RESUMO
We report a fatal case of acute lower respiratory tract disease with human rhinovirus C (HRV-C) as the unique cause in a 19-month-old girl with a history of repeated episodes of bronchiolitis. HRV-C type 8 nucleic acids were observed in respiratory, stool, and cerebrospinal fluid samples, and infectious virions were isolated from patient serum after inoculation onto reconstituted airway epithelia.
Assuntos
Sangue/virologia , Bronquiolite/etiologia , Infecções por Picornaviridae/diagnóstico , Infecções por Picornaviridae/virologia , Rhinovirus/isolamento & purificação , Viremia/diagnóstico , Viremia/virologia , Bronquiolite/complicações , Líquido Cefalorraquidiano/virologia , Evolução Fatal , Fezes/virologia , Feminino , Humanos , Lactente , Infecções por Picornaviridae/patologia , Sistema Respiratório/virologia , Rhinovirus/classificação , Rhinovirus/genética , Viremia/patologia , Cultura de VírusRESUMO
OBJECTIVES: To describe a human metapneumovirus (hMPV) outbreak occurring in a nursing home for older adults and to identify the risk factors associated with the clinical infection. DESIGN: A retrospective, case-controlled study. SETTING AND PARTICIPANTS: A French nursing home for older adults between December 27, 2014 and January 20, 2015. Probable cases were residents presenting at least 1 respiratory symptom or 1 constitutional symptom. Confirmed cases identified in the same way as probable cases but with a positive RT-PCR test for hMPV. Controls were residents with no symptoms of respiratory infection. MEASURES: Identification of hMPV was realized on nasal swab samples by RT-PCR. RESULTS: Seventy-eight older people were resident at the time of the outbreak. Three of the 4 tested were positive for hMPV by RT-PCR and negative for 13 other viruses or bacteria. All probable infected residents presented cough; other symptoms were scarcer. An inflammatory response was present, with median C-reactive protein at 50 mg/L. The median duration of the illness was 7 days. The rate of infection among residents was high (51%), with 5 hospitalizations (12.5%) and 1 death (2.5%). In multivariate analysis, vaccination against influenza virus appeared to emerge as associated with a probable hMPV infection, but this might be an artifact, as the proportion of unvaccinated residents was low (15%). A clear infected population profile was hard to define, although limited autonomy and low ADL score may play a role. Basic hygiene precautions were reinforced, but droplet precautions seemed difficult to apply rigorously to this population. CONCLUSIONS/IMPLICATIONS: Clinical and biological presentations were nonspecific. The rate of infection was high, highlighting the need for the rapid introduction of strict precautions to contain the infection.
Assuntos
Metapneumovirus , Infecções por Paramyxoviridae , Infecções Respiratórias , Idoso , Surtos de Doenças , Humanos , Lactente , Casas de Saúde , Infecções por Paramyxoviridae/diagnóstico , Infecções por Paramyxoviridae/epidemiologia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Estudos RetrospectivosRESUMO
We report a fatal case of acute gastroenteritis in a child with autism spectrum disorder. Multiple viral coinfections were detected by PCR in the patient's stool and digestive biopsy specimens. As viral detection is not necessarily associated with symptomatic disease, a semi-quantitative approach using cycle treshold values was proposed for the clinical interpretation of PCR. We discuss whether concomitant viral infections could be a risk factor for severe outcome in gastroenteritis cases. Individual risk factors are also addressed.
Assuntos
Coinfecção/diagnóstico , Coinfecção/virologia , Gastroenterite/diagnóstico , Gastroenterite/virologia , Viroses/diagnóstico , Viroses/virologia , Vírus/isolamento & purificação , Pré-Escolar , Evolução Fatal , Feminino , Humanos , Vírus/classificaçãoRESUMO
BACKGROUND: Several mumps outbreaks have been reported in Europe and in the United States among highly vaccinated populations. Biological diagnosis is classically based on the detection of mumps-specific IgM, but the ability of serological tests to confirm mumps infection seems to be limited among vaccinated patients. OBJECTIVES: We aim to report a mumps outbreak in an engineering school in Grenoble, France, from February to June 2013 and results of the biological testing. STUDY DESIGN: WHO definitions were used to define cases. Mumps--specific IgM and IgG were assessed by a commercially available EIA. Mumps RNA detection by real time reverse transcriptase polymerase chain reaction tests (RT-PCR) and mumps genotyping were performed by the French National Reference Centre for Paramyxoviridae. RESULTS: Sixty two mumps patient-cases were identified using WHO case definitions, 20 being biologically explored, of which 17 were confirmed by biological tests. Vaccination status was documented for 27 patients/62: 4 (14.8%) patients had received one dose of MMR vaccine, and 23 (85.2) two doses of MMR vaccine. Among the biologically explored patients, 83% had a positive RT PCR at the first sampling whereas only 45% had positive or equivocal IgM. All the genotyped strains were genotype G. CONCLUSIONS: Mumps laboratory diagnosis in a highly vaccinated population is challenging. Serological tests among vaccinated patients should be interpreted cautiously and confirmed by RT-PCR tests at the beginning of a mumps outbreak.