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Brien SC, LeBreton M, Doty JB, Mauldin MR, Morgan CN, Pieracci EG, Ritter JM, Matheny A, Tafon BG, Tamoufe U, Missoup AD, Nwobegahay J, Takuo JM, Nkom F, Mouiche MMM, Feussom JMK, Wilkins K, Wade A, McCollum AM. Clinical Manifestations of an Outbreak of Monkeypox Virus in Captive Chimpanzees in Cameroon, 2016. J Infect Dis 2024; 229:S275-S284. [PMID: 38164967 DOI: 10.1093/infdis/jiad601] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024] Open
Abstract
Monkeypox virus (MPXV) is a reemerging virus of global concern. An outbreak of clade I MPXV affected 20 captive chimpanzees in Cameroon in 2016. We describe the epidemiology, virology, phylogenetics, and clinical progression of this outbreak. Clinical signs included exanthema, facial swelling, perilaryngeal swelling, and eschar. Mpox can be lethal in captive chimpanzees, with death likely resulting from respiratory complications. We advise avoiding anesthesia in animals with respiratory signs to reduce the likelihood of death. This outbreak presented a risk to animal care staff. There is a need for increased awareness and a One Health approach to preparation for outbreaks in wildlife rescue centers in primate range states where MPXV occurs. Control measures should include quarantining affected animals, limiting human contacts, surveillance of humans and animals, use of personal protective equipment, and regular decontamination of enclosures.
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Affiliation(s)
- Stephanie C Brien
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, United Kingdom
- Ape Action Africa, Mefou Park, Cameroon
| | | | - Jeffrey B Doty
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew R Mauldin
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clint N Morgan
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily G Pieracci
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jana M Ritter
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Audrey Matheny
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Alain D Missoup
- Zoology Unit, Laboratory of Biology and Physiology of Animal Organisms, Faculty of Science, University of Douala, Cameroon
| | | | | | | | - Moctar M M Mouiche
- Mosaic, Yaoundé, Cameroon
- School of Veterinary Medicine and Sciences, University of Ngaounderé, Cameroon
| | - Jean Marc K Feussom
- Cameroon Epidemiological Network for Animal Diseases, Directorate of Veterinary Services, Ministry of Livestock, Fisheries and Animal Industries, Yaoundé, Cameroon
| | - Kimberly Wilkins
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Abel Wade
- National Veterinary Laboratory, Garoua, Cameroon
| | - Andrea M McCollum
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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2
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Holzbauer SM, Schrodt CA, Prabhu RM, Asch-Kendrick RJ, Ireland M, Klumb C, Firestone MJ, Liu G, Harry K, Ritter JM, Levine MZ, Orciari LA, Wilkins K, Yager P, Gigante CM, Ellison JA, Zhao H, Niezgoda M, Li Y, Levis R, Scott D, Satheshkumar PS, Petersen BW, Rao AK, Bell WR, Bjerk SM, Forrest S, Gao W, Dasheiff R, Russell K, Pappas M, Kiefer J, Bickler W, Wiseman A, Jurantee J, Reichard RR, Smith KE, Lynfield R, Scheftel J, Wallace RM, Bonwitt J. Fatal Human Rabies Infection With Suspected Host-Mediated Failure of Post-Exposure Prophylaxis Following a Recognized Zoonotic Exposure-Minnesota, 2021. Clin Infect Dis 2023; 77:1201-1208. [PMID: 36988328 PMCID: PMC11097918 DOI: 10.1093/cid/ciad098] [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: 12/07/2022] [Revised: 02/03/2023] [Accepted: 02/15/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND No human rabies post-exposure prophylaxis (PEP) failure has been documented in the United States using modern cell culture-based vaccines. In January 2021, an 84-year-old male died from rabies 6 months after being bitten by a rabid bat despite receiving timely rabies PEP. We investigated the cause of breakthrough infection. METHODS We reviewed medical records, laboratory results, and autopsy findings and performed whole-genome sequencing (WGS) to compare patient and bat virus sequences. Storage, administration, and integrity of PEP biologics administered to the patient were assessed; samples from leftover rabies immunoglobulin were evaluated for potency. We conducted risk assessments for persons potentially exposed to the bat and for close patient contacts. RESULTS Rabies virus antibodies present in serum and cerebrospinal fluid were nonneutralizing. Antemortem blood testing revealed that the patient had unrecognized monoclonal gammopathy of unknown significance. Autopsy findings showed rabies meningoencephalitis and metastatic prostatic adenocarcinoma. Rabies virus sequences from the patient and the offending bat were identical by WGS. No deviations were identified in potency, quality control, administration, or storage of administered PEP. Of 332 persons assessed for potential rabies exposure to the case patient, 3 (0.9%) warranted PEP. CONCLUSIONS This is the first reported failure of rabies PEP in the Western Hemisphere using a cell culture-based vaccine. Host-mediated primary vaccine failure attributed to previously unrecognized impaired immunity is the most likely explanation for this breakthrough infection. Clinicians should consider measuring rabies neutralizing antibody titers after completion of PEP if there is any suspicion for immunocompromise.
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Affiliation(s)
- Stacy M Holzbauer
- Minnesota Department of Health, St. Paul, Minnesota, USA
- Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Caroline A Schrodt
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Malia Ireland
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Carrie Klumb
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Melanie J Firestone
- Minnesota Department of Health, St. Paul, Minnesota, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gongping Liu
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Katie Harry
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Jana M Ritter
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Min Z Levine
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lillian A Orciari
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kimberly Wilkins
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Pamela Yager
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Crystal M Gigante
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James A Ellison
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hui Zhao
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael Niezgoda
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yu Li
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robin Levis
- US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Dorothy Scott
- US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Panayampalli S Satheshkumar
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brett W Petersen
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Agam K Rao
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - W Robert Bell
- University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | | | | | | | | | | | | | | | | | - R Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kirk E Smith
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Joni Scheftel
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Ryan M Wallace
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jesse Bonwitt
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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3
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Holzbauer SM, Schrodt CA, Prabhu RM, Asch-Kendrick RJ, Ireland M, Klumb C, Firestone MJ, Liu G, Harry K, Levine MZ, Orciari LA, Wilkins K, Ellison JA, Zhao H, Niezgoda M, Satheshkumar PS, Petersen BW, Rao AK, Bell WR, Forrest S, Gao W, Dasheiff R, Russell K, Wiseman A, Reichard RR, Smith KE, Lynfield R, Scheftel J, Wallace RM, Bonwitt J. Reply to Willoughby. Clin Infect Dis 2023; 77:931-932. [PMID: 37200504 DOI: 10.1093/cid/ciad295] [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] [Received: 05/02/2023] [Accepted: 05/12/2023] [Indexed: 05/20/2023] Open
Affiliation(s)
- Stacy M Holzbauer
- Minnesota Department of Health, St. Paul, Minnesota, USA
- Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Caroline A Schrodt
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Malia Ireland
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Carrie Klumb
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Melanie J Firestone
- Minnesota Department of Health, St. Paul, Minnesota, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gongping Liu
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Katie Harry
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Min Z Levine
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lillian A Orciari
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kimberly Wilkins
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James A Ellison
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hui Zhao
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael Niezgoda
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Panayampalli S Satheshkumar
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brett W Petersen
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Agam K Rao
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - W Robert Bell
- University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Wangcai Gao
- Allina Health, The Commons at Midtown Exchange, Minneapolis, Minnesota, USA
| | | | | | | | - R Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kirk E Smith
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Joni Scheftel
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Ryan M Wallace
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jesse Bonwitt
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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4
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Gigante CM, Korber B, Seabolt MH, Wilkins K, Davidson W, Rao AK, Zhao H, Smith TG, Hughes CM, Minhaj F, Waltenburg MA, Theiler J, Smole S, Gallagher GR, Blythe D, Myers R, Schulte J, Stringer J, Lee P, Mendoza RM, Griffin-Thomas LA, Crain J, Murray J, Atkinson A, Gonzalez AH, Nash J, Batra D, Damon I, McQuiston J, Hutson CL, McCollum AM, Li Y. Multiple lineages of monkeypox virus detected in the United States, 2021-2022. Science 2022; 378:560-565. [PMID: 36264825 DOI: 10.1126/science.add4153] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Monkeypox is a viral zoonotic disease endemic in Central and West Africa. In May 2022, dozens of non-endemic countries reported hundreds of monkeypox cases, most with no epidemiological link to Africa. We identified two lineages of monkeypox virus (MPXV) among two 2021 and seven 2022 US monkeypox cases: the major 2022 outbreak variant called B.1 and a minor contemporaneously sampled variant called A.2. Analyses of mutations among these two variants revealed an extreme preference for GA-to-AA mutations indicative of human APOBEC3 cytosine deaminase activity among Clade IIb MPXV (previously West African, Nigeria) sampled since 2017. Such mutations were not enriched within other MPXV clades. These findings suggest that APOBEC3 editing may be a recurrent and a dominant driver of MPXV evolution within the current outbreak.
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Affiliation(s)
- Crystal M Gigante
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Bette Korber
- T-6: Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, New Mexico, USA; New Mexico Consortium, Los Alamos, NM, USA
| | - Matthew H Seabolt
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Leidos Inc., Reston, VA 20190, USA
| | - Kimberly Wilkins
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Whitni Davidson
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Agam K Rao
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hui Zhao
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Todd G Smith
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christine M Hughes
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Faisal Minhaj
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle A Waltenburg
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James Theiler
- ISR-3: Space Data Science and Systems, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - Sandra Smole
- Massachusetts Department of Public Health, Jamaica Plain, MA, USA
| | - Glen R Gallagher
- Massachusetts Department of Public Health, Jamaica Plain, MA, USA
| | - David Blythe
- Infectious Disease Epidemiology and Outbreak Response Bureau, Maryland Department of Health, Baltimore, MD, USA
| | - Robert Myers
- Infectious Disease Epidemiology and Outbreak Response Bureau, Maryland Department of Health, Baltimore, MD, USA
| | - Joann Schulte
- Dallas County Health and Human Services Public Health Laboratory, Dallas, Texas, USA
| | - Joey Stringer
- Dallas County Health and Human Services Public Health Laboratory, Dallas, Texas, USA
| | - Philip Lee
- Florida Department of Health Bureau of Public Health Laboratories-Jacksonville, Jacksonville, FL, USA
| | - Rafael M Mendoza
- Florida Department of Health in Broward County, Hollywood, FL, USA
| | - LaToya A Griffin-Thomas
- Virginia Department of General Services, Division of Consolidated Laboratory Services, Richmond, VA, USA
| | - Jenny Crain
- Virginia Department of Health, Richmond, VA, USA
| | - Jade Murray
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| | - Annette Atkinson
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| | | | - June Nash
- Sacramento County Public Health, Sacramento, CA, USA
| | - Dhwani Batra
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Inger Damon
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer McQuiston
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christina L Hutson
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrea M McCollum
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yu Li
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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5
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Priyamvada L, Kallemeijn WW, Faronato M, Wilkins K, Goldsmith CS, Cotter CA, Ojeda S, Solari R, Moss B, Tate EW, Satheshkumar PS. Inhibition of vaccinia virus L1 N-myristoylation by the host N-myristoyltransferase inhibitor IMP-1088 generates non-infectious virions defective in cell entry. PLoS Pathog 2022; 18:e1010662. [PMID: 36215331 PMCID: PMC9584500 DOI: 10.1371/journal.ppat.1010662] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/20/2022] [Accepted: 08/26/2022] [Indexed: 11/06/2022] Open
Abstract
We have recently shown that the replication of rhinovirus, poliovirus and foot-and-mouth disease virus requires the co-translational N-myristoylation of viral proteins by human host cell N-myristoyltransferases (NMTs), and is inhibited by treatment with IMP-1088, an ultrapotent small molecule NMT inhibitor. Here, we examine the importance of N-myristoylation during vaccinia virus (VACV) infection in primate cells and demonstrate the anti-poxviral effects of IMP-1088. N-myristoylated proteins from VACV and the host were metabolically labelled with myristic acid alkyne during infection using quantitative chemical proteomics. We identified VACV proteins A16, G9 and L1 to be N-myristoylated. Treatment with NMT inhibitor IMP-1088 potently abrogated VACV infection, while VACV gene expression, DNA replication, morphogenesis and EV formation remained unaffected. Importantly, we observed that loss of N-myristoylation resulted in greatly reduced infectivity of assembled mature virus particles, characterized by significantly reduced host cell entry and a decline in membrane fusion activity of progeny virus. While the N-myristoylation of VACV entry proteins L1, A16 and G9 was inhibited by IMP-1088, mutational and genetic studies demonstrated that the N-myristoylation of L1 was the most critical for VACV entry. Given the significant genetic identity between VACV, monkeypox virus and variola virus L1 homologs, our data provides a basis for further investigating the role of N-myristoylation in poxviral infections as well as the potential of selective NMT inhibitors like IMP-1088 as broad-spectrum poxvirus inhibitors.
