1
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Yuen KY, Lo JYC. Gross negligence manslaughter and hindsight. Hong Kong Med J 2021; 27:384. [PMID: 34706992 DOI: 10.12809/hkmj219766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- K Y Yuen
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - J Y C Lo
- Centre for Health Protection, Department of Health, Hong Kong SAR Government, Hong Kong
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Yeung ML, Jia L, Yip CCY, Chan JFW, Teng JLL, Chan KH, Cai JP, Zhang C, Zhang AJ, Wong WM, Kok KH, Lau SKP, Woo PCY, Lo JYC, Jin DY, Shih SR, Yuen KY. Human tryptophanyl-tRNA synthetase is an IFN-γ-inducible entry factor for Enterovirus. J Clin Invest 2018; 128:5163-5177. [PMID: 30153112 DOI: 10.1172/jci99411] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 08/23/2018] [Indexed: 01/08/2023] Open
Abstract
Enterovirus A71 (EV-A71) receptors that have been identified to date cannot fully explain the pathogenesis of EV-A71, which is an important global cause of hand, foot, and mouth disease and life-threatening encephalitis. We identified an IFN-γ-inducible EV-A71 cellular entry factor, human tryptophanyl-tRNA synthetase (hWARS), using genome-wide RNAi library screening. The importance of hWARS in mediating virus entry and infectivity was confirmed by virus attachment, in vitro pulldown, antibody/antigen blocking, and CRISPR/Cas9-mediated deletion. Hyperexpression and plasma membrane translocation of hWARS were observed in IFN-γ-treated semipermissive (human neuronal NT2) and cDNA-transfected nonpermissive (mouse fibroblast L929) cells, resulting in their sensitization to EV-A71 infection. Our hWARS-transduced mouse infection model showed pathological changes similar to those seen in patients with severe EV-A71 infection. Expression of hWARS is also required for productive infection by other human enteroviruses, including the clinically important coxsackievirus A16 (CV-A16) and EV-D68. This is the first report to our knowledge on the discovery of an entry factor, hWARS, that can be induced by IFN-γ for EV-A71 infection. Given that we detected high levels of IFN-γ in patients with severe EV-A71 infection, our findings extend the knowledge of the pathogenicity of EV-A71 in relation to entry factor expression upon IFN-γ stimulation and the therapeutic options for treating severe EV-A71-associated complications.
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Affiliation(s)
- Man Lung Yeung
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Lilong Jia
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Cyril C Y Yip
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jasper F W Chan
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jade L L Teng
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Kwok-Hung Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Jian-Piao Cai
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Chaoyu Zhang
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Anna J Zhang
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wan-Man Wong
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Kin-Hang Kok
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Susanna K P Lau
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Patrick C Y Woo
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Janice Y C Lo
- Public Health Laboratory Centre, Department of Health, Hong Kong Special Administrative Region, China
| | - Dong-Yan Jin
- School of Biological Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shin-Ru Shih
- Research Center for Emerging Viral Infection, Chang Gung University, Kwei-Shan Tao-Yuan, Taiwan, Republic of China.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Kwei-Shan Tao-Yuan, Taiwan, Republic of China
| | - Kwok-Yung Yuen
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China.,The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China.,University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
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Cowling BJ, Wu P, Lo JYC, Chan KH, Chan ELY, Fang VJ, So LY, Peiris JSM, Chiu SS. Population-Based Pediatric Hospitalization Burden of Lineage-Specific Influenza B in Hong Kong, 2004-2014. Clin Infect Dis 2018; 65:300-307. [PMID: 28387792 DOI: 10.1093/cid/cix312] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/01/2017] [Indexed: 12/12/2022] Open
Abstract
Background Influenza B virus has been perceived to cause less disease burden and milder disease compared with influenza A, but recent studies suggest that influenza B does have a significant impact. We aimed to estimate the burden of influenza B virus infections on hospitalizations in Hong Kong, in the context of virus lineage changes over time. Methods The pediatric age-specific rates of influenza B hospitalization in Hong Kong for 2004-2014 were estimated based on admissions to 2 hospitals that together catered for 72.5% of all pediatric admissions on Hong Kong Island. Influenza B virus was detected by immunofluorescence and culture on nasopharyngeal aspirates. Lineage typing was performed by real-time reverse-transcription polymerase chain reaction. Results A total of 5085 children were recruited on 1 designated day each week, year-round during the 11 years, and 221 (4.3%) tested positive for influenza B. Hospitalization rates were highest in children aged 2 to <5 years with year-to-year variation. Victoria-lineage viruses appeared to be associated with a greater fraction of influenza B hospitalizations in children than of influenza B infections in the general community. Influenza B did not cause significant hospitalization in infants <1 year of age. Conclusions We report one of the first population-based, age- and lineage-specific studies of pediatric hospitalization for influenza B. We found that changes in lineage were associated with higher hospitalization rates and documented that Victoria lineage viruses were associated with greater pediatric hospitalization burden compared with Yamagata lineage viruses.
