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Raadsen M, Langerak T, Du Toit J, Kruip MJHA, Aynekulu Mersha D, De Maat MPM, Vermin B, Van den Akker JPC, Schmitz KS, Bakhtiari K, Meijers JCM, van Gorp ECM, Short KR, Haagmans B, de Vries RD, Gommers DAMPJ, Endeman H, Goeijenbier M. Presence of procoagulant peripheral blood mononuclear cells in severe COVID-19 patients relate to ventilation perfusion mismatch and precede pulmonary embolism. J Crit Care 2024; 79:154463. [PMID: 37976997 DOI: 10.1016/j.jcrc.2023.154463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/07/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Pulmonary emboli (PE) contribute substantially to coronavirus disease 2019 (COVID-19) related mortality and morbidity. Immune cell-mediated hyperinflammation drives the procoagulant state in COVID-19 patients, resulting in immunothrombosis. To study the role of peripheral blood mononuclear cells (PBMC) in the procoagulant state of COVID-19 patients, we performed a functional bioassay and related outcomes to the occurrence of PE. Secondary aims were to relate this functional assay to plasma D-dimer levels, ventilation perfusion mismatch and TF expression on monocyte subsets. METHODS PBMC from an ICU biobank were obtained from 20 patients with a computed tomography angiograph (CTA) proven PE and compared to 15 COVID-19 controls without a proven PE. Functional procoagulant properties of PBMC were measured using a modified fibrin generation time (MC-FGT) assay. Tissue factor (TF) expression on monocyte subsets were measured by flow cytometry. Additional clinical data were obtained from patient records including end-tidal to arterial carbon dioxide gradient. RESULTS MC-FGT levels were highest in the samples taken closest to the PE detection, similar to the end-tidal to arterial carbon dioxide gradient (ETCO2 - PaCO2), a measurement to quantify ventilation-perfusion mismatch. In patients without proven PE, peak MC-FGT relates to an increase in end-tidal to arterial carbon dioxide gradient. We identified non-classical, CD16 positive monocytes as the subset with increased TF expression. CONCLUSION We show that the procoagulant state of PBMC could aid in early detection of PE in COVID-19 ICU patients. Combined with end-tidal to ETCO2 - PaCO2 gradient, these tests could improve early detection of PE on the ICU.
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Affiliation(s)
- M Raadsen
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - T Langerak
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - J Du Toit
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Hematology, Wits Donal Gordon Medical Center, Johannesburg, South Africa
| | - M J H A Kruip
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - D Aynekulu Mersha
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | - M P M De Maat
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - B Vermin
- Department of Intensive care, Spaarne Gasthuis, Haarlem, Hoofddorp, the Netherlands
| | | | - K S Schmitz
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - K Bakhtiari
- Department of Molecular Hematology, Sanquin Research, Amsterdam, the Netherlands
| | - J C M Meijers
- Department of Molecular Hematology, Sanquin Research, Amsterdam, the Netherlands
| | - E C M van Gorp
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - K R Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Australia
| | - B Haagmans
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - R D de Vries
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - D A M P J Gommers
- Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | - H Endeman
- Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | - M Goeijenbier
- Department of Intensive care, Spaarne Gasthuis, Haarlem, Hoofddorp, the Netherlands; Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands.
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den Otter LAS, Vermin B, Goeijenbier M. Fat embolism syndrome in a patient that sustained a femoral neck fracture: A case report. Front Med (Lausanne) 2022; 9:1058824. [PMID: 36569129 PMCID: PMC9772285 DOI: 10.3389/fmed.2022.1058824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 12/12/2022] Open
Abstract
Background We present a case of a patient with a femoral neck fracture that shows neurological impairment and respiratory distress 1 day after trauma, caused by the Fat Embolism Syndrome with the presence of Cerebral Fat Embolisms. Case summary A 75 year old female remained unresponsive after a hemi arthroplasty was performed because of a 1 day old femoral neck fracture. She rapidly developed respiratory insufficiency and an obstructive shock with right ventricle dilatation on transthoracic echocardiography. The diffusion-weighted MRI brain images showed the "Starfield" pattern, a radiologic phenomenon typical for FES. During 3 weeks of ICU admission the neurologic state slowly ameliorated. Conclusion The rare FES is a clinical diagnosis with mainly respiratory, neurologic and dermatologic symptoms in the setting of a trauma patient. Fat embolisms are able to reach the brain without the presence of a patent foramen ovale to cause neurological symptoms. Diagnosing FES remains challenging but the distinctive "Starfield" pattern on MRI scans is promising.
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Affiliation(s)
- L. A. S. den Otter
- Department of Intensive Care Medicine, Spaarne Gasthuis, Haarlem, Netherlands,*Correspondence: L. A. S. den Otter
| | - B. Vermin
- Department of Intensive Care Medicine, Spaarne Gasthuis, Haarlem, Netherlands
| | - M. Goeijenbier
- Department of Intensive Care Medicine, Spaarne Gasthuis, Haarlem, Netherlands,Department of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, Netherlands
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Shein R, du Toit J, Goeijenbier M, du Toit C, Verburgh E. HIV-associated and idiopathic-acquired haemophilia A: A single-centre case series from Cape Town, South Africa. Neth J Med 2020; 78:196-201. [PMID: 32641545] [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: 06/11/2023]
Abstract
Acquired haemophilia A is a rare coagulation disorder, which can lead to life-threatening haemorrhages if not identified and treated promptly. It is characterised by the presence of autoantibodies (inhibitors) to factor VIII. Acquired haemophilia A associated with HIV is a rare but well described phenomenon with limited directions to its management. We comparatively describe four patients - two with HIV and two without - that presented with unusual bleeding episodes with a prolonged activated partial thromboplastin time secondary to factor VIII inhibitors. An empiric observation is that the patients with acquired haemophilia A associated with HIV had higher antibody titres at presentation, that required more prolonged immunosuppressive therapy to induce remission.
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Affiliation(s)
- R Shein
- 1Department of Medicine, Division of Clinical Haematology, University of Cape Town, Cape Town, South Africa
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de Jong W, Asmarawati T, van Gorp ECM, Goeijenbier M. A diphtheria case in Indonesia: a future foe to Europe? Neth J Med 2020; 78:41-43. [PMID: 32043479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- W de Jong
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
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Doornekamp L, de Jong W, Wagener MN, Goeijenbier M, van Gorp ECM. Dutch healthcare professionals' opinion on vaccination and education to prevent infections in immunocompromised patients: A mixed-method study with recommendations for daily practice. Vaccine 2019; 37:1476-1483. [PMID: 30739793 DOI: 10.1016/j.vaccine.2019.01.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/10/2018] [Revised: 12/21/2018] [Accepted: 01/23/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The fast-growing population of immunocompromised patients (ICP) is more vulnerable to infectious diseases, demanding strategies to protect them. These strategies seem inconsistent in available guidelines and in practices. We aim to evaluate healthcare professionals' (HCP) opinions on vaccination to reduce the number and severity of infections in ICP. METHODS A mixed-method study, with an exploratory sequential design, was performed. Medical specialists from various departments in a tertiary care center in the Netherlands were invited for semi-structured interviews to explore their perspective on preventive care of ICP. Topics that play a substantial role in daily practice for ICP were translated into a survey to gain insight into what extent opinions were generalizable to Erasmus Medical Center. RESULTS Surveys were completed by 689 HCP (43% of the invitees), 269 of them treated at least two ICP weekly on average and were considered eligible for further analysis. Quantitative data showed that according to 80 percent of HCP, preventive care for ICP can be improved. Education was chosen by 40 percent as the most important intervention to reduce the number and severity of infections. Vaccinations were valued as important by seventeen percent of HCP. Except for influenza, vaccinations were not regularly discussed during routine consultations. Difficulties to administer vaccinations were experienced by 75 percent of HCP. CONCLUSION According to our respondents, education is the most promising intervention to reduce the number and severity of infections in ICP. To reach a higher vaccine uptake, we recommend HCP to address vaccinations more frequently during consultations and to search for solutions to alleviate barriers to vaccinate.
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Affiliation(s)
- L Doornekamp
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - W de Jong
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - M N Wagener
- Center of Expertise Innovations in Care, Rotterdam University of Applied Science, the Netherlands
| | - M Goeijenbier
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - E C M van Gorp
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine/Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
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Goeijenbier M, van Sloten TT, Slobbe L, Mathieu C, van Genderen P, Beyer WEP, Osterhaus ADME. Benefits of flu vaccination for persons with diabetes mellitus: A review. Vaccine 2017; 35:5095-5101. [PMID: 28807608 DOI: 10.1016/j.vaccine.2017.07.095] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [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: 03/03/2017] [Revised: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
Abstract
Diabetes mellitus imposes a significant and increasing burden on society, with major consequences for human health, welfare and the economy worldwide. Persons with diabetes mellitus are at increased risk of developing severe complications after influenza virus infection and guidelines advise vaccination. The present evidence for influenza vaccine effectiveness in persons with diabetes mellitus is mainly based on observational studies with clinical endpoints like hospitalization and death, indicating a beneficial reduction of morbidity and mortality. Further supportive evidence comes from serological studies, in which persons with diabetes mellitus usually develop similar antibody levels after vaccination as healthy people. Observational studies may be prone to selection bias, and serological studies may not completely mirror vaccine effectiveness in the field. Although more controlled trials in persons with diabetes mellitus with laboratory-confirmed, influenza-specific outcomes would be desirable to better estimate the effect of vaccination, the currently available data justify routine influenza vaccination in persons with diabetes mellitus. As in this risk group, the use of influenza vaccine is far below target worldwide, efforts should be made to increase vaccination coverage.
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Affiliation(s)
- M Goeijenbier
- Institute for Tropical Diseases, Havenziekenhuis, Rotterdam, The Netherlands; Erasmus Medical Centre, Department of Viroscience, Rotterdam, The Netherlands; European Scientific Working Group on Influenza (ESWI), Belgium
| | - T T van Sloten
- Maxima Medical Centre, Eindhoven, The Netherlands; Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L Slobbe
- Institute for Tropical Diseases, Havenziekenhuis, Rotterdam, The Netherlands
| | - C Mathieu
- Department of Endocrinology, UZ Leuven, Leuven, Belgium
| | - P van Genderen
- Institute for Tropical Diseases, Havenziekenhuis, Rotterdam, The Netherlands
| | - Walter E P Beyer
- Erasmus Medical Centre, Department of Viroscience, Rotterdam, The Netherlands; Artemis One Health Research Foundation, Utrecht, The Netherlands
| | - Albert D M E Osterhaus
- European Scientific Working Group on Influenza (ESWI), Belgium; Artemis One Health Research Foundation, Utrecht, The Netherlands; Research Institute for Emerging Infections and Zoonoses, Veterinary University Hannover, Germany.
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Abstract
BACKGROUND Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. METHODS We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. RESULTS Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. CONCLUSIONS Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some travellers.
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Affiliation(s)
- M Goeijenbier
- Institute for Tropical Diseases, Havenziekenhuis, Rotterdam, The Netherlands
| | - P van Genderen
- Institute for Tropical Diseases, Havenziekenhuis, Rotterdam, The Netherlands
| | - B J Ward
- Research institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - A Wilder-Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Institute of Public Health, University of Heidelberg, Germany
| | - R Steffen
- Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travelers Health, University of Zurich Travel Health Centre, Zurich, Switzerland
| | - A D M E Osterhaus
- ARTEMIS One Health Research Institute Utrecht, The Netherlands.,Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine, Hannover, Germany
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Goeijenbier M, Slobbe L, van der Eijk A, de Mendonça Melo M, Koopmans MPG, Reusken CBEM. Zika virus and the current outbreak: an overview. Neth J Med 2016; 74:104-109. [PMID: 27020989] [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: 06/05/2023]
Abstract
Zika virus (ZIKV), a mosquito-borne flavivirus closely related to yellow fever virus and dengue virus, is currently causing a large outbreak in the Americas. Historically, ZIKV infection was considered a sporadic, relatively mild disease characterised by fever, maculopapular rash, conjunctivitis and often arthralgia. However, current observational studies suggest that ZIKV may cause more severe neurological sequelae such as Guillain-Barre syndrome, and birth defects, mainly microcephaly, in babies of whom the mother was infected with ZIKV during pregnancy. This article provides a clinically focussed overview of ZIKV, with emphasis on the current outbreak, clinical manifestations, diagnostic tools and caveats.
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Affiliation(s)
- M Goeijenbier
- Department of Viroscience, Erasmus MC, the Netherlands
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Goeijenbier M, Verner-Carlsson J, van Gorp ECM, Rockx B, Koopmans MPG, Lundkvist Å, van der Giessen JWB, Reusken CBEM. Seoul hantavirus in brown rats in the Netherlands: implications for physicians--Epidemiology, clinical aspects, treatment and diagnostics. Neth J Med 2015; 73:155-160. [PMID: 25968286] [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: 06/04/2023]
Abstract
The recent discovery of Seoul hantavirus (SEOV) presence in wild rat populations in the Netherlands has direct implications for Dutch clinicians and hantavirus diagnostics. SEOV is amongst the Old World hantaviruses which cause haemorrhagic fever and renal syndrome (HFRS) in humans. HFRS is characterised by a classical triad of fever, acute kidney injury and haemorrhage, but can show different signs and symptoms in specific cases. SEOV is transmitted from infected rats to humans by inhalation of aerosolised excreta. When compared with the known circulating hantaviruses in the Netherlands, Puumala (PUUV) and Tula (TULV), SEOV causes a more severe form of HFRS. Data from cohort studies undertaken in China and Northern Europe show differences in signs and symptoms at onset of disease, (haemorrhagic) complications and mortality. Furthermore, routine diagnostics currently available for hantavirus diagnosis in the Netherlands are not optimised for SEOV detection. The clinical outcome of an SEOV and PUUV infection will greatly benefit from an early diagnosis which will reduce the costs of unnecessary tests and treatments as well. The discovery of SEOV circulation in the Netherlands follows recent findings of SEOV infections in both rodents and humans in England, Wales, France, Belgium and Sweden, indicating the emerging character of SEOV and a high importance of this hantavirus for Public Health in large areas of Europe. Here, we review the current knowledge on the clinical manifestation of SEOV versus PUUV infections in humans, the treatment of clinical cases and diagnostics.
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Affiliation(s)
- M Goeijenbier
- Department of Virology, Erasmus MC, Rotterdam, the Netherlands
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Goeijenbier M, van Kampen JJA, Reusken CBEM, Koopmans MPG, van Gorp ECM. Ebola virus disease: a review on epidemiology, symptoms, treatment and pathogenesis. Neth J Med 2014; 72:442-448. [PMID: 25387613] [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: 06/04/2023]
Abstract
Currently, West Africa is facing the largest outbreak of Ebola virus disease (EVD) in history. The virus causing this outbreak, the Zaire Ebolavirus (EBOV), belongs to the genus Ebolavirus which together with the genus Marburgvirus forms the family of the Filoviridae. EBOV is one of the most virulent pathogens among the viral haemorrhagic fevers, and case fatality rates up to 90% have been reported. Mortality is the result of multi-organ failure and severe bleeding complications. By 18 September 2014, the WHO reported of 5335 cases (confirmed, suspected and probable) with 2622 deaths, resulting in a case fatality rate of around 50%. This review aims to provide an overview of EVD for clinicians, with the emphasis on pathogenesis, clinical manifestations, and treatment options.
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Affiliation(s)
- M Goeijenbier
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
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Goeijenbier M, Hartskeerl RA, Reimerink J, Verner-Carlsson J, Wagenaar JF, Goris MG, Martina BE, Lundkvist Å, Koopmans M, Osterhaus AD, van Gorp EC, Reusken CB. The hanta hunting study: underdiagnosis of Puumala hantavirus infections in symptomatic non-travelling leptospirosis-suspected patients in the Netherlands, in 2010 and April to November 2011. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.32.20878] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Leptospirosis and haemorrhagic fever with renal syndrome (HFRS) are hard to distinguish clinically since these two important rodent-borne zoonoses share hallmark symptoms such as renal failure and haemorrhage. Leptospirosis is caused by infection with a spirochete while HFRS is the result of an infection with certain hantaviruses. Both diseases are relatively rare in the Netherlands. Increased incidence of HFRS has been observed since 2007 in countries that border the Netherlands. Since a similar rise in incidence has not been registered in the Netherlands, we hypothesise that due to overlapping clinical manifestations, hantavirus infections may be confused with leptospirosis, leading to underdiagnosis. Therefore, we tested a cohort of non-travelling Dutch patients with symptoms compatible with leptospirosis, but with a negative diagnosis, during 2010 and from April to November 2011. Sera were screened with pan-hantavirus IgG and IgM enzyme-linked immunosorbent assays (ELISAs). Sera with IgM reactivity were tested by immunofluorescence assay (IFA). ELISA (IgM positive) and IFA results were confirmed using focus reduction neutralisation tests (FRNTs). We found hantavirus-specific IgG and/or IgM antibodies in 4.3% (11/255) of samples taken in 2010 and in 4.1% (6/146) of the samples during the 2011 period. After FRNT confirmation, seven patients were classed as having acute Puumala virus infections. A review of hantavirus diagnostic requests revealed that at least three of the seven confirmed acute cases as well as seven probable acute cases of hantavirus infection were missed in the Netherlands during the study period.
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Affiliation(s)
- M Goeijenbier
- Erasmus MC, Department of Virology, Rotterdam, the Netherlands
| | - R A Hartskeerl
- Royal Tropical Institute (KIT), KIT Biomedical Research, Amsterdam, the Netherlands
| | - J Reimerink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - J F Wagenaar
- Royal Tropical Institute (KIT), KIT Biomedical Research, Amsterdam, the Netherlands
| | - M G Goris
- Royal Tropical Institute (KIT), KIT Biomedical Research, Amsterdam, the Netherlands
| | - B E Martina
- Erasmus MC, Department of Virology, Rotterdam, the Netherlands
| | - Å Lundkvist
- Public Health Agency of Sweden, Solna, Sweden
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - M Koopmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Erasmus MC, Department of Virology, Rotterdam, the Netherlands
| | - A D Osterhaus
- Erasmus MC, Department of Virology, Rotterdam, the Netherlands
| | - E C van Gorp
- These authors share senior authorship
- Erasmus MC, Department of Virology, Rotterdam, the Netherlands
| | - C B Reusken
- Erasmus MC, Department of Virology, Rotterdam, the Netherlands
- These authors share senior authorship
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Goeijenbier M, van Wissen M, van de Weg C, Jong E, Gerdes VEA, Meijers JCM, Brandjes DPM, van Gorp ECM. Review: Viral infections and mechanisms of thrombosis and bleeding. J Med Virol 2013; 84:1680-96. [PMID: 22930518 PMCID: PMC7166625 DOI: 10.1002/jmv.23354] [Citation(s) in RCA: 195] [Impact Index Per Article: 17.7] [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: 12/22/2022]
Abstract
Viral infections are associated with coagulation disorders. All aspects of the coagulation cascade, primary hemostasis, coagulation, and fibrinolysis, can be affected. As a consequence, thrombosis and disseminated intravascular coagulation, hemorrhage, or both, may occur. Investigation of coagulation disorders as a consequence of different viral infections have not been performed uniformly. Common pathways are therefore not fully elucidated. In many severe viral infections there is no treatment other than supportive measures. A better understanding of the pathophysiology behind the association of viral infections and coagulation disorders is crucial for developing therapeutic strategies. This is of special importance in case of severe complications, such as those seen in hemorrhagic viral infections, the incidence of which is increasing worldwide. To date, only a few promising targets have been discovered, meaning the implementation in a clinical context is still hampered. This review discusses non‐hemorrhagic and hemorrhagic viruses for which sufficient data on the association with hemostasis and related clinical features is available. This will enable clinicians to interpret research data and place them into a perspective. J. Med. Virol. 84:1680–1696, 2012. © 2012 Wiley Periodicals, Inc.
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Affiliation(s)
- M Goeijenbier
- Department of Virology, Erasmus Medical Centre, University of Rotterdam, Rotterdam, The Netherlands.
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Goeijenbier M, Nur E, Goris M, Wagenaar JFP, Grünberg K, Nurmohamed SA, Martina BE, Osterhaus AD, van Gorp ECM. An unusual cause of a usual presentation. Hantavirus infection. Neth J Med 2011; 69:285-289. [PMID: 21868815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- M Goeijenbier
- Department of Virology, Erasmus MC, Rotterdam, the Netherlands.
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