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2.
Artículo en Inglés | MEDLINE | ID: mdl-32411619

RESUMEN

The availability of pathogen-specific treatment options for respiratory tract infections (RTIs) increased the need for rapid diagnostic tests. Besides, retrospective studies, improved lab-based detection methods and the intensified search for new viruses since the beginning of the twenty-first century led to the discovery of several novel respiratory viruses. Among them are human bocavirus (HBoV), human coronaviruses (HCoV-HKU1, -NL63), human metapneumovirus (HMPV), rhinovirus type C (RV-C), and human polyomaviruses (KIPyV, WUPyV). Additionally, new viruses like SARS coronavirus (SARS-CoV), MERS coronavirus (MERS-CoV), novel strains of influenza virus A and B, and (most recently) SARS coronavirus 2 (SARS-CoV-2) have emerged. Although clinical presentation may be similar among different viruses, associated symptoms may range from a mild cold to a severe respiratory illness, and thus require a fast and reliable diagnosis. The increasing number of commercially available rapid point-of-care tests (POCTs) for respiratory viruses illustrates both the need for this kind of tests but also the problem, i.e., that the majority of such assays has significant limitations. In this review, we summarize recently published characteristics of POCTs and discuss their implications for the treatment of RTIs. The second key aspect of this work is a description of new and innovative diagnostic techniques, ranging from biosensors to novel portable and current lab-based nucleic acid amplification methods with the potential future use in point-of-care settings. While prototypes for some methods already exist, other ideas are still experimental, but all of them give an outlook of what can be expected as the next generation of POCTs.


Asunto(s)
Enfermedades Transmisibles Emergentes/diagnóstico , Enfermedades Transmisibles Emergentes/virología , Pruebas en el Punto de Atención , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/virología , Técnicas Biosensibles/métodos , Virus ADN/aislamiento & purificación , Humanos , Reacción en Cadena de la Polimerasa/métodos , Virus ARN/aislamiento & purificación
3.
J Korean Med Sci ; 35(19): e189, 2020 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-32419401

RESUMEN

BACKGROUND: When an emergency-care patient is diagnosed with an emerging infectious disease, hospitals in Korea may temporarily close their emergency departments (EDs) to prevent nosocomial transmission. Since February 2020, multiple, consecutive ED closures have occurred due to the coronavirus disease 2019 (COVID-19) crisis in Daegu. However, sudden ED closures are in contravention of laws for the provision of emergency medical care that enable the public to avail prompt, appropriate, and 24-hour emergency medical care. Therefore, this study ascertained the vulnerability of the ED at tertiary hospitals in Daegu with regard to the current standards. A revised triage and surveillance protocol has been proposed to tackle the current crisis. METHODS: This study was retrospectively conducted at 6 level 1 or 2 EDs in a metropolitan city where ED closure due to COVID-19 occurred from February 18 to March 26, 2020. The present status of ED closure and patient characteristics and findings from chest radiography and laboratory investigations were assessed. Based on the experience from repeated ED closures and the modified systems that are currently used in EDs, revised triage and surveillance protocols have been developed and proposed. RESULTS: During the study period, 6 level 1 or 2 emergency rooms included in the study were shut down 27 times for 769 hours. Thirty-one confirmed COVID-19 cases, of whom 7 died, were associated with the incidence of ED closure. Typical patient presentation with respiratory symptoms of COVID-19 was seen in less than 50% of patients, whereas abnormal findings on chest imaging investigations were detected in 93.5% of the study population. The chest radiography facility, resuscitation rooms, and triage area were moved to locations outside the ED, and a new surveillance protocol was applied to determine the factors warranting quarantine, including symptoms, chest radiographic findings, and exposure to a source of infection. The incidence of ED closures decreased after the implementation of the revised triage and surveillance protocols. CONCLUSION: Triage screening by emergency physicians and surveillance protocols with an externally located chest imaging facility were effective in the early isolation of COVID-19 patients. In future outbreaks of emerging infectious diseases, efforts should be focused toward the provision of continued ED treatment with the implementation of revised triage and surveillance protocols.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Servicio de Urgencia en Hospital , Clausura de las Instituciones de Salud , Neumonía Viral/epidemiología , Adulto , Betacoronavirus , Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Brotes de Enfermedades/prevención & control , Servicios Médicos de Urgencia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , República de Corea/epidemiología , Estudios Retrospectivos , Centros de Atención Terciaria , Triaje
4.
Virus Res ; 283: 197976, 2020 07 02.
Artículo en Inglés | MEDLINE | ID: mdl-32294518

RESUMEN

An outbreak of atypical pneumonia caused by a novel Betacoronavirus (ßCoV), named SARS-CoV-2 has been declared a public health emergency of international concern by the World Health Organization. In order to gain insight into the emergence, evolution and adaptation of SARS-CoV-2 viruses, a comprehensive analysis of genome composition and codon usage of ßCoV circulating in China was performed. A biased nucleotide composition was found for SARS-CoV-2 genome. This bias in genomic composition is reflected in its codon and amino acid usage patterns. The overall codon usage in SARS-CoV-2 is similar among themselves and slightly biased. Most of the highly frequent codons are A- and U-ending, which strongly suggests that mutational bias is the main force shaping codon usage in this virus. Significant differences in relative synonymous codon usage frequencies among SARS-CoV-2 and human cells were found. These differences are due to codon usage preferences.


