are a critical component of protective immunity. Here, we demonstrate that plasma IgM contributes to ZIKV immunity in pregnancy, mediating neutralization up to 3 months post-symptoms. From a ZIKV-infected pregnant woman, we isolated a pentameric ZIKV-specific IgM (DH1017.IgM) that exhibited ultrapotent ZIKV neutralization dependent on the IgM isotype. DH1017.IgM targets an envelope dimer epitope within domain II. The epitope arrangement on the virion is compatible with concurrent engagement of all ten antigen-binding sites of DH1017.IgM, a solution not available to IgG. DH1017.IgM protected mice against viremia upon lethal ZIKV challenge more efficiently than when expressed as an IgG. Our findings identify a role for antibodies of the IgM isotype in protection against ZIKV and posit DH1017.IgM as a safe and effective candidate immunotherapeutic, particularly during pregnancy.
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Affiliation(s)
- Tulika Singh
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA,Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA 94709, USA
| | - Kwan-Ki Hwang
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Andrew S. Miller
- Department of Biological Sciences, Purdue Institute of Inflammation, Immunology, and Infectious Disease, Purdue University, West Lafayette, IN 47907, USA
| | - Rebecca L. Jones
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Cesar A. Lopez
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sarah J. Dulson
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Camila Giuberti
- Núcleo de Doenças Infecciosas—Universidade Federal do Espírito Santo, Vitoria, Espírito Santo 29075-910, Brazil
| | - Morgan A. Gladden
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Itzayana Miller
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA,Department of Pediatrics, Weill Cornell Medicine, New York City, NY 10065, USA
| | - Helen S. Webster
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Joshua A. Eudailey
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA,Department of Pediatrics, Weill Cornell Medicine, New York City, NY 10065, USA
| | - Kan Luo
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Tarra Von Holle
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Robert J. Edwards
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Sarah Valencia
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Katherine E. Burgomaster
- Viral Pathogenesis Section, Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 USA
| | - Summer Zhang
- Duke-National University of Singapore Medical School, 169857, Singapore
| | - Jesse F. Mangold
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Joshua J. Tu
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Maria Dennis
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - S. Munir Alam
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
| | - Lakshmanane Premkumar
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Reynaldo Dietze
- Núcleo de Doenças Infecciosas—Universidade Federal do Espírito Santo, Vitoria, Espírito Santo 29075-910, Brazil,Global Health & Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon 1349-008, Portugal
| | - Theodore C. Pierson
- Viral Pathogenesis Section, Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 USA
| | - Eng Eong Ooi
- Duke-National University of Singapore Medical School, 169857, Singapore
| | - Helen M. Lazear
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Richard J. Kuhn
- Department of Biological Sciences, Purdue Institute of Inflammation, Immunology, and Infectious Disease, Purdue University, West Lafayette, IN 47907, USA
| | - Sallie R. Permar
- Department of Pediatrics, Weill Cornell Medicine, New York City, NY 10065, USA,Senior author. These authors contributed equally,Correspondence: (S.R.P.), (M.B.)
| | - Mattia Bonsignori
- Translational Immunobiology Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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14
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Kao YF, Spainhour R, Cowan SR, Nafe L, Birkenheuer A, Reichard MV, Miller CA. A Serodiagnostic IgM ELISA to Detect Acute Cytauxzoonosis. Pathogens 2022; 11:pathogens11101183. [PMID: 36297239 PMCID: PMC9611129 DOI: 10.3390/pathogens11101183] [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] [Received: 09/15/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/15/2022] Open
Abstract
Cytauxzoonosis is a tick-borne infectious disease affecting domestic cats with high mortality and limited treatment modalities. Because early diagnosis and therapeutic intervention are crucial to survival of infected cats, the objective of this study was to develop an ELISA capable of detecting cytauxzoonosis and differentiating acute vs. chronic infection in clinical feline blood samples. A microsphere immunoassay (MIA) was developed to evaluate the production of Cytauxzoon felis-specific IgM and IgG antibodies in serial plasma samples from cats with experimental C. felis infection by targeting a C. felis-specific transmembrane protein (c88). Recombinant c88 protein was utilized to develop indirect ELISAs to detect IgM and IgG antibodies in clinical plasma samples from: PCR-positive cats with acute C. felis infection (n = 36), C. felis-negative cats with pyrexia (n = 10), healthy C. felis-negative cats (n = 22), and chronic C. felis carriers (n = 4). Anti-c88 IgM antibodies were detectable at day 12 post-tick infestation in cats with experimental C. felis infection (within 24 hours of developing clinical signs), while anti-c88 IgG was detectable at day 15 post-tick infestation - indicating IgM could be used to detect early infection. Using a cut-off value of 19.85 percent positive, the C. felis IgM ELISA detected acute cytauxzoonosis in 94.44% (34/36) of cats presented with clinical signs of acute cytauxzoonosis with 100% specificity (indicating a "Strong Positive" result). When a lower cutoff of 8.60 percent positive was used, cytauxzoonosis was detected in the 2 remaining PCR-positive cats with 87.88% specificity (indicating of a "Weak Positive" result). One C. felis-negative, febrile cat had high IgG, and chronic carriers had variable IgM and IgG results. Combined interpretation of IgM and IgG ELISAs did not reliably differentiate acute vs. chronic infection. While further validation on assay performance is needed, the C. felis IgM ELISA is a promising test to detect acute cytauxzoonosis and can be utilized to develop a point-of-care test for clinical use.
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Affiliation(s)
- Yun-Fan Kao
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74075, USA
| | - Rebecca Spainhour
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74075, USA
| | - Shannon R. Cowan
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74075, USA
| | - Laura Nafe
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
| | - Adam Birkenheuer
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC 27606, USA
| | - Mason V. Reichard
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74075, USA
| | - Craig A. Miller
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74075, USA
- Correspondence:
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15
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Srichawla BS. Neuroinvasive West Nile Virus (WNV) Encephalitis With Anton Syndrome: Epidemiology and Pathophysiology Review. Cureus 2022; 14:e26264. [PMID: 35911357 PMCID: PMC9312882 DOI: 10.7759/cureus.26264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 02/06/2023] Open
Abstract
The West Nile virus (WNV) belongs to the genus of flaviviruses and is known to cause irreversible neurologic deficits. Neuroinvasive WNV cases continue to be rare and have a higher prevalence in South America, Africa, and Asia. Here we report a 55-year-old female from North America who presented with acute-onset encephalopathy, fever, myalgias, and Anton syndrome. Neuroradiographic findings included diffuse white matter abnormalities of both cortical and subcortical structures and the patient was diagnosed with posterior reversible encephalopathy syndrome (PRES). Further workup revealed WNV antibodies in both cerebrospinal fluid (CSF) and serum. Management of WNV encephalitis continues to be poor and thus the patient was referred to a long-term care facility. Furthermore, Anton syndrome is a rare focal neurologic deficit that has never been previously associated with the WNV. This case aims to highlight the epidemiology of WNV in the United States, the mechanisms of WNV encephalitis, and an overview of Anton syndrome.
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16
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Staples JE, Gibney KB, Panella AJ, Prince HE, Basile AJ, Laven J, Sejvar JJ, Fischer M. Duration of West Nile Virus Immunoglobulin M Antibodies up to 81 Months Following West Nile Virus Disease Onset. Am J Trop Med Hyg 2022; 106:tpmd211234. [PMID: 35405658 PMCID: PMC9209930 DOI: 10.4269/ajtmh.21-1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/08/2022] [Indexed: 11/07/2022] Open
Abstract
West Nile virus (WNV) IgM antibodies typically indicate a recent infection. However, WNV IgM antibodies can remain detectable for months to years following illness onset. We found that 23% (11/47) of samples tested with a WNV ELISA and 43% (20/47) of samples tested with WNV microsphere immunoassay (MIA) at 16-19 months following WNV illness onset were positive for IgM antibodies. The proportion of samples testing positive for WNV IgM by ELISA decreased over time, but 5% (2/44) of individuals remained positive at 60-63 months after their acute illness and 4% (2/50) were WNV IgM equivocal at 72-81 months. Testing by MIA showed the same general trend of decreased proportion positive over time though the rates of positivity were higher at most time points compared with the ELISA, including 6% (3/50) of participant's samples identified as IgM positive by MIA at 72-81 months post their acute illness. With the MIA, there also was a high proportion of samples with nonspecific results at each time point; average of 23% across all time points. Clinicians and public health officials should consider these findings along with clinical and epidemiologic data when interpreting WNV IgM antibody test results.