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Affiliation(s)
- Lalita Priyamvada
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Wouter W. Kallemeijn
- Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, United Kingdom
- The Francis Crick Institute, London, United Kingdom
| | - Monica Faronato
- Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, United Kingdom
- The Francis Crick Institute, London, United Kingdom
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Cynthia S. Goldsmith
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Catherine A. Cotter
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Suany Ojeda
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
- Clinipace, Morrisville, North Carolina, United States of America
| | - Roberto Solari
- National Heart and Lung Institute, Imperial College of Science, Technology & Medicine, London, United Kingdom
| | - Bernard Moss
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Edward W. Tate
- Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, United Kingdom
- The Francis Crick Institute, London, United Kingdom
- * E-mail: (EWT); (PSS)
| | - Panayampalli Subbian Satheshkumar
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail: (EWT); (PSS)
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6
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Aden TA, Blevins P, York SW, Rager S, Balachandran D, Hutson CL, Lowe D, Mangal CN, Wolford T, Matheny A, Davidson W, Wilkins K, Cook R, Roulo RM, White MK, Berman L, Murray J, Laurance J, Francis D, Green NM, Berumen RA, Gonzalez A, Evans S, Hudziec M, Noel D, Adjei M, Hovan G, Lee P, Tate L, Gose RB, Voermans R, Crew J, Adam PR, Haydel D, Lukula S, Matluk N, Shah S, Featherston J, Ware D, Pettit D, McCutchen E, Acheampong E, Buttery E, Gorzalski A, Perry M, Fowler R, Lee RB, Nickla R, Huard R, Moore A, Jones K, Johnson R, Swaney E, Jaramillo J, Reinoso Webb C, Guin B, Yost J, Atkinson A, Griffin-Thomas L, Chenette J, Gant J, Sterkel A, Ghuman HK, Lute J, Smole SC, Arora V, Demontigny CK, Bielby M, Geeter E, Newman KAM, Glazier M, Lutkemeier W, Nelson M, Martinez R, Chaitram J, Honein MA, Villanueva JM. Rapid Diagnostic Testing for Response to the Monkeypox Outbreak - Laboratory Response Network, United States, May 17-June 30, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:904-907. [PMID: 35834423 PMCID: PMC9290387 DOI: 10.15585/mmwr.mm7128e1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
As part of public health preparedness for infectious disease threats, CDC collaborates with other U.S. public health officials to ensure that the Laboratory Response Network (LRN) has diagnostic tools to detect Orthopoxviruses, the genus that includes Variola virus, the causative agent of smallpox. LRN is a network of state and local public health, federal, U.S. Department of Defense (DOD), veterinary, food, and environmental testing laboratories. CDC developed, and the Food and Drug Administration (FDA) granted 510(k) clearance* for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set (non-variola Orthopoxvirus [NVO] assay), a polymerase chain reaction (PCR) diagnostic test to detect NVO. On May 17, 2022, CDC was contacted by the Massachusetts Department of Public Health (DPH) regarding a suspected case of monkeypox, a disease caused by the Orthopoxvirus Monkeypox virus. Specimens were collected and tested by the Massachusetts DPH public health laboratory with LRN testing capability using the NVO assay. Nationwide, 68 LRN laboratories had capacity to test approximately 8,000 NVO tests per week during June. During May 17-June 30, LRN laboratories tested 2,009 specimens from suspected monkeypox cases. Among those, 730 (36.3%) specimens from 395 patients were positive for NVO. NVO-positive specimens from 159 persons were confirmed by CDC to be monkeypox; final characterization is pending for 236. Prompt identification of persons with infection allowed rapid response to the outbreak, including isolation and treatment of patients, administration of vaccines, and other public health action. To further facilitate access to testing and increase convenience for providers and patients by using existing provider-laboratory relationships, CDC and LRN are supporting five large commercial laboratories with a national footprint (Aegis Science, LabCorp, Mayo Clinic Laboratories, Quest Diagnostics, and Sonic Healthcare) to establish NVO testing capacity of 10,000 specimens per week per laboratory. On July 6, 2022, the first commercial laboratory began accepting specimens for NVO testing based on clinician orders.
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7
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Minhaj FS, Ogale YP, Whitehill F, Schultz J, Foote M, Davidson W, Hughes CM, Wilkins K, Bachmann L, Chatelain R, Donnelly MA, Mendoza R, Downes BL, Roskosky M, Barnes M, Gallagher GR, Basgoz N, Ruiz V, Kyaw NTT, Feldpausch A, Valderrama A, Alvarado-Ramy F, Dowell CH, Chow CC, Li Y, Quilter L, Brooks J, Daskalakis DC, McClung RP, Petersen BW, Damon I, Hutson C, McQuiston J, Rao AK, Belay E, McCollum AM. Monkeypox Outbreak - Nine States, May 2022. MMWR Morb Mortal Wkly Rep 2022; 71:764-769. [PMID: 35679181 PMCID: PMC9181052 DOI: 10.15585/mmwr.mm7123e1] [Citation(s) in RCA: 171] [Impact Index Per Article: 85.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
On May 17, 2022, the Massachusetts Department of Public Health (MDPH) Laboratory Response Network (LRN) laboratory confirmed the presence of orthopoxvirus DNA via real-time polymerase chain reaction (PCR) from lesion swabs obtained from a Massachusetts resident. Orthopoxviruses include Monkeypox virus, the causative agent of monkeypox. Subsequent real-time PCR testing at CDC on May 18 confirmed that the patient was infected with the West African clade of Monkeypox virus. Since then, confirmed cases* have been reported by nine states. In addition, 28 countries and territories,† none of which has endemic monkeypox, have reported laboratory-confirmed cases. On May 17, CDC, in coordination with state and local jurisdictions, initiated an emergency response to identify, monitor, and investigate additional monkeypox cases in the United States. This response has included releasing a Health Alert Network (HAN) Health Advisory, developing interim public health and clinical recommendations, releasing guidance for LRN testing, hosting clinician and public health partner outreach calls, disseminating health communication messages to the public, developing protocols for use and release of medical countermeasures, and facilitating delivery of vaccine postexposure prophylaxis (PEP) and antivirals that have been stockpiled by the U.S. government for preparedness and response purposes. On May 19, a call center was established to provide guidance to states for the evaluation of possible cases of monkeypox, including recommendations for clinical diagnosis and orthopoxvirus testing. The call center also gathers information about possible cases to identify interjurisdictional linkages. As of May 31, this investigation has identified 17§ cases in the United States; most cases (16) were diagnosed in persons who identify as gay, bisexual, or men who have sex with men (MSM). Ongoing investigation suggests person-to-person community transmission, and CDC urges health departments, clinicians, and the public to remain vigilant, institute appropriate infection prevention and control measures, and notify public health authorities of suspected cases to reduce disease spread. Public health authorities are identifying cases and conducting investigations to determine possible sources and prevent further spread. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.¶.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Monkeypox Response Team 2022
- Epidemic Intelligence Service, CDC; Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC; Massachusetts Department of Public Health; New York City Department of Health and Mental Hygiene, New York, New York; Salt Lake County Health Department, Salt Lake City, Utah; Florida Department of Health; Fairfax County Health Department, Fairfax, Virginia; Public Health - Seattle & King County, Seattle, Washington; Colorado Department of Public Health and Environment; Massachusetts General Hospital, Boston Massachusetts; Georgia Department of Health; Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of Global Migration and Quarantine, National Center of Emerging Zoonotic Infectious Diseases, CDC; National Institute for Occupational Safety and Health; Division of Global Health Protection, Center for Global Health, CDC; Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
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8
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Rao AK, Schulte J, Chen TH, Hughes CM, Davidson W, Neff JM, Markarian M, Delea KC, Wada S, Liddell A, Alexander S, Sunshine B, Huang P, Honza HT, Rey A, Monroe B, Doty J, Christensen B, Delaney L, Massey J, Waltenburg M, Schrodt CA, Kuhar D, Satheshkumar PS, Kondas A, Li Y, Wilkins K, Sage KM, Yu Y, Yu P, Feldpausch A, McQuiston J, Damon IK, McCollum AM. Monkeypox in a Traveler Returning from Nigeria - Dallas, Texas, July 2021. MMWR Morb Mortal Wkly Rep 2022; 71:509-516. [PMID: 35389974 PMCID: PMC8989376 DOI: 10.15585/mmwr.mm7114a1] [Citation(s) in RCA: 154] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Monkeypox is a rare, sometimes life-threatening zoonotic infection that occurs in west and central Africa. It is caused by Monkeypox virus, an orthopoxvirus similar to Variola virus (the causative agent of smallpox) and Vaccinia virus (the live virus component of orthopoxvirus vaccines) and can spread to humans. After 39 years without detection of human disease in Nigeria, an outbreak involving 118 confirmed cases was identified during 2017-2018 (1); sporadic cases continue to occur. During September 2018-May 2021, six unrelated persons traveling from Nigeria received diagnoses of monkeypox in non-African countries: four in the United Kingdom and one each in Israel and Singapore. In July 2021, a man who traveled from Lagos, Nigeria, to Dallas, Texas, became the seventh traveler to a non-African country with diagnosed monkeypox. Among 194 monitored contacts, 144 (74%) were flight contacts. The patient received tecovirimat, an antiviral for treatment of orthopoxvirus infections, and his home required large-scale decontamination. Whole genome sequencing showed that the virus was consistent with a strain of Monkeypox virus known to circulate in Nigeria, but the specific source of the patient's infection was not identified. No epidemiologically linked cases were reported in Nigeria; no contact received postexposure prophylaxis (PEP) with the orthopoxvirus vaccine ACAM2000.
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9
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Whitehouse ER, Bonwitt J, Hughes CM, Lushima RS, Likafi T, Nguete B, Kabamba J, Monroe B, Doty JB, Nakazawa Y, Damon I, Malekani J, Davidson W, Wilkins K, Li Y, Radford KW, Schmid DS, Pukuta E, Muyamuna E, Karhemere S, Tamfum JJM, Okitolonda EW, McCollum AM, Reynolds MG. Clinical and Epidemiological Findings from Enhanced Monkeypox Surveillance in Tshuapa Province, Democratic Republic of the Congo During 2011-2015. J Infect Dis 2021; 223:1870-1878. [PMID: 33728469 DOI: 10.1093/infdis/jiab133] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [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: 11/20/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Monkeypox is a poorly described emerging zoonosis endemic to Central and Western Africa. METHODS Using surveillance data from Tshuapa Province, Democratic Republic of the Congo during 2011-2015, we evaluated differences in incidence, exposures, and clinical presentation of polymerase chain reaction-confirmed cases by sex and age. RESULTS We report 1057 confirmed cases. The average annual incidence was 14.1 per 100 000 (95% confidence interval, 13.3-15.0). The incidence was higher in male patients (incidence rate ratio comparing males to females, 1.21; 95% confidence interval, 1.07-1.37), except among those 20-29 years old (0.70; .51-.95). Females aged 20-29 years also reported a high frequency of exposures (26.2%) to people with monkeypox-like symptoms.The highest incidence was among 10-19-year-old males, the cohort reporting the highest proportion of animal exposures (37.5%). The incidence was lower among those presumed to have received smallpox vaccination than among those presumed unvaccinated. No differences were observed by age group in lesion count or lesion severity score. CONCLUSIONS Monkeypox incidence was twice that reported during 1980-1985, an increase possibly linked to declining immunity provided by smallpox vaccination. The high proportion of cases attributed to human exposures suggests changing exposure patterns. Cases were distributed across age and sex, suggesting frequent exposures that follow sociocultural norms.
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Affiliation(s)
- Erin R Whitehouse
- Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jesse Bonwitt
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christine M Hughes
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Toutou Likafi
- Ecole de Santé Publique de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Beatrice Nguete
- Ecole de Santé Publique de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Joelle Kabamba
- US Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | - Benjamin Monroe
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeffrey B Doty
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yoshinori Nakazawa
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Inger Damon
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jean Malekani
- Faculty of Science, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Whitni Davidson
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kimberly Wilkins
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yu Li
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kay W Radford
- Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia,USA
| | - D Scott Schmid
- Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia,USA
| | - Elisabeth Pukuta
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Elisabeth Muyamuna
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Stomy Karhemere
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | | | | | - Andrea M McCollum
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary G Reynolds
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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10
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Silverthorne C, Daniels J, Thompson M, Robson J, Ndosi M, Swales C, Wilkins K, Dures E. POS1472-HPR CLINICIANS’ PERSPECTIVES ON PSYCHOLOGICAL DISTRESS AND MEETING PATIENTS’ SUPPORT NEEDS IN RHEUMATOLOGY CARE SETTINGS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:People with inflammatory rheumatic diseases (IRDs) face challenges that include fluctuations in pain, fatigue and flares of disease activity, complex medical regimens, and decisions about when to seek clinical help with symptoms [1,2]. Evidence suggests levels of anxiety and depression are higher in people with IRDs compared to the general population [3]. Rheumatology teams report that psychologically distressed patients can have additional support needs and require more time. Patients’ concerns include health-related anxiety and difficulty accepting the diagnosis. This group can have poor outcomes and poor adherence to treatments. However, little is currently known about optimal ways to meet these patients’ support needs.Objectives:To understand rheumatology clinicians’ perspectives on psychological distress in care settings with the long-term aim to develop a proposed model/pathway of support.Methods:Telephone interviews were conducted with members of UK rheumatology teams who have clinical experience with patients experiencing distress. The semi-structured interviews explored both ‘what happens now’ (current clinical practice) and ‘what should happen’ (acceptable models of future psychological support provision). The semi-structured format provided flexibility to probe more deeply and develop new lines of enquiry based on participants’ responses.Results:Fourteen interviews were conducted with rheumatology clinicians including 2 consultants, 4 nurses, 1 physiotherapist, 4 occupational therapists, 2 clinical psychologists and 1 podiatrist. Inductive thematic analysis was used to analyse the data. Two main themes represent the data (Table 1).Table 1.Main ThemeSub-themes1. ‘No one shoe fits all’ – the many manifestations of distress in patients.‘I pick up on distress as increased emotion…tearfulness and sadness I suppose, but also frustration, anger...A lot of helplessness comments’1. ‘Distress can be quite emotive and quite obvious, but then it can also hide away’2. ‘They’re [patients] trying to manage their own conditions, but they’re also trying to manage life’2. ‘If Rheumatology could be interwoven with psychological principles’ – the need to attend to the psychological impact of IRDs, alongside the physical impact.‘The physical and mental health side of things are so closely linked because one affects the other…after a while they [patients] don’t really know what’s affecting what’1. ‘Prioritising physical health…sometimes the stress gets not thought about’2. ‘Make best use of everyone in the team to work with patients who are struggling’3. ‘For the psychological side of things we don’t measure anything about that at all’Conclusion:Distress can be obvious or hidden and cause issues for both patient and clinician. It can lead to poor engagement with care provision. Clinicians differ in their perceptions of distress and in their thresholds for dealing with distress and have described the inconsistency of support offered for distressed patients. They described the powerful link between physical and mental distress, the vicious cycle that can develop, and the benefits of incorporating a psychological approach to treatment. This study suggests psychological support should be embedded within the team as it is felt there is a need for speciality understanding and for patients’ emotional wellbeing to consistently be given equal priority to their physical wellbeing.References:[1]Gettings L. Psychological well-being in rheumatoid arthritis: a review of the literature. Musculoskeletal care 2010;8(2):99-106. doi: 10.1002/msc.171 [published Online First: 2010/03/17][2]Homer D. Addressing psychological and social issues of rheumatoid arthritis within the consultation: a case report. Musculoskeletal care 2005;3(1):54-9. doi: 10.1002/msc.26 [published Online First: 2006/10/17][3]Isik A, Koca SS, Ozturk A, et al. Anxiety and depression in patients with rheumatoid arthritis. Clinical rheumatology 2007;26(6):872-8. doi: 10.1007/s10067-006-0407-y [published Online First: 2006/08/31]Disclosure of Interests:None declared
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11
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Laiton-Donato K, Ávila-Robayo P, Páez-Martinez A, Benjumea-Nieto P, Usme-Ciro JA, Pinzón-Nariño N, Giraldo I, Torres-Castellanos D, Nakazawa Y, Patel N, Wilkins K, Li Y, Davidson W, Burgado J, Satheshkumar PS, Styczynski A, Mauldin MR, Gracia-Romero M, Petersen BW. Progressive Vaccinia Acquired through Zoonotic Transmission in a Patient with HIV/AIDS, Colombia. Emerg Infect Dis 2021; 26:601-605. [PMID: 32091366 PMCID: PMC7045850 DOI: 10.3201/eid2603.191365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/19/2022] Open
Abstract
In March 2015, a patient in Colombia with HIV/AIDS was hospitalized for disseminated ulcers after milking cows that had vesicular lesions on their udders. Vaccinia virus was detected, and the case met criteria for progressive vaccinia acquired by zoonotic transmission. Adherence to an optimized antiretroviral regimen resulted in recovery.
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12
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Hughes CM, Liu L, Davidson WB, Radford KW, Wilkins K, Monroe B, Metcalfe MG, Likafi T, Lushima RS, Kabamba J, Nguete B, Malekani J, Pukuta E, Karhemere S, Muyembe Tamfum JJ, Okitolonda Wemakoy E, Reynolds MG, Schmid DS, McCollum AM. A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo. Am J Trop Med Hyg 2020. [PMID: 33289470 DOI: 10.4269/ajtmh.200589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time.
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Affiliation(s)
- Christine M Hughes
- 1Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lindy Liu
- 2Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.,3Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Whitni B Davidson
- 1Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kay W Radford
- 4Viral Vaccine Preventable Diseases Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kimberly Wilkins
- 1Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Benjamin Monroe
- 1Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maureen G Metcalfe
- 3Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Toutou Likafi
- 5Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | | | - Joelle Kabamba
- 7U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of Congo
| | - Beatrice Nguete
- 5Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Jean Malekani
- 8Department of Biology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Elisabeth Pukuta
- 9Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Stomy Karhemere
- 9Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | | | | | - Mary G Reynolds
- 1Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - D Scott Schmid
- 4Viral Vaccine Preventable Diseases Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea M McCollum
- 1Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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13
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Hughes CM, Liu L, Davidson WB, Radford KW, Wilkins K, Monroe B, Metcalfe MG, Likafi T, Lushima RS, Kabamba J, Nguete B, Malekani J, Pukuta E, Karhemere S, Muyembe Tamfum JJ, Okitolonda Wemakoy E, Reynolds MG, Schmid DS, McCollum AM. A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo. Am J Trop Med Hyg 2020; 104:604-611. [PMID: 33289470 PMCID: PMC7866336 DOI: 10.4269/ajtmh.20-0589] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/17/2020] [Indexed: 12/16/2022] Open
Abstract
Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time.
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Affiliation(s)
- Christine M. Hughes
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lindy Liu
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Whitni B. Davidson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kay W. Radford
- Viral Vaccine Preventable Diseases Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Benjamin Monroe
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maureen G. Metcalfe
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Toutou Likafi
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | | | - Joelle Kabamba
- U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of Congo
| | - Beatrice Nguete
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Jean Malekani
- Department of Biology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Elisabeth Pukuta
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Stomy Karhemere
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | | | | | - Mary G. Reynolds
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - D. Scott Schmid
- Viral Vaccine Preventable Diseases Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea M. McCollum
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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14
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Lindholm DA, Fisher RD, Montgomery JR, Davidson W, Yu PA, Yu YC, Burgado J, Wilkins K, Petersen BW, Okulicz JF. Preemptive Tecovirimat Use in an Active Duty Service Member Who Presented With Acute Myeloid Leukemia After Smallpox Vaccination. Clin Infect Dis 2020; 69:2205-2207. [PMID: 30959520 DOI: 10.1093/cid/ciz286] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 12/09/2018] [Accepted: 04/03/2019] [Indexed: 11/13/2022] Open
Abstract
Smallpox vaccine is contraindicated in immunosuppression due to increased risk for adverse reactions (eg, progressive vaccinia). We describe the first-ever use of tecovirimat as a preemptive vaccinia virus treatment strategy during induction chemotherapy in an active duty service member who presented with acute leukemia and inadvertent autoinoculation after smallpox vaccination.
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Affiliation(s)
- David A Lindholm
- Infectious Disease Service, Joint Base San Antonio-Fort Sam Houston, Texas.,Department of Medicine, San Antonio Military Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
| | - Raymond D Fisher
- Department of Medicine, San Antonio Military Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
| | - Jay R Montgomery
- Immunization Healthcare Branch, Defense Health Agency, Falls Church, Virginia
| | - Whitni Davidson
- Division of High-Consequence Pathogens and Pathology (Poxvirus and Rabies Branch)
| | - Patricia A Yu
- Division of Preparedness and Emerging Infections (Regulatory Affairs), National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yon C Yu
- Division of Preparedness and Emerging Infections (Regulatory Affairs), National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jillybeth Burgado
- Division of High-Consequence Pathogens and Pathology (Poxvirus and Rabies Branch)
| | - Kimberly Wilkins
- Division of High-Consequence Pathogens and Pathology (Poxvirus and Rabies Branch)
| | - Brett W Petersen
- Division of High-Consequence Pathogens and Pathology (Poxvirus and Rabies Branch)
| | - Jason F Okulicz
- Infectious Disease Service, Joint Base San Antonio-Fort Sam Houston, Texas.,Department of Medicine, San Antonio Military Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
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15
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Duggan AT, Klunk J, Porter AF, Dhody AN, Hicks R, Smith GL, Humphreys M, McCollum AM, Davidson WB, Wilkins K, Li Y, Burke A, Polasky H, Flanders L, Poinar D, Raphenya AR, Lau TTY, Alcock B, McArthur AG, Golding GB, Holmes EC, Poinar HN. The origins and genomic diversity of American Civil War Era smallpox vaccine strains. Genome Biol 2020; 21:175. [PMID: 32684155 PMCID: PMC7370420 DOI: 10.1186/s13059-020-02079-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 10/30/2019] [Accepted: 06/19/2020] [Indexed: 12/11/2022] Open
Abstract
Vaccination has transformed public health, most notably including the eradication of smallpox. Despite its profound historical importance, little is known of the origins and diversity of the viruses used in smallpox vaccination. Prior to the twentieth century, the method, source and origin of smallpox vaccinations remained unstandardised and opaque. We reconstruct and analyse viral vaccine genomes associated with smallpox vaccination from historical artefacts. Significantly, we recover viral molecules through non-destructive sampling of historical materials lacking signs of biological residues. We use the authenticated ancient genomes to reveal the evolutionary relationships of smallpox vaccination viruses within the poxviruses as a whole.
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Affiliation(s)
- Ana T Duggan
- Department of Anthropology, McMaster University, Hamilton, L8S 4L9, Canada.
| | - Jennifer Klunk
- Department of Biology, McMaster University, Hamilton, L8S 4L9, Canada.,Present address: Arbor Biosciences, Ann Arbor, MI, 48103, USA
| | - Ashleigh F Porter
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Life and Environmental Sciences and School of Medical Sciences, University of Sydney, Sydney, NSW, 2006, Australia
| | - Anna N Dhody
- Mütter Research Institute, Philadelphia, PA, 19103, USA.,Mütter Museum of The College of Physicians of Philadelphia, Philadelphia, PA, 19103, USA
| | - Robert Hicks
- Mütter Research Institute, Philadelphia, PA, 19103, USA.,Mütter Museum of The College of Physicians of Philadelphia, Philadelphia, PA, 19103, USA
| | - Geoffrey L Smith
- Department of Pathology, University of Cambridge, Cambridge, CB2 1QP, UK
| | | | - Andrea M McCollum
- U.S. Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Atlanta, GA, 30333, USA
| | - Whitni B Davidson
- U.S. Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Atlanta, GA, 30333, USA
| | - Kimberly Wilkins
- U.S. Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Atlanta, GA, 30333, USA
| | - Yu Li
- U.S. Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Atlanta, GA, 30333, USA
| | - Amanda Burke
- Mütter Museum of The College of Physicians of Philadelphia, Philadelphia, PA, 19103, USA
| | - Hanna Polasky
- Mütter Museum of The College of Physicians of Philadelphia, Philadelphia, PA, 19103, USA
| | - Lowell Flanders
- Mütter Museum of The College of Physicians of Philadelphia, Philadelphia, PA, 19103, USA
| | - Debi Poinar
- Department of Anthropology, McMaster University, Hamilton, L8S 4L9, Canada
| | | | - Tammy T Y Lau
- Present address: BC Cancer Research Centre, Vancouver, V5Z 1G1, Canada.,M.G. DeGroote Institute for Infectious Disease Research, Department of Biochemistry and Biomedical Sciences, DeGroote School of Medicine, McMaster University, Hamilton, L8S 4K1, Canada
| | - Brian Alcock
- Present address: BC Cancer Research Centre, Vancouver, V5Z 1G1, Canada
| | - Andrew G McArthur
- Present address: BC Cancer Research Centre, Vancouver, V5Z 1G1, Canada
| | - G Brian Golding
- Department of Biology, McMaster University, Hamilton, L8S 4L9, Canada
| | - Edward C Holmes
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Life and Environmental Sciences and School of Medical Sciences, University of Sydney, Sydney, NSW, 2006, Australia
| | - Hendrik N Poinar
- Department of Anthropology, McMaster University, Hamilton, L8S 4L9, Canada.,Present address: BC Cancer Research Centre, Vancouver, V5Z 1G1, Canada.,Department of Biochemistry, McMaster University, Hamilton, L8S 4L9, Canada
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16
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Whitehouse ER, Rao AK, Yu YC, Yu PA, Griffin M, Gorman S, Angel KA, McDonald EC, Manlutac AL, de Perio MA, McCollum AM, Davidson W, Wilkins K, Ortega E, Satheshkumar PS, Townsend MB, Isakari M, Petersen BW. Novel Treatment of a Vaccinia Virus Infection from an Occupational Needlestick - San Diego, California, 2019. MMWR Morb Mortal Wkly Rep 2019; 68:943-946. [PMID: 31647789 PMCID: PMC6812835 DOI: 10.15585/mmwr.mm6842a2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Gigante CM, Gao J, Tang S, McCollum AM, Wilkins K, Reynolds MG, Davidson W, McLaughlin J, Olson VA, Li Y. Genome of Alaskapox Virus, A Novel Orthopoxvirus Isolated from Alaska. Viruses 2019; 11:v11080708. [PMID: 31375015 PMCID: PMC6723315 DOI: 10.3390/v11080708] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/19/2019] [Accepted: 07/21/2019] [Indexed: 01/10/2023] Open
Abstract
Since the eradication of smallpox, there have been increases in poxvirus infections and the emergence of several novel poxviruses that can infect humans and domestic animals. In 2015, a novel poxvirus was isolated from a resident of Alaska. Diagnostic testing and limited sequence analysis suggested this isolate was a member of the Orthopoxvirus (OPXV) genus but was highly diverged from currently known species, including Akhmeta virus. Here, we present the complete 210,797 bp genome sequence of the Alaska poxvirus isolate, containing 206 predicted open reading frames. Phylogenetic analysis of the conserved central region of the genome suggested the Alaska isolate shares a common ancestor with Old World OPXVs and is diverged from New World OPXVs. We propose this isolate as a member of a new OPXV species, Alaskapox virus (AKPV). The AKPV genome contained host range and virulence genes typical of OPXVs but lacked homologs of C4L and B7R, and the hemagglutinin gene contained a unique 120 amino acid insertion. Seven predicted AKPV proteins were most similar to proteins in non-OPXV Murmansk or NY_014 poxviruses. Genomic analysis revealed evidence suggestive of recombination with Ectromelia virus in two putative regions that contain seven predicted coding sequences, including the A-type inclusion protein.
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Affiliation(s)
- Crystal M Gigante
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Jinxin Gao
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Shiyuyun Tang
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Andrea M McCollum
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Mary G Reynolds
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Whitni Davidson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Joseph McLaughlin
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, AK 99503, USA
| | - Victoria A Olson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Yu Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
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18
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Yinka-Ogunleye A, Aruna O, Dalhat M, Ogoina D, McCollum A, Disu Y, Mamadu I, Akinpelu A, Ahmad A, Burga J, Ndoreraho A, Nkunzimana E, Manneh L, Mohammed A, Adeoye O, Tom-Aba D, Silenou B, Ipadeola O, Saleh M, Adeyemo A, Nwadiutor I, Aworabhi N, Uke P, John D, Wakama P, Reynolds M, Mauldin MR, Doty J, Wilkins K, Musa J, Khalakdina A, Adedeji A, Mba N, Ojo O, Krause G, Ihekweazu C. Outbreak of human monkeypox in Nigeria in 2017-18: a clinical and epidemiological report. Lancet Infect Dis 2019; 19:872-879. [PMID: 31285143 PMCID: PMC9628943 DOI: 10.1016/s1473-3099(19)30294-4] [Citation(s) in RCA: 404] [Impact Index Per Article: 80.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/25/2019] [Accepted: 04/05/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND In September, 2017, human monkeypox re-emerged in Nigeria, 39 years after the last reported case. We aimed to describe the clinical and epidemiological features of the 2017-18 human monkeypox outbreak in Nigeria. METHODS We reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept 22, 2017, and Sept 16, 2018. Data were collected with a standardised case investigation form, with a case definition of human monkeypox that was based on previously established guidelines. Diagnosis was confirmed by viral identification with real-time PCR and by detection of positive anti-orthopoxvirus IgM antibodies. Whole-genome sequencing was done for seven cases. Haplotype analysis results, genetic distance data, and epidemiological data were used to infer a likely series of events for potential human-to-human transmission of the west African clade of monkeypox virus. FINDINGS 122 confirmed or probable cases of human monkeypox were recorded in 17 states, including seven deaths (case fatality rate 6%). People infected with monkeypox virus were aged between 2 days and 50 years (median 29 years [IQR 14]), and 84 (69%) were male. All 122 patients had vesiculopustular rash, and fever, pruritus, headache, and lymphadenopathy were also common. The rash affected all parts of the body, with the face being most affected. The distribution of cases and contacts suggested both primary zoonotic and secondary human-to-human transmission. Two cases of health-care-associated infection were recorded. Genomic analysis suggested multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility. INTERPRETATION This study describes the largest documented human outbreak of the west African clade of the monkeypox virus. Our results suggest endemicity of monkeypox virus in Nigeria, with some evidence of human-to-human transmission. Further studies are necessary to explore animal reservoirs and risk factors for transmission of the virus in Nigeria. FUNDING None.
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Affiliation(s)
| | - Olusola Aruna
- Nigeria Centre for Disease Control, Abuja, Nigeria; International Health Regulations Strengthening Programme in Nigeria, Public Health England, Abuja, Nigeria
| | | | - Dimie Ogoina
- Niger Delta University Teaching Hospital, Niger Delta University, Yenagoa, Nigeria
| | - Andrea McCollum
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yahyah Disu
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | - Adama Ahmad
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Joel Burga
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Adolphe Ndoreraho
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Edouard Nkunzimana
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Lamin Manneh
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | | | | | - Daniel Tom-Aba
- Helmholtz Centre for Infection Research, Braunschweig, Germany; German Centre for Infection Research, Braunschweig, Germany
| | - Bernard Silenou
- Helmholtz Centre for Infection Research, Braunschweig, Germany; German Centre for Infection Research, Braunschweig, Germany
| | - Oladipupo Ipadeola
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Muhammad Saleh
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Patience Uke
- Cross State Ministry of Health, Calabar, Nigeria
| | - Doris John
- Department of Health, Federal Capital Territory, Abuja, Nigeria
| | - Paul Wakama
- Nigeria Prison Services, Port Harcourt, Rivers State, Nigeria
| | - Mary Reynolds
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew R Mauldin
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeffrey Doty
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joy Musa
- University Of Maryland, Abuja, Nigeria
| | | | | | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Olubunmi Ojo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Gerard Krause
- Helmholtz Centre for Infection Research, Braunschweig, Germany; German Centre for Infection Research, Braunschweig, Germany
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19
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Hodo CL, Mauldin MR, Light JE, Wilkins K, Tang S, Nakazawa Y, Emerson GL, Ritter JM, Mansell JL, Hamer SA. Novel Poxvirus in Proliferative Lesions of Wild Rodents in East Central Texas, USA. Emerg Infect Dis 2019; 24:1069-1072. [PMID: 29774837 PMCID: PMC6004845 DOI: 10.3201/eid2406.172057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Northern pygmy mice from 2 localities in East Central Texas, USA, had proliferative epidermal lesions on the tail and feet. Electron microscopy of lesion tissue revealed poxvirus. Phylogenetic analyses indicated the virus differed 35% from its closest relatives, the Chordopoxvirinae. Future research is needed to determine whether this virus could affect human health.
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20
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Eteng WE, Mandra A, Doty J, Yinka-Ogunleye A, Aruna S, Reynolds MG, McCollum AM, Davidson W, Wilkins K, Saleh M, Ipadeola O, Manneh L, Anebonam U, Abdulkareem Z, Okoli N, Agenyi J, Dan-Nwafor C, Mahmodu I, Ihekweazu C. Notes from the Field: Responding to an Outbreak of Monkeypox Using the One Health Approach - Nigeria, 2017-2018. MMWR Morb Mortal Wkly Rep 2018; 67:1040-1041. [PMID: 30235181 PMCID: PMC6147416 DOI: 10.15585/mmwr.mm6737a5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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21
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Yinka-Ogunleye A, Aruna O, Ogoina D, Aworabhi N, Eteng W, Badaru S, Mohammed A, Agenyi J, Etebu EN, Numbere TW, Ndoreraho A, Nkunzimana E, Disu Y, Dalhat M, Nguku P, Mohammed A, Saleh M, McCollum A, Wilkins K, Faye O, Sall A, Happi C, Mba N, Ojo O, Ihekweazu C. Reemergence of Human Monkeypox in Nigeria, 2017. Emerg Infect Dis 2018; 24:1149-1151. [PMID: 29619921 PMCID: PMC6004876 DOI: 10.3201/eid2406.180017] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [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: 11/28/2022] Open
Abstract
In Nigeria, before 2017 the most recent case of human monkeypox had been reported in 1978. By mid-November 2017, a large outbreak caused by the West African clade resulted in 146 suspected cases and 42 laboratory-confirmed cases from 14 states. Although the source is unknown, multiple sources are suspected.
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22
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Gigante CM, Dettinger L, Powell JW, Seiders M, Condori REC, Griesser R, Okogi K, Carlos M, Pesko K, Breckenridge M, Simon EMM, Chu MYJV, Davis AD, Brunt SJ, Orciari L, Yager P, Carson WC, Hartloge C, Saliki JT, Sanchez S, Deldari M, Hsieh K, Wadhwa A, Wilkins K, Peredo VY, Rabideau P, Gruhn N, Cadet R, Isloor S, Nath SS, Joseph T, Gao J, Wallace R, Reynolds M, Olson VA, Li Y. Multi-site evaluation of the LN34 pan-lyssavirus real-time RT-PCR assay for post-mortem rabies diagnostics. PLoS One 2018; 13:e0197074. [PMID: 29768505 PMCID: PMC5955534 DOI: 10.1371/journal.pone.0197074] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/25/2018] [Indexed: 12/15/2022] Open
Abstract
Rabies is a fatal zoonotic disease that requires fast, accurate diagnosis to prevent disease in an exposed individual. The current gold standard for post-mortem diagnosis of human and animal rabies is the direct fluorescent antibody (DFA) test. While the DFA test has proven sensitive and reliable, it requires high quality antibody conjugates, a skilled technician, a fluorescence microscope and diagnostic specimen of sufficient quality. The LN34 pan-lyssavirus real-time RT-PCR assay represents a strong candidate for rabies post-mortem diagnostics due to its ability to detect RNA across the diverse Lyssavirus genus, its high sensitivity, its potential for use with deteriorated tissues, and its simple, easy to implement design. Here, we present data from a multi-site evaluation of the LN34 assay in 14 laboratories. A total of 2,978 samples (1,049 DFA positive) from Africa, the Americas, Asia, Europe, and the Middle East were tested. The LN34 assay exhibited low variability in repeatability and reproducibility studies and was capable of detecting viral RNA in fresh, frozen, archived, deteriorated and formalin-fixed brain tissue. The LN34 assay displayed high diagnostic specificity (99.68%) and sensitivity (99.90%) when compared to the DFA test, and no DFA positive samples were negative by the LN34 assay. The LN34 assay produced definitive findings for 80 samples that were inconclusive or untestable by DFA; 29 were positive. Five samples were inconclusive by the LN34 assay, and only one sample was inconclusive by both tests. Furthermore, use of the LN34 assay led to the identification of one false negative and 11 false positive DFA results. Together, these results demonstrate the reliability and robustness of the LN34 assay and support a role for the LN34 assay in improving rabies diagnostics and surveillance.
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Affiliation(s)
- Crystal M. Gigante
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lisa Dettinger
- Bureau of Laboratories, Pennsylvania Department of Health, Exton, Pennsylvania, United States of America
| | - James W. Powell
- Rabies Unit, Wisconsin State Laboratory of Hygiene, Madison, Wisconsin, United States of America
| | - Melanie Seiders
- Bureau of Laboratories, Pennsylvania Department of Health, Exton, Pennsylvania, United States of America
| | - Rene Edgar Condori Condori
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Richard Griesser
- Rabies Unit, Wisconsin State Laboratory of Hygiene, Madison, Wisconsin, United States of America
| | - Kenneth Okogi
- Rabies Laboratory, Center for Zoonotic and Vectorborne Diseases, Maryland Department of Health, Baltimore, Maryland, United States of America
| | - Maria Carlos
- Rabies Laboratory, Center for Zoonotic and Vectorborne Diseases, Maryland Department of Health, Baltimore, Maryland, United States of America
| | - Kendra Pesko
- Scientific Laboratory Division, New Mexico Department of Health, Santa Fe, New Mexico, United States of America
| | - Mike Breckenridge
- Scientific Laboratory Division, New Mexico Department of Health, Santa Fe, New Mexico, United States of America
| | - Edson Michael M. Simon
- Special Pathogens Laboratory, Department of Health, Research Institute for Tropical Medicine, Alabang Muntinlupa City, Manila, Philippines
| | - Maria Yna Joyce V. Chu
- Special Pathogens Laboratory, Department of Health, Research Institute for Tropical Medicine, Alabang Muntinlupa City, Manila, Philippines
| | - April D. Davis
- Rabies Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Scott J. Brunt
- Rabies Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Lillian Orciari
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Pamela Yager
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - William C. Carson
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire Hartloge
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeremiah T. Saliki
- Athens Veterinary Diagnostic Laboratory, University of Georgia, Athens, Georgia, United States of America
| | - Susan Sanchez
- Athens Veterinary Diagnostic Laboratory, University of Georgia, Athens, Georgia, United States of America
| | - Mojgan Deldari
- California Department of Public Health, Sacramento, California, United States of America
| | - Kristina Hsieh
- California Department of Public Health, Sacramento, California, United States of America
| | - Ashutosh Wadhwa
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Veronica Yung Peredo
- Rabies section, Viral Disease, Public Health Institute of Chile, Santiago, Chile
| | - Patricia Rabideau
- Public Health Command Europe, Laboratory Sciences, Biological Analysis Division, Kirchberg Kaserne, Landstuhl, Germany
| | - Nina Gruhn
- Public Health Command Europe, Laboratory Sciences, Biological Analysis Division, Kirchberg Kaserne, Landstuhl, Germany
| | - Rolain Cadet
- Ministère de l’Agriculture, Port-au-Prince, Haiti
| | - Shrikrishna Isloor
- OIE Twinned KVAFSU-CVA-Crucell Rabies Diagnostic Laboratory, Deptartment of Veterinary Microbiology, Veterinary College, KVAFSU, Hebbal, Bangalore, India
| | - Sujith S. Nath
- OIE Twinned KVAFSU-CVA-Crucell Rabies Diagnostic Laboratory, Deptartment of Veterinary Microbiology, Veterinary College, KVAFSU, Hebbal, Bangalore, India
| | - Tomy Joseph
- Animal Health Centre, Ministry of Agriculture, Abbotsford, British Columbia, Canada
| | - Jinxin Gao
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ryan Wallace
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mary Reynolds
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Victoria A. Olson
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Yu Li
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
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23
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Gao J, Gigante C, Khmaladze E, Liu P, Tang S, Wilkins K, Zhao K, Davidson W, Nakazawa Y, Maghlakelidze G, Geleishvili M, Kokhreidze M, Carroll DS, Emerson G, Li Y. Genome Sequences of Akhmeta Virus, an Early Divergent Old World Orthopoxvirus. Viruses 2018; 10:v10050252. [PMID: 29757202 PMCID: PMC5977245 DOI: 10.3390/v10050252] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/08/2018] [Accepted: 05/11/2018] [Indexed: 12/29/2022] Open
Abstract
Annotated whole genome sequences of three isolates of the Akhmeta virus (AKMV), a novel species of orthopoxvirus (OPXV), isolated from the Akhmeta and Vani regions of the country Georgia, are presented and discussed. The AKMV genome is similar in genomic content and structure to that of the cowpox virus (CPXV), but a lower sequence identity was found between AKMV and Old World OPXVs than between other known species of Old World OPXVs. Phylogenetic analysis showed that AKMV diverged prior to other Old World OPXV. AKMV isolates formed a monophyletic clade in the OPXV phylogeny, yet the sequence variability between AKMV isolates was higher than between the monkeypox virus strains in the Congo basin and West Africa. An AKMV isolate from Vani contained approximately six kb sequence in the left terminal region that shared a higher similarity with CPXV than with other AKMV isolates, whereas the rest of the genome was most similar to AKMV, suggesting recombination between AKMV and CPXV in a region containing several host range and virulence genes.
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Affiliation(s)
- Jinxin Gao
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Crystal Gigante
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Ekaterine Khmaladze
- Laboratory of Molecular Epidemiology, National Center for Disease Control and Public Health of Georgia, 9 M. Asatiani Street, Tbilisi 0177, Georgia.
| | - Pengbo Liu
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Shiyuyun Tang
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Kun Zhao
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Whitni Davidson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Yoshinori Nakazawa
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Giorgi Maghlakelidze
- Division of Global Health Protection (DGHP), Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Marika Geleishvili
- Division of Global Health Protection (DGHP), Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Maka Kokhreidze
- Laboratory of the Ministry of Agriculture of Georgia (LMA), Animal Disease Diagnostic Department, 49 Vaso Godziashvilis Street, Tbilisi 0159, Georgia.
| | - Darin S Carroll
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Ginny Emerson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Yu Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
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24
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Springer YP, Hsu CH, Werle ZR, Olson LE, Cooper MP, Castrodale LJ, Fowler N, McCollum AM, Goldsmith CS, Emerson GL, Wilkins K, Doty JB, Burgado J, Gao J, Patel N, Mauldin MR, Reynolds MG, Satheshkumar PS, Davidson W, Li Y, McLaughlin JB. Novel Orthopoxvirus Infection in an Alaska Resident. Clin Infect Dis 2018; 64:1737-1741. [PMID: 28329402 PMCID: PMC5447873 DOI: 10.1093/cid/cix219] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 12/14/2016] [Accepted: 03/08/2017] [Indexed: 01/28/2023] Open
Abstract
Background. Human infection by orthopoxviruses is being reported with increasing frequency, attributed in part to the cessation of smallpox vaccination and concomitant waning of population-level immunity. In July 2015, a female resident of interior Alaska presented to an urgent care clinic with a dermal lesion consistent with poxvirus infection. Laboratory testing of a virus isolated from the lesion confirmed infection by an Orthopoxvirus. Methods. The virus isolate was characterized by using electron microscopy and nucleic acid sequencing. An epidemiologic investigation that included patient interviews, contact tracing, and serum testing, as well as environmental and small-mammal sampling, was conducted to identify the infection source and possible additional cases. Results. Neither signs of active infection nor evidence of recent prior infection were observed in any of the 4 patient contacts identified. The patient's infection source was not definitively identified. Potential routes of exposure included imported fomites from Azerbaijan via the patient's cohabiting partner or wild small mammals in or around the patient's residence. Phylogenetic analyses demonstrated that the virus represents a distinct and previously undescribed genetic lineage of Orthopoxvirus, which is most closely related to the Old World orthopoxviruses. Conclusions. Investigation findings point to infection of the patient after exposure in or near Fairbanks. This conclusion raises questions about the geographic origins (Old World vs North American) of the genus Orthopoxvirus. Clinicians should remain vigilant for signs of poxvirus infection and alert public health officials when cases are suspected.
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Affiliation(s)
- Yuri P Springer
- Alaska Division of Public Health, Section of Epidemiology, Anchorage.,Epidemic Intelligence Service, Division of Scientific Education and Professional Development
| | - Christopher H Hsu
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development.,Poxvirus and Rabies Branch, and
| | | | | | - Michael P Cooper
- Alaska Division of Public Health, Section of Epidemiology, Anchorage
| | | | - Nisha Fowler
- Alaska Division of Public Health, Section of Laboratories, Fairbanks
| | | | - Cynthia S Goldsmith
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | | | | | - Matthew R Mauldin
- Poxvirus and Rabies Branch, and.,Oak Ridge Institute for Science and Education, Tennessee
| | | | | | | | - Yu Li
- Poxvirus and Rabies Branch, and
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25
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Usme-Ciro JA, Paredes A, Walteros DM, Tolosa-Pérez EN, Laiton-Donato K, Pinzón MDC, Petersen BW, Gallardo-Romero NF, Li Y, Wilkins K, Davidson W, Gao J, Patel N, Nakazawa Y, Reynolds MG, Satheshkumar PS, Emerson GL, Páez-Martínez A. Detection and Molecular Characterization of Zoonotic Poxviruses Circulating in the Amazon Region of Colombia, 2014. Emerg Infect Dis 2018; 23:649-653. [PMID: 28322708 PMCID: PMC5367405 DOI: 10.3201/eid2304.161041] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 01/04/2023] Open
Abstract
During 2014, cutaneous lesions were reported in dairy cattle and farmworkers in the Amazon Region of western Colombia. Samples from 6 patients were analyzed by serologic and PCR testing, and results demonstrated the presence of vaccinia virus and pseudocowpox virus. These findings highlight the need for increased poxvirus surveillance in Colombia.
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26
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Dhatt R, Theobald S, Buzuzi S, Ros B, Vong S, Muraya K, Molyneux S, Hawkins K, González-Beiras C, Ronsin K, Lichtenstein D, Wilkins K, Thompson K, Davis K, Jackson C. The role of women's leadership and gender equity in leadership and health system strengthening. Glob Health Epidemiol Genom 2017; 2:e8. [PMID: 29868219 PMCID: PMC5870471 DOI: 10.1017/gheg.2016.22] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 07/31/2016] [Revised: 12/02/2016] [Accepted: 12/02/2016] [Indexed: 12/05/2022] Open
Abstract
Gender equity is imperative to the attainment of healthy lives and wellbeing of all, and promoting gender equity in leadership in the health sector is an important part of this endeavour. This empirical research examines gender and leadership in the health sector, pooling learning from three complementary data sources: literature review, quantitative analysis of gender and leadership positions in global health organisations and qualitative life histories with health workers in Cambodia, Kenya and Zimbabwe. The findings highlight gender biases in leadership in global health, with women underrepresented. Gender roles, relations, norms and expectations shape progression and leadership at multiple levels. Increasing women's leadership within global health is an opportunity to further health system resilience and system responsiveness. We conclude with an agenda and tangible next steps of action for promoting women's leadership in health as a means to promote the global goals of achieving gender equity.
