1
|
Van Poelvoorde LAE, Gobbo A, Nauwelaerts SJD, Verhaegen B, Lesenfants M, Janssens R, Hutse V, Fraiture MA, De Keersmaecker S, Herman P, Van Hoorde K, Roosens N. Development of a reverse transcriptase digital droplet polymerase chain reaction-based approach for SARS-CoV-2 variant surveillance in wastewater. Water Environ Res 2024; 96:e10999. [PMID: 38414298 DOI: 10.1002/wer.10999] [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] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/16/2024] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
An urgent need for effective surveillance strategies arose due to the global emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although vaccines and antivirals are available, concerns persist about the evolution of new variants with potentially increased infectivity, transmissibility, and immune evasion. Therefore, variant monitoring is crucial for public health decision-making. Wastewater-based surveillance has proven to be an effective tool to monitor SARS-CoV-2 variants within populations. Specific SARS-CoV-2 variants are detected and quantified in wastewater in this study using a reverse transcriptase digital droplet polymerase chain reaction (RT-ddPCR) approach. The 11 designed assays were first validated in silico using a substantial dataset of high-quality SARS-CoV-2 genomes to ensure comprehensive variant coverage. The assessment of the sensitivity and specificity with reference material showed the capability of the developed assays to reliably identify target mutations while minimizing false positives and false negatives. The applicability of the assays was evaluated using wastewater samples from a wastewater treatment plant in Ghent, Belgium. The quantification of the specific mutations linked to the variants of concern present in these samples was calculated using these assays based on the detection of single mutations, which confirms their use for real-world variant surveillance. In conclusion, this study provides an adaptable protocol to monitor SARS-CoV-2 variants in wastewater with high sensitivity and specificity. Its potential for broader application in other viral surveillance contexts highlights its added value for rapid response to emerging infectious diseases. PRACTITIONER POINTS: Robust RT-ddPCR methodology for specific SARS-CoV-2 variants of concern detection in wastewater. Rigorous validation that demonstrates high sensitivity and specificity. Demonstration of real-world applicability using wastewater samples. Valuable tool for rapid response to emerging infectious diseases.
Collapse
Affiliation(s)
| | - Andrea Gobbo
- Transversal activities in Applied Genomics, Sciensano, Brussels, Belgium
| | | | | | - Marie Lesenfants
- Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | - Raphael Janssens
- Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | - Veronik Hutse
- Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | | | | | | | | | - Nancy Roosens
- Transversal activities in Applied Genomics, Sciensano, Brussels, Belgium
| |
Collapse
|
2
|
Riekkinen M, Pakkanen SH, Hutse V, Roukaerts I, Ollgren J, Käyhty H, Herzog C, Rombo L, Kantele A. Coadministered pneumococcal conjugate vaccine decreases immune response to hepatitis A vaccine: a randomized controlled trial. Clin Microbiol Infect 2023; 29:1553-1560. [PMID: 37572831 DOI: 10.1016/j.cmi.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES We explored the influence of coadministration on safety and immunogenicity of the most common travellers' vaccine hepatitis A (HepA) and the pneumococcal conjugate vaccine (PCV) increasingly used both at home and before travel. METHODS Volunteers aged ≥18 years (n = 305) were randomly assigned 1:1:1 into three groups receiving: 13-valent PCV (PCV13) + HepA, PCV13, or HepA. Anti-pneumococcal IgG concentrations, opsonophagocytic activity (OPA) titres, and total hepatitis A antibody (anti-HAV) concentrations were measured before and 28 ± 3 days after vaccination. Adverse events (AEs) were recorded over 4 weeks. RESULTS After vaccination, the anti-HAV geometric mean concentration was significantly lower in the PCV13+HepA than the HepA group: 34.47 mIU/mL (95% CI: 26.42-44.97 mIU/mL) versus 72.94 mIU/mL (95% CI: 55.01-96.72 mIU/mL), p < 0.001. Anti-HAV ≥10 mIU/mL considered protective was reached by 71 of 85 (83.5%) in the PCV13+HepA group versus 76 of 79 (96.2%) in the HepA group, p 0.008. The increases in anti-pneumococcal IgG and OPA levels were comparable in the PCV13+HepA and PCV13 groups, apart from a bigger rise in the PCV13+HepA group for serotype 3 (one-way ANOVA: serotype 3 IgG p 0.010, OPA p 0.002). AEs proved more frequent among those receiving PCV13 than HepA, but simultaneous administration did not increase the rates: ≥one AE was reported by 45 of 56 (80.4%) PCV13, 43 of 54 (79.6%) PCV13+HepA, and 25 of 53 (47.2%) HepA recipients providing structured AE data. DISCUSSION Coadministration of HepA and PCV13 did not cause safety concerns, nor did it impact the patients' response to PCV13, apart from serotype 3. However, coadministered PCV13 significantly impaired antibody responses to HepA.
Collapse
Affiliation(s)
- Marianna Riekkinen
- Meilahti Vaccine Research Center, MeVac, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland; Human Microbiome Research Unit, University of Helsinki, Helsinki, Finland; Travel Clinic, Aava Medical Center, Helsinki, Finland
| | - Sari H Pakkanen
- Meilahti Vaccine Research Center, MeVac, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Human Microbiome Research Unit, University of Helsinki, Helsinki, Finland
| | - Veronik Hutse
- National Reference Centre of Hepatitis Viruses, Infectious Diseases in Humans, Sciensano Laboratory, Brussels, Belgium
| | - Inge Roukaerts
- National Reference Centre of Hepatitis Viruses, Infectious Diseases in Humans, Sciensano Laboratory, Brussels, Belgium
| | - Jukka Ollgren
- Infectious Disease Control and Vaccination Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Helena Käyhty
- Infectious Disease Control and Vaccination Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Christian Herzog
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Lars Rombo
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center, Uppsala University, Uppsala, Sweden; Centre for Clinical Research, Sörmland County Council, Eskilstuna, Sweden
| | - Anu Kantele
- Meilahti Vaccine Research Center, MeVac, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland; Human Microbiome Research Unit, University of Helsinki, Helsinki, Finland; Travel Clinic, Aava Medical Center, Helsinki, Finland.
| |
Collapse
|
3
|
Tobback E, Degroote S, Buysse S, Delesie L, Van Dooren L, Vanherrewege S, Barbezange C, Hutse V, Romano M, Thomas I, Padalko E, Callens S, De Scheerder MA. Efficacy and safety of camostat mesylate in early COVID-19 disease in an ambulatory setting: a randomized placebo-controlled phase II trial. Int J Infect Dis 2022; 122:628-635. [PMID: 35803469 PMCID: PMC9254441 DOI: 10.1016/j.ijid.2022.06.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 04/29/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES This study aimed to assess the efficacy and safety of 300 mg camostat mesylate three times daily in a fasted state to treat early phase COVID-19 in an ambulatory setting. METHODS We conducted a phase II randomized controlled trial in symptomatic (maximum 5 days) and asymptomatic patients with confirmed COVID-19 infection. Patients were randomly assigned in a 2:1 ratio to receive either camostat mesylate or a placebo. Outcomes included change in nasopharyngeal viral load, time to clinical improvement, the presence of neutralizing antibodies, and safety. RESULTS Of 96 participants randomized between November 2020 and June 2021, analyses were performed on the data of 90 participants who completed treatment (N = 61 camostat mesylate, N = 29 placebo). The estimated mean change in cycle threshold between day 1 and day 5 between the camostat and placebo group was 1.183 (P = 0.511). The unadjusted hazard ratio for clinical improvement in the camostat group was 0.965 (95% confidence interval, 0.480-1.942, P = 0.921 by Cox regression). The percentage distribution of the 50% neutralizing antibody titer at day 28 visit and frequency of adverse events were similar between the two groups. CONCLUSION Under this protocol, camostat mesylate was not found to be effective as an antiviral drug against SARS-CoV-2. TRIAL REGISTRATION ClinicalTrials.gov NCT04625114; November 12, 2020.