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Affiliation(s)
- J. Erin Staples
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Katherine B. Gibney
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
- Epidemic Intelligence Service Program, CDC, Atlanta, Georgia
| | - Amanda J. Panella
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Harry E. Prince
- Quest Diagnostics Infectious Disease, Inc., San Juan Capistrano, California
| | - Alison J. Basile
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Janeen Laven
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - James J. Sejvar
- Division of High-Consequence Pathogens and Pathology, CDC, Atlanta, Georgia
| | - Marc Fischer
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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17
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Joyner G, Mavin S, Milner R, Lim C. Introduction of IgM testing for the diagnosis of acute Lyme borreliosis: a study of the benefits, limitations and costs. Eur J Clin Microbiol Infect Dis 2022; 41:671-675. [PMID: 35089441 PMCID: PMC8934319 DOI: 10.1007/s10096-021-04366-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022]
Abstract
Testing for IgM antibodies to Borrelia burgdorferi in Scottish patients with suspected Lyme borreliosis was introduced in 2018 to supplement the IgG testing already in situ. Results from 2018 to 2020 were assessed alongside available clinical data to evaluate the utility of IgM testing in serum. An estimated false positive rate of 25.5% was observed with IgM immunoblot vs 80.1% for IgM chemiluminescent immunoassay (CLIA). IgM testing can aid earlier diagnoses if used within a selective two-tier testing protocol: only patients with acute onset of symptoms should be tested for IgM CLIA but confirmation by immunoblot and consideration of clinical picture is necessary.
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Affiliation(s)
- Greg Joyner
- Scottish Lyme Disease and Tick-Borne Infections Reference Laboratory (SLDTRL), Raigmore Hospital, Inverness, IV2 3UJ, UK
| | - Sally Mavin
- Scottish Lyme Disease and Tick-Borne Infections Reference Laboratory (SLDTRL), Raigmore Hospital, Inverness, IV2 3UJ, UK.
| | - Rachel Milner
- Scottish Lyme Disease and Tick-Borne Infections Reference Laboratory (SLDTRL), Raigmore Hospital, Inverness, IV2 3UJ, UK
| | - Chin Lim
- Scottish Lyme Disease and Tick-Borne Infections Reference Laboratory (SLDTRL), Raigmore Hospital, Inverness, IV2 3UJ, UK
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18
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Hills SL, Laven J, Biggerstaff BJ, Kosoy O, Staples JE, Panella A. Frequency of Zika Virus Immunoglobulin M Antibody in Persons with West Nile Virus Infection. Vector Borne Zoonotic Dis 2021; 21:817-821. [PMID: 34292777 DOI: 10.1089/vbz.2021.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
West Nile virus (WNV) and Zika virus (ZIKV) are mosquito-borne viruses in the family Flaviviridae. Residents in, and travelers to, areas where the viruses are circulating are at risk for infection, and both viruses can cause an acute febrile illness. Given known cross-reactivity in flavivirus serologic assays, it is possible a patient with acute WNV infection could be misdiagnosed as having ZIKV infection if appropriate testing is not conducted. To understand how frequently persons with WNV infection have detectable cross-reactive ZIKV immunoglobulin M (IgM) antibody, we used archived serum samples from patients in the United States with recent WNV infection confirmed by a microsphere-based immunoassay test for IgM antibody and neutralizing antibody testing. Samples were tested for ZIKV IgM antibody with the Centers for Disease Control and Prevention (CDC) ZIKV IgM antibody capture enzyme-linked immunosorbent assay. Among 153 sera from patients with acute WNV infection, the ZIKV IgM antibody result was positive in 56 (37%; 95% confidence interval [CI] 29-44%) and equivocal in 28 (18%; 95% CI 13-25%). With 55% of samples having cross-reactive antibodies, it is important for health care providers to request appropriate testing based on the most likely cause of a patient's possible arboviral infection considering their clinical symptoms and signs, travel history, and place of residence. For cases where the epidemiology does not support the preliminary IgM findings, confirmatory neutralizing antibody testing should be performed. These measures will avoid an incorrect diagnosis of ZIKV infection, based on cross-reactive antibodies, in a person truly infected with WNV.
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Affiliation(s)
- Susan L Hills
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Janeen Laven
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Olga Kosoy
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Amanda Panella
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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19
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Ronca SE, Ruff JC, Murray KO. A 20-year historical review of West Nile virus since its initial emergence in North America: Has West Nile virus become a neglected tropical disease? PLoS Negl Trop Dis 2021; 15:e0009190. [PMID: 33956816 PMCID: PMC8101735 DOI: 10.1371/journal.pntd.0009190] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
After the unexpected arrival of West Nile virus (WNV) in the United States in 1999, the mosquito-borne virus quickly spread throughout North America. Over the past 20 years, WNV has become endemic, with sporadic epizootics. Concerns about the economic impact of infection in horses lead to the licensure of an equine vaccine as early as 2005, but few advances regarding human vaccines or treatments have since been made. There is a high level of virus transmission in hot/humid, subtropical climates, and high morbidity that may disproportionately affect vulnerable populations including the homeless, elderly, and those with underlying health conditions. Although WNV continues to cause significant morbidity and mortality at great cost, funding and research have declined in recent years. These factors, combined with neglect by policy makers and amenability of control measures, indicate that WNV has become a neglected tropical disease.
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Affiliation(s)
- Shannon E. Ronca
- Department of Pediatrics, Section of Pediatric Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas, United States of America
- William T. Shearer Center for Human Immunobiology, Texas Children’s Hospital, Houston, Texas, United States of America
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Jeanne C. Ruff
- Department of Pediatrics, Section of Pediatric Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas, United States of America
- William T. Shearer Center for Human Immunobiology, Texas Children’s Hospital, Houston, Texas, United States of America
| | - Kristy O. Murray
- Department of Pediatrics, Section of Pediatric Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas, United States of America
- William T. Shearer Center for Human Immunobiology, Texas Children’s Hospital, Houston, Texas, United States of America
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail:
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20
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Heyming TW, Sanger T, Tongol A, Schomberg J, Bacon K, Lara B. Provider Antibody Serology Study of Virus in the Emergency Room (PASSOVER) Study: Special Population COVID-19 Seroprevalence. West J Emerg Med 2021; 22:565-571. [PMID: 34125028 PMCID: PMC8203005 DOI: 10.5811/westjem.2021.1.50058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/23/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction Limited data on the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCW) are publicly available. In this study we sought to determine the seroprevalence of SARS-CoV-2 in a population of HCWs in a pediatric emergency department (ED). Methods We conducted this observational cohort study from April 14–May 13, 2020 in a pediatric ED in Orange County, CA. Asymptomatic HCW ≥18 years of age were included in the study. Blood samples were obtained by fingerstick at the start of each shift. The inter-sampling interval was ≤96 hours. The primary outcome was positive seroprevalence of SARS-CoV-2 as determined with an antibody fast detection kit (Colloidal Gold, Superbio, Timisoara, Romania) for the SARS-CoV-2 immunoglobulin M/immunoglobulin G (IgM/IgG) antibody. Results A total of 143 HCWs participated in the study. Overall SARS-CoV-2 seroprevalence was 10.5% (n = 15). Positive seroprevalence was classified as IgG only (4.9%), IgM+IgG (3.5%), or IgM only (2.1%). SARS-CoV-2 was detected by reverse transcription polymerase chain reaction RT-PCR in 0.7% of the overall study population (n = 1). Samples obtained on Day 1 indicated seropositivity in 4.2% of the study population (n = 6). Subsequent seroconversion occurred in 6.3% of participants (n = 9). The rate of seroconversion was linear with a rate of approximately one new case every two days, starting at Day 9 of the study. Conclusion We observed a linear rate of seroconversion to SARS-CoV-2–positive status among asymptomatic HCWs who underwent daily symptom surveys and temperature screens in an environment with universal source control. Rapid antibody testing may be useful for screening for SARS-CoV-2 seropositivity in high-risk populations, such as HCWs in the ED.
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Affiliation(s)
- Theodore W Heyming
- Children's Hospital of Orange County, Department of Emergency Medicine, Orange, California.,University of California, Irvine, Department of Emergency Medicine, Irvine, California
| | - Terence Sanger
- University of California, Irvine, Department of Electrical Engineering and Computer Science, Irvine, California.,Children's Hospital of Orange County, Research Institute, Orange, California
| | - Aprille Tongol
- Children's Hospital of Orange County, Research Institute, Orange, California
| | - John Schomberg
- Children's Hospital of Orange County, Department of Nursing, Orange, California
| | - Kellie Bacon
- Children's Hospital of Orange County, Research Institute, Orange, California
| | - Bryan Lara
- Children's Hospital of Orange County, Research Institute, Orange, California
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21
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Robertson SN, Cameron AI, Morales PR, Burnside WM. West Nile Virus Seroprevalence in an Outdoor Nonhuman Primate Breeding Colony in South Florida. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2021; 60:168-175. [PMID: 33441221 PMCID: PMC7974820 DOI: 10.30802/aalas-jaalas-20-000029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/01/2020] [Accepted: 08/11/2020] [Indexed: 11/05/2022]
Abstract
West Nile virus (WNV) was first detected in Florida in July 2001, with 404 human cases reported to the Centers for Disease Control and Prevention as of February 2020. The subtropical climate of Florida is ideal for the mosquitoes that transmit WNV. We investigated the WNV seroprevalence in 3 NHP species housed outdoors at The Mannheimer Foundation in South Florida. From January to December 2016, 520 3 to 30 y old NHP were sampled at our 2 closed sites in Homestead and LaBelle: 200 rhesus macaques (Macaca mulatta), 212 cynomolgus macaques (Macaca fascicularis), and 108 hamadryas baboons (Papio hamadryas hamadryas). The presence of WNV IgG antibodies in these animals was determined by serum neutralization assays, which found a total seroprevalence of 14%. Seroprevalence was significantly higher in the baboons (29%) than the rhesus (11%) and cynomolgus (9%) macaques. The probability of seropositivity significantly increased with age, but sex and site did not significantly affect seroprevalence. The frequency of WNV seropositivity detected in these outdoor-housed NHP suggests that screening for WNV and other vector-borne diseases may be necessary prior to experimental use, particularly for infectious disease studies in which viremia or viral antibodies could confound results, and especially for populations housed outdoors in warm, wet climates. As no seropositive subjects demonstrated clinical signs of WNV and WNV exposure did not appear to significantly impact colony health, routine testing is likely unnecessary for most NHP colonies. However, WNV infection should still be considered as a differential diagnosis for any NHP presenting with nonspecific neurologic signs. Mosquito abatement plans and vigilant sanitation practices to further decrease mosquito and avian interaction with research NHP should also be considered.
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Affiliation(s)
| | - Angus I Cameron
- School of Pure and Applied Sciences, Florida SouthWestern State College, LaBelle, Florida
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22
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Hills S, Van Keulen A, Feser J, Panella A, Letson B, Staples E, Marfin T, Brault A. Persistence of IgM Antibodies after Vaccination with Live Attenuated Japanese Encephalitis Vaccine. Am J Trop Med Hyg 2020; 104:576-579. [PMID: 33236716 PMCID: PMC7866339 DOI: 10.4269/ajtmh.20-1132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/13/2020] [Indexed: 12/27/2022] Open
Abstract
Japanese encephalitis (JE) is a vaccine-preventable, mosquito-borne disease. Substantial progress with JE control in Asia has been made during the past decade, with most endemic countries now having JE vaccination programs, commonly using live attenuated SA14-14-2 JE vaccine (trade name CD-JEV). If a child develops encephalitis during the weeks to months following CD-JEV vaccination and anti-JE virus IgM (JE IgM) antibody is detected in serum, the question arises if this is JE virus infection indicating vaccine failure, or persistent JE IgM antibody postvaccination. To better understand JE IgM seropositivity following vaccination, sera from 268 children from a previous CD-JEV study were tested by two different JE IgM assays to determine JE IgM antibody frequency on days 28, 180, and 365 postvaccination. With the CDC JE IgM antibody capture ELISA (MAC-ELISA), 110 children (41%) had JE IgM positive or equivocal results on their day 28 sample, and eight (3%) and two (1%) had positive or equivocal results on day 180 and day 365 samples, respectively. With the InBios JE Detect™ MAC-ELISA (Seattle, WA), 118 (44%) children had positive or equivocal results on day 28 sample, and three (1%) and one (0.4%) had positive or equivocal results on day 180 and day 365 samples, respectively. Our results indicate that more than 40% children vaccinated with CD-JEV can have JE IgM antibodies in their serum at 1 month postvaccination but JE IgM antibody is rare by 6 months. These data will help healthcare workers assess the likelihood that JE IgM antibodies in the serum of a child with encephalitis after vaccination are vaccine related.
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Affiliation(s)
- Susan Hills
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Alex Van Keulen
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Amanda Panella
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Erin Staples
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Aaron Brault
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
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23
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Affiliation(s)
- Mohamed Sharafeldin
- Department of Chemistry, University of Oxford, South Parks Road, Oxford OX1 3QZ, U.K
| | - Jason J. Davis
- Department of Chemistry, University of Oxford, South Parks Road, Oxford OX1 3QZ, U.K
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24
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Point-Of-Care or Point-Of-Need Diagnostic Tests: Time to Change Outbreak Investigation and Pathogen Detection. Trop Med Infect Dis 2020; 5:tropicalmed5040151. [PMID: 32992688 PMCID: PMC7709694 DOI: 10.3390/tropicalmed5040151] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 12/23/2022] Open
Abstract
In the recent years, the progress of international trade and travel has led to an increased risk of emerging infections. Around 75 percent of the pathogens causing these infections are of animal origin. Point-of-care tests (POCT) and point-of-need tests (PONT) have been established in order to directly provide accurate and rapid diagnostics at field level, the patient bed-side or at the site of outbreaks. These assays can help physicians and decision makers to take the right action without delay. Typically, POCT and PONT rely on genomic identification of pathogens or track their immunological fingerprint. Recently, protocols for metagenomic diagnostics in the field have been developed. In this review, we give an overview of the latest developments in portable diagnostic methods. In addition, four mobile platforms for the implementation of these techniques at point-of-care and point-of-need are described. These approaches can provide reliable diagnostics and surveillance, especially in low resource settings as well as at the level of one health.
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25
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Suhandynata RT, Hoffman MA, Kelner MJ, McLawhon RW, Reed SL, Fitzgerald RL. Longitudinal Monitoring of SARS-CoV-2 IgM and IgG Seropositivity to Detect COVID-19. J Appl Lab Med 2020; 5:908-920. [PMID: 32428207 PMCID: PMC7313967 DOI: 10.1093/jalm/jfaa079] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/11/2020] [Indexed: 12/19/2022]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a novel beta-coronavirus that has recently emerged as the cause of the 2019 coronavirus pandemic (COVID-19). Polymerase chain reaction (PCR) based tests are optimal and recommended for the diagnosis of an acute SARS-CoV-2 infection. Serology tests for viral antibodies provide an important tool to diagnose previous exposure to the virus. Here we evaluate the analytical performance parameters of the Diazyme SARS-CoV-2 IgM/IgG serology assays and describe the kinetics of IgM and IgG seroconversion observed in patients with PCR confirmed COVID-19 who were admitted to our hospital. Methods We validated the performance of the Diazyme assay in 235 subjects to determine specificity. Subsequently, we evaluated the SARS-CoV-2 IgM and IgG seroconversion of 54 PCR confirmed COVID-19 patients and determined sensitivity of the assay at three different timeframes. Result Sensitivity and specificity for detecting seropositivity at ≥ 15 days following a positive SARS-CoV-2 PCR result, was 100.0% and 98.7% when assaying for the panel of IgM and IgG. The median time to seropositivity observed for a reactive IgM and IgG result from the date of a positive PCR was 5 days (IQR: 2.75-9 days) and 4 days (IQR: 2.75-6.75 days), respectively. Conclusions Our data demonstrates that the Diazyme IgM/IgG assays are suited for the purpose of detecting SARS-CoV-2 IgG and IgM in patients with suspected SARS-CoV-2 infections. For the first time, we report longitudinal data showing the evolution of seroconversion for both IgG and IgM in a cohort of acutely ill patients in the United States. We also demonstrate a low false positive rate in patients who were presumed to be disease free.
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Affiliation(s)
| | | | | | | | - Sharon L Reed
- Department of Pathology UC, San Diego Health, San Diego, CA
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26
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Kofman A, Linderman S, Su K, Purpura LJ, Ervin E, Brown S, Morales-Betoulle M, Graziano J, Cannon DL, Klena JD, Desamu-Thorpe R, Fankhauser J, Orone R, Soka M, Glaybo U, Massaquoi M, Nysenswah T, Nichol ST, Kollie J, Kiawu A, Freeman E, Giah G, Tony H, Faikai M, Jawara M, Kamara K, Kamara S, Flowers B, Mohammed K, Chiriboga D, Williams DE, Hinrichs SH, Ahmed R, Vonhm B, Rollin PE, Choi MJ. Characteristics of Ebola Virus Disease Survivor Blood and Semen in Liberia: Serology and RT-PCR. Clin Infect Dis 2020; 73:e3641-e3646. [PMID: 32894277 DOI: 10.1093/cid/ciaa1331] [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: 05/03/2020] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Ebola virus (EBOV), species Zaire ebolavirus, may persist in the semen of male survivors of Ebola Virus Disease (EVD). We conducted a study of male survivors of the 2014-2016 EVD outbreak in Liberia and evaluated their immune responses to EBOV. We report here findings from the serologic testing of blood for EBOV-specific antibodies, molecular testing for EBOV in blood and semen, and serologic testing of peripheral blood mononuclear cells (PBMCs) in a subset of study participants. METHODS We tested for EBOV RNA in blood by qRT-PCR, and for anti-EBOV-specific IgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA) for 126 study participants. We performed peripheral blood mononuclear cell (PBMC) analysis on a subgroup of 26 IgG-negative participants. RESULTS All 126 participants tested negative for EBOV RNA in blood by qRT-PCR. The blood of 26 participants tested negative for EBOV-specific IgG antibodies by ELISA. PBMCs were collected from 23/26 EBOV IgG-negative participants. Of these, 1/23 participants had PBMCs which produced anti-EBOV-specific IgG antibodies upon stimulation with EBOV-specific GP and NP antigens. DISCUSSION The blood of EVD survivors, collected when they did not have symptoms meeting the case definition for acute or relapsed EVD, is unlikely to pose a risk for EBOV transmission. We identified one IgM/IgG negative participant who had PBMCs which produced anti-EBOV-specific antibodies upon stimulation. Immunogenicity following acute EBOV infection may exist along a spectrum and absence of antibody response should not be exclusionary in determining an individual's status as a survivor of EVD.
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Affiliation(s)
- Aaron Kofman
- Epidemic Intelligence Service, CDC.,Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | | | - Kaihong Su
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Lawrence J Purpura
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | - Elizabeth Ervin
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | - Shelley Brown
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | - Maria Morales-Betoulle
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | | | - Deborah L Cannon
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | - John D Klena
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | - Rodel Desamu-Thorpe
- Office of, Public Health Preparedness and Response, Center for Preparedness and Response, CDC
| | - John Fankhauser
- ELWA Hospital, Samaritan's Purse.,Ventura County Medical Center, Ventura, CA', CA
| | | | - Moses Soka
- Ministry of Health Liberia, Men's, Health Screening Program, Liberia
| | | | - Moses Massaquoi
- Ministry of Health Liberia, Men's, Health Screening Program, Liberia
| | | | - Stuart T Nichol
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | - Jomah Kollie
- Ministry of Health Liberia, Men's, Health Screening Program, Liberia
| | - Armah Kiawu
- University of Massachusetts Medical School, Worcester, MA
| | - Edna Freeman
- University of Massachusetts Medical School, Worcester, MA
| | - Giovanni Giah
- University of Massachusetts Medical School, Worcester, MA
| | - Henry Tony
- University of Massachusetts Medical School, Worcester, MA
| | - Mylene Faikai
- University of Massachusetts Medical School, Worcester, MA
| | - Mary Jawara
- University of Massachusetts Medical School, Worcester, MA
| | - Kuku Kamara
- University of Massachusetts Medical School, Worcester, MA
| | - Samuel Kamara
- Ministry of Health Liberia, Men's, Health Screening Program, Liberia
| | - Benjamin Flowers
- Ministry of Health Liberia, Men's, Health Screening Program, Liberia
| | - Kromah Mohammed
- Ministry of Health Liberia, Men's, Health Screening Program, Liberia
| | | | | | - Steven H Hinrichs
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Rafi Ahmed
- Emory Vaccine Center, Emory University, Atlanta, GA
| | | | - Pierre E Rollin
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
| | - Mary J Choi
- Division of High-Consequence Pathogens and Pathology, National Center, for Emerging and Zoonotic Infectious Diseases, CDC
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Majumdar S, Bean CJ, De Staercke C, Bost J, Nickel R, Coates T, Campbell A, Thompson A. Parvovirus B19 infection in sickle cell disease: An analysis from the Centers for Disease Control haemoglobinopathy blood surveillance project. Transfus Med 2020; 30:226-230. [PMID: 32131139 PMCID: PMC7461246 DOI: 10.1111/tme.12671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE In the multicentre Haemoglobinopathy Blood Surveillance Project, to evaluate the seroprevalence of parvovirus B19 and DNA viral load in sickle cell disease (SCD). BACKGROUND Although the epidemiology of parvovirus B19 seropositivity in SCD has been well documented, there are few studies that have assessed possible persistent parvovirus DNAemia and associated risk factors including blood transfusion. METHODS A qualitative analysis of parvovirus B19 serology using ELISA and quantitative parvovirus B19 DNA by RT-PCR was performed in patients with SCD. RESULTS Of 322 patients, 113 (35%) were parvovirus IgG positive and 119 (37%) were IgM positive at enrolment. The prevalence of IgG positivity increased with age. 71/322 (22%) were parvovirus DNA positive at enrolment with a mean viral load of 15 227 ± 55 227 SD. (range 72-329 238 IU/mL). Patients who were positive for parvovirus B19 DNA received a significantly higher red blood cell transfusion volume in the prior year compared to patients who were negative (mean RBC volume = 8310 mL vs 5435 mL, respectively; P = .0073). Seventy-seven patients had follow-up testing approximately 1 year after enrolment and 11/28 (39%) patients had persistently positive IgM. CONCLUSION Further studies are needed to better understand the natural history of parvovirus B19 infection in SCD especially in relation to RBC transfusion as a risk factor, as well as disease outcome and severity.
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MESH Headings
- Adolescent
- Adult
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Infant, Newborn
- Male
- Anemia, Sickle Cell/blood
- Anemia, Sickle Cell/epidemiology
- Anemia, Sickle Cell/therapy
- Anemia, Sickle Cell/virology
- Antibodies, Viral/blood
- Centers for Disease Control and Prevention, U.S.
- DNA, Viral/blood
- Erythema Infectiosum/blood
- Erythema Infectiosum/epidemiology
- Immunoglobulin G/blood
- Immunoglobulin M/blood
- Parvovirus B19, Human/metabolism
- Risk Factors
- United States
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Affiliation(s)
- Suvankar Majumdar
- Children’s National Medical Center, George Washington University School of Medicine & Health Sciences, Washington, DC
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Christopher J. Bean
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christine De Staercke
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James Bost
- Children’s National Medical Center, George Washington University School of Medicine & Health Sciences, Washington, DC
| | - Robert Nickel
- Children’s National Medical Center, George Washington University School of Medicine & Health Sciences, Washington, DC
| | - Thomas Coates
- Division of Hematology, Children’s Hospital Los Angeles, Los Angeles, California
| | - Andrew Campbell
- Children’s National Medical Center, George Washington University School of Medicine & Health Sciences, Washington, DC
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Alexis Thompson
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Campos GS, Hughes Carvalho R, Bandeira AC, Reboredo-Oliveira L, Dos Santos Costa R, Figueiredo CA, Sardi SI. New Challenge for Zika Virus Infection: Human Reservoirs? Viral Immunol 2020; 33:489-492. [PMID: 32311307 DOI: 10.1089/vim.2019.0187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Zika virus (ZIKV) is considered to cause an acute self-limited infection in adults, and microcephaly in fetus. Presence of the virus for long periods has been detected in body fluids; however, persistent viremia in serum for more than 1 year has not yet been reported. We have investigated persistence of ZIKV in serum samples of 77 subjects who were infected by the virus between 18 months and 3 years before the start of this study. The subjects included children with microcephaly and their parents. Serum samples were subjected to routine RT-qPCR assay for ZIKV, Chikungunya virus, and Dengue virus. From the 77 subjects, five showed positive for the presence of ZIKV particles by RT-qPCR, including four members of the same family. Viral isolation in Vero cells and C6/36 cells confirmed the result and showed the viral particles were active. We have detected viremia in healthy carriers up to 3 years after symptom onset. Humans acting as potential viral reservoirs have major implication for the current understanding of ZIKV infection.