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Affiliation(s)
- R. Dhatt
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
| | - S. Theobald
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool L3 5QA, UK
- Institute of Development Studies, Institute of Development Studies, Library Road Brighton BN1 9RE, UK
| | - S. Buzuzi
- Biomedical Training Research Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe
| | - B. Ros
- Cambodia Development Resource Institute, 56 St. 315, Phnom Penh 622, Cambodia
| | - S. Vong
- Cambodia Development Resource Institute, 56 St. 315, Phnom Penh 622, Cambodia
| | - K. Muraya
- Kenya Medical Research Institute – KEMRI-Wellcome Trust Research Programme, P.O. Box 230, Kilifi, Kenya
| | - S. Molyneux
- Kenya Medical Research Institute – KEMRI-Wellcome Trust Research Programme, P.O. Box 230, Kilifi, Kenya
- Nuffield Department of Medicine, Centre for Global Health and Tropical Medicine, University of Oxford, Oxford, UK
| | - K. Hawkins
- Pamoja Communications, UK Bishopstone, 36 Crescent Road, Worthing BN11 1RL, UK
| | - C. González-Beiras
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
- Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Rua da Junqueira 100, Lisbon, Portugal
| | - K. Ronsin
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
| | - D. Lichtenstein
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
| | - K. Wilkins
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
| | - K. Thompson
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
| | - K. Davis
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
| | - C. Jackson
- Women in Global Health, 30901 Wiegmen Road, Hayward, CA 94544, USA
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27
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Li D, Wilkins K, McCollum AM, Osadebe L, Kabamba J, Nguete B, Likafi T, Balilo MP, Lushima RS, Malekani J, Damon IK, Vickery MCL, Pukuta E, Nkawa F, Karhemere S, Tamfum JJM, Okitolonda EW, Li Y, Reynolds MG. Evaluation of the GeneXpert for Human Monkeypox Diagnosis. Am J Trop Med Hyg 2017; 96:405-410. [PMID: 27994107 PMCID: PMC5303045 DOI: 10.4269/ajtmh.16-0567] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/27/2016] [Indexed: 11/17/2022] Open
Abstract
Monkeypox virus (MPXV), a zoonotic orthopoxvirus (OPX), is endemic in the Democratic Republic of Congo (DRC). Currently, diagnostic assays for human monkeypox (MPX) focus on real-time quantitative polymerase chain reaction (PCR) assays, which are typically performed in sophisticated laboratory settings. Herein, we evaluated the accuracy and utility of a multiplex MPX assay using the GeneXpert platform, a portable rapid diagnostic device that may serve as a point-of-care test to diagnose infections in endemic areas. The multiplex MPX/OPX assay includes a MPX-specific PCR test, OPX-generic PCR test, and an internal control PCR test. In total, 164 diagnostic specimens (50 crusts and 114 vesicular swabs) were collected from suspected MPX cases in Tshuapa Province, DRC, under national surveillance guidelines. The specimens were tested with the GeneXpert MPX/OPX assay and an OPX PCR assay at the Institut National de Recherche Biomedicale (INRB) in Kinshasa. Aliquots of each specimen were tested in parallel with a MPX-specific PCR assay at the Centers for Disease Control and Prevention. The results of the MPX PCR were used as the gold standard for all analyses. The GeneXpert MPX/OPX assay performed at INRB had a sensitivity of 98.8% and specificity of 100%. The GeneXpert assay performed well with both crust and vesicle samples. The GeneXpert MPX/OPX test incorporates a simple methodology that performs well in both laboratory and field conditions, suggesting its viability as a diagnostic platform that may expand and expedite current MPX detection capabilities.
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Affiliation(s)
- Daniel Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea M. McCollum
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lynda Osadebe
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joelle Kabamba
- Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of Congo
| | - Beatrice Nguete
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Toutou Likafi
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Marcel Pie Balilo
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | | | - Jean Malekani
- University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Inger K. Damon
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Elisabeth Pukuta
- Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, Democratic Republic of Congo
| | - Frida Nkawa
- Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, Democratic Republic of Congo
| | - Stomy Karhemere
- Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, Democratic Republic of Congo
| | | | | | - Yu Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary G. Reynolds
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Hughes L, Wilkins K, Goldsmith CS, Smith S, Hudson P, Patel N, Karem K, Damon I, Li Y, Olson VA, Satheshkumar PS. A rapid Orthopoxvirus purification protocol suitable for high-containment laboratories. J Virol Methods 2017; 243:68-73. [PMID: 28131867 PMCID: PMC9533856 DOI: 10.1016/j.jviromet.2017.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/26/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 11/07/2022]
Abstract
Virus purification in a high-containment setting provides unique challenges due to barrier precautions and operational safety approaches that are not necessary in lower biosafety level (BSL) 2 environments. The need for high risk group pathogen diagnostic assay development, anti-viral research, pathogenesis and vaccine efficacy research necessitates work in BSL-3 and BSL-4 labs with infectious agents. When this work is performed in accordance with BSL-4 practices, modifications are often required in standard protocols. Classical virus purification techniques are difficult to execute in a BSL-3 or BSL-4 laboratory because of the work practices used in these environments. Orthopoxviruses are a family of viruses that, in some cases, requires work in a high-containment laboratory and due to size do not lend themselves to simpler purification methods. Current CDC purification techniques of orthopoxviruses uses 1,1,2-trichlorotrifluoroethane, commonly known as Genetron®. Genetron® is a chlorofluorocarbon (CFC) that has been shown to be detrimental to the ozone and has been phased out and the limited amount of product makes it no longer a feasible option for poxvirus purification purposes. Here we demonstrate a new Orthopoxvirus purification method that is suitable for high-containment laboratories and produces virus that is not only comparable to previous purification methods, but improves on purity and yield.
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Affiliation(s)
- Laura Hughes
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Cynthia S Goldsmith
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Scott Smith
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Paul Hudson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Nishi Patel
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Kevin Karem
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Inger Damon
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Yu Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Victoria A Olson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - P S Satheshkumar
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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29
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Wadhwa A, Wilkins K, Gao J, Condori Condori RE, Gigante CM, Zhao H, Ma X, Ellison JA, Greenberg L, Velasco-Villa A, Orciari L, Li Y. A Pan-Lyssavirus Taqman Real-Time RT-PCR Assay for the Detection of Highly Variable Rabies virus and Other Lyssaviruses. PLoS Negl Trop Dis 2017; 11:e0005258. [PMID: 28081126 PMCID: PMC5230753 DOI: 10.1371/journal.pntd.0005258] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 12/14/2016] [Indexed: 11/19/2022] Open
Abstract
Rabies, resulting from infection by Rabies virus (RABV) and related lyssaviruses, is one of the most deadly zoonotic diseases and is responsible for up to 70,000 estimated human deaths worldwide each year. Rapid and accurate laboratory diagnosis of rabies is essential for timely administration of post-exposure prophylaxis in humans and control of the disease in animals. Currently, only the direct fluorescent antibody (DFA) test is recommended for routine rabies diagnosis. Reverse-transcription polymerase chain reaction (RT-PCR) based diagnostic methods have been widely adapted for the diagnosis of other viral pathogens, but there is currently no widely accepted rapid real-time RT-PCR assay for the detection of all lyssaviruses. In this study, we demonstrate the validation of a newly developed multiplex real-time RT-PCR assay named LN34, which uses a combination of degenerate primers and probes along with probe modifications to achieve superior coverage of the Lyssavirus genus while maintaining sensitivity and specificity. The primers and probes of the LN34 assay target the highly conserved non-coding leader region and part of the nucleoprotein (N) coding sequence of the Lyssavirus genome to maintain assay robustness. The probes were further modified by locked nucleotides to increase their melting temperature to meet the requirements for an optimal real-time RT-PCR assay. The LN34 assay was able to detect all RABV variants and other lyssaviruses in a validation panel that included representative RABV isolates from most regions of the world as well as representatives of 13 additional Lyssavirus species. The LN34 assay was successfully used for both ante-mortem and post-mortem diagnosis of over 200 clinical samples as well as field derived surveillance samples. This assay represents a major improvement over previously published rabies specific RT-PCR and real-time RT-PCR assays because of its ability to universally detect RABV and other lyssaviruses, its high throughput capability and its simplicity of use, which can be quickly adapted in a laboratory to enhance the capacity of rabies molecular diagnostics. The LN34 assay provides an alternative approach for rabies diagnostics, especially in rural areas and rabies endemic regions that lack the conditions and broad experience required to run the standard DFA assay. Rabies is a preventable disease–but is still responsible for approximately 70,000 human deaths worldwide each year. The majority of human deaths occur in Asia and Africa where there is a lack of diagnostic resources and expertise, making it difficult to develop effective prevention and control strategies. In recent years, several real-time RT-PCR based diagnostic assays have been introduced to many developing countries in an effort to control the H1N1 pandemic flu, Ebola outbreak, and other tropical viral infections. In an effort to further improve rabies diagnostics, we developed a pan-lyssavirus Taqman real-time RT-PCR assay called LN34 for the detection of all known RABV variants and other lyssavirus species. The LN34 assay uses a combination of degenerate nucleotides, multiplex primers and probes, and unique probe modifications to achieve superior sensitivity and specificity compared to previously published RT-PCR based rabies diagnostics. Equally important, the LN34 assay is simple to set up, high throughput, combines multiple standard controls and can be used directly in widely available real-time RT-PCR systems. The LN34 assay was validated using a broad and comprehensive panel of highly diverse RABV variants and other lyssaviruses. A validated universal rabies diagnostic assay will be important in regions where RABV and other lyssaviruses co-circulate and for establishing a widely accepted diagnostic protocol. Over 200 clinical samples (including ante-mortem, post-mortem, and field derived samples) were tested with the LN34 assay, and the assay achieved 100% diagnostic sensitivity and specificity in our laboratory. Over 300 published genome sequences from representatives of RABV and other lyssaviruses were found to contain the conserved LN34 primer and probe targeting sites in an in silico analysis. We are expanding the validation of the LN34 assay to multiple domestic and international laboratories and expect the LN34 assay will drastically improve rabies diagnostic capacities globally.
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Affiliation(s)
- Ashutosh Wadhwa
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Jinxin Gao
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Rene Edgar Condori Condori
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Crystal M. Gigante
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Hui Zhao
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Xiaoyue Ma
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - James A. Ellison
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Lauren Greenberg
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Andres Velasco-Villa
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Lillian Orciari
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Yu Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- * E-mail:
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Mansell J, Cooke M, Read M, Rudd H, Shiel A, Wilkins K, Manso M. Chitinase 3-like 1 expression by human (MG63) osteoblasts in response to lysophosphatidic acid and 1,25-dihydroxyvitamin D3. Biochimie 2016; 128-129:193-200. [DOI: 10.1016/j.biochi.2016.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 08/25/2016] [Indexed: 01/05/2023]
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Ramphal R, Aubin S, Czaykowski P, De Pauw S, Johnson A, McKillop S, Szwajcer D, Wilkins K, Rogers P. Adolescent and young adult cancer: principles of care. ACTA ACUST UNITED AC 2016; 23:204-9. [PMID: 27330350 DOI: 10.3747/co.23.3013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adolescents and young adults (ayas) with cancer in active treatment face a number of barriers to optimal care. In the present article, we focus on the 3 critical domains of care for ayas-medical, psychosocial, and research-and how changes to the system could overcome barriers. We summarize the current literature, outline recommended principles of care, raise awareness of barriers to optimal care, and suggest specific changes to the system to overcome those barriers in the Canadian context. Many of the recommendations can nevertheless be applied universally. These recommendations are endorsed by the Canadian Task Force on Adolescents and Young Adults with Cancer and build on outcomes from two international workshops held by that group.
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Affiliation(s)
- R Ramphal
- Division of Pediatric Hematology/Oncology, University of Ottawa, Ottawa, ON
| | - S Aubin
- Division of Gynecologic Oncology, McGill University, Montreal, QC
| | - P Czaykowski
- Division of Hematology/Oncology, University of Manitoba, Winnipeg, MB
| | - S De Pauw
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON
| | - A Johnson
- Division of Pediatric Hematology, Oncology and Bone Marrow Transplantation, BC Children's Hospital and University of British Columbia, Vancouver, BC
| | - S McKillop
- Division of Pediatric Hematology/Oncology, University of Alberta, Edmonton, AB
| | - D Szwajcer
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB
| | - K Wilkins
- Faculty of Nursing, University of New Brunswick, Fredericton, NB
| | - P Rogers
- Division of Hematology/Oncology, University of Manitoba, Winnipeg, MB
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McCollum AM, Nakazawa Y, Ndongala GM, Pukuta E, Karhemere S, Lushima RS, Ilunga BK, Kabamba J, Wilkins K, Gao J, Li Y, Emerson G, Damon IK, Carroll DS, Reynolds MG, Malekani J, Tamfum JJM. Human Monkeypox in the Kivus, a Conflict Region of the Democratic Republic of the Congo. Am J Trop Med Hyg 2015; 93:718-21. [PMID: 26283752 PMCID: PMC4596588 DOI: 10.4269/ajtmh.15-0095] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 02/02/2015] [Accepted: 03/31/2015] [Indexed: 11/07/2022] Open
Abstract
Monkeypox (MPX) is a zoonotic Orthopoxvirus infection endemic in central and western Africa. Human MPX cases occur in the central and northern regions of the Democratic Republic of the Congo (DRC), and this is the first report of confirmed MPX cases in the forested areas of North and South Kivu Provinces, with a detailed epidemiological investigation for one case. The location of each case is within areas predicted to be suitable for MPX virus transmission based on an ecological niche model. Phylogenetic analysis places these viruses in the Congo Basin clade.