Collapse
Affiliation(s)
- Els Tobback
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Sophie Degroote
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Sabine Buysse
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Liesbeth Delesie
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Lucas Van Dooren
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Sophie Vanherrewege
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Cyril Barbezange
- National Influenza Centre, Sciensano, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Veronik Hutse
- National Influenza Centre, Sciensano, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Marta Romano
- Immune Response Service, Sciensano, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Isabelle Thomas
- National Influenza Centre, Sciensano, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Elizaveta Padalko
- Department of Laboratory Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Steven Callens
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Marie-Angélique De Scheerder
- Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| |
Collapse
|
4
|
Mortgat L, Verdonck K, Hutse V, Thomas I, Barbezange C, Heyndrickx L, Fischer N, Vuylsteke B, Kabouche I, Ariën KK, Desombere I, Duysburgh E. Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study. BMJ Open 2021; 11:e050824. [PMID: 34187832 PMCID: PMC8245288 DOI: 10.1136/bmjopen-2021-050824] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/25/2021] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To describe prevalence and incidence of anti-SARS-CoV-2 antibodies among Belgian hospital healthcare workers (HCW) in April-December 2020. DESIGN Prospective cohort study. Follow-up was originally planned until September and later extended. SETTING Multicentre study, 17 hospitals. PARTICIPANTS 50 HCW were randomly selected per hospital. HCW employed beyond the end of the study and whose profession involved contact with patients were eligible. 850 HCW entered the study in April-May 2020, 673 HCW (79%) attended the September visit and 308 (36%) the December visit. OUTCOME MEASURES A semiquantitative ELISA was used to detect IgG against SARS-CoV-2 in serum (Euroimmun) at 10 time points. In seropositive samples, neutralising antibodies were measured using a virus neutralisation test. Real-time reverse transcription PCR (RT-qPCR) was performed to detect SARS-CoV-2 on nasopharyngeal swabs. Participant characteristics and the presence of symptoms were collected via an online questionnaire. RESULTS Among all participants, 80% were women, 60% nurses and 21% physicians. Median age was 40 years. The seroprevalence remained relatively stable from April (7.7% (95% CI: 4.8% to 12.1%) to September (8.2% (95% CI: 5.7% to 11.6%)) and increased thereafter, reaching 19.7% (95% CI: 12.0% to 30.6%) in December 2020. 76 of 778 initially seronegative participants seroconverted during the follow-up (incidence: 205/1000 person-years). Among all seropositive individuals, 118/148 (80%) had a positive neutralisation test, 83/147 (56%) presented or reported a positive RT-qPCR, and 130/147 (88%) reported COVID-19-compatible symptoms at least once. However, only 46/73 (63%) of the seroconverters presented COVID-19-compatible symptoms in the month prior to seroconversion. CONCLUSIONS The seroprevalence among hospital HCW was slightly higher than that of the general Belgian population but followed a similar evolution, suggesting that infection prevention and control measures were effective and should be strictly maintained. After two SARS-CoV-2 waves, 80% of HCW remained seronegative, justifying their prioritisation in the vaccination strategy. TRIAL REGISTRATION NUMBER NCT04373889.
Collapse
Affiliation(s)
- Laure Mortgat
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- European Programme for Intervention Epidemiology Training (EPIET), ECDC, Solna, Sweden
| | - Kristien Verdonck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Veronik Hutse
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Isabelle Thomas
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Cyril Barbezange
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Leo Heyndrickx
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Natalie Fischer
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
- European Public Health Microbiology Training (EUPHEM), ECDC, Solna, Sweden
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ines Kabouche
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Kevin K Ariën
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Isabelle Desombere
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Els Duysburgh
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| |
Collapse
|
5
|
Duysburgh E, Mortgat L, Barbezange C, Dierick K, Fischer N, Heyndrickx L, Hutse V, Thomas I, Van Gucht S, Vuylsteke B, Ariën KK, Desombere I. Persistence of IgG response to SARS-CoV-2. Lancet Infect Dis 2020; 21:163-164. [PMID: 33341124 PMCID: PMC7833610 DOI: 10.1016/s1473-3099(20)30943-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Els Duysburgh
- Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
| | - Laure Mortgat
- Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium; European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Cyril Barbezange
- Department of Infectious Diseases in Humans, Sciensano, 1050 Brussels, Belgium
| | - Katelijne Dierick
- Department of Infectious Diseases in Humans, Sciensano, 1050 Brussels, Belgium
| | - Natalie Fischer
- Department of Infectious Diseases in Humans, Sciensano, 1050 Brussels, Belgium; European Public Health Microbiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Leo Heyndrickx
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Veronik Hutse
- Department of Infectious Diseases in Humans, Sciensano, 1050 Brussels, Belgium
| | - Isabelle Thomas
- Department of Infectious Diseases in Humans, Sciensano, 1050 Brussels, Belgium
| | - Steven Van Gucht
- Department of Infectious Diseases in Humans, Sciensano, 1050 Brussels, Belgium
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kevin K Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Isabelle Desombere
- Department of Infectious Diseases in Humans, Sciensano, 1050 Brussels, Belgium
| |
Collapse
|
6
|
Ho E, Schenk J, Hutse V, Suin V, Litzroth A, Blaizot S, Herzog SA, Verburgh V, Jacques M, Rahman A, Michielsen P, Van Damme P, Van Gucht S, Theeten H, Hens N, Vanwolleghem T. Stable HEV IgG seroprevalence in Belgium between 2006 and 2014. J Viral Hepat 2020; 27:1253-1260. [PMID: 32564516 DOI: 10.1111/jvh.13347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/15/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022]
Abstract
Recent European studies suggest an emergence of hepatitis E virus (HEV) infection. We evaluated trends in birth cohort-specific HEV seroprevalence and regional differences in Belgium. HEV IgG seroprevalence was analysed on national serum banks (1579 and 2087 samples for 2006 and 2014, respectively. Hepatitis E virus antigen was tested on positive samples. Observed data were modelled using a generalized additive model with a complementary log-log link. No significant differences between birth cohorts or sexes were found. Modelling identified the individual's age and province as relevant factors. The probability of HEV seropositivity increases significantly with age. An estimated total of 434 819 (yearly rate of 54,352) (sero-)infections were found between 2006 and 2014. Overall, HEV IgG seroprevalences were 4.1% (64/1579, 95% CI 3.1-5.1) and 5.8% (121/2087, CI 4.8-6.9) in 2006 and 2014, respectively. Observed HEV antigen seroprevalence was 0.027% (1/3666) for the entire cohort. These results show stable HEV IgG seroprevalence in Belgium.