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Affiliation(s)
- Benjamin J Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, University of Hong Kong
| | - Peng Wu
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, University of Hong Kong
| | - Janice Y C Lo
- Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Department of Health
| | | | | | - Vicky J Fang
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, University of Hong Kong
| | - Lok-Yee So
- Department of Pediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital
| | - J S Malik Peiris
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, University of Hong Kong.,Centre of Influenza Research, School of Public Health, University of Hong Kong, Hong Kong Special Administration Region, China
| | - Susan S Chiu
- Pediatrics and Adolescent Medicine, University of Hong Kong
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Cheng VCC, Sridhar S, Wong SC, Wong SCY, Chan JFW, Yip CCY, Chau CH, Au TWK, Hwang YY, Yau CSW, Lo JYC, Lee CK, Yuen KY. Japanese Encephalitis Virus Transmitted Via Blood Transfusion, Hong Kong, China. Emerg Infect Dis 2018; 24. [PMID: 29043965 PMCID: PMC5749455 DOI: 10.3201/eid2401.171297] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Japanese encephalitis virus (JEV) is a mosquitoborne virus endemic to China and Southeast Asia that causes severe encephalitis in <1% of infected persons. Transmission of JEV via blood transfusion has not been reported. We report transmission of JEV via blood donation products from an asymptomatic viremic donor to 2 immunocompromised recipients. One recipient on high-dose immunosuppressive drugs received JEV-positive packed red blood cells after a double lung transplant; severe encephalitis and a poor clinical outcome resulted. JEV RNA was detected in serum, cerebrospinal fluid, and bronchoalveolar lavage fluid specimens. The second recipient had leukemia and received platelets after undergoing chemotherapy. This patient was asymptomatic; JEV infection was confirmed in this person by IgM seroconversion. This study illustrates that, consistent with other pathogenic flaviviruses, JEV can be transmitted via blood products. Targeted donor screening and pathogen reduction technologies could be used to prevent transfusion-transmitted JEV infection in highly JEV-endemic areas.
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Wong SCY, Poon RWS, Chen JHK, Tse H, Lo JYC, Ng TK, Au JCK, Tse CWS, Cheung IYY, Yuk MT, Luk WK, Yuen KY. Corynebacterium kroppenstedtii Is an Emerging Cause of Mastitis Especially in Patients With Psychiatric Illness on Antipsychotic Medication. Open Forum Infect Dis 2017; 4:ofx096. [PMID: 28852671 PMCID: PMC5570011 DOI: 10.1093/ofid/ofx096] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/04/2017] [Indexed: 11/13/2022] Open
Abstract
This retrospective study of patients with Corynebacterium kroppenstedtii infections revealed a predominance of mastitis and a potential association with psychiatric illnesses. At least one third of our patients with C kroppenstedtii mastitis had psychiatric illness, and >92% received antipsychotic medications. Drug-induced hyperprolactinemia may be an important modifiable risk factor in these patients.
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Affiliation(s)
- Sally C Y Wong
- Queen Mary Hospital, Hong Kong.,The University of Hong Kong
| | | | | | | | - Janice Y C Lo
- Centre for Health Protection, Department of Health, Hong Kong
| | | | | | | | | | | | | | - Kwok-Yung Yuen
- Queen Mary Hospital, Hong Kong.,The University of Hong Kong
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6
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Chiu SS, Feng S, Chan KH, Lo JYC, Chan ELY, So LY, Cowling BJ, Peiris JSM. Hospital-based vaccine effectiveness against influenza B lineages, Hong Kong, 2009-14. Vaccine 2016; 34:2164-9. [PMID: 27013437 DOI: 10.1016/j.vaccine.2016.03.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 03/07/2016] [Accepted: 03/14/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND We estimated vaccine effectiveness (VE) against pediatric influenza B hospitalizations in Hong Kong year round between November 2001 and October 2014. METHODS We conducted a test-negative year-round study, enrolling children 6 months to 17 years of age admitted to two hospitals in Hong Kong with a febrile acute respiratory infection. Children were tested for influenza A and B. Conditional logistic regression was used to estimate overall and lineage-specific vaccine effectiveness comparing influenza vaccination history of the trivalent influenza vaccine (TIV) among patients testing positive for influenza B versus negative for influenza A and B, adjusting for age and sex and matching by calendar week of recruitment. RESULTS Of the 6013 children included in the analysis, 262 tested positive for influenza B. Vaccination coverage was low: 6.5% in the influenza B positive children when compared with 8.8% in children who tested negative for both influenza A and B (p=0.248). Overall, VE was 47.6% (95% CI: 10.0, 69.4%) against influenza B hospitalization despite variable co-circulation of both lineages in all years. VE for Victoria-like virus calculated from 3 years when the vaccine was lineage-matched was 59.1% (95% CI: 6.2, 82.2%). Lineage-matched VE for Yamagata-like virus was -8.8% (95% CI: -215.4, 62.5%) in a clade mismatch season. With wide confidence intervals, we were unable to demonstrate cross-lineage protection: VE against the mismatched B/Yamagata-like virus was 9.5% (95% CI: -240.4, 76.0%) in 2011/12 and against mismatched B/Victoria-like virus in 2013/14 was 42.7% (95% CI: -368.6, 93.0%). CONCLUSIONS TIV conferred an overall VE of 47.6% (95% CI: 10.0, 69.4%) against influenza B hospitalization in children despite variable co-circulation of both lineages in all years. Lineage-matched VE for Yamagata-like virus was poor and may be related to clade mismatch. Cross-lineage protection was not observed.
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Affiliation(s)
- Susan S Chiu
- Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Shuo Feng
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kwok-Hung Chan
- Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Janice Y C Lo
- Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, China
| | - Eunice L Y Chan
- Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Lok-Yee So
- Department of Pediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong Special Administrative Region, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - J S Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China; Centre of Influenza Research, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Cowling BJ, Chan KH, Feng S, Chan ELY, Lo JYC, Peiris JSM, Chiu SS. The effectiveness of influenza vaccination in preventing hospitalizations in children in Hong Kong, 2009-2013. Vaccine 2014; 32:5278-84. [PMID: 25092636 PMCID: PMC4165553 DOI: 10.1016/j.vaccine.2014.07.084] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/11/2014] [Accepted: 07/22/2014] [Indexed: 11/28/2022]
Abstract
Background Influenza vaccination is widely recommended every year to protect individuals against influenza virus infection and illness. There are few published estimates of influenza vaccine effectiveness against hospitalization in children or from subtropical regions. Methods We conducted a test-negative year-round study between October 2009 and September 2013, recruiting children 6 months to 17 years of age admitted to two hospitals in Hong Kong with a febrile acute respiratory infection. Cases were tested for influenza A and B and conditional logistic regression was used to estimate vaccine effectiveness comparing influenza vaccination history of the trivalent influenza vaccine (TIV) among patients testing positive versus negative for influenza, adjusting for age and sex and matching by calendar week of recruitment. Results Overall vaccine effectiveness against hospitalization with laboratory-confirmed influenza A and B was estimated to be 61.7% (95% CI: 43.0%, 74.2%). The estimated vaccine effectiveness against A(H3N2) was 36.6% (95% CI: −25.5%, 67.9%) compared to 71.5% (95% CI: 39.4%, 86.6%) for A(H1N1)pdm09 and 68.8% (95% CI: 41.6%, 83.3%) for B. Conclusions Vaccine effectiveness against hospitalization in children varied from year to year, but was moderate to high overall even in an area with influenza activity throughout the year.
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Affiliation(s)
- Benjamin J Cowling
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kwok-Hung Chan
- Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shuo Feng
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eunice L Y Chan
- Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Janice Y C Lo
- Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - J S Malik Peiris
- Division of Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China; Centre for Influenza Research, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Susan S Chiu
- Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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Wong CK, Hung P, Lo JYC. Ciguatera fish poisoning in Hong Kong--a 10-year perspective on the class of ciguatoxins. Toxicon 2014; 86:96-106. [PMID: 24878373 DOI: 10.1016/j.toxicon.2014.05.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 05/13/2014] [Accepted: 05/16/2014] [Indexed: 12/01/2022]
Abstract
The present study used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to investigate retrospectively ciguatoxin (CTX)-positive samples as determined by mouse bioassay (MBA) in the past 10 years in Hong Kong. The results showed that Pacific CTXs (P-CTX-1, -2 and -3) were the most commonly observed toxins found in the samples, indicating Pacific Ocean areas as the most important origin of ciguatera fish poisoning. Clinical diagnosis from ciguatera patients also revealed the predominance of neurological illnesses in most cases, supporting intoxication of Pacific origin. This study demonstrated the ability of laboratory analysis to identify and quantify Pacific CTXs in suspected fish samples, so as to support the clinical diagnosis of ciguatera. Comparative analysis (Student's t-test and Spearman's rank correlation analysis) on the two CTX detection methods showed approximate linearity for overall P-CTXs (P-CTX-1, -2 and -3)/P-CTX-1 alone as derived by LC-MS/MS and total toxicity levels (P-CTX-1 equivalent) as determined by MBA. The LC-MS/MS method coupled with the rapid extraction method could allow the detection of trace amount of CTXs at levels below the clinically relevant limit, 0.1 ppb P-CTX-1 in fish flesh. For practical application, the adoption of a two-tiered approach for testing, chemical analysis by LC-MS/MS for toxic fish screening, coupled with biological assay by MBA for final toxicity confirmation, was proposed for first-line screening of CTX in potentially contaminated fish samples in the market, with an aim to minimizing the use of laboratory mice and at the same time providing reasonably effective means for routine analysis.
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Affiliation(s)
- Chun-Kwan Wong
- Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong St., Shek Kip Mei, Kowloon, Hong Kong, China.
| | - Patricia Hung
- Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong St., Shek Kip Mei, Kowloon, Hong Kong, China.
| | - Janice Y C Lo
- Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong St., Shek Kip Mei, Kowloon, Hong Kong, China.
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Yip CCY, Lau SKP, Woo PCY, Wong SSY, Tsang THF, Lo JYC, Lam WK, Tsang CC, Chan KH, Yuen KY. Recombinant coxsackievirus A2 and deaths of children, Hong Kong, 2012. Emerg Infect Dis 2014; 19:1285-8. [PMID: 23876841 PMCID: PMC3739500 DOI: 10.3201/eid1908.121498] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A natural recombinant of coxsackievirus A2 was found in 4 children with respiratory symptoms in Hong Kong, China, during the summer of 2012. Two of these children died. Vigilant monitoring of this emerging recombinant enterovirus is needed to prevent its transmission to other regions.
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Yip CCY, Lau SKP, Lo JYC, Chan KH, Woo PCY, Yuen KY. Genetic characterization of EV71 isolates from 2004 to 2010 reveals predominance and persistent circulation of the newly proposed genotype D and recent emergence of a distinct lineage of subgenotype C2 in Hong Kong. Virol J 2013; 10:222. [PMID: 23822185 PMCID: PMC3716818 DOI: 10.1186/1743-422x-10-222] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/25/2013] [Indexed: 01/26/2023] Open
Abstract
Background Enterovirus 71 (EV71) is a common etiological agent of hand, foot and mouth disease (HFMD) in children. EV71 epidemics have been reported in Hong Kong in recent years, and yet the genetic information of EV71 strains circulating in our locality is limited. The objective of this study was to investigate the genetic evolution of these EV71 isolates in Hong Kong over a 7-year period. Methods Twenty-two EV71 isolates from Hong Kong during 2004–2010 were included for phylogenetic analysis using partial VP2-VP3, 2C and 3D regions. Eight EV71 strains were selected for complete genome sequencing and recombination analysis. Results Among the 22 EV71 isolates, 20 belonged to subgenotype C4 and 2 belonged to subgenotype C2 based on the phylogenetic analysis of partial VP2-VP3, 2C and 3D gene regions. Phylogenetic, similarity plot and bootscan analyses using complete genome sequences of seven EV71 isolates of subgenotype C4 supported that the “double-recombinant” strains of subgenotype C4 persistently circulating in Hong Kong should belong to a newly proposed genotype D. Further analysis revealed two clusters, subgenotypes C4b and C4a (proposed genotypes D1a and D1b respectively), with “genotype D1b” strains being predominant in recent years in Hong Kong. A distinct lineage of EV71 subgenotype C2 has emerged in Hong Kong in 2008. The evolutionary rate of EV71 was 3.1 × 10-3 nucleotide substitutions per site per year similar to that of other enterovirus, such as EV68, but was relatively lower than those of echovirus 30 and poliovirus. Molecular clock analysis using VP1 gene dated the time to the most recent common ancestor of all EV71 genotypes to 1900s, while the EV71 “double-recombinant” strains of “genotype D” were detected as early as 1998. Conclusions This study provides the molecular basis for proposing a new “genotype D” of EV71 and assigning a discrete lineage of subgenotype C2. EV71 strains of “genotype D” have been circulating in Hong Kong for over 7 years, with “genotype D1b” being predominant.
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Affiliation(s)
- Cyril C Y Yip
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
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Luk EYY, Lo JYC, Li AZL, Lau MCK, Cheung TKM, Wong AYM, Wong MMH, Wong CW, Chuang SK, Tsang T. Scarlet fever epidemic, Hong Kong, 2011. Emerg Infect Dis 2013; 18:1658-61. [PMID: 23018120 PMCID: PMC3471614 DOI: 10.3201/eid1810.111900] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
More than 900 cases of scarlet fever were recorded in Hong Kong during January–July, 2011. Six cases were complicated by toxic shock syndrome, of which 2 were fatal. Pulsed-field gel electrophoresis patterns suggested a multiclonal epidemic; emm12 was the predominant circulating type. We recommend genetic testing of and antimicrobial resistance monitoring for this reportable disease.
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Affiliation(s)
- Emma Y Y Luk
- Centre for Health Protection, Hong Kong, People’s Republic of China.
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Tsang KY, Luk S, Lo JYC, Tsang TY, Lai ST, Ng TK. Hong Kong experiences the 'Ultimate superbug': NDM-1 Enterobacteriaceae. Hong Kong Med J 2012; 18:439-441. [PMID: 23018074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
We report the second imported case of New Delhi metallo-beta-lactamase (NDM-1) Enterobacteriaceae encountered in Hong Kong soon after the patient's arrival in the territory for medical care. As NDM-1 is spreading throughout the world via international travel, being an international city, Hong Kong was always expected to encounter the same public health threat. This case also illustrates the importance of active surveillance of at-risk patients in preventing the spread of this 'superbug'.
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Affiliation(s)
- K Y Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong.
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Chu YW, Tung VWN, Cheung TKM, Chu MY, Cheng N, Lai C, Tsang DNC, Lo JYC. Carbapenemases in enterobacteria, Hong Kong, China, 2009. Emerg Infect Dis 2011; 17:130-2. [PMID: 21192875 PMCID: PMC3204654 DOI: 10.3201/eid1701.101443] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
AIMS The aim of this study was to characterise clinical and microbiological features of isolates obtained from both invasive and non-invasive Streptococcus pyogenes infections in Hong Kong, between October 2005 and April 2008. METHOD Clinical data of invasive isolates were collected retrospectively. Altogether 281 isolates were emm sequence typed and tested for antimicrobial susceptibility using disk diffusion method. Detection of the presence of the streptococcal pyrogenic exotoxin genes was also carried out. RESULTS emm1, emm4 and emm12 were the most prevalent in both the invasive and non-invasive groups with an increase in incidence of emm22 compared with a previous study. emm22 was associated with invasive cellulitis and wound infection. The overall rate of erythromycin resistance was 25.6% and was significantly higher in emm22 strains (85.7%). The phage-encoded superantigen gene speA was exclusively associated with emm1 in both invasive and non-invasive isolates. CONCLUSION This study revealed a changing epidemiology of S. pyogenes infection in Hong Kong, with a unique pattern compared with other Asian countries. Invasiveness is not related to the presence of speA, speC or ssa genes and the antimicrobial resistance rate was high for macrolides. The findings have an implication on the use and efficacy of the polyvalent S. pyogenes vaccine under development.
