Prolonged respiratory viral shedding in transplant patients.

Respiratory viral infections are frequent causes of morbidity in transplant patients. We screened symptomatic adult transplant recipients for respiratory viruses in a cohort of patients attending a referral medical center in Brazil. The duration of viral shedding and the prevalence of viral codetections were also determined. During a 1-year period (2011-2012), swabs were obtained from 50 patients. An in-house polymerase chain reaction panel designed to detect 10 viruses was used. Viruses were identified in 19 (38%) patients, particularly parainfluenza III (32%) and the respiratory syncytial virus (20%); multiple viruses were identified in 26% of patients. Prolonged viral shedding was observed with 60% of individuals excreting viruses for >10 days. The clinical and epidemiologic relevance of prolonged viral shedding remains to be determined.

Study of the kinetics of antibodies titres against viral pathogens and detection of rotavirus and parainfluenza 3 infections in captive crias of guanacos (Lama guanicoe).

A longitudinal study was conducted to investigate the presence of antibodies (Ab) to Rotavirus (RV), Parainfluenza-3 virus (PI-3), Bovine Herpesvirus-1 (BoHV-1), Bovine Viral Diarrhoea virus (BVDV-1) and Bluetongue virus (BTV) in eleven guanaco's crias (chulengos) relocated from Rio Negro to Buenos Aires Province (Argentina) and reared in captivity for a year in an experimental field. Serum samples were collected periodically to detect the evidence of viral infections. Faecal samples were collected to investigate RV shedding. We detected the evidence of Ab to RV from the beginning of the experience, suggesting the presence of maternal Ab against the virus. RV infection was detected in seven of the eleven chulengos, by seroconversion (4), virus shedding in stools (1) or both (2). In all cases, the RV strain was typed as [P1]G8, the same G/P type combination detected in captive chulengos with acute diarrhoea sampled in Rio Negro, in 2001. In contrast, we could not detect antibodies against PI-3, BoHV-1, BVDV or BT in any of initial samples. No Abs against BoHV-1, BVDV or BTV were detected in the chulengos throughout the study. However, all the chulengos became asymptomatically seropositive to PI-3 by the 7 month after arrival. This study suggest that wild-born guanacos raised in captivity can be relatively susceptible to common livestock viral infections, such as RV and PI-3, which are easily spread among chulengos.

Screening for respiratory syncytial virus and assignment to a cohort at admission to reduce nosocomial transmission.

To limit nosocomial spread of respiratory syncytial virus (RSV) infection, a longitudinal intervention trial was instituted. Nasal secretions or washes were screened for RSV antigen by enzyme-linked immunosorbent assay, and patients were assigned to an RSV-infected or an RSV-uninfected cohort. The baseline (preintervention) rate of 7.17 nosocomial cases of RSV per 1000 patient-days of care was used for comparison. Despite continued infections in the community after screening was initiated, there were no cases of RSV infection in 1880 patient-days of care for 3 months (p = 0.039). During the fourth month, an RSV-infected child was erroneously assigned to the RSV-uninfected cohort, and three nosocomial cases occurred--5.33/1000 patient-days of care (p = 0.286). Overall, there were three nosocomial RSV infections in 2443 patient-days of care in the 1987 season after screening was introduced--1.23/1000 patient-days of care (p = 0.026). In the subsequent RSV season, there was one nosocomial case--0.461/1000 patient-days of care for 3 months (p = 0.0074). During the same period, nosocomial cases of RSV were observed in the pediatric and neonatal intensive care units, where assignment to a cohort was not possible. We conclude that entry into a cohort at the time of admission, on the basis of prospective RSV screening by enzyme-linked immunosorbent assay, effectively reduces nosocomial transmission of RSV.

Isolation of avian paramyxovirus-2 from domestic and wild birds in Costa Rica.

A survey for Newcastle disease virus (NDV) in wild birds of Costa Rica was conducted by swabbing wild-caught pet birds, backyard chickens, and wild birds captured in Japanese mist nets in tropical rain forests and agricultural areas. Cloacal swabs were collected from 876 birds of approximately 132 species representing 24 taxonomic families. Hemagglutinating agents were isolated from 18.7% of the birds. Paramyxovirus type 2(PMV-2) (Yucaipa-like), unreported in free-flying passerines in the Americas, was recovered from a finch, wren, and chicken, each from a different location. Pathogenicity trials with infected turkey poults and newly hatched chicks did not result in growth impairment or significant clinical signs of disease. Attempts to isolate NDV were negative.

A simultaneous outbreak of respiratory syncytial virus and parainfluenza virus type 3 in a newborn nursery.

Over a 3-week period, 20 of 34 (59%) infants in a newborn nursery developed nosocomial viral respiratory tract disease. Either respiratory syncytial virus (seven infants) or parainfluenza virus type 3 (five) or both (two) were demonstrated in respiratory secretions from 14 of the 20 symptomatic patients. Symptoms in the 20 infants included rhinitis (15 infants), cough (14), apnea (eight), pulmonary infiltrates (seven), and fever (six). There were no differences in symptoms between children infected with respiratory syncytial virus alone, with parainfluenza virus alone, or with both viruses concurrently. Patients were clustered in the nursery by agent: infants with the same virus tended to share contiguous bed spaces, supporting the concept that parainfluenza virus as well as respiratory syncytial virus can be transmitted from patient to patient. In addition to this risk for contiguous bed spaces, the presence of a nasogastric tube was associated with risk of illness (P less than 0.05). In the presence of a nursery outbreak of respiratory tract disease, more than one virus may circulate concurrently, and an individual patient may be infected simultaneously by more than one virus.

Concurrent outbreaks of rhinovirus and respiratory syncytial virus in an intensive care nursery: epidemiology and associated risk factors.

An outbreak of viral respiratory disease occurred in eight infants in a neonatal intensive care unit during the 1980 winter respiratory season. Four infections with respiratory syncytial virus and four infections with rhinovirus were identified. Epidemiologic investigation revealed that viral respiratory infection was significantly associated with intubation with orotracheal tubes (P = 0.001), with the presence of both a nasal feeding tube plus an orotracheal tube together (P = 0.007), and with assisted ventilation (P = 0.009) when compared to uninfected controls. Twenty-seven of 85 (30.6%) personnel working in the unit at the time of the outbreak reported a history of upper respiratory illness during the week prior to the outbreak, and 46 (54.1%) of them had had contact with patients in areas of the hospital where patients infected with RSV and rhinovirus were housed. The data suggest that both viruses were transmitted to the babies by hospital personnel. Rhinoviruses can be nosocomial pathogen in neonates with compromised pulmonary function, and the clinical presentation of rhinovirus infection in neonates may be difficult to distinguish from that produced by RSV.