Collapse
Affiliation(s)
- Erwin Ho
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.,Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Julie Schenk
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium.,Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Veronik Hutse
- Scientific Directorate Infectious Diseases in Humans, National Reference Centre for Hepatitis Viruses, Sciensano, Belgium
| | - Vanessa Suin
- Scientific Directorate Infectious Diseases in Humans, National Reference Centre for Hepatitis Viruses, Sciensano, Belgium
| | - Amber Litzroth
- Scientific Directorate Epidemiology and Public Health, Sciensano, Belgium
| | - Stéphanie Blaizot
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Sereina A Herzog
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vera Verburgh
- Scientific Directorate Infectious Diseases in Humans, National Reference Centre for Hepatitis Viruses, Sciensano, Belgium
| | - Marjorie Jacques
- Scientific Directorate Infectious Diseases in Humans, National Reference Centre for Hepatitis Viruses, Sciensano, Belgium
| | - Abbas Rahman
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Peter Michielsen
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.,Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Steven Van Gucht
- Scientific Directorate Infectious Diseases in Humans, National Reference Centre for Hepatitis Viruses, Sciensano, Belgium
| | - Heidi Theeten
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium.,Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Thomas Vanwolleghem
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.,Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
7
|
Suin V, Klamer SE, Hutse V, Wautier M, Jacques M, Abady M, Lamoral S, Verburgh V, Thomas I, Brochier B, Subissi L, Van Gucht S. Epidemiology and genotype 3 subtype dynamics of hepatitis E virus in Belgium, 2010 to 2017. ACTA ACUST UNITED AC 2020; 24. [PMID: 30862337 PMCID: PMC6415497 DOI: 10.2807/1560-7917.es.2019.24.10.1800141] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 12/27/2022]
Abstract
BackgroundHepatitis E virus (HEV) is an emerging public health concern in high-income countries and can cause acute and chronic hepatitis. Reported numbers of indigenously acquired HEV infection have increased in the past decade in many European countries. Since 2010, the National Reference Centre (NRC) for Hepatitis Viruses has been testing samples of suspected hepatitis E cases in Belgium.AimIn this surveillance report, we present the epidemiological trends of symptomatic HEV infections in Belgium, from the distribution by age, sex and geography to the molecular characterisation of the viral strains.MethodSerum samples of suspected cases sent to the NRC between 2010 and 2017 were analysed for the presence of HEV-specific IgM and RNA. Virus was sequenced for genotyping and phylogenetic analysis in all samples containing sufficient viral RNA.ResultsThe NRC reported an increase in the number of samples from suspected cases (from 309 to 2,663 per year) and in the number of laboratory-confirmed hepatitis E cases (from 25 to 117 per year). Among 217 sequenced samples, 92.6% were genotype 3 (HEV-3), followed by 6.5% of genotype 1 and 0.9% of genotype 4. HEV-3 subtype viruses were mainly 3f, 3c and 3e. HEV-3f was the most common subtype until 2015, while HEV-3c became the most common subtype in 2016 and 2017.ConclusionThe increasing trend of HEV diagnoses in Belgium may be largely explained by increased awareness and testing.
Collapse
Affiliation(s)
- Vanessa Suin
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Sofieke E Klamer
- European Program for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden.,Epidemiology of Infectious Diseases, Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Veronik Hutse
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Magali Wautier
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Marjorie Jacques
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Mona Abady
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Sophie Lamoral
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Vera Verburgh
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Isabelle Thomas
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Bernard Brochier
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Lorenzo Subissi
- European Program for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden.,National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Steven Van Gucht
- National Reference Centre of Hepatitis Viruses, Viral Diseases, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| |
Collapse
|
8
|
Muyldermans G, Bielen R, Botterman R, Bourgeois S, Colle I, Deressa B, Devolder G, Horsmans Y, Hutse V, Lanthier N, Lasser L, Platteau S, Robaeys G, Suin V, Verhelst X, Van Vlierberghe H, Van Baelen L. Hepatitis C virus (HCV) prevalence estimation in the adult general population in Belgium : a meta-analysis. Acta Gastroenterol Belg 2019; 82:479-485. [PMID: 31950802] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND STUDY AIMS Although multiple HCV prevalence studies were recently performed in the general population from Belgium, they suffer from a lack of geographical representativeness, an insufficient number of participants or a lack of inclusion of high prevalence groups. The aim of this study is to provide robust information on the HCV burden. METHODS Recently performed HCV prevalence studies in the general, adult population were included in this study, based on well-defined selection criteria. A meta-analysis was performed to estimate the seroprevalence, the prevalence of participants with viremia and the prevalence estimation for people with viremia which were unaware of their status. RESULTS Eight studies fulfilled the criteria for inclusion of the quantitative prevalence estimation. Based on the meta-analysis on these 8 studies, we estimated an HCV seroprevalence of 1.01% [95% CI : 0.66-1.42%], representing a total of 90,722 adult, HCV seropositives of which 64,412 individuals (0.71%) were confirmed seropositive. Based on the RNA presence, an estimated viremic prevalence of 0.33% [95% CI : 0.21-0.47 %] was determined, corresponding with 29,642 individuals. This is 46,0% of the true HCV seropositive residents. Further, based on the availability of patient information in 5 out of the 8 studies, a prevalence of 0.18% [95% CI : 0.07-0.33] representing 16,168 individuals from the adult Belgian population are unaware of their HCV status. CONCLUSIONS We believe that the quantitative measurement by the meta-analysis will be more reliable for their use in the design of a screening strategy or in the development of prevention campaigns as compared to the prevalence estimations performed at local level.
Collapse
Affiliation(s)
| | - R Bielen
- Department of Gastroenterology, Ziekenhuis-Oost Limburg, Genk, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| | - R Botterman
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - S Bourgeois
- Department of Gastroenterology and Hepatology, ZNA Antwerp, Antwerp, Belgium
| | - I Colle
- Department of Hepatology and Gastroenterology and Intensive Care Unit, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
| | - B Deressa
- Hepatogastroenterology Department, CHU Brugmann Brussels, Belgium
| | - G Devolder
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Y Horsmans
- Service d'Hépato-gastroentérologie, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Belgium
| | - V Hutse
- Sciensano, Brussels, Belgium
| | - N Lanthier
- Service d'Hépato-gastroentérologie, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Belgium
| | - L Lasser
- Hepatogastroenterology Department, CHU Brugmann Brussels, Belgium
| | - S Platteau
- Department of Hepatology and Gastroenterology and Intensive Care Unit, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
| | - G Robaeys
- Department of Gastroenterology, Ziekenhuis-Oost Limburg, Genk, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals KULeuven, Herestraat 49, 3000 Leuven, Belgium
| | - V Suin
- Sciensano, Brussels, Belgium
| | - X Verhelst
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - H Van Vlierberghe
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | | |
Collapse
|
9
|
Vermeire T, Barbezange C, Francart A, Hamouda A, Litzroth A, Hutse V, Martens L, Vandermarliere E, Van Gucht S. Sera from different age cohorts in Belgium show limited cross-neutralization between the mumps vaccine and outbreak strains. Clin Microbiol Infect 2019; 25:907.e1-907.e6. [DOI: 10.1016/j.cmi.2018.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/05/2018] [Accepted: 11/10/2018] [Indexed: 11/30/2022]
|
10
|
Litzroth A, Suin V, Wyndham-Thomas C, Quoilin S, Muyldermans G, Vanwolleghem T, Kabamba-Mukadi B, Verburgh V, Jacques M, Van Gucht S, Hutse V. Low hepatitis C prevalence in Belgium: implications for treatment reimbursement and scale up. BMC Public Health 2019; 19:39. [PMID: 30621662 PMCID: PMC6325873 DOI: 10.1186/s12889-018-6347-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 09/21/2018] [Accepted: 12/19/2018] [Indexed: 01/20/2023] Open
Abstract
Background Prevalence data of chronic hepatitis C virus (HCV) infection are needed to estimate the budgetary impact of reimbursement of direct-acting antivirals (DAAs). In Belgium, the restricted reimbursement criteria are mainly guided by regional seroprevalence estimates of 0.87% from 1993 to 1994. In this first Belgian nationwide HCV prevalence study, we set out to update the seroprevalence and prevalence of chronic HCV infection estimates in the Belgian general population in order to guide decisions on DAA reimbursement. Methods Residual sera were collected through clinical laboratories. We collected data on age, sex and district. HCV antibody status was determined with ELISA and confirmed with a line-immunoassay (LIA). In specimens with undetermined or positive LIA result, HCV viral load was measured. Specimens were classified seronegative, seropositive with resolved infection, indicative of chronic infection and with undetermined HCV status according to the test outcomes. Results were standardized for age, sex and population per district, and adjusted for clustered sampling. Results In total 3209 specimens, collected by 28 laboratories, were tested. HCV seropositivity in the Belgian general population was estimated to be 0.22% (95% CI: 0.09–0.54%), and prevalence of chronic HCV infection 0.12% (95% CI: 0.03–0.41). In individuals of 20 years and older, these estimates were 0.26% (95% CI: 0.10–0.64%) and 0.13% (95% CI: 0.04–0.43), respectively. Of the total estimated number of HCV seropositive individuals in Belgium, 66% were between 50 and 69 years old. Conclusions Prevalence of HCV seropositivity and chronic infection in the Belgian general population were low and comparable to many surrounding countries. These adjusted prevalences can help estimate the cost of reimbursement of DAAs and invite Belgian policy makers to accelerate the scaling up of reimbursement, giving all chronically infected HCV patients a more timely access to treatment.