Asunto(s)
Betacoronavirus/clasificación , Betacoronavirus/genética , Uso de Codones/genética , Enfermedades Transmisibles Emergentes/virología , Regulación Viral de la Expresión Génica/genética , Genoma Viral/genética , Genómica , Aminoácidos/genética , Animales , Betacoronavirus/aislamiento & purificación , China/epidemiología , Quirópteros/virología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/veterinaria , Infecciones por Coronavirus/virología , Evolución Molecular , Hurones/virología , Humanos , Mutagénesis/genética , Sistemas de Lectura Abierta/genética , Viverridae/virología
5.
PLoS Negl Trop Dis ; 14(3): e0008146, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32226011

RESUMEN

BACKGROUND: Cryptosporidiosis is an emerging infectious disease of public health significance worldwide. The burden of disease caused by Cryptosporidium varies between and within countries/areas. To have a comprehensive understanding of epidemiological status and characteristics of human Cryptosporidium infection in China since the first report in 1987, a retrospective epidemiological analysis was conducted by presenting differences in the prevalence of Cryptosporidium by province, year, population, living environment and season and possible transmission routes and risk factors as well as genetic characteristics of Cryptosporidium in humans. METHODOLOGY/PRINCIPAL FINDINGS: A systematic search was conducted to obtain epidemiological papers of human Cryptosporidium infection/cryptosporidiosis from PubMed and Chinese databases. Finally, 164 papers were included in our analysis. At least 200,054 people from 27 provinces were involved in investigational studies of Cryptosporidium, with an average prevalence of 2.97%. The prevalence changed slightly over time. Variable prevalences were observed: 0.65-11.15% by province, 1.89-47.79% by population, 1.77-12.87% and 0-3.70% in rural and urban areas, respectively. The prevalence peak occurred in summer or autumn. Indirect person-to-person transmission was documented in one outbreak of cryptosporidiosis in a pediatric hospital. 263 Cryptosporidium isolates were obtained, and seven Cryptosporidium species were identified: C. hominis (48.3%), C. andersoni (22.43%), C. parvum (16.7%), C. meleagridis (8.36%), C. felis (3.04%), C. canis (0.76%) and C. suis (0.38%). CONCLUSIONS/SIGNIFICANCES: This systematic review reflects current epidemiological status and characteristics of Cryptosporidium in humans in China. These data will be helpful to develop efficient control strategies to intervene with and prevent occurrence of human Cryptosporidium infection/cryptosporidiosis in China as well as have a reference effect to other countries. Further studies should focus on addressing a high frequency of C. andersoni in humans and a new challenge with respect to cryptosporidiosis with an increasing population of elderly people and patients with immunosuppressive diseases.


Asunto(s)
Criptosporidiosis/epidemiología , Cryptosporidium/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , China/epidemiología , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/transmisión , Criptosporidiosis/transmisión , Brotes de Enfermedades , Transmisión de Enfermedad Infecciosa , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Adulto Joven
8.
Turk J Med Sci ; 50(SI-1): 557-562, 2020 04 21.
Artículo en Inglés | MEDLINE | ID: mdl-32293833

RESUMEN

Infectious diseases remain as the significant causes of human and animal morbidity and mortality, leading to extensive outbreaks and epidemics. Acute respiratory viral diseases claim over 4 million deaths and cause millions of hospitalizations in developing countries every year. Emerging viruses, especially the RNA viruses, are more pathogenic since most people have no herd immunity. The RNA viruses can adapt to the rapidly changing global and local environment due to the high error rate of their polymerases that replicate their genomes. Currently, coronavirus disease 2019 (COVID-19) is determined as an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified in 2019 in Wuhan. Herein we discuss emerging and reemerging respiratory viral infections till to SARS-CoV-2.


Asunto(s)
Infecciones por Coronavirus/historia , Pandemias/historia , Neumonía Viral/historia , Enfermedades Respiratorias/historia , Enfermedades Respiratorias/virología , Virosis/historia , Betacoronavirus , Enfermedades Transmisibles Emergentes/historia , Enfermedades Transmisibles Emergentes/virología , Historia del Siglo XX , Historia del Siglo XXI , Humanos
9.
Rev Med Virol ; 30(3): e2106, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32302058

RESUMEN

Emerging and reemerging infectious diseases are global public concerns. With the outbreak of unknown pneumonia in Wuhan, China in December 2019, a new coronavirus, SARS-CoV-2 has been attracting tremendous attention. Rapid and accurate laboratory testing of SARS-CoV-2 is essential for early discovery, early reporting, early quarantine, early treatment, and cutting off epidemic transmission. The genome structure, transmission, and pathogenesis of SARS-CoV-2 are basically similar to SARS-CoV and MERS-CoV, the other two beta-CoVs of medical importance. During the SARS-CoV and MERS-CoV epidemics, a variety of molecular and serological diagnostic assays were established and should be referred to for SARS-CoV-2. In this review, by summarizing the articles and guidelines about specimen collection, nucleic acid tests (NAT) and serological tests for SARS-CoV, MERS-CoV, and SARS-CoV-2, several suggestions are put forward to improve the laboratory testing of SARS-CoV-2. In summary, for NAT: collecting stool and blood samples at later periods of illness to improve the positive rate if lower respiratory tract specimens are unavailable; increasing template volume to raise the sensitivity of detection; putting samples in reagents containing guanidine salt to inactivate virus as well as protect RNA; setting proper positive, negative and inhibition controls to ensure high-quality results; simultaneously amplifying human RNase P gene to avoid false-negative results. For antibody test, diverse assays targeting different antigens, and collecting paired samples are needed.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Enfermedades Transmisibles Emergentes/virología , Anticuerpos Antivirales/aislamiento & purificación , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , Enfermedades Transmisibles Emergentes/diagnