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Jaumdally S, Tomasicchio M, Pooran A, Esmail A, Kotze A, Meier S, Wilson L, Oelofse S, van der Merwe C, Roomaney A, Davids M, Suliman T, Joseph R, Perumal T, Scott A, Shaw M, Preiser W, Williamson C, Goga A, Mayne E, Gray G, Moore P, Sigal A, Limberis J, Metcalfe J, Dheda K. Frequency, kinetics and determinants of viable SARS-CoV-2 in bioaerosols from ambulatory COVID-19 patients infected with the Beta, Delta or Omicron variants. Nat Commun 2024; 15:2003. [PMID: 38443359 PMCID: PMC10914788 DOI: 10.1038/s41467-024-45400-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
Airborne transmission of SARS-CoV-2 aerosol remains contentious. Importantly, whether cough or breath-generated bioaerosols can harbor viable and replicating virus remains largely unclarified. We performed size-fractionated aerosol sampling (Andersen cascade impactor) and evaluated viral culturability in human cell lines (infectiousness), viral genetics, and host immunity in ambulatory participants with COVID-19. Sixty-one percent (27/44) and 50% (22/44) of participants emitted variant-specific culture-positive aerosols <10μm and <5μm, respectively, for up to 9 days after symptom onset. Aerosol culturability is significantly associated with lower neutralizing antibody titers, and suppression of transcriptomic pathways related to innate immunity and the humoral response. A nasopharyngeal Ct <17 rules-in ~40% of aerosol culture-positives and identifies those who are probably highly infectious. A parsimonious three transcript blood-based biosignature is highly predictive of infectious aerosol generation (PPV > 95%). There is considerable heterogeneity in potential infectiousness i.e., only 29% of participants were probably highly infectious (produced culture-positive aerosols <5μm at ~6 days after symptom onset). These data, which comprehensively confirm variant-specific culturable SARS-CoV-2 in aerosol, inform the targeting of transmission-related interventions and public health containment strategies emphasizing improved ventilation.
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Affiliation(s)
- S Jaumdally
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - M Tomasicchio
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Pooran
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Esmail
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Kotze
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - S Meier
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - L Wilson
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - S Oelofse
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - C van der Merwe
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Roomaney
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - M Davids
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - T Suliman
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - R Joseph
- Division of Medical Virology, Wellcome Centre for Infectious Diseases in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - T Perumal
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Scott
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - M Shaw
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - W Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus; Medical Virology, National Health Laboratory Service Tygerberg, Parow, Cape Town, South Africa
| | - C Williamson
- Division of Medical Virology, Wellcome Centre for Infectious Diseases in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- National Health Laboratory Service (NHLS), Cape Town, South Africa
| | - A Goga
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa
| | - E Mayne
- Department of Immunology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
- Division of Immunology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - G Gray
- South African Medical Research Council, Cape Town, South Africa
| | - P Moore
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- SA MRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - A Sigal
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Max Planck Institute for Infection Biology, Berlin, Germany
| | - J Limberis
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Centre, University of California, San Francisco, San Francisco, CA, USA
| | - J Metcalfe
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Centre, University of California, San Francisco, San Francisco, CA, USA
| | - K Dheda
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa.
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa.
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
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Lemmer Y, Chapman R, Abolnik C, Smith T, Schäfer G, Hermanus T, du Preez I, Goosen K, Sepotokele KM, Gers S, Suliman T, Preiser W, Shaw ML, Roth R, Truyts A, Chipangura J, Magwaza M, Mahanjana O, Moore PL, O'Kennedy MM. Protective efficacy of a plant-produced beta variant rSARS-CoV-2 VLP vaccine in golden Syrian hamsters. Vaccine 2024; 42:738-744. [PMID: 38238112 DOI: 10.1016/j.vaccine.2024.01.036] [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: 09/11/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 02/10/2024]
Abstract
In the quest for heightened protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, we engineered a prototype vaccine utilizing the plant expression system of Nicotiana benthamiana, to produce a recombinant SARS-CoV-2 virus-like particle (VLP) vaccine presenting the S-protein from the Beta (B.1.351) variant of concern (VOC). This innovative vaccine, formulated with either a squalene oil-in-water emulsion or a synthetic CpG oligodeoxynucleotide adjuvant, demonstrated efficacy in a golden Syrian Hamster challenge model. The Beta VLP vaccine induced a robust humoral immune response, with serum exhibiting neutralization not only against SARS-CoV-2 Beta but also cross-neutralizing Delta and Omicron pseudoviruses. Protective efficacy was demonstrated, evidenced by reduced viral RNA copies and mitigated weight loss and lung damage compared to controls. This compelling data instills confidence in the creation of a versatile platform for the local manufacturing of potential pan-sarbecovirus vaccines, against evolving viral threats.
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Affiliation(s)
- Yolandy Lemmer
- Council for Scientific and Industrial Research (CSIR) Next Generation Health, Pretoria, South Africa; Department of Biochemistry, Genetics and Microbiology, University of Pretoria, South Africa.
| | - Ros Chapman
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Celia Abolnik
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria (UP), South Africa
| | - Tanja Smith
- Council for Scientific and Industrial Research (CSIR) Next Generation Health, Pretoria, South Africa; Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria (UP), South Africa
| | - Georgia Schäfer
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; International Centre for Genetic Engineering and Biotechnology, Observatory, Cape Town, South Africa; Wellcome Trust Centre for Infectious Disease Research in Africa, University of Cape Town, South Africa
| | - Tandile Hermanus
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Ilse du Preez
- Council for Scientific and Industrial Research (CSIR) Next Generation Health, Pretoria, South Africa
| | - Kruger Goosen
- La-Bio Research Animal Laboratory (a Division of Disease Control Africa), 33 Eland Street, Koedoespoort Industrial, Pretoria, South Africa
| | - Kamogelo M Sepotokele
- Council for Scientific and Industrial Research (CSIR) Next Generation Health, Pretoria, South Africa; Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria (UP), South Africa
| | | | - Tasnim Suliman
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - Wolfgang Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University Tygerberg Campus, Cape Town, South Africa
| | - Megan L Shaw
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa; Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University Tygerberg Campus, Cape Town, South Africa
| | - Robyn Roth
- Council for Scientific and Industrial Research (CSIR) Next Generation Health, Pretoria, South Africa
| | - Alma Truyts
- Council for Scientific and Industrial Research (CSIR) Next Generation Health, Pretoria, South Africa; Department of Biochemistry, Genetics and Microbiology, University of Pretoria, South Africa
| | - John Chipangura
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Martin Magwaza
- Tautomer Pty Ltd., Woodmead North Office, 54 Maxwell Drive, Block B, Ground Floor Woodmead, 2191 Gauteng, South Africa
| | - Osborn Mahanjana
- 3Sixty Biopharmaceuticals Pty Ltd., 23 Impala Road, Block B, Chislehurston, Sandton, Gauteng 2196, South Africa
| | - Penny L Moore
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Martha M O'Kennedy
- Council for Scientific and Industrial Research (CSIR) Next Generation Health, Pretoria, South Africa; Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria (UP), South Africa
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Essaidi-Laziosi M, Pérez-Rodríguez FJ, Alvarez C, Sattonnet-Roche P, Torriani G, Bekliz M, Adea K, Lenk M, Suliman T, Preiser W, Müller MA, Drosten C, Kaiser L, Eckerle I. Distinct phenotype of SARS-CoV-2 Omicron BA.1 in human primary cells but no increased host range in cell lines of putative mammalian reservoir species. Virus Res 2024; 339:199255. [PMID: 38389324 PMCID: PMC10652112 DOI: 10.1016/j.virusres.2023.199255] [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: 07/27/2023] [Revised: 10/03/2023] [Accepted: 10/25/2023] [Indexed: 02/24/2024]
Abstract
SARS-CoV-2's genetic plasticity has led to several variants of concern (VOCs). Here we studied replicative capacity for seven SARS-CoV-2 isolates (B.1, Alpha, Beta, Gamma, Delta, Zeta, and Omicron BA.1) in primary reconstituted airway epithelia (HAE) and lung-derived cell lines. Furthermore, to investigate the host range of Delta and Omicron compared to ancestral SARS-CoV-2, we assessed replication in 17 cell lines from 11 non-primate mammalian species, including bats, rodents, insectivores and carnivores. Only Omicron's phenotype differed in vitro, with rapid but short replication and efficient production of infectious virus in nasal HAEs, in contrast to other VOCs, but not in lung cell lines. No increased infection efficiency for other species was observed, but Delta and Omicron infection efficiency was increased in A549 cells. Notably replication in A549 and Calu3 cells was lower than in nasal HAE. Our results suggest better adaptation of VOCs towards humans, without an extended host range, and may be relevant to the search for the putative intermediate host and reservoirs prior to the pandemic.
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Affiliation(s)
- Manel Essaidi-Laziosi
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland; Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland
| | - Francisco J Pérez-Rodríguez
- Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland; Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Catia Alvarez
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland; Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland
| | - Pascale Sattonnet-Roche
- Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland; Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Giulia Torriani
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland
| | - Meriem Bekliz
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland; Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland
| | - Kenneth Adea
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland; Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland
| | - Matthias Lenk
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Greifswald, Germany
| | - Tasnim Suliman
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - Wolfgang Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Division of Medical Virology, Tygerberg Hospital, National Health Laboratory Service, Cape Town, South Africa
| | - Marcel A Müller
- Institute of Virology Charité, - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Drosten
- Institute of Virology Charité, - Universitätsmedizin Berlin, Berlin, Germany
| | - Laurent Kaiser
- Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland; Laboratory of Virology, Division of Infectious Diseases and Division of Laboratory Medicine, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Isabella Eckerle
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland; Geneva Centre for Emerging Viral Diseases, University Hospitals Geneva, and University of Geneva, Switzerland; Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland.
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Kuhlmann C, Mayer CK, Claassen M, Maponga T, Burgers WA, Keeton R, Riou C, Sutherland AD, Suliman T, Shaw ML, Preiser W. Breakthrough infections with SARS-CoV-2 omicron despite mRNA vaccine booster dose. Lancet 2022; 399:625-626. [PMID: 35063123 PMCID: PMC8765759 DOI: 10.1016/s0140-6736(22)00090-3] [Citation(s) in RCA: 227] [Impact Index Per Article: 113.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 12/17/2022]
Affiliation(s)
- Constanze Kuhlmann
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Carla Konstanze Mayer
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa
| | - Mathilda Claassen
- Medical Virology, National Health Laboratory Service Tygerberg, Parow, Cape Town, South Africa
| | - Tongai Maponga
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa
| | - Wendy A Burgers
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Roanne Keeton
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Catherine Riou
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Observatory, Cape Town, South Africa
| | - Andrew D Sutherland
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa
| | - Tasnim Suliman
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - Megan L Shaw
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - Wolfgang Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa; Medical Virology, National Health Laboratory Service Tygerberg, Parow, Cape Town, South Africa.
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Müller MA, van der Hoek L, Voss D, Bader O, Lehmann D, Schulz AR, Kallies S, Suliman T, Fielding BC, Drosten C, Niedrig M. Human coronavirus NL63 open reading frame 3 encodes a virion-incorporated N-glycosylated membrane protein. Virol J 2010; 7:6. [PMID: 20078868 PMCID: PMC2819038 DOI: 10.1186/1743-422x-7-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [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: 09/29/2009] [Accepted: 01/15/2010] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Human pathogenic coronavirus NL63 (hCoV-NL63) is a group 1 (alpha) coronavirus commonly associated with respiratory tract infections. In addition to known non-structural and structural proteins all coronaviruses have one or more accessory proteins whose functions are mostly unknown. Our study focuses on hCoV-NL63 open reading frame 3 (ORF 3) which is a highly conserved accessory protein among coronaviruses. RESULTS In-silico analysis of the 225 amino acid sequence of hCoV-NL63 ORF 3 predicted a triple membrane-spanning protein. Expression in infected CaCo-2 and LLC-MK2 cells was confirmed by immunofluorescence and Western blot analysis. The protein was detected within the endoplasmatic reticulum/Golgi intermediate compartment (ERGIC) where coronavirus assembly and budding takes place. Subcellular localization studies using recombinant ORF 3 protein transfected in Huh-7 cells revealed occurrence in ERGIC, Golgi- and lysosomal compartments. By fluorescence microscopy of differently tagged envelope (E), membrane (M) and nucleocapsid (N) proteins it was shown that ORF 3 protein colocalizes extensively with E and M within the ERGIC. Using N-terminally FLAG-tagged ORF 3 protein and an antiserum specific to the C-terminus we verified the proposed topology of an extracellular N-terminus and a cytosolic C-terminus. By in-vitro translation analysis and subsequent endoglycosidase H digestion we showed that ORF 3 protein is N-glycosylated at the N-terminus. Analysis of purified viral particles revealed that ORF 3 protein is incorporated into virions and is therefore an additional structural protein. CONCLUSIONS This study is the first extensive expression analysis of a group 1 hCoV-ORF 3 protein. We give evidence that ORF 3 protein is a structural N-glycosylated and virion-incorporated protein.
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Abstract
The purpose of this preliminary investigation is to systematically characterize the signs and symptoms of cannabis psychosis in individuals who presented for psychiatric treatment in Pakistan after ingestion of bhang; a beverage containing cannabis. In order to control for the behavioral effects of cannabis alone, symptoms produced by bhang ingestion among non-patients consuming the same beverage were compared with those symptoms found among psychotic patients. Patients differed from controls in that a higher proportion of patients were found to be chronic users of bhang, and had a past history of psychotic episodes. Presenting symptoms of bhang-induced psychosis found in patients included grandiosity, excitement, hostility, uncooperativeness, disorientation, hallucinatory behavior and unusual thought content. Neuroleptic treatment successfully attenuated psychotic symptoms within five days of the initiation of the episode. The presenting symptoms of bhang-induced psychosis are consistent with a brief mania-like disorder with paranoid psychotic features, and cognitive dysfunction. Several etiologic hypotheses are proposed.
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Affiliation(s)
- H R Chaudry
- King Edward Medical College, Mayo Hospital, Lahore, Pakistan
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