Collapse
Affiliation(s)
- Amber Litzroth
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium.
| | - Vanessa Suin
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Chloé Wyndham-Thomas
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Sophie Quoilin
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Gaëtan Muyldermans
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Thomas Vanwolleghem
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken Building S, Universiteitsplein 1, 2610, Wilrijk, Belgium.,Department of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Benoît Kabamba-Mukadi
- Microbiology department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Vera Verburgh
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Marjorie Jacques
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Steven Van Gucht
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Veronik Hutse
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| |
Collapse
|
11
|
Bouacida L, Suin V, Hutse V, Boudewijns M, Cartuyvels R, Debaisieux L, De Laere E, Hallin M, Hougardy N, Lagrou K, Oris E, Padalko E, Reynders M, Roussel G, Senterre JM, Stalpaert M, Ursi D, Vael C, Vaira D, Van Acker J, Verstrepen W, Van Gucht S, Kabamba B, Quoilin S, Muyldermans G. Distribution of HCV genotypes in Belgium from 2008 to 2015. PLoS One 2018; 13:e0207584. [PMID: 30517127 PMCID: PMC6281185 DOI: 10.1371/journal.pone.0207584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 03/30/2018] [Accepted: 11/03/2018] [Indexed: 01/25/2023] Open
Abstract
Background The knowledge of circulating HCV genotypes and subtypes in a country is crucial to guide antiviral therapy and to understand local epidemiology. Studies investigating circulating HCV genotypes and their trends have been conducted in Belgium. However they are outdated, lack nationwide representativeness or were not conducted in the general population. Methods In order to determine the distribution of different circulating HCV genotypes in Belgium, we conducted a multicentre study with all the 19 Belgian laboratories performing reimbursed HCV genotyping assays. Available genotype and subtype data were collected for the period from 2008 till 2015. Furthermore, a limited number of other variables were collected: some demographic characteristics from the patients and the laboratory technique used for the determination of the HCV genotype. Results For the study period, 11,033 unique records collected by the participating laboratories were used for further investigation. HCV genotype 1 was the most prevalent (53.6%) genotype in Belgium, with G1a and G1b representing 19.7% and 31.6%, respectively. Genotype 3 was the next most prevalent (22.0%). Further, genotype 4, 2, and 5 were responsible for respectively 16.1%, 6.2%, and 1.9% of HCV infections. Genotype 6 and 7 comprise the remaining <1%. Throughout the years, a stable distribution was observed for most genotypes. Only for genotype 5, a decrease as a function of the year of analysis was observed, with respectively 3.6% for 2008, 2.3% for 2009 and 1.6% for the remaining years. The overall M:F ratio was 1.59 and was mainly driven by the high M:F ratio of 3.03 for patients infected with genotype 3. Patients infected with genotype 3 are also younger (mean age 41.7 years) than patients infected with other genotypes (mean age above 50 years for all genotypes). The patients for whom a genotyping assay was performed in 2008 were younger than those from 2015. Geographical distribution demonstrates that an important number of genotyped HCV patients live outside the Belgian metropolitan cities. Conclusion This national monitoring study allowed a clear and objective view of the circulating HCV genotypes in Belgium and will help health authorities in the establishment of cost effectiveness determinations before implementation of new treatment strategies. This baseline characterization of the circulating genotypes is indispensable for a continuous surveillance, especially for the investigation of the possible impact of migration from endemic regions and prior to the increasing use of highly potent direct-acting antiviral (DAA) agents.
Collapse
Affiliation(s)
- Lobna Bouacida
- Sciensano, Laboratory of medical microbiology, Brussels, Belgium
| | - Vanessa Suin
- Sciensano, Viral diseases, Brussels, Belgium
- National reference center for hepatitis viruses, Belgium, Belgium
| | - Veronik Hutse
- Sciensano, Viral diseases, Brussels, Belgium
- National reference center for hepatitis viruses, Belgium, Belgium
| | | | | | | | | | | | - Nicolas Hougardy
- Clin. Sud Luxembourg, Site St-Joseph Labo D'analyses Médicales, Arlon, Belgium
| | - Katrien Lagrou
- UZ Leuven, Clinical Department of Laboratory Medicine, Leuven, and-KU Leuven, Department of Microbiology and Immunology, Leuven, Belgium
| | - Els Oris
- Ziekenhuis Oost-Limburg, Labo Klinische Biologie, Genk, Belgium
| | - Elizaveta Padalko
- UZ Ghent, Clinical Biology–Medical Microbiology Laboratory, Ghent, Belgium
| | - Marijke Reynders
- AZ Sint-Jan Brugge-Oostende AV, Laboratory Medicine, Brugge, Belgium
| | - Gatien Roussel
- Clinique St. Pierre, Laboratoire De Biologie Clinique, Ottignies, Belgium
| | | | | | - Dominique Ursi
- University Hospital Antwerp, Laboratory of Molecular Diagnostics in Microbiology, Antwerp, Belgium
| | - Carl Vael
- AZ KLINA, Clinical Laboratory, Brasschaat, Belgium
| | - Dolores Vaira
- CHU de Liège, Laboratoire de Référence SIDA-ULg, Liège, Belgium
| | | | | | - Steven Van Gucht
- Sciensano, Viral diseases, Brussels, Belgium
- National reference center for hepatitis viruses, Belgium, Belgium
| | - Benoit Kabamba
- National reference center for hepatitis viruses, Belgium, Belgium
- Cliniques Universitaires Saint-Luc, Labo Biologie Clinique Ria, Brussels, Belgium
| | - Sophie Quoilin
- Sciensano, Epidemiology of infectious diseases, Brussels, Belgium
| | - Gaëtan Muyldermans
- Sciensano, Epidemiology of infectious diseases, Brussels, Belgium
- * E-mail:
| |
Collapse
|
12
|
Cattoir L, Van Hoecke F, Van Maerken T, Nys E, Ryckaert I, De Boulle M, Geerts A, Verhelst X, Colle I, Hutse V, Suin V, Wautier M, Van Gucht S, Van Vlierberghe H, Padalko E. Clinical burden of hepatitis E virus infection in a tertiary care center in Flanders, Belgium. J Clin Virol 2018; 103:8-11. [DOI: 10.1016/j.jcv.2018.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 10/17/2022]
|
13
|
Grammens T, Schirvel C, Leenen S, Shodu N, Hutse V, Mendes da Costa E, Sabbe M. Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges. ACTA ACUST UNITED AC 2017; 22:30524. [PMID: 28488998 PMCID: PMC5434888 DOI: 10.2807/1560-7917.es.2017.22.17.30524] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/27/2017] [Indexed: 11/20/2022]
Abstract
We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management.
Collapse
Affiliation(s)
- Tine Grammens
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Carole Schirvel
- Infectious Disease Surveillance Unit, Agence pour une Vie de Qualité (AVIQ), Walloon region, Charleroi, Belgium
| | - Sylvie Leenen
- Infectious Disease Surveillance Unit, Agence pour une Vie de Qualité (AVIQ), Walloon region, Charleroi, Belgium
| | - Nathalie Shodu
- Infectious Disease Surveillance Unit, Agence pour une Vie de Qualité (AVIQ), Walloon region, Charleroi, Belgium
| | - Veronik Hutse
- National Reference Centre for measles, mumps and rubella, Service of Viral Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - Elise Mendes da Costa
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Martine Sabbe
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| |
Collapse
|
14
|
Cattoir L, Van Hoecke F, Van Maerken T, Nys E, Ryckaert I, De Boulle M, Geerts A, Verhelst X, Colle I, Hutse V, Suin V, Wautier M, Van Gucht S, Van Vlierberghe H, Padalko E. Hepatitis E virus serology and PCR: does the methodology matter? Arch Virol 2017; 162:2625-2632. [DOI: 10.1007/s00705-017-3395-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/26/2017] [Indexed: 12/27/2022]
|
15
|
Grammens T, Maes V, Hutse V, Laisnez V, Schirvel C, Trémérie JM, Sabbe M. Different measles outbreaks in Belgium, January to June 2016 - a challenge for public health. ACTA ACUST UNITED AC 2017; 21:30313. [PMID: 27541858 PMCID: PMC4998501 DOI: 10.2807/1560-7917.es.2016.21.32.30313] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 07/18/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Abstract
During the first half of 2016, several outbreaks of measles were reported in the three regions of Belgium. Main challenges for public health were severe complications occurring in adults, nosocomial transmission and infection in healthcare workers. Here, we describe those outbreaks and lessons learnt for public health.
Collapse
Affiliation(s)
- Tine Grammens
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | | | | | | | | | | | | |
Collapse
|
16
|
Vermeire T, Vermaere S, Van Gucht S, Hutse V, Martens L, Vandermarliere E. Computational analysis of mumps surface proteins reveals their interaction mechanism. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
Leuridan E, Maertens K, Wautier M, Hutse V, Theeten H. Susceptibility to measles, mumps, and rubella in 5-year-old children in Flanders, Belgium. Eur J Pediatr 2015; 174:925-32. [PMID: 25579232 DOI: 10.1007/s00431-014-2481-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/28/2014] [Accepted: 12/12/2014] [Indexed: 11/29/2022]
Abstract
UNLABELLED The second dose of an MMR vaccine is a catch up for persons who did not receive the first dose or for primary vaccine failures. Catch up doses can be scheduled according to convenience into the program of the country. The second MMR dose is often administered at the age of 5 years, before school entry. Some countries chose to implement the second dose at the age of 10-13 years, as is the case for Belgium. The here presented long-term follow-up of a cohort of children, set up originally to analyze maternal antibodies against vaccine preventable diseases, offers a unique opportunity to evaluate ad interim the current long-interval MMR vaccination schedule in Belgium. After 1 MMR dose at 12 months of age, rubella immunity is almost intact at 5 years of age (94.5 % is seropositive), measles seropositivity scores 86.8 %, and mumps 32 %, measured with ELISA. A seroneutralization (SN) test for mumps antibodies reveals much higher seropositivity rates (88 %). Using a regression model on the log (IgG) titer for all antigens, no influence was found from any of the studied variables, except for girls who had a significantly higher rubella IgG titer (p=0.002) compared to boys. CONCLUSION The data show considerable susceptibility to mumps and measles in 5-year-old children, confirming a previously conducted seroprevalence study (2006). Both advantages and disadvantages of shortening or enlarging the vaccine schedule are discussed.
Collapse
Affiliation(s)
- E Leuridan
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium,
| | | | | | | | | |
Collapse
|
18
|
Braeye T, Linina I, De Roy R, Hutse V, Wauters M, Cox P, Mak R. Mumps increase in Flanders, Belgium, 2012–2013: Results from temporary mandatory notification and a cohort study among university students. Vaccine 2014; 32:4393-4398. [DOI: 10.1016/j.vaccine.2014.06.069] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 06/03/2014] [Accepted: 06/13/2014] [Indexed: 11/17/2022]
|
19
|
Fransen K, Vermoesen T, Beelaert G, Menten J, Hutse V, Wouters K, Platteau T, Florence E. Using conventional HIV tests on oral fluid. J Virol Methods 2013; 194:46-51. [PMID: 23969313 DOI: 10.1016/j.jviromet.2013.08.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/31/2013] [Accepted: 08/02/2013] [Indexed: 01/08/2023]
Abstract
There is need for more evaluations of non-invasive tests in order to broaden the reach of testing programs and to perform large scale epidemiological studies. In this study, three different human immunodeficiency virus (HIV) enzyme linked immunosorbent assays (ELISAs) and one line immunoassay were evaluated to detect HIV antibodies in oral fluid samples. Specimens were collected, after informed consent was obtained, with the Oracol (MMD, Worcester, England) device. A total IgG quantitation test was performed to demonstrate the quality of the sample. Assessment of a modified protocol of the Vironostika HIV Ag/Ab, Enzygnost Anti-HIV 1/2 Plus Genscreen HIV-1/2 Version 2 and a line immune confirmatory assay the INNO-LIA HIV I/II score was done, using oral fluid specimens of 325 HIV positive and negative individuals. For the ELISAs, the addition of an extra internal oral fluid control was evaluated as well as different cut-offs, time between sampling and testing and the effect of drinking water just before sampling. Finally, the confirmatory test and some testing algorithms and combination of tests were discussed. The results obtained from the oral fluid specimens were compared with the gold standard on paired serum specimens. Firstly, there was no significant difference observed between the use of the kit controls and the oral fluid controls. New protocols and calculation of cut-offs were defined for two of the three ELISAs. High sensitivities and specificities were obtained with all three ELISAs without any statistical difference between the three tests. Secondly, no statistically significant difference was observed when samples were stored for different time periods between sampling and testing, meaning that a period of seven days at room temperature before testing is still acceptable. Thirdly, drinking water before sample collection did not interfere with the testing, although lower optical densities were observed. None of the positive samples were missed. In addition, the line immunoassay INNO-LIA HIV I/II score test is a promising test for confirmation of reactive oral fluid specimen, but more samples need to be validated in order to adapt the interpretation rules specifically for oral fluid specimens. Different choices/algorithms adapted for the purpose of testing can be proposed. In conclusion, it can be said that the commercial ELISAs with adapted protocol and cut-off values are suitable tools for making HIV test performance accessible to people. With this non-invasive sampling method, more eligible individuals can and will be selected for further HIV test on blood.
Collapse
Affiliation(s)
- K Fransen
- Department of Clinical Science, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Braeye T, Sabbe M, Hutse V, Flipse W, Godderis L, Top G. Obstacles in measles elimination: an in-depth description of a measles outbreak in Ghent, Belgium, spring 2011. ACTA ACUST UNITED AC 2013; 71:17. [PMID: 23834074 PMCID: PMC3716678 DOI: 10.1186/0778-7367-71-17] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 06/24/2013] [Indexed: 12/03/2022]
Abstract
Background From Mid-February to April 2011 one of the largest measles-outbreak in Flanders, since the start of the 2-dose vaccination scheme in 1995, took place in Ghent, Belgium. The outbreak started in a day care center, infecting children too young to be vaccinated, after which it spread to anthroposophic schools with a low measles, mumps and rubella vaccination coverage. This report describes the outbreak and evaluates the control measures and interventions. Methods Data collection was done through the system of mandatory notification of the public health authority. Vaccination coverage in the schools was assessed by a questionnaire and the electronic immunization database ‘Vaccinnet’. A case was defined as anyone with laboratory confirmed measles or with clinical symptoms and an epidemiological link to a laboratory confirmed case. Towards the end of the outbreak we only sought laboratory confirmation for persons with an atypical clinical presentation or without an epidemiological link. In search for an index patient we determined the measles IgG level of infants from the day care center. Results A total of 65 cases were reported of which 31 were laboratory confirmed. Twenty-five were confirmed by PCR and/or IgM. In 6 infants, too young to be vaccinated, only elevated measles IgG levels were found. Most cases (72%) were young children (0–9 years old). All but two cases were completely unimmunized. In the day care center all the infants who were too young to be vaccinated (N=14) were included as cases. Thirteen of them were laboratory confirmed. Eight of these infants were hospitalized with symptoms suspicious for measles. Vaccination coverage in the affected anthroposophic schools was low, 45-49% of the pupils were unvaccinated. We organized vaccination campaigns in the schools and vaccinated 79 persons (25% of those unvaccinated or incompletely vaccinated). Conclusions Clustering of unvaccinated persons, in a day care center and in anthroposophic schools, allows for measles outbreaks and is an important obstacle for the elimination of measles. Isolation measures, a vacation period and an immunization campaign limited the spread of measles within the schools but could not prevent further spread among unvaccinated family members. It was necessary to raise clinicians' awareness of measles since it had become a rare, less known disease and went undiagnosed.
Collapse
Affiliation(s)
- Toon Braeye
- Scientific Institute of Public Health, Brussels, Belgium.
| | | | | | | | | | | |
Collapse
|
21
|
Leuridan E, Goeyvaerts N, Hens N, Hutse V, Van Damme P. Maternal mumps antibodies in a cohort of children up to the age of 1 year. Eur J Pediatr 2012; 171:1167-73. [PMID: 22395563 DOI: 10.1007/s00431-012-1691-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 02/07/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED The duration of the presence of maternal mumps antibodies in a prospective cohort study is presented. Immunoglobulin G against mumps was portioned with a commercial ELISA test (Euroimmun® anti-mumps Virus AT ELISA, Germany) on samples from 213 mother-child pairs at seven time points between pregnancy and 12 months of age. Non-linear mixed models were used to model maternal antibody decay in infants. The model-based median time to loss of antibodies was 3.6 months. The median child-specific time to loss of antibodies in children of naturally immune women (3.8 months) and children of vaccinated women (2.4 months) differed significantly (p = 0.025). The log antibody level of the mother and the log birth weight were correlated with the duration of maternal antibodies in infants (p < 0.0001). CONCLUSION Children of vaccinated women loose maternal mumps antibodies significantly earlier in life compared to children of naturally infected women. If early administration (<12 months) of the combined measles, mumps, and rubella vaccine is needed, maternal mumps antibodies are not expected to interfere with infant humoral vaccine responses.
Collapse
Affiliation(s)
- E Leuridan
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, WHO Collaborating Centre for Control and Prevention of Infectious Diseases, University of Antwerp, UA-CDE-R 2.13, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | | | | | | | | |
Collapse
|
22
|
Mankertz A, Mihneva Z, Gold H, Baumgarte S, Baillot A, Helble R, Roggendorf H, Bosevska G, Nedeljkovic J, Makowka A, Hutse V, Holzmann H, Aberle SW, Cordey S, Necula G, Mentis A, Korukluoğlu G, Carr M, Brown KE, Hübschen JM, Muller CP, Mulders MN, Santibanez S. Spread of measles virus D4-Hamburg, Europe, 2008-2011. Emerg Infect Dis 2011; 17:1396-401. [PMID: 21801615 PMCID: PMC3381563 DOI: 10.3201/eid1708.101994] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A new strain of measles virus, D4-Hamburg, was imported from London to Hamburg in December 2008 and subsequently spread to Bulgaria, where an outbreak of >24,300 cases was observed. We analyzed spread of the virus to demonstrate the importance of addressing hard-to-reach communities within the World Health Organization European Region regarding access to medical care and vaccination campaigns. The D4-Hamburg strain appeared during 2009-2011 in Poland, Ireland, Northern Ireland, Austria, Greece, Romania, Turkey, Macedonia, Serbia, Switzerland, and Belgium and was repeatedly reimported to Germany. The strain was present in Europe for >27 months and led to >25,000 cases in 12 countries. Spread of the virus was prevalently but not exclusively associated with travel by persons in the Roma ethnic group; because this travel extends beyond the borders of any European country, measures to prevent the spread of measles should be implemented by the region as a whole.
Collapse
|
23
|
Abstract
From 1 January to 14 April 2011, a total of 155 measles cases were notified in Belgium, whereas throughout 2010, there were only 40. Of the 103 cases with known vaccination status, 87% had not been vaccinated with measles-mumps-rubella vaccine. The resurgence of measles is the consequence of insufficient vaccine coverage in previous years. Efforts to communicate the benefits of measles vaccination to the public and to advise health professionals on control measures and outbreak management are ongoing.
Collapse
Affiliation(s)
- M Sabbe
- Scientific Institute of Public Health, Brussels, Belgium
| | - D Hue
- Scientific Institute of Public Health, Brussels, Belgium
| | - V Hutse
- Scientific Institute of Public Health, Brussels, Belgium
| | - P Goubau
- National committee for the elimination of measles and rubella in Belgium
- Department of Virology, Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
24
|
Sabbe M, Hue D, Hutse V, Goubau P. Measles resurgence in Belgium from January to mid-April 2011: a preliminary report. Euro Surveill 2011; 16:19848. [PMID: 21527134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
From 1 January to 14 April 2011, a total of 155 measles cases were notified in Belgium, whereas throughout 2010, there were only 40. Of the 103 cases with known vaccination status, 87% had not been vaccinated with measles-mumps-rubella vaccine. The resurgence of measles is the consequence of insufficient vaccine coverage in previous years. Efforts to communicate the benefits of measles vaccination to the public and to advise health professionals on control measures and outbreak management are ongoing.
Collapse
Affiliation(s)
- M Sabbe
- Scientific Institute of Public Health, Brussels, Belgium
| | | | | | | |
Collapse
|
25
|
Hutse V, Van Hecke K, De Bruyn R, Samu O, Lernout T, Muyembe JJ, Brochier B. Oral fluid for the serological and molecular diagnosis of measles. Int J Infect Dis 2010; 14:e991-7. [PMID: 20851015 DOI: 10.1016/j.ijid.2010.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 06/02/2010] [Accepted: 06/09/2010] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Since measles presents mostly in children, a non-invasive sample collection technique such as oral fluid sampling would be very useful in the early detection of measles RNA and antibodies. The aim of this study was to validate the detection of anti-measles IgM and measles virus RNA in oral fluid and to make a comparison with the gold standard methods of ELISA using serum (Enzygnost(®) anti-Measles IgM) and in-house nested reverse transcriptase polymerase chain reaction (RT-PCR) using nasopharyngeal secretions. METHODS Three samples each from 73 measles-positive and 44 measles-negative subjects (serum, oral fluid, and nasopharyngeal secretions) were analyzed. RESULTS The anti-measles IgM ELISA (MicroImmune) on oral fluid was validated against the IgM ELISA (Siemens) for serum and this resulted in a sensitivity of 92% and specificity of 100%. A molecular nested RT-PCR using oral fluid was validated against the standard assay on nasopharyngeal secretions and gave a sensitivity of 100% and specificity of 100%. CONCLUSIONS The results confirm that both serological and molecular oral fluid assays are suitable for routine use. The use of oral fluid samples for the detection of measles virus may encourage patients, general practitioners, and pediatricians to participate in the Belgian measles surveillance system and other epidemiological studies in the framework of the World Health Organization elimination program.
Collapse
Affiliation(s)
- V Hutse
- Viral Diseases, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | | | | | | | | | | | | |
Collapse
|
26
|
Leuridan E, Hens N, Hutse V, Aerts M, Van Damme P. Kinetics of maternal antibodies against rubella and varicella in infants. Vaccine 2010; 29:2222-6. [PMID: 20558248 DOI: 10.1016/j.vaccine.2010.06.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 05/21/2010] [Accepted: 06/01/2010] [Indexed: 11/29/2022]
Abstract
Kinetics of maternal rubella and varicella antibodies in 213 mother-infant pairs are described in a longitudinal study in Belgium. Blood samples are taken at 7 time points (week 36 of pregnancy, birth (cord), 1, 3, 6, 9, and 12 months), and analyzed for anti-rubella IgG and anti-varicella IgG by enzyme linked immunosorbent assay (ELISA). A generalized exponential model is used to analyse maternal antibody decay in infants. Model based, the mean duration of passive immunity is 2.1 months for rubella and 2.4 months for varicella. Infants are susceptible at young age for rubella, a disease with high vaccination coverage, as well as for varicella, an endemic disease in Western Europe.
Collapse
Affiliation(s)
- E Leuridan
- Centre for Evaluation of Vaccination, Vaccine and Infectious Disease Institute, Faculty of Medicine, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | | | | | | | | |
Collapse
|
27
|
Abstract
OBJECTIVE To investigate the duration of the presence of maternal antibodies to measles in infants. DESIGN Prospective study (May 2006 to November 2008). SETTING Five hospitals in the Province of Antwerp, Belgium. PARTICIPANTS Of 221 pregnant women recruited, 207 healthy woman-infant pairs were included-divided into a vaccinated group (n=87) and naturally immune group (n=120), according to vaccination documents and history. MAIN OUTCOME MEASURE Measles IgG antibodies measured by enzyme linked immunosorbent assay (ELISA) at seven time points (week 36 of pregnancy, birth (cord), and 1, 6, 9, and 12 months); decay of maternal antibody in infants modelled with linear mixed models. RESULTS Vaccinated women had significantly fewer IgG antibodies (geometric mean titre 779 (95% confidence interval 581 to 1045) mIU/ml) than did naturally immune women (2687 (2126 to 3373) mIU/ml) (P<0.001). Maternal values were highly correlated with neonatal values (r=0.93 at birth). Infants of vaccinated women had significantly lower antibody concentrations than did infants of naturally immune women (P<0.001 at all ages over the follow-up period). Presence of maternal antibodies endured for a median of 2.61 months-3.78 months for infants of naturally infected women and 0.97 months for infants of vaccinated women. At 6 months of age, more than 99% of infants of vaccinated women and 95% of infants of naturally immune women had lost maternal antibodies according to the model. CONCLUSIONS This study describes a very early susceptibility to measles in infants of both vaccinated women and women with naturally acquired immunity. This finding is important in view of recent outbreaks and is an argument for timeliness of the first dose of a measles vaccine and vaccination of travelling or migrating children under the age of 1 year.
Collapse
Affiliation(s)
- E Leuridan
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, Faculty of Medicine, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium.
| | | | | | | | | | | |
Collapse
|
28
|
Lernout T, Kissling E, Hutse V, De Schrijver K, Top G. An outbreak of measles in orthodox Jewish communities in Antwerp, Belgium, 2007-2008: different reasons for accumulation of susceptibles. Euro Surveill 2009; 14. [DOI: 10.2807/ese.14.02.19087-en] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
From August 2007 to May 2008, an outbreak of at least 137 cases of measles occurred in some orthodox Jewish communities in Antwerp, Belgium. The outbreak was linked to outbreaks in the same communities in the United Kingdom and in Israel. The reasons for this outbreak were diverse: cultural factors, misinformation on vaccination by some medical doctors and the lack of a catch-up vaccination programme in private Jewish schools. The identification of smaller susceptible groups for measles transmission and vaccination of these groups represent a major challenge for the measles elimination programme.
Collapse
Affiliation(s)
- T Lernout
- Scientific Institute of Public Health, Epidemiology, Brussels, Belgium
| | - E Kissling
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Scientific Institute of Public Health, Epidemiology, Brussels, Belgium
| | - V Hutse
- Scientific Institute of Public Health, Virology, Brussels, Belgium
| | - K De Schrijver
- Public Health Surveillance of Flanders, Infectious diseases and Immunisation, Antwerp, Belgium
| | - G Top
- Public Health Surveillance of Flanders, Infectious diseases and Immunisation, Antwerp, Belgium
| |
Collapse
|
29
|
Lernout T, Kissling E, Hutse V, Top G. Clusters of measles cases in Jewish orthodox communities in Antwerp, epidemiologically linked to the United Kingdom: a preliminary report. ACTA ACUST UNITED AC 2007; 12:E071115.3. [PMID: 18005643 DOI: 10.2807/esw.12.46.03308-en] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
In October 2007, a school health service in Antwerp reported eight suspected cases of measles in two Jewish schools in the city. The diagnosis of measles was confirmed on saliva and nasopharyngeal samples for five cases.
Collapse
Affiliation(s)
- T Lernout
- Scientific Institute of Public Health, Epidemiology, Belgium.
| | | | | | | |
Collapse
|
30
|
Quoilin S, Hutse V, Vandenberghe H, Claeys F, Verhaegen E, De Cock L, Van Loock F, Top G, Van Damme P, Vranckx R, Van Oyen H. A population-based prevalence study of hepatitis A, B and C virus using oral fluid in Flanders, Belgium. Eur J Epidemiol 2007; 22:195-202. [PMID: 17356926 DOI: 10.1007/s10654-007-9105-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [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: 09/13/2006] [Accepted: 01/01/2007] [Indexed: 12/17/2022]
Abstract
Ten years after the first seroprevalence study performed in Flanders, the aim of this cross sectional study was to follow the evolution of hepatitis A, B and C prevalence. The prevalence of hepatitis A antibodies, hepatitis B surface antigen and hepatitis C antibodies was measured in oral fluid samples collected by postal survey. Using the National Population Register, an incremental sampling plan was developed to obtain a representative sampling of the general population. A total of 24,000 persons were selected and 6,000 persons among them contacted in a first wave. With 1834 participants a response rate of 30.6% was achieved. The prevalence was weighted for age and was 20.2% (95% CI 19.43-21.08) for hepatitis A, 0.66% (95% CI 0.51-0.84) for hepatitis B surface antigen and 0.12% (95% CI 0.09-0.39) for hepatitis C. The prevalence of hepatitis A and C in the Flemish population is lower in 2003 compared with the results of the study performed in 1993. The difference may be due to a real decrease of the diseases but also to differences in the methodology. The prevalence of hepatitis B surface antigen remains stable. Considering the 30% response rate and the high quality of the self-collected samples as reflect of a good participation of the general population, saliva test for prevalence study is a good epidemiological monitoring tool.
