Secondary hemophagocytic lymphohistiocytosis in pediatric patients with visceral leishmaniasis and Epstein-Barr virus infection.

Visceral leishmaniasis-associated hemophagocytic lymphohistiocytosis (VL-HLH) is indistinguishable from those of HLH of other etiologies due to the overlap symptoms, posing a serious threat to life. In this study, we aimed to provide insights for early diagnosis and improve outcomes in pediatric patients with VL-HLH. We retrospectively analyzed the clinical and laboratory data of 10 pediatric patients with VL-HLH and 58 pediatric patients with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH). The median time from symptom onset to cytopenia in patients with VL-HLH and EBV-HLH was 11 days (interquartile range, 7-15 days) and five days (interquartile range, 3.75-9.25 days) (P = 0.005). Both groups showed liver injury and increased lactate dehydrogenase levels; however the levels of aspartate aminotransferase, alanine aminotransferase, direct bilirubin, and lactate dehydrogenase in patients with VL-HLH were significantly lower than those in patients with EBV-HLH (P < 0.05). The fibrinogen and triglyceride levels were almost normal in VL-HLH patients but were significantly altered in EBV-HLH cases ( P < 0.05). The positive rate of first bone marrow microscopy examination, anti-rK39 IgG detection, and blood metagenomic next-generation sequencing was 50%, 100%, and 100%, respectively. After VL diagnosis, eight patients were treated with sodium stibogluconate and two were treated with liposomal amphotericin B. All the patients with VL-HLH recovered. Our study demonstrates that regular triglyceride and fibrinogen levels in pediatric patients with VL-HLH may help in differential diagnosis from EBV-HLH. VL-HLH is milder than EBV-HLH, with less severe liver injury and inflammatory responses, and timely treatment with antileishmanial agents is essential to improve the outcomes of pediatric patients with VL-HLH.

Epidemiological and Phylogenetic Analysis of Mumps Virus Isolated from 2016 to 2019 in Henan Province, China.

Routine vaccination has proven to be highly effective in reducing the incidence of mumps. However, sporadic cases and/or mumps outbreaks have been reported in children and adolescents younger than 15 years of age, particularly among those aged 5-9 years. To explore the characteristics of such outbreaks in the Henan Province, clinical data of patients infected with mumps virus (MuV) were collected, and the isolated strains were phylogenetically analyzed. Of the total 426 samples analyzed, MuV RNA targeting the small hydrophobic (SH) gene was detected in 153 samples. MuV-positive cases in age groups <5 years, 5-9 years, 10-15 years, 16-19 years, and ≥20 years accounted for 1%, 17%, 12%, 2%, and 4% of the total number of cases, respectively. Phylogenetic analysis based on the SH gene sequences indicated that all of the isolated strains were of genotype F, and isolates in the same subcluster and with identical SH gene sequences tended to be derived from the same community or municipalities when analyzed alongside epidemiological data. In conclusion, the incidence of mumps in the Henan Province was high. The data provided in this study might promote further research in the clarification of the specific causes of mumps outbreaks, which can facilitate the implementation of effective prevention and control measures.

Epidemiological and phylogenetic analysis of rabies virus isolated from humans in Henan province, China.

Rabies remains a public health threat in China, and most transmissions are dog-mediated. In this study, we studied 31 clinically diagnosed human rabies patients that had been scratched or bitten by dogs. Real-time reverse transcription polymerase chain reaction (RT-qPCR) and nested RT-PCR were performed on saliva samples or cerebrospinal fluid, and samples from 28 patients tested positive for rabies virus. A total of one near-complete genome sequence, 15 complete glycoprotein (G) gene sequences, and five partial G gene sequences were determined. Phylogenetic analysis was performed, based on complete G gene sequences, using the maximum-likelihood method. The results indicated that the isolates belonged to the lyssavirus genotype I lineage and China I lineage. The Chinese rabies virus can be divided into six major lineages. The China I lineage was the dominant clade and could be divided into four subclades. Isolates 17HN19, 17HN75, and 18HN162 fell within clade IC subgroup, and the other isolates were assigned to the clade IA subgroup. This study provides epidemiological and genetic information on rabies incidence in humans.

Genomic characterization of GII.3 noroviruses isolated from children in Zhengzhou city, China, 2015/16.

In this study, we isolated, amplified and sequenced GII.3 norovirus (NoV) strains from children admitted to a department of pediatric gastroenterology presenting with acute gastroenteritis from September 2015 to March 2016. A total of 35 stool samples were collected and eight were GII.3 NoV positive, based on sequencing. The complete genome sequences were determined for two strains while partial genome sequences, encompassing approximately 3.2 kb of the 3´end, were generated for the six other strains. Genotyping analysis of all strains indicated that they belonged to GII P12/GII.3. Phylogenetic analysis indicated that these isolated strains could be divided into two clusters. Strains in cluster IV were the most frequently isolated and exhibited less intra-cluster variation in nucleotide sequences. Our study demonstrated that the GII.P12/GII.3 recombinant strain was the dominant GII.3 NoVs in Zhengzhou city.

Characterization of a Norovirus-specific monoclonal antibody that exhibits wide spectrum binding activities.

Noroviruses (NoVs) are increasingly recognized as the leading cause of acute non-bacterial gastroenteritis worldwide. To screen for NoV-specific monoclonal antibodies (mAbs) with wide spectrum binding activities that could be used for the development of NoV-related detection reagents, we immunized mice with a combination of virus like particles (VLPs) derived from eight different genotypes (two from genogroup I and six from genogroup II), of which two (GI.7 and GII.2) were newly produced VLPs. Indirect enzyme-linked immunosorbent assay (ELISA) confirmed that two mAbs (8D8 and 10B11) bound to all eight major capsid proteins (VP1) with varied binding abilities. Epitope mapping using short peptides covering the N-terminal half of GII.3 VP1 indicated that the binding site of mAb 8D8 was located between amino acid 31 and 60. Multiple amino acid sequence alignment of VP1 suggested that this site harbors conservative sequences across all genogroups. Indirect and sandwich ELISA indicated that mAb 8D8 was unable bind intact VLPs. In summary, we successfully produced GI.7 and GII.2 VLPs using recombinant baculovirus expression system and a cross-reactive mAb by immunizing mice with eight different VLPs that might be useful in the studying and detecting NoVs.