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Affiliation(s)
- Gubio Soares Campos
- Laboratory of Virology, Health Sciences Institute, Universidade Federal da Bahia, Salvador, Brazil
| | - Rejane Hughes Carvalho
- Laboratory of Virology, Health Sciences Institute, Universidade Federal da Bahia, Salvador, Brazil
| | | | | | | | | | - Silvia Ines Sardi
- Laboratory of Virology, Health Sciences Institute, Universidade Federal da Bahia, Salvador, Brazil
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29
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Gold J, Zhao K, Abraham M, Behmer Hansen R, Lad M, Mammis A. Encephalopathy of Unknown Origin in a Baclofen Patient: Case Report and Review of the Literature. World Neurosurg 2020; 136:136-139. [DOI: 10.1016/j.wneu.2020.01.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 01/15/2023]
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Blandino R, Baumgarth N. Secreted IgM: New tricks for an old molecule. J Leukoc Biol 2019; 106:1021-1034. [PMID: 31302940 PMCID: PMC6803036 DOI: 10.1002/jlb.3ri0519-161r] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/27/2022] Open
Abstract
Secreted IgM (sIgM) is a multifunctional evolutionary conserved antibody that is critical for the maintenance of tissue homeostasis as well as the development of fully protective humoral responses to pathogens. Constitutive secretion of self- and polyreactive natural IgM, produced mainly by B-1 cells, provides a circulating antibody that engages with autoantigens as well as invading pathogens, removing apoptotic and other cell debris and initiating strong immune responses. Pathogen-induced IgM production by B-1 and conventional B-2 cells strengthens this early, passive layer of IgM-mediated immune defense and regulates subsequent IgG production. The varied effects of secreted IgM on immune homeostasis and immune defense are facilitated through its binding to numerous different cell types via different receptors. Recent studies identified a novel function for pentameric IgM, namely as a transporter for the effector protein ″apoptosis-inhibitor of macrophages″ (AIM/CD5L). This review aims to provide a summary of the known functions and effects of sIgM on immune homeostasis and immune defense, and its interaction with its various receptors, and to highlight the many critical immune regulatory functions of this ancient and fascinating immunoglobulin.
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Affiliation(s)
- Rebecca Blandino
- Biochemistry, Molecular, Cellular and Developmental Biology Graduate Group, University of California, Davis
- Center for Comparative Medicine and University of California, Davis
| | - Nicole Baumgarth
- Biochemistry, Molecular, Cellular and Developmental Biology Graduate Group, University of California, Davis
- Center for Comparative Medicine and University of California, Davis
- Dept. Pathology, Microbiology & Immunology, University of California, Davis
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Abstract
Patients with central nervous system (CNS) infection experience very high levels of morbidity and mortality, in part because of the many challenges inherent to the diagnosis of CNS infection and identification of a causative pathogen. The clinical presentation of CNS infection is nonspecific, so clinicians must often order and interpret many diagnostic tests in parallel. This can be a daunting task given the large number of potential pathogens and the availability of different testing modalities. Here, we review traditional diagnostic techniques including Gram stain and culture, serology, and polymerase chain reaction (PCR). We highlight which of these are recommended for the pathogens most commonly tested among U.S. patients with suspected CNS infection. Finally, we describe the newer broad-range diagnostic approaches, multiplex PCR and metagenomic sequencing, which are increasingly used in clinical practice.
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Affiliation(s)
- Sanjat Kanjilal
- Division of Infectious Diseases, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
| | - Tracey A Cho
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Anne Piantadosi
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
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Chelluboina S, Robin S, Aswathyraj S, Arunkumar G. Persistence of antibody response in chikungunya. Virusdisease 2019; 30:469-473. [PMID: 31803816 DOI: 10.1007/s13337-019-00534-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 06/15/2019] [Indexed: 10/26/2022] Open
Abstract
Chikungunya is a mosquito-borne viral illness associated with chronic arthritic symptoms that persist for months. The IgM antibody appears within a week post any infection and declines at 2-3 months. The present study was aimed to demonstrate the presence of specific IgM antibody among chikungunya confirmed cases. Blood samples were collected from chikungunya PCR positive patients at the time of diagnosis, at 1-week, 1, 8, 10 and 12 months post infection. All acute and follow-up serum samples were evaluated for chikungunya virus-specific IgM antibodies using ELISA technique. Our findings indicate the persistence of anti-chikungunya IgM up to 10-months post-infection in a majority of chikungunya virus infected persons. Interpretation of results should be carefully done as only IgM ELISA is used to diagnose acute infection, especially post chikungunya outbreak. The presence of IgM antibody does not rule out the absence of any other diagnosis due to its persistence. Thus, we hypothesize that real-time PCR is more reliable for the detection of acute chikungunya cases in endemic areas while IgM detection may be useful in identifying exposure to this disease.
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Affiliation(s)
- Shweta Chelluboina
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - S Robin
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - S Aswathyraj
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - G Arunkumar
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
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Vilibic-Cavlek T, Kristofic B, Savic V, Kolaric B, Barbic L, Tabain I, Peric L, Sabadi D, Miklausic B, Potocnik-Hunjadi T, Zember S, Stevanovic V, Listes E, Savini G. Diagnostic significance of immunoglobulin G avidity in symptomatic and asymptomatic West Nile virus infection. Rev Soc Bras Med Trop 2018; 51:591-595. [PMID: 30304263 DOI: 10.1590/0037-8682-0482-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/18/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION West Nile virus (WNV) immunoglobulin M (IgM) antibodies have been shown to persist for up to 500 days in certain patients. To evaluate the usefulness of immunoglobulin G (IgG) avidity assessment in the diagnosis of WNV infection, we analyzed 54 WNV IgM- and/or IgG-positive serum samples from 39 patients with neuroinvasive disease and 15 asymptomatic cases tested during a seroprevalence investigation. METHODS Serological tests (WNV IgM/IgG antibody detection, IgG avidity) were performed using commercially available enzyme-linked immunosorbent assays. RESULTS WNV IgM antibodies were detected in 47 (87%) samples. Acute/recent WNV infection was confirmed based on low/borderline avidity index (AI) in 44 IgM-positive samples (93.6%). In three IgM-positive samples (6.4%), high IgG AIs were detected, thus indicating persisting IgM antibodies from previous infections. All IgM-negative samples showed high AIs. Patients with WNV neuroinvasive disease tested within 30 days showed low AIs. In six patients tested 34-50 days after disease onset, AI was borderline (42%-60%), suggesting earlier WNV IgG maturation. Samples with the highest IgM values were associated with the lowest AIs (Spearman's rho coefficient -0.767, p < 0.001). CONCLUSIONS Our results indicate that IgG avidity differentiates current/recent WNV infection from persistent IgM seropositivity from the previous WNV transmission season both in patients with WNV neuroinvasive disease and in asymptomatic persons. A strong negative correlation between IgM antibody levels and AI indicates that in cases with very high IgM levels, determination of IgG avidity may not be necessary. As many patients showed rapid avidity maturation, low IgG avidity is indicative of WNV infection within the previous month.
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Affiliation(s)
- Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine University of Zagreb, Zagreb, Croatia
| | - Branimir Kristofic
- Department of Gynecology and Obstetrics, County Hospital Cakovec, Cakovec, Croatia
| | - Vladimir Savic
- Poultry Centre, Croatian Veterinary Institute, Zagreb, Croatia
| | - Branko Kolaric
- Department of Epidemiology, Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia.,School of Medicine University of Rijeka, Rijeka, Croatia
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Irena Tabain
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Ljiljana Peric
- Department of Infectious Diseases, Clinical Hospital Centre Osijek, Osijek,Croatia.,Medical Faculty, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Dario Sabadi
- Department of Infectious Diseases, Clinical Hospital Centre Osijek, Osijek,Croatia.,Medical Faculty, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Bozana Miklausic
- Department of Infectious Diseases, General Hospital "Dr Josip Bencevic", Slavonski Brod, Croatia
| | | | - Sanja Zember
- Department of Infectious Diseases, General Hospital Varazdin, Varazdin, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Eddy Listes
- Croatian Veterinary Institute, Regional Institute Split, Split, Croatia
| | - Giovanni Savini
- OIE Reference Centre for West Nile Disease, Istituto Zooprofilattico Sperimentale "G. Caporale", Teramo, Italy
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Lustig Y, Sofer D, Bucris ED, Mendelson E. Surveillance and Diagnosis of West Nile Virus in the Face of Flavivirus Cross-Reactivity. Front Microbiol 2018; 9:2421. [PMID: 30369916 PMCID: PMC6194321 DOI: 10.3389/fmicb.2018.02421] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/21/2018] [Indexed: 01/20/2023] Open
Abstract
West Nile Virus (WNV) is an arthropod-borne flavivirus whose zoonotic cycle includes both mosquitoes and birds as amplifiers and humans and horses as dead-end hosts. In recent years WNV has been spreading globally and is currently endemic in Africa, The Middle East, India, Australia, central and southern Europe, and the Americas. Integrated surveillance schemes and environmental data aim to detect viral circulation and reduce the risk of infection for the human population emphasizing the critical role for One Health principles in public health. Approximately 20% of WNV infected patients develop West Nile Fever while in less than 1%, infection results in West Nile Neurological Disease. Currently, the diagnosis of WNV infection is primarily based on serology, since molecular identification of WNV RNA is unreliable due to the short viremia. The recent emergence of Zika virus epidemic in America and Asia has added another layer of complexity to WNV diagnosis due to significant cross-reactivity between several members of the Flaviviridae family such as Zika, dengue, Usutu, and West Nile viruses. Diagnosis is especially challenging in persons living in regions with flavivirus co-circulation as well as in travelers from WNV endemic countries traveling to Zika or dengue infected areas or vise-versa. Here, we review the recent studies implementing WNV surveillance of mosquitoes and birds within the One Health initiative. Furthermore, we discuss the utility of novel molecular methods, alongside traditional molecular and serological methods, in WNV diagnosis and epidemiological research.