Collapse
Affiliation(s)
- Sophie Quoilin
- Unit of Epidemiology, Scientific Institute of Public Health, Juliette Wytsmanstreet 14, 1050 Brussels, Belgium.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Hutse V, Verhaegen E, De Cock L, Quoilin S, Vandenberghe H, Horsmans Y, Michielsen P, Van Damme P, Van Vlierberghe H, Claeys F, Vranckx R, Van Oyen H. Oral fluid as a medium for the detection of hepatitis B surface antigen. J Med Virol 2005; 77:53-6. [PMID: 16032713 DOI: 10.1002/jmv.20413] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Currently viral antigens and antibodies are detected by traditional serological tests. However, the introduction of oral fluid as an alternative medium would allow other alternatives. The collection of oral fluid is, in comparison with venepuncture, less invasive, less painful, less expensive (i.e., no trained personal required), and safe (prevention of needle stick injuries). Also large numbers of samples can be collected easily for epidemiological purposes. Forty-three HBsAg positive and seventy-three HBsAg negative paired serum/oral fluid samples were tested. They were collected from patients attending university hospitals. The oral fluid samples were collected using the Oracol collection device and they were subjected to an IgG quantification assay to ensure their quality and quantity. The detection of HBsAg in oral fluid was carried out using a modified ETI-MAK-4 ELISA. The validation of this oral fluid test gave a sensitivity and specificity of 90.7% and 100%, respectively. The modified ETI-MAK-4 ELISA is a suitable test for oral fluid samples collected by the Oracol collection device for epidemiological purposes.
Collapse
Affiliation(s)
- Veronik Hutse
- Unit of Epidemiology, Scientific Institute of Public Health, Brussels, Belgium.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Cock De L, Hutse V, Vranckx R. Correlation between detection of antibodies against hepatitis C virus in oral fluid and hepatitis C virus RNA in serum. Eur J Clin Microbiol Infect Dis 2005; 24:566-8. [PMID: 16133413 DOI: 10.1007/s10096-005-1369-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Reported here are the results of a study designed to determine the correlation between hepatitis C virus (HCV) RNA positivity in serum and the detection of antibodies against HCV in oral fluid by testing paired serum/oral fluid samples. For the 85 serum samples found positive for antibodies against HCV, using a screening assay and a confirmation assay, 70 of the corresponding oral fluid samples tested positive for HCV antibodies using a previously modified screening assay. For 52 of the 59 serum samples found positive for HCV RNA, the corresponding oral fluid samples also tested seropositive for HCV, while 18 of the 26 serum samples that were negative for HCV RNA had corresponding oral fluid samples that tested seropositive for HCV. For the control group of 54 serum samples that were negative for HCV antibodies, all of the corresponding oral fluid samples were also negative for HCV antibodies, while 53 of the serum samples tested negative for HCV RNA. These results suggest that HCV antibody detection in oral fluid has a slightly higher sensitivity when used to test patients whose serum samples are positive for HCV RNA (chi-square test, p=0.035; Mid-P exact, p=0.049).
Collapse
Affiliation(s)
- L Cock De
- Department of Microbiology, Scientific Institute of Public Health, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | | | | |
Collapse
|
33
|
De Doncker S, Hutse V, Abdellati S, Rijal S, Singh Karki BM, Decuypere S, Jacquet D, Le Ray D, Boelaert M, Koirala S, Dujardin JC. A new PCR-ELISA for diagnosis of visceral leishmaniasis in blood of HIV-negative subjects. Trans R Soc Trop Med Hyg 2005; 99:25-31. [PMID: 15550258 DOI: 10.1016/j.trstmh.2004.01.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [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: 09/19/2003] [Revised: 01/12/2004] [Accepted: 01/12/2004] [Indexed: 11/18/2022] Open
Abstract
The PCR-ELISA represents a promising advance for diagnosis of visceral leishmaniasis (VL) in blood samples. However, the method has been validated mostly with HIV-positive patients who are known to have high levels of parasitaemia. We developed a new PCR-ELISA assay for specific detection of Leishmania in patients' blood and validated it in Nepalese subjects with clinically suspected VL, almost all of whom were HIV-negative. For blood samples, PCR-ELISA was more sensitive (83.9%) than conventional PCR (73.2%), and demonstrated 100% and 87.2% specificity when using healthy controls who had never travelled to a VL-endemic area and controls from a VL-endemic area as references, respectively. We have demonstrated the ability of PCR-ELISA to detect parasites in blood of HIV-negative patients. The method could be used for epidemiological as well as clinical purposes, as it reduces the need for traumatic bone marrow sampling and risky spleen aspiration.
Collapse
Affiliation(s)
- Simonne De Doncker
- Laboratory of Molecular Parasitology, Prins Leopold Instituut voor Tropische Geneeskunde, Nationalestraat 155, B-2000 Antwerp, Belgium
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
De Cock L, Hutse V, Verhaegen E, Quoilin S, Vandenberghe H, Vranckx R. Detection of HCV antibodies in oral fluid. J Virol Methods 2005; 122:179-83. [PMID: 15542142 DOI: 10.1016/j.jviromet.2004.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [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: 01/05/2004] [Revised: 05/24/2004] [Accepted: 09/01/2004] [Indexed: 11/25/2022]
Abstract
Although conventionally the detection of HCV antibodies is carried out on serum, the collection of oral fluid is non-invasive, safe and cost effective. In this study, the efficacy of the detection of HCV antibodies in oral fluid was assessed. 73 anti-HCV positive and 73 anti-HCV negative paired serum/oral fluid samples, drawn from patients visiting a Belgian academic hospital, were tested using the modified Ortho HCV 3.0 and LIA confirmation assay. Performing the test on oral fluid with the modified protocol, 61/73 anti-HCV positive samples were tested positive, while 73/73 anti-HCV negative samples were tested negative, giving a sensitivity and specificity of 83.6% (95% CI: 72.7-90.9%) and 100.0% (95% CI: 93.8-100.0%), respectively. Comparing S/CO of concordantly positive and negative samples, the cut-off point was lowered by 30% resulting in a sensitivity of 89.0% (95% CI: 79.0-94.8%) while the specificity remained 100.0% (95% CI: 93.8-100.0%). The confirmation assay was carried out as described by the manufacturer, diluting the oral fluid 1:10. Testing paired samples gave a concordance of 85.6% (125/146), yielding no more accurate results. These findings suggested that the modified ELISA method for anti-HCV detection in oral fluid can be used for epidemiological surveys.
Collapse
Affiliation(s)
- L De Cock
- Department of Microbiology, Scientific Institute of Public Health, Section of Virology, Juliette Wytsmanstreet 14, B-1050 Brussels, Belgium.
| | | | | | | | | | | |
Collapse
|