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Affiliation(s)
- Janice C K Chan
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong SAR, China.
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Lo JYC. Early-onset group B streptococcus neonatal disease: a target for prevention? Hong Kong Med J 2009; 15:412-413. [PMID: 19966343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Chu YW, Wong CH, Chu MY, Cheung CPF, Cheung TKM, Tse C, Luk WK, Lo JYC. Varibaculum cambriense infections in Hong Kong, China, 2006. Emerg Infect Dis 2009; 15:1137-9. [PMID: 19624944 PMCID: PMC2744223 DOI: 10.3201/eid1507.081291] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ho PL, Yip KS, Chow KH, Lo JYC, Que TL, Yuen KY. Antimicrobial resistance among uropathogens that cause acute uncomplicated cystitis in women in Hong Kong: a prospective multicenter study in 2006 to 2008. Diagn Microbiol Infect Dis 2009; 66:87-93. [PMID: 19446980 DOI: 10.1016/j.diagmicrobio.2009.03.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 03/18/2009] [Accepted: 03/27/2009] [Indexed: 01/18/2023]
Abstract
A prospective multicenter study was conducted to assess the epidemiology of antimicrobial resistance among uropathogens causing uncomplicated cystitis. Adult women with clinical diagnosis of uncomplicated cystitis were enrolled from 54 participating centers distributed all over Hong Kong during 2006 to 2008. A positive urine culture was found in 59.5% (352/592) patients. The patients had mean age of 44.9 years, and most (89.2%) were otherwise healthy. The most prevalent causative organism was Escherichia coli (77%), followed by other Enterobacteriaceae (14.2%), staphylococci (5.1%), and other Gram-positive bacteria (3.7%). The resistance rates of E. coli to co-trimoxazole and ciprofloxacin were 29.5% and 12.9%, respectively, and 14 isolates (5.2%) were confirmed as extended-spectrum beta-lactamase (ESBL) producers. Of the ESBL producers, molecular studies showed CTX-M-14, CTX-M-24, or CTX-M-9. Nitrofurantoin and fosfomycin were active against >90% of the isolates, regardless of resistance phenotypes for other drugs. Pulsed-field gel electrophoresis of representative isolates showed that the antibiotic-resistant strains were genetically diverse. Patients with history of recent antibiotic use were significantly more likely to have infection by E. coli with co-trimoxazole resistance (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.4-5.7; P = 0.003) and ciprofloxacin resistance (OR, 2.5; 95% CI, 1.1-5.8; P = 0.03). Knowledge of the resistance data and risk factors could inform better use of antibiotics for empiric therapy for acute uncomplicated cystitis.
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Affiliation(s)
- Pak-leung Ho
- Department of Microbiology and Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong SAR, China.
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Ho MK, Lo JYC, Lo ACT, Cheng FK, Chan FK. Evaluation of replacing the existing diagnostic strategy for Neisseria gonorrhoeae and Chlamydia trachomatis infections with sole molecular testing of urine specimens in a sexually transmitted infection clinic setting. Sex Transm Infect 2009; 85:322-5. [PMID: 19406739 DOI: 10.1136/sti.2008.035220] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To evaluate nucleic acid testing of urine specimens against conventional Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) tests in genital swab specimens in a sexually transmitted infection (STI) clinic setting. METHODS Genital swab and urine samples were collected from attendees of public STI clinics in Hong Kong from May to June 2007. Swab specimens were subjected to on-site Gram stained microscopy and inoculation onto modified Thayer-Martin medium for NG culture before laboratory processing. CT PCR on genital swabs was performed by the Roche Cobas Amplicor test. Urine samples were tested for CT and NG by the Aptima Combo 2 (AC2) assay. RESULTS Data from 414 patients were analysed. The sensitivity and specificity of AC2 for NG were 100% (35/35) and 98.4% (373/379), respectively, with culture of genital swab specimens as standard. On-site microscopy provided timely results for empirical antimicrobial therapy, whereas culture yielded bacterial isolates for susceptibility testing and typing studies. Regarding CT, using Amplicor on genital swab specimens as reference, the sensitivity and specificity of AC2 were 98.7% (78/79) and 97.5% (313/321), respectively. Amplicor yielded uninterpretable results in 14 specimens due to PCR inhibitors. CONCLUSIONS The current STI clinic and laboratory practices were practical and useful for clinical management, even though favourable results were obtained with the AC2 assay, which had streamlined laboratory workflow. The use of a molecular testing strategy may be cost-effective with microscopy and culture being targetted for patient groups with the highest expected yield of positive results.
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Affiliation(s)
- M K Ho
- Social Hygiene Service, Public Health Services Branch, Centre for Health Protection, Department of Health, Hong Kong SAR
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Lo JYC, Ho KM, Leung AOC, Tiu FST, Tsang GKL, Lo ACT, Tapsall JW. Ceftibuten resistance and treatment failure of Neisseria gonorrhoeae infection. Antimicrob Agents Chemother 2008; 52:3564-7. [PMID: 18663018 PMCID: PMC2565891 DOI: 10.1128/aac.00198-08] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 04/30/2008] [Accepted: 07/22/2008] [Indexed: 11/20/2022] Open
Abstract
Neisseria gonorrhoeae infections have been empirically treated in Hong Kong with a single oral 400-mg dose of ceftibuten since 1997. Following anecdotal reports of the treatment failure of gonorrhea with oral extended-spectrum cephalosporins, the current study was undertaken to determine the antimicrobial susceptibility pattern and molecular characteristics of isolates of N. gonorrhoeae among patients with putative treatment failure in a sexually transmitted disease clinic setting. Between October 2006 and August 2007, 44 isolates of N. gonorrhoeae were studied from patients identified clinically to have treatment failure with empirical ceftibuten. The ceftibuten MICs for three strains were found to have been 8 mg/liter. These strains were determined by N. gonorrhoeae multiantigen sequence typing to belong to sequence type 835 (ST835) or the closely related ST2469. The testing of an additional eight archived ST835 strains revealed similarly elevated ceftibuten MICs. The penA gene sequences of these 11 isolates all had the mosaic pattern previously described as pattern X. Of note is that the ceftriaxone susceptibility results of these strains all fell within the susceptible range. It is concluded that ceftibuten resistance may contribute to the empirical treatment failure of gonorrhea caused by strains harboring the mosaic penA gene, which confers reduced susceptibility to oral extended-spectrum cephalosporins. Screening for such resistance in the routine clinical laboratory may be undertaken by the disk diffusion test. The continued monitoring of antimicrobial resistance and molecular characteristics of N. gonorrhoeae isolates is important to ensure that control and prevention strategies remain effective.
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Affiliation(s)
- Janice Y C Lo
- Microbiology Division, Public Health Laboratory Centre, Kowloon, Hong Kong, SAR.