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Affiliation(s)
- Andrea M McCollum
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Yoshinori Nakazawa
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Guy Mutombo Ndongala
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Elisabeth Pukuta
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Stomy Karhemere
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Robert Shongo Lushima
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Benoit Kebela Ilunga
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Joelle Kabamba
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Kimberly Wilkins
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jinxin Gao
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Yu Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ginny Emerson
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Inger K Damon
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Darin S Carroll
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Mary G Reynolds
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean Malekani
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe Tamfum
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Division Provinciale de la Santé, Ministère de la Santé Publique, Goma, Nord-Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo; U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo; University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Hsu CH, Farland J, Winters T, Gunn J, Caron D, Evans J, Osadebe L, Bethune L, McCollum AM, Patel N, Wilkins K, Davidson W, Petersen B, Barry MA. Laboratory-acquired vaccinia virus infection in a recently immunized person--Massachusetts, 2013. MMWR Morb Mortal Wkly Rep 2015; 64:435-8. [PMID: 25928468 PMCID: PMC4584810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
On November 26, 2013, the CDC poxvirus laboratory was notified by the Boston Public Health Commission (BPHC) of an inadvertent inoculation of a recently vaccinated (ACAM2000 smallpox vaccine) laboratory worker with wild type vaccinia virus (VACV) Western Reserve. A joint investigation by CDC and BPHC confirmed orthopoxvirus infection in the worker, who had reported a needle stick in his thumb while inoculating a mouse with VACV. He experienced a non-tender, red rash on his arm, diagnosed at a local emergency department as cellulitis. He subsequently developed a necrotic lesion on his thumb, diagnosed as VACV infection. Three weeks after the injury, the thumb lesion was surgically debrided and at 2 months post-injury, the skin lesion had resolved. The investigation confirmed that the infection was the first reported VACV infection in the United States in a laboratory worker vaccinated according to the Advisory Committee on Immunization Practices (ACIP) recommendations. The incident prompted the academic institution to outline biosafety measures for working with biologic agents, such as biosafety training of laboratory personnel, vaccination (if appropriate), and steps in incident reporting. Though vaccination has been shown to be an effective measure in protecting personnel in the laboratory setting, this case report underscores the importance of proper safety measures and incident reporting.
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Affiliation(s)
- Christopher H. Hsu
- Epidemic Intelligence Service, CDC,Division of High-Consequence Pathogens and Pathology, CDC,Corresponding author: Christopher Hsu, , 404-639-4526
| | | | | | | | | | | | - Lynda Osadebe
- Epidemic Intelligence Service, CDC,Division of High-Consequence Pathogens and Pathology, CDC
| | | | | | - Nishi Patel
- Division of High-Consequence Pathogens and Pathology, CDC
| | | | | | - Brett Petersen
- Division of High-Consequence Pathogens and Pathology, CDC
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Coletta A, Sanchez B, O'Connor A, Dalton R, Springer S, Koozehchian M, Jung Y, Simbo S, Cho M, Goodenough C, Reyes A, Galvan E, Levers K, Wilkins K, Rasmussen C, Kreider R. Influence of Obesity‐Related Genotype on Weight Loss Success and Body Composition Changes While Participating in an a 3‐Month Exercise and Weight Loss Program: Preliminary Findings. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.lb241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A Coletta
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - B Sanchez
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - A O'Connor
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - R Dalton
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - S Springer
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - M Koozehchian
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - Y Jung
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - S Simbo
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - M Cho
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - C Goodenough
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - A Reyes
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - E Galvan
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - K Levers
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - K Wilkins
- Functional GeneticsInterleukin GeneticsWalthamMA
| | - C Rasmussen
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
| | - R Kreider
- Exercise & Sport Nutrition LabTexas A&M UniversityCollege StationTX
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Osadebe LU, Manthiram K, McCollum AM, Li Y, Emerson GL, Gallardo-Romero NF, Doty JB, Wilkins K, Zhao H, Drew CP, Metcalfe MG, Goldsmith CS, Muehlenbachs A, Googe PB, Dunn J, Duenckel T, Henderson H, Carroll DS, Zaki SR, Denison MR, Reynolds MG, Damon IK. Novel poxvirus infection in 2 patients from the United States. Clin Infect Dis 2015; 60:195-202. [PMID: 25301210 PMCID: PMC5854477 DOI: 10.1093/cid/ciu790] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Some human poxvirus infections can be acquired through zoonotic transmission. We report a previously unknown poxvirus infection in 2 patients, 1 of whom was immunocompromised; both patients had known equine contact. METHODS The patients were interviewed and clinical information was abstracted from the patients' medical files. Biopsies of the skin lesions were collected from both patients for histopathology, immunohistochemistry, and transmission electron microscopy analysis. Oral and skin swabs were collected from animals with frequent contact with the patients, and environmental sampling including rodent trapping was performed on the farm where the immunosuppressed patient was employed. "Pan-pox and high Guanine-cytosine" polymerase chain reaction assays were performed on patient, animal, and environmental isolates. Amplicon sequences of the viral DNA were used for agent identification and phylogenetic analysis. RESULTS Specimens from both human cases revealed a novel poxvirus. The agent shares 88% similarity to viruses in the Parapoxvirus genus and 78% to those in the Molluscipoxvirus genus but is sufficiently divergent to resist classification as either. All animal and environmental specimens were negative for poxvirus and both patients had complete resolution of lesions. CONCLUSIONS This report serves as a reminder that poxviruses should be considered in cutaneous human infections, especially in individuals with known barnyard exposures. The clinical course of the patients was similar to that of parapoxvirus infections, and the source of this virus is currently unknown but is presumed to be zoonotic. This report also demonstrates the importance of a comprehensive approach to diagnosis of human infections caused by previously unknown pathogens.
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Affiliation(s)
- Lynda U. Osadebe
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kalpana Manthiram
- Division of Pediatric Infectious Disease, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Andrea M. McCollum
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yu Li
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ginny L. Emerson
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nadia F. Gallardo-Romero
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeffrey B. Doty
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kimberly Wilkins
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hui Zhao
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Clifton P. Drew
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maureen G. Metcalfe
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cynthia S. Goldsmith
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Atis Muehlenbachs
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul B. Googe
- Knoxville Dermatopathology Laboratory, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John Dunn
- Tennessee Department of Health, Nashville, Tennessee
| | - Todd Duenckel
- Animal and Plant Health Inspection Service, US Department of Agriculture Regional Office, Nashville, Tennessee
| | | | - Darin S. Carroll
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherif R. Zaki
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark R. Denison
- Knoxville Dermatopathology Laboratory, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mary G. Reynolds
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Inger K. Damon
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
Although it has been >30 years since the eradication of smallpox, the unearthing of well-preserved tissue material in which the virus may reside has called into question the viability of variola virus decades or centuries after its original occurrence. Experimental data to address the long-term stability and viability of the virus are limited. There are several instances of well-preserved corpses and tissues that have been examined for poxvirus viability and viral DNA. These historical specimens cause concern for potential exposures, and each situation should be approached cautiously and independently with the available information. Nevertheless, these specimens provide information on the history of a major disease and vaccination against it.
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McCollum AM, Li Y, Wilkins K, Karem KL, Davidson WB, Paddock CD, Reynolds MG, Damon IK. Poxvirus viability and signatures in historical relics. Emerg Infect Dis 2014; 20:177-84. [PMID: 24447382 DOI: 10.3201/eid2002/131098] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although it has been >30 years since the eradication of smallpox, the unearthing of well-preserved tissue material in which the virus may reside has called into question the viability of variola virus decades or centuries after its original occurrence. Experimental data to address the long-term stability and viability of the virus are limited. There are several instances of well-preserved corpses and tissues that have been examined for poxvirus viability and viral DNA. These historical specimens cause concern for potential exposures, and each situation should be approached cautiously and independently with the available information. Nevertheless, these specimens provide information on the history of a major disease and vaccination against it.
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Zhao H, Wilkins K, Damon IK, Li Y. Specific qPCR assays for the detection of orf virus, pseudocowpox virus and bovine papular stomatitis virus. J Virol Methods 2013; 194:229-34. [DOI: 10.1016/j.jviromet.2013.08.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 08/16/2013] [Accepted: 08/21/2013] [Indexed: 10/26/2022]
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Emerson GL, Nordhausen R, Garner MM, Huckabee JR, Johnson S, Wohrle RD, Davidson WB, Wilkins K, Li Y, Doty JB, Gallardo-Romero NF, Metcalfe MG, Karem KL, Damon IK, Carroll DS. Novel poxvirus in big brown bats, northwestern United States. Emerg Infect Dis 2013; 19:1002-4. [PMID: 23735421 PMCID: PMC3713833 DOI: 10.3201/eid1906.121713] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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 wildlife hospital and rehabilitation center in northwestern United States received several big brown bats with necrosuppurative osteomyelitis in multiple joints. Wing and joint tissues were positive by PCR for poxvirus. Thin-section electron microscopy showed poxvirus particles within A-type inclusions. Phylogenetic comparison supports establishment of a new genus of Poxviridae.
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Affiliation(s)
- Ginny L Emerson
- Poxvirus Program, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G06, Atlanta, GA 30333, USA.
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Reisner AT, Khitrov MY, Chen L, Blood A, Wilkins K, Doyle W, Wilcox S, Denison T, Reifman J. Development and validation of a portable platform for deploying decision-support algorithms in prehospital settings. Appl Clin Inform 2013; 4:392-402. [PMID: 24155791 DOI: 10.4338/aci-2013-04-ra-0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 08/13/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Advanced decision-support capabilities for prehospital trauma care may prove effective at improving patient care. Such functionality would be possible if an analysis platform were connected to a transport vital-signs monitor. In practice, there are technical challenges to implementing such a system. Not only must each individual component be reliable, but, in addition, the connectivity between components must be reliable. OBJECTIVE We describe the development, validation, and deployment of the Automated Processing of Physiologic Registry for Assessment of Injury Severity (APPRAISE) platform, intended to serve as a test bed to help evaluate the performance of decision-support algorithms in a prehospital environment. METHODS We describe the hardware selected and the software implemented, and the procedures used for laboratory and field testing. RESULTS The APPRAISE platform met performance goals in both laboratory testing (using a vital-sign data simulator) and initial field testing. After its field testing, the platform has been in use on Boston MedFlight air ambulances since February of 2010. CONCLUSION These experiences may prove informative to other technology developers and to healthcare stakeholders seeking to invest in connected electronic systems for prehospital as well as in-hospital use. Our experiences illustrate two sets of important questions: are the individual components reliable (e.g., physical integrity, power, core functionality, and end-user interaction) and is the connectivity between components reliable (e.g., communication protocols and the metadata necessary for data interpretation)? While all potential operational issues cannot be fully anticipated and eliminated during development, thoughtful design and phased testing steps can reduce, if not eliminate, technical surprises.
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Reynolds MG, Emerson GL, Pukuta E, Karhemere S, Muyembe JJ, Bikindou A, McCollum AM, Moses C, Wilkins K, Zhao H, Damon IK, Karem KL, Li Y, Carroll DS, Mombouli JV. Detection of human monkeypox in the Republic of the Congo following intensive community education. Am J Trop Med Hyg 2013; 88:982-985. [PMID: 23400570 PMCID: PMC3752768 DOI: 10.4269/ajtmh.12-0758] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/16/2013] [Indexed: 11/24/2022] Open
Abstract
Monkeypox is an acute viral infection with a clinical course resembling smallpox. It is endemic in northern and central Democratic Republic of the Congo (DRC), but it is reported only sporadically in neighboring Republic of the Congo (ROC). In October 2009, interethnic violence in northwestern DRC precipitated the movement of refugees across the Ubangi River into ROC. The influx of refugees into ROC heightened concerns about monkeypox in the area, because of the possibility that the virus could be imported, or that incidence could increase caused by food insecurity and over reliance on bush meat. As part of a broad-based campaign to improve health standards in refugee settlement areas, the United Nations International Children's Emergency Fund (UNICEF) sponsored a program of intensive community education that included modules on monkeypox recognition and prevention. In the 6 months immediately following the outreach, 10 suspected cases of monkeypox were reported to health authorities. Laboratory testing confirmed monkeypox virus infection in two individuals, one of whom was part of a cluster of four suspected cases identified retrospectively. Anecdotes collected at the time of case reporting suggest that the outreach campaign contributed to detection of suspected cases of monkeypox.
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Affiliation(s)
- Mary G. Reynolds
- U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Institut National de Recherche Biomédicale, Kinshasa, République Démocratique du Congo; Medecins d'Afrique, Brazzaville, République du Congo; International Conservation and Education Fund, Washington, District of Columbia; Délégation Générale pour la Recherche Scientifique et Technique, Brazzaville, République du Congo
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Saunders C, Rowe G, Wilkins K, Collins P. Impact of glucose and acetate on the characteristics of the platelet storage lesion in platelets suspended in additive solutions with minimal plasma. Vox Sang 2013; 105:1-10. [PMID: 23347286 DOI: 10.1111/vox.12013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 10/22/2012] [Accepted: 10/23/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Glucose and acetate have been proposed to be required elements in platelet storage media. This study investigated the role of these compounds on the varied elements that comprise the platelet storage lesion. MATERIALS AND METHODS For each replicate, four pooled and split ABO group-specific buffy coat-derived platelet concentrates were suspended in an in-house additive solution with minimal plasma and varying final concentrations of acetate or glucose. Units were sampled on days 2, 3, 6, 8 and 10 and tested for markers of platelet morphology, activation, function, metabolism and indicators of cell death. RESULTS The absence of glucose was associated with a decrease in ATP, falling to a mean of 1·1 ± 0·1 μmol/10(11) plts in units with no added glucose compared with 4·2 ± 0·6 μmol/10(11) plts (P < 0·001) in units with 30 mm glucose. As glucose became depleted, the decrease in ATP to levels below 3 μmol/10(11) plts was associated with an increase in both annexin V binding and intracellular free calcium. In units lacking exogenous acetate, ATP levels on day 10 were 5·2 ± 1·5 μmol/10(11) plts compared with 2·7 ± 0·9 μmol/10(11) plts in units with 56 mm acetate (P = 0·006). Higher concentrations of exogenous acetate were associated with a lower hypotonic shock response and higher surface expression of CD62P suggestive of a dose dependency. CONCLUSION Under current physical storage conditions, glucose appears necessary for the maintenance of platelets stored as concentrates in minimal volumes of plasma. The addition of acetate was associated with increased platelet activation and reduced ATP levels.
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McCollum AM, Austin C, Nawrocki J, Howland J, Pryde J, Vaid A, Holmes D, Weil MR, Li Y, Wilkins K, Zhao H, Smith SK, Karem K, Reynolds MG, Damon IK. Investigation of the first laboratory-acquired human cowpox virus infection in the United States. J Infect Dis 2012; 206:63-8. [PMID: 22539811 DOI: 10.1093/infdis/jis302] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cowpox virus is an Orthopoxvirus that can cause infections in humans and a variety of animals. Infections occur in Eurasia; infections in humans and animals have not been reported in the United States. This report describes the occurrence of the first known human case of laboratory-acquired cowpox virus infection in the United States and the ensuing investigation. METHODS The patient and laboratory personnel were interviewed, and laboratory activities were reviewed. Real-time polymerase chain reaction (PCR) and serologic assays were used to test the patient's specimens. PCR assays were used to test specimens obtained during the investigation. RESULTS A specimen from the patient's lesion tested positive for cowpox virus DNA. Genome sequencing revealed a recombinant region consistent with a strain of cowpox virus stored in the research laboratory's freezer. Cowpox virus contamination was detected in 6 additional laboratory stocks of viruses. Orthopoxvirus DNA was present in 3 of 20 environmental swabs taken from laboratory surfaces. CONCLUSIONS The handling of contaminated reagents or contact with contaminated surfaces was likely the mode of transmission. Delays in recognition and diagnosis of this infection in a laboratory researcher underscore the importance of a thorough patient history-including occupational information-and laboratory testing in facilitating a prompt investigation and application of control and remediation measures.
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Affiliation(s)
- Andrea M McCollum
- Poxvirus Team, Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Young GE, Hidalgo CM, Sullivan-Frohm A, Schult C, Davis S, Kelly-Cirino C, Egan C, Wilkins K, Emerson GL, Noyes K, Blog D. Secondary and tertiary transmission of vaccinia virus from US military service member. Emerg Infect Dis 2011; 17:718-21. [PMID: 21470470 PMCID: PMC3377411 DOI: 10.3201/eid1704.101316] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [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] [Indexed: 11/19/2022] Open
Abstract
During February and March 2010, the New York State Department of Health investigated secondary and tertiary vaccinia contact transmission from a military vaccinee to 4 close contacts. Identification of these cases underscores the need for strict adherence to postvaccination infection control guidance to avoid transmission of the live virus.
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Affiliation(s)
- Gregory E Young
- New York State Department of Health, Buffalo, New York 14202, USA.
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Saunders C, Rowe G, Wilkins K, Holme S, Collins P. In vitro storage characteristics of platelet concentrates suspended in 70% SSP+TM additive solution versus plasma over a 14-day storage period. Vox Sang 2011; 101:112-21. [DOI: 10.1111/j.1423-0410.2011.01468.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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46
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Li Y, Zhao H, Wilkins K, Hughes C, Damon IK. Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA. J Virol Methods 2010; 169:223-7. [PMID: 20643162 PMCID: PMC9628942 DOI: 10.1016/j.jviromet.2010.07.012] [Citation(s) in RCA: 247] [Impact Index Per Article: 17.6] [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: 04/28/2010] [Revised: 06/30/2010] [Accepted: 07/12/2010] [Indexed: 10/19/2022]
Abstract
Orthopoxvirus monkeypox (MPXV) forms two distinct clades: the MPXV Congo Basin clade viruses are endemic in the Congo Basin, human illness typically presents with symptoms similar to discrete, ordinary smallpox and has a case fatality rate of approximately 10% in unvaccinated populations; the MPXV West African clade viruses have been isolated in West Africa and appear to cause a less severe, and less inter-human transmissible disease. Recently, monkeypox outbreaks were reported in US and Sudan caused by MPXV West African and Congo Basin strains respectively. These events demonstrated the ability and trend of the virus to exploit new hosts and emerge globally; it also emphasizes the need for the diagnosis of MPXV, especially the ability to distinguish between Congo Basin and West African monkeypox strains. In this study, three new real-time PCR assays based on TaqMan probe technology were reported: the MPXV West African specific, Congo Basin strain specific and MPXV generic assays. The new assays demonstrated good specificity and sensitivity in the validation study with multiple platforms and various PCR reagent kits, and will improve the rapid detection and differentiation of monkeypox infections from other rash illness.
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Affiliation(s)
- Yu Li
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology (Proposed), National Center for Emerging and Zoonotic Infectious Diseases (Proposed), Centers for Disease Control and Prevention, Atlanta, GA 30333, United States.
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47
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Ryman T, Macauley R, Nshimirimana D, Taylor P, Shimp L, Wilkins K. Reaching every district (RED) approach to strengthen routine immunization services: evaluation in the African region, 2005. J Public Health (Oxf) 2009; 32:18-25. [PMID: 19542268 DOI: 10.1093/pubmed/fdp048] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [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: 11/15/2022] Open
Abstract
BACKGROUND This evaluation was undertaken in 2005, in the African region, to better understand the reaching every district (RED) implementation process that provides a framework for strengthening immunization services at the district level. METHODS In June 2005, a convenience sample of five countries was selected to evaluate the implementation of RED. Evaluation teams consisting of key partners conducted site visits to the national, district and health facility levels using standardized qualitative questionnaires. RESULTS RED was implemented in a similar manner in all five countries, i.e. starting with training and micro-planning. All RED components were implemented to some degree in the countries. Common implementation factors included development of plans, expanding outreach services (defined as services provided in sites outside fixed immunization sites), planning of supervisory visits and efforts to link with communities and utilize community volunteers. Monitoring tools such as wall charts and maps were observed and reportedly used. CONCLUSIONS Evaluation of the RED implementation process provided evidence of improvement in delivery of routine immunization services. The RED framework should continue to be used to strengthen the immunization delivery system to meet continuing new demands, such as the introduction of new vaccines and integrated delivery of other child survival interventions.
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Affiliation(s)
- T Ryman
- Global Immunization Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E05, Atlanta, GA 30333, USA.
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Norton KJ, Wilkins K, O'Connor R, Wilson N, Edwards R, Peace J. Properties of "light" cigarettes sold in New Zealand. N Z Med J 2008; 121:107-10. [PMID: 18797495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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49
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McIntyre R, Wilkins K, Gilmour H, Soczynska J, Konarksi J, Miranda A, Woldeyohannes H, Vagic D, Alsuwaiden M, Kennedy S. The effect of bipolar I disorder and major depressive disorder on workforce function. ACTA ACUST UNITED AC 2008. [DOI: 10.24095/hpcdp.28.3.01] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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]
Abstract
This investigation was undertaken to explore and compare the effect of bipolar I disorder (BD) and major depressive disorder (MDD) on workforce function. The data for this analysis were procured from the Canadian Community Health Survey (CCHS 1.2). The sample consisted of 20 747 individuals (≥ 18 years old and currently working); the proportions screening positive for lifetime BD and MDD were 2.4% and 11.2%, respectively. Individuals with BD or MDD had a signifi cantly lower mean annual income, compared to people without these disorders. Individuals with BD had a signifi cantly lower annual income when compared to MDD (p $lt; 0.05). Results from a multiple logistic regression also indicate that employed individuals with BD had greater odds of reporting one or more mental health disability days in the past two weeks, compared with those with MDD (OR = 1.6; 95% CI = 1.0 to 2.6). Currently employed individuals with BD had lower odds of “good job security” relative to those with MDD (OR = 0.6 95% CI = 0.5 to 0.9). The data herein underscore the pernicious effect of BD on workforce function, and suggest that opportunistic screening for BD in all individuals utilizing employment assistance programs for depression might be warranted.
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Affiliation(s)
- R.S. McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON
- Department of Pharmacology, University of Toronto, Toronto, ON
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON
| | - K. Wilkins
- Health Statistics Division, Statistics Canada, Ottawa, ON
| | - H. Gilmour
- Health Statistics Division, Statistics Canada, Ottawa, ON
| | - J.K. Soczynska
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON
- Institute of Medical Science, University of Toronto, Toronto, ON
| | - J.Z. Konarksi
- Health Statistics Division, Statistics Canada, Ottawa, ON
| | - A. Miranda
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON
| | - H.O. Woldeyohannes
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON
| | - D. Vagic
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON
| | - M. Alsuwaiden
- Department of Psychiatry, University of Toronto, Toronto, ON
| | - S.H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON
- Institute of Medical Science, University of Toronto, Toronto, ON
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50
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McIntyre RS, Wilkins K, Gilmour H, Soczynska JK, Konarksi JZ, Miranda A, Woldeyohannes HO, Vagic D, Alsuwaidan M, Kennedy SH. The effect of bipolar I disorder and major depressive disorder on workforce function. Chronic Dis Can 2008; 28:84-91. [PMID: 18341762] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This investigation was undertaken to explore and compare the effect of bipolar I disorder (BD) and major depressive disorder (MDD) on workforce function. The data for this analysis were procured from the Canadian Community Health Survey (CCHS 1.2). The sample consisted of 20,747 individuals (>or=18 years or older and currently working); the proportions screening positive for lifetime BD and MDD were 2.4% and 11.2%, respectively. Individuals with BD or MDD had a significantly lower mean annual income, compared to people without these disorders. Individuals with BD had a significantly lower annual income when compared to MDD (p < 0.05). Results from a multiple logistic regression also indicate that employed individuals with BD had greater odds of reporting one or more mental health disability days in the past two weeks, compared with those with MDD (OR = 1.6; 95% CI = 1.0 to 2.6). Currently employed individuals with BD had lower odds of "good job security" relative to those with MDD (OR = 0.6 95% CI = 0.5 to 0.9). The data herein underscore the pernicious effect of BD on workforce function, and suggest that opportunistic screening for BD in all individuals utilizing employment assistance programs for depression might be warranted.
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Affiliation(s)
- R S McIntyre
- Department of Psychiatry, University of Toronto, ON, Canada.
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