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Affiliation(s)
- Yaniv Lustig
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan, Israel
| | - Danit Sofer
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan, Israel
| | - Efrat Dahan Bucris
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan, Israel.,School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Vanichanan J, Salazar L, Wootton SH, Aguilera E, Garcia MN, Murray KO, Hasbun R. Use of Testing for West Nile Virus and Other Arboviruses. Emerg Infect Dis 2018; 22. [PMID: 27537988 PMCID: PMC4994361 DOI: 10.3201/eid2209.152050] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
In the United States, the most commonly diagnosed arboviral disease is West Nile virus (WNV) infection. Diagnosis is made by detecting WNV IgG or viral genomic sequences in serum or cerebrospinal fluid. To determine frequency of this testing in WNV-endemic areas, we examined the proportion of tests ordered for patients with meningitis and encephalitis at 9 hospitals in Houston, Texas, USA. We identified 751 patients (567 adults, 184 children), among whom 390 (52%) experienced illness onset during WNV season (June-October). WNV testing was ordered for 281 (37%) of the 751; results indicated acute infection for 32 (11%). Characteristics associated with WNV testing were acute focal neurologic deficits; older age; magnetic resonance imaging; empirically prescribed antiviral therapy; worse clinical outcomes: and concomitant testing for mycobacterial, fungal, or other viral infections. Testing for WNV is underutilized, and testing of patients with more severe disease raises the possibility of diagnostic bias in epidemiologic studies.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Arbovirus Infections/diagnosis
- Arbovirus Infections/epidemiology
- Arbovirus Infections/immunology
- Arbovirus Infections/virology
- Arboviruses/genetics
- Arboviruses/immunology
- Child
- Child, Preschool
- Cohort Studies
- Diagnostic Tests, Routine
- Encephalitis, Arbovirus/diagnosis
- Encephalitis, Arbovirus/epidemiology
- Encephalitis, Arbovirus/etiology
- Encephalitis, Arbovirus/therapy
- Female
- Humans
- Immunoenzyme Techniques
- Infant
- Male
- Meningitis, Viral/diagnosis
- Meningitis, Viral/epidemiology
- Meningitis, Viral/etiology
- Meningitis, Viral/therapy
- Middle Aged
- Patient Outcome Assessment
- Polymerase Chain Reaction
- Population Surveillance
- Seasons
- Texas/epidemiology
- West Nile Fever/diagnosis
- West Nile Fever/epidemiology
- West Nile Fever/immunology
- West Nile Fever/virology
- West Nile virus/genetics
- West Nile virus/immunology
- Young Adult
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Stark PM, Fredregill CL, Nolan MS, Debboun M. Field cage insecticide resistance tests against Culex quinquefasciatus Say (Diptera: Culicidae) in Harris County, Texas, U.S.A. JOURNAL OF VECTOR ECOLOGY : JOURNAL OF THE SOCIETY FOR VECTOR ECOLOGY 2017; 42:279-288. [PMID: 29125254 DOI: 10.1111/jvec.12268] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/07/2017] [Indexed: 06/07/2023]
Abstract
The ground adulticiding program in densely populated Harris County has been employed on the basis of virus-positive mosquitoes almost exclusively using the 'rotation of chemicals best practices' stratagem. To evaluate its effectiveness, 15 comparative field cage testing events were conducted from 2011-2015 using seven wild population samples from repeatedly collected locations of Culex quinquefasciatus Say and a laboratory susceptible Sebring strain colony reared to adults. A 3 × 3 plot design was employed for exposure to ultra-low volume applications of malathion and synergized permethrin. No significant differences were found in mortality rate among testing dates, year, row placement, or relative humidity. Mortality was significantly different between adulticides (p<0.001) with mean mortality rates for malathion 96.42% (±7.95%) and permethrin 92.38% (±14.04). There was a significant temperature difference for permethrin (p<0.001) but none for malathion (p=0.644). Mosquito population mortality was statistically different by study operational area (p<0.011) and chemical (p<0.001). Susceptible colony adults used as positive controls downwind strongly aided determination of efficacy and resistance to each adulticide, providing evidence of individual application coverage, though comparative analysis was done with overall mortalities by normal methodology.
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Affiliation(s)
- Pamela M Stark
- Harris County Public Health Mosquito and Vector Control Division, Houston, TX 77021, U.S.A
| | - Chris L Fredregill
- Harris County Public Health Mosquito and Vector Control Division, Houston, TX 77021, U.S.A
| | - Melissa S Nolan
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030, U.S.A
| | - Mustapha Debboun
- Harris County Public Health Mosquito and Vector Control Division, Houston, TX 77021, U.S.A
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Athar P, Hasbun R, Nolan MS, Salazar L, Woods SP, Sheikh K, Murray KO. Long-term neuromuscular outcomes of west nile virus infection: A clinical and electromyographic evaluation of patients with a history of infection. Muscle Nerve 2017; 57:77-82. [PMID: 28380696 DOI: 10.1002/mus.25660] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 03/13/2017] [Accepted: 04/02/2017] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Neuromuscular clinical manifestations during acute West Nile virus (WNV) infection are well documented; however, long-term neurologic outcomes still require investigation. METHODS We conducted a long-term follow-up study in patients with history of WNV infection. Of the 117 patients who participated in neurologic and neurocognitive evaluations, 30 were referred for neuromuscular and electrodiagnostic evaluation based on abnormal findings. RESULTS We found that 33% of these patients (10 of 30) showed abnormalities on nerve conduction and/or needle electromyography due to primary or secondary outcomes of WNV infection. Most common electrodiagnostic findings and causes of long-term disability were related to anterior horn cell poliomyelitis (WNV poliomyelitis). Electrical data on these patient populations were similar to those observed in chronic poliomyelitis. DISCUSSION With more than 16,000 cases of WNV neuroinvasive disease reported across the USA since 1999, understanding clinical outcomes from infection will provide a resource for physicians managing long-term care of these patients. Muscle Nerve 57: 77-82, 2018.