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Chu YW, Chan AKF, Tsang GKL, Lo JYC. Detection of cysteine-dependent Escherichia coli in a public health laboratory setting in Hong Kong. J Med Microbiol 2007; 56:1704. [PMID: 18033845 DOI: 10.1099/jmm.0.47316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yiu Wai Chu
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Amy K F Chan
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Grand K L Tsang
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Janice Y C Lo
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
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Chu YW, Wong CH, Tsang GKL, Kwok MSW, Wong RKO, Lo JYC, Kam KM. Authors' reply to ‘Controversial data on the association of Aeromonas with diarrhoea in a recent Hong Kong study’. J Med Microbiol 2007. [DOI: 10.1099/jmm.0.47225-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yiu Wai Chu
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR
| | - Chi Ho Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR
| | - Grand K. L. Tsang
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR
| | - Mike S. W. Kwok
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR
| | - Raymond K. O. Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR
| | - Janice Y. C. Lo
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR
| | - Kai Man Kam
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR
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Chu YW, Cheung TKM, Ng TK, Tsang D, To WK, Kam KM, Lo JYC. Quinolone resistance determinant qnrA3 in clinical isolates of Salmonella in 2000-2005 in Hong Kong. J Antimicrob Chemother 2006; 58:904-5. [PMID: 16943211 DOI: 10.1093/jac/dkl340] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chu YW, Wong CH, Tsang GKL, Kwok MSW, Wong RKO, Lo JYC, Kam KM. Lack of association between presentation of diarrhoeal symptoms and faecal isolation of Aeromonas spp. amongst outpatients in Hong Kong. J Med Microbiol 2006; 55:349-351. [PMID: 16476802 DOI: 10.1099/jmm.0.46266-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yiu Wai Chu
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Chi Ho Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Grand K L Tsang
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Mike S W Kwok
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Raymond K O Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Janice Y C Lo
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
| | - Kai Man Kam
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 382 Nam Cheong Street, Kowloon, Hong Kong SAR, PR China
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Chung BHY, Ip PPK, Wong VCN, Lo JYC, Harding B. Acute fulminant subacute sclerosing panencephalitis with absent measles and PCR studies in cerebrospinal fluid. Pediatr Neurol 2004; 31:222-4. [PMID: 15351025 DOI: 10.1016/j.pediatrneurol.2004.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2003] [Accepted: 03/16/2004] [Indexed: 11/28/2022]
Abstract
This report describes an atypical case of rapidly progressive subacute sclerosing panencephalitis presenting as transient visual agnosia and myoclonus in a 14-year-old male. There were no typical periodic complexes in serial electroencephalographic monitoring; cerebrospinal fluid measles antibody titer was negative. The diagnosis was made by molecular and histologic examination of open brain biopsy tissue.
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Affiliation(s)
- Brian H Y Chung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, China
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Lau CS, Wong DA, Tong LKL, Lo JYC, Ma AMC, Cheng PKC, Lim WWL. High rate and changing molecular epidemiology pattern of norovirus infections in sporadic cases and outbreaks of gastroenteritis in Hong Kong. J Med Virol 2004; 73:113-7. [PMID: 15042657 DOI: 10.1002/jmv.20066] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Noroviruses (Norwalk-like viruses (NLV)) are recognised as major causes of acute gastroenteritis worldwide. Numerous studies had been carried out on the molecular epidemiology of norovirus in outbreaks but relatively few on sporadic cases. In this study, the molecular epidemiology of noroviruses in sporadic and outbreak cases of acute gastroenteritis in Hong Kong was examined over a 12-month period from July 2001 to June 2002. Specimens from three groups of patients were used in this study. Nine hundred ninety-five specimens from patients enrolled in the Acute Diarrhoeal Diseases Surveillance Programme of the Department of Health, Hong Kong Government; 735 clinical specimens from hospital patients with acute gastroenteritis, and 122 specimens from 44 norovirus outbreaks. Ninety-two (9.2%) surveillance specimens were positive for norovirus RNA by reverse transcription-polymerase chain reaction (RT-PCR), compared to 123 (16.7%) clinical and 101 (82.8%) outbreak specimens. For the first 6 months of the study period, the predominant strain was the Bristol strain that belongs to genogroup II (GII). In the latter 6 months of the study, genogroup I (GI) and strains belonging to other clusters of GII were seen more commonly. The vast majority of strains belonging to the Bristol virus cluster were closely related to the 95/96-US subset that was associated with pandemic infection from 1995 onwards. This study clearly establishes the importance of norovirus as a cause of sporadic cases of acute gastroenteritis in all age groups in Hong Kong.
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Affiliation(s)
- Chi-Shan Lau
- Government Virus Unit, Public Health Laboratory Centre, Shek Kip Mei, Kowloon, Hong Kong
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