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Affiliation(s)
- Parveen Athar
- School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rodrigo Hasbun
- School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Melissa S Nolan
- Department of Pediatrics, Section of Pediatric Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, One Baylor Plaza, BCM 320, Houston, Texas, 77030, USA
| | - Lucrecia Salazar
- School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Steven P Woods
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Kazim Sheikh
- School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kristy O Murray
- Department of Pediatrics, Section of Pediatric Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, One Baylor Plaza, BCM 320, Houston, Texas, 77030, USA
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Eppes C, Rac M, Dunn J, Versalovic J, Murray KO, Suter MA, Sanz Cortes M, Espinoza J, Seferovic MD, Lee W, Hotez P, Mastrobattista J, Clark SL, Belfort MA, Aagaard KM. Testing for Zika virus infection in pregnancy: key concepts to deal with an emerging epidemic. Am J Obstet Gynecol 2017; 216:209-225. [PMID: 28126366 DOI: 10.1016/j.ajog.2017.01.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 01/05/2017] [Accepted: 01/17/2017] [Indexed: 01/14/2023]
Abstract
Zika virus is an emerging mosquito-borne (Aedes genus) arbovirus of the Flaviviridae family. Following epidemics in Micronesia and French Polynesia during the past decade, more recent Zika virus infection outbreaks were first reported in South America as early as May 2013 and spread to now 50 countries throughout the Americas. Although no other flavivirus has previously been known to cause major fetal malformations following perinatal infection, reports of a causal link between Zika virus and microcephaly, brain and ocular malformations, and fetal loss emerged from hard-hit regions of Brazil by October 2015. Among the minority of infected women with symptoms, clinical manifestations of Zika virus infection may include fever, headache, arthralgia, myalgia, and maculopapular rash; however, only 1 of every 4-5 people who are infected have any symptoms. Thus, clinical symptom reporting is an ineffective screening tool for the relative risk assessment of Zika virus infection in the majority of patients. As previously occurred with other largely asymptomatic viral infections posing perinatal transmission risk (such as HIV or cytomegalovirus), we must develop and implement rapid, sensitive, and specific screening and diagnostic testing for both viral detection and estimation of timing of exposure. Unfortunately, despite an unprecedented surge in attempts to rapidly advance perinatal clinical testing for a previously obscure arbovirus, there are several ongoing hindrances to molecular- and sonographic-based screening and diagnosis of congenital Zika virus infection. These include the following: (1) difficulty in estimating the timing of exposure for women living in endemic areas and thus limited interpretability of immunoglobulin M serologies; (2) cross-reaction of immunoglobulin serologies with other endemic flaviruses, such as dengue; (3) persistent viremia and viruria in pregnancy weeks to months after primary exposure; and (4) fetal brain malformations and anomalies preceding the sonographic detection of microcephaly. In this commentary, we discuss screening and diagnostic considerations that are grounded not only in the realities of current obstetrical practice in a largely global population but also in basic immunology and virology. We review recent epidemiological data pertaining to the risk of congenital Zika virus malformations based on trimester of exposure and consider side by side with emerging data demonstrating replication of Zika virus in placental and fetal tissue throughout gestation. We discuss limitations to ultrasound based strategies that rely largely or solely on the detection of microcephaly and provide alternative neurosonographic approaches for the detection of malformations that may precede or occur independent of a small head circumference. This expert review provides information that is of value for the following: (1) obstetrician, maternal-fetal medicine specialist, midwife, patient, and family in cases of suspected Zika virus infection; (2) review of the methodology for laboratory testing to explore the presence of the virus and the immune response; (3) ultrasound-based assessment of the fetus suspected to be exposed to Zika virus with particular emphasis on the central nervous system; and (4) identification of areas ready for development.
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Affiliation(s)
- Catherine Eppes
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Martha Rac
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - James Dunn
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX; Department of Pathology and Immunology, Texas Children's Hospital, Houston, TX
| | - James Versalovic
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX; National School for Tropical Medicine, Baylor College of Medicine, Houston, TX; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX; Department of Pathology and Immunology, Texas Children's Hospital, Houston, TX; Department of Pediatrics, Texas Children's Hospital, Houston, TX
| | - Kristy O Murray
- National School for Tropical Medicine, Baylor College of Medicine, Houston, TX; Department of Pediatrics, Texas Children's Hospital, Houston, TX
| | - Melissa A Suter
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Magda Sanz Cortes
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Jimmy Espinoza
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Maxim D Seferovic
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Wesley Lee
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Peter Hotez
- National School for Tropical Medicine, Baylor College of Medicine, Houston, TX; Department of Pediatrics, Texas Children's Hospital, Houston, TX
| | - Joan Mastrobattista
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Steven L Clark
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Michael A Belfort
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; National School for Tropical Medicine, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX
| | - Kjersti M Aagaard
- Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX; National School for Tropical Medicine, Baylor College of Medicine, Houston, TX; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Children's Hospital, Houston, TX.
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Safronetz D, Sacko M, Sogoba N, Rosenke K, Martellaro C, Traoré S, Cissé I, Maiga O, Boisen M, Nelson D, Oottamasathien D, Millett M, Garry RF, Branco LM, Doumbia S, Feldmann H, Traoré MS. Vectorborne Infections, Mali. Emerg Infect Dis 2016; 22:340-2. [PMID: 26812625 PMCID: PMC4734548 DOI: 10.3201/eid2202.150688] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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40
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West Nile Virus Retinopathy and Associations with Long Term Neurological and Neurocognitive Sequelae. PLoS One 2016; 11:e0148898. [PMID: 26950214 PMCID: PMC4780769 DOI: 10.1371/journal.pone.0148898] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 01/24/2016] [Indexed: 11/25/2022] Open
Abstract
West Nile virus (WNV) has emerged as an important vector-borne pathogen in North America, with more than 3 million estimated to have been infected. Retinopathy from WNV infection has been previously reported in acute cases, though those prior reports did not evaluate the risk of retinopathy based on clinical severity of neurologic disease. The purpose of this cross-sectional study was to perform comprehensive ophthalmological and neurological examinations on 111 patients with a history of West Nile virus infection and describe the ocular manifestations. Out of 111 patients, 27 (24%) had evidence for West Nile virus associated retinopathy (WNVR); this observation was higher (49%) in those patients who initially presented with encephalitis. Individuals with WNVR had more frequent involvement of the macula and peripheral involvement compared to those patients without WNVR (p<0.05). WNVR was also associated with a greater likelihood of abnormal reflexes on neurological exam, poorer learning, greater dependence in activities of daily living, and lower quality of life (p<0.05). WNVR was seen more frequently in elderly patients (age > 60 years), and was associated with higher rates of diabetes mellitus and a history of encephalitis (p<0.05). A multivariable logistic regression revealed that only a history of encephalitis was independently associated with WNVR [Adjusted Odds Ratio = 4.9 (1.8–13.2); p = 0.001]. Our study found that WNVR occurs in one fourth of patients with a history of WNV infection and is more frequently observed in those with apparent severe neurological sequelae (e.g., encephalitis). The clinical relevance of WNVR was supported by its associations with dependence in activities of daily living and lower quality of life. This unique evaluation of WNV patients included fundoscopic examinations and their associations with neurologic impairment. Our findings can be used during ophthalmological consultation for the evaluation, treatment and rehabilitation phases of care for WNV patients.
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Tsioris K, Gupta NT, Ogunniyi AO, Zimnisky RM, Qian F, Yao Y, Wang X, Stern JNH, Chari R, Briggs AW, Clouser CR, Vigneault F, Church GM, Garcia MN, Murray KO, Montgomery RR, Kleinstein SH, Love JC. Neutralizing antibodies against West Nile virus identified directly from human B cells by single-cell analysis and next generation sequencing. Integr Biol (Camb) 2015; 7:1587-97. [PMID: 26481611 PMCID: PMC4754972 DOI: 10.1039/c5ib00169b] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
West Nile virus (WNV) infection is an emerging mosquito-borne disease that can lead to severe neurological illness and currently has no available treatment or vaccine. Using microengraving, an integrated single-cell analysis method, we analyzed a cohort of subjects infected with WNV - recently infected and post-convalescent subjects - and efficiently identified four novel WNV neutralizing antibodies. We also assessed the humoral response to WNV on a single-cell and repertoire level by integrating next generation sequencing (NGS) into our analysis. The results from single-cell analysis indicate persistence of WNV-specific memory B cells and antibody-secreting cells in post-convalescent subjects. These cells exhibited class-switched antibody isotypes. Furthermore, the results suggest that the antibody response itself does not predict the clinical severity of the disease (asymptomatic or symptomatic). Using the nucleotide coding sequences for WNV-specific antibodies derived from single cells, we revealed the ontogeny of expanded WNV-specific clones in the repertoires of recently infected subjects through NGS and bioinformatic analysis. This analysis also indicated that the humoral response to WNV did not depend on an anamnestic response, due to an unlikely previous exposure to the virus. The innovative and integrative approach presented here to analyze the evolution of neutralizing antibodies from natural infection on a single-cell and repertoire level can also be applied to vaccine studies, and could potentially aid the development of therapeutic antibodies and our basic understanding of other infectious diseases.
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Affiliation(s)
- Konstantinos Tsioris
- Department of Chemical Engineering, Koch Institute of Integrative Cancer Research, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Bldg. 76-253, Cambridge, MA 02139, USA.
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Papa A, Anastasiadou A, Delianidou M. West Nile virus IgM and IgG antibodies three years post- infection. Hippokratia 2015; 19:34-36. [PMID: 26435644 PMCID: PMC4574583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND West Nile virus (WNV) causes to humans a variety of symptoms, from asymptomatic infection to severe neuroinvasive disease. In a previous study, it was shown that WNV IgM antibodies persisted in three of 26 (12%) patients, nine months after onset of the symptoms. The aim of the present study was to test 10 of these patients, three years post-infection for probable persistence of IgM antibodies and to investigate their IgG antibody patterns. MATERIAL AND METHODS In summer 2013 serum samples were collected from 10 persons who were infected with WNV in 2010; 6 of them had a neuroinvasive disease. The three persons with detectable WNV IgM antibodies, nine months after onset of the symptoms, were included in the study. All samples were tested by ELISA in parallel with their stored paired samples taken in 2011. The positive results were confirmed by neutralization test. RESULTS WNV IgM antibodies were still detectable in the three persons, while high levels of WNV IgG and neutralizing antibodies were present in nine of the 10 persons, regardless the involvement of the nervous system. CONCLUSIONS WNV IgM antibodies persist for more than three years in 12% of patients with WNV infection, while WNV IgG antibodies persist and even increase their levels, regardless the involvement of the nervous system, suggesting that the immune response in the symptomatic WNV infections is strong and long-lasting. Hippokratia 2015, 19 (1): 34-36.
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Affiliation(s)
- A Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki
| | - A Anastasiadou
- Clinic of Internal Medicine, General Hospital of Giannitsa, Greece
| | - M Delianidou
- Clinic of Internal Medicine, General Hospital of Giannitsa, Greece
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Garcia MN, Hasbun R, Murray KO. Persistence of West Nile virus. Microbes Infect 2014; 17:163-8. [PMID: 25499188 DOI: 10.1016/j.micinf.2014.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 12/01/2014] [Accepted: 12/02/2014] [Indexed: 12/15/2022]
Abstract
West Nile virus (WNV) is a widespread global pathogen that results in significant morbidity and mortality. Data from animal models provide evidence of persistent renal and neurological infection from WNV; however, the possibility of persistent infection in humans and long-term neurological and renal outcomes related to viral persistence remain largely unknown. In this paper, we provide a review of the literature related to persistent infection in parallel with the findings from cohorts of patients with a history of WNV infection. The next steps for enhancing our understanding of WNV as a persistent pathogen are discussed.
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Affiliation(s)
- Melissa N Garcia
- Section of Pediatric Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Rodrigo Hasbun
- University of Texas Health Science Center at Houston, School of Medicine, Houston, TX 77030, USA
| | - Kristy O Murray
- Section of Pediatric Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA
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Smith JC, Mailman T, MacDonald NE. West Nile virus: should pediatricians care? J Infect 2014; 69 Suppl 1:S70-6. [PMID: 25138381 DOI: 10.1016/j.jinf.2014.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2014] [Indexed: 12/21/2022]
Abstract
Given the recurrent serious outbreaks of West Nile Virus (WNV) in the United States over the past decade, the spread to Canada and South America, the recurrent outbreaks in Europe, and the potential for serious neurological disease even in children under 18 years, paediatricians in affected areas must consider WNV in the differential diagnosis of all children presenting with aseptic meningitis, encephalitis and acute flaccid paralysis. Additionally, given that WNV encephalitis can occur after WNV infection, suspicion for neurological WNV disease must remain high even after otherwise benign febrile illnesses if the child lives in or has traveled to an affected region. Under-diagnosis in the pediatric population is likely a serious problem, necessitating further educational efforts. More follow-up studies of WNV neurological disease in children and youth are needed to better understand the potential long-term sequelae during vulnerable times of neurodevelopment and neural remodeling. Similarly, more research is need on short and long-term fetal outcomes of maternal WNV infection.
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Affiliation(s)
- Jennifer C Smith
- Paediatric Infectious Diseases, Paediatrics Dalhousie University, IWK Health Center, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada.
| | - Tim Mailman
- Paediatrics and Microbiology, Dalhousie University, IWK Health Center, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada.
| | - Noni E MacDonald
- Paediatrics, Dalhousie University, IWK Health Center, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada.
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Garcia MN, Hause AM, Walker CM, Orange JS, Hasbun R, Murray KO. Evaluation of prolonged fatigue post-West Nile virus infection and association of fatigue with elevated antiviral and proinflammatory cytokines. Viral Immunol 2014; 27:327-33. [PMID: 25062274 DOI: 10.1089/vim.2014.0035] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study aimed to characterize fatigue postinfection among study participants with a history of West Nile virus (WNV) infection and determine whether antiviral and pro-inflammatory cytokines were significantly elevated in those reporting prolonged fatigue. We found that 31% (44/140) of study participants experienced prolonged (more than 6 months) fatigue postinfection, with an average length of fatigue duration of 5 years. Females, those younger than 50 years of age, and those with symptomatic clinical WNV disease were significantly more likely to report fatigue. Pro-inflammatory and antiviral cytokines (granulocyte macrophage colony stimulating factor, interferon-γ, interferon-γ inducing protein 10, interleukin 2, interleukin 6, and interleukin 12p70) were significantly elevated in those reporting fatigue postinfection compared to those not reporting fatigue. Clinicians should consider history of WNV infection as a possible factor when evaluating causes of prolonged fatigue following a febrile viral illness in their patients.
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Affiliation(s)
- Melissa N Garcia
- 1 Section of Pediatric Tropical Medicine, Baylor College of Medicine , National School of Tropical Medicine, Houston, Texas
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Abstract
PURPOSE OF REVIEW West Nile virus (WNV) is the most important cause of epidemic encephalitis in the United States. We review articles published in the last 18 months related to the epidemiology, immunology, clinical features, and treatment of this disease. RECENT FINDINGS There was a resurgence in WNV disease in the United States in 2012. The WNV strain now predominant in the United States (NA/WN02) differs from the initial emergent isolate in 1999 (NY99). However, differences in the genetics of currently circulating United States WNV strains do not explain variations in epidemic magnitude or disease severity. Innate and acquired immunity are critical in control of WNV, and in some cases pathways are central nervous system specific. The clinical features of infection are now well understood, although nonconfirmed observations of chronic viral excretion in urine remain controversial. There is no specific antiviral therapy for WNV, but studies of antivirals specific for other flaviviruses may identify agents with promise against WNV. Phase I and II human WNV vaccine clinical trials have established that well tolerated and immunogenic WNV vaccines can be developed. SUMMARY WNV remains an important public health problem. Although recent studies have significantly increased our understanding of host immune and genetic factors involved in control of WNV infection, no specific therapy is yet available. Development of a well tolerated, immunogenic, and effective vaccine against WNV is almost certainly feasible, but economic factors and the lack of predictability of the magnitude and location of outbreaks are problematic for designing phase III trials and ultimate licensure.
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Affiliation(s)
- Kenneth L. Tyler
- Department of Neurology, University of Colorado School of Medicine, Aurora
- Denver Veterans Affairs Medical Center, Eastern Colorado Healthcare System, Denver, Colorado, USA
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Abstract
The resurgence of West Nile virus (WNV) in North America and Europe in recent years has raised the concerns of local authorities and highlighted that mosquito-borne disease is not restricted to tropical regions of the world. WNV is maintained in enzootic cycles involving, primarily, Culex spp. mosquitoes and avian hosts, with epizootic spread to mammals, including horses and humans. Human infection results in symptomatic illness in approximately one-fifth of cases and neuroinvasive disease in less than 1% of infected persons. The most consistently recognized risk factor for neuroinvasive disease is older age, although diabetes mellitus, alcohol excess, and a history of cancer may also increase risk. Despite the increasing public health concern, the current WNV treatments are inadequate. Current evidence supporting the use of ribavirin, interferon α, and WNV-specific immunoglobulin are reviewed. Nucleic acid detection has been an important diagnostic development, which is particularly important for the protection of the donated blood supply. While effective WNV vaccines are widely available for horses, no human vaccine has been registered. Uncertainty surrounds the magnitude of future risk posed by WNV, and predictive models are limited by the heterogeneity of environmental, vector, and host factors, even in neighboring regions. However, recent history has demonstrated that for regions where suitable mosquito vectors and reservoir hosts are present, there will be a risk of major epidemics. Given the potential for these outbreaks to include severe neuroinvasive disease, strategies should be implemented to monitor for, and respond to, outbreak risk. While broadscale mosquito control programs will assist in reducing the abundance of mosquito populations and subsequently reduce the risks of disease, for many individuals, the use of topical insect repellents and other personal protective strategies will remain the first line of defense against infection.
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Affiliation(s)
- Timothy J Gray
- Department of Infectious Diseases, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Cameron E Webb
- Department of Medical Entomology, Centre for Infectious Diseases and Microbiology and Pathology West - Institute of Clinical Pathology and Medical Research, Westmead, NSW, Australia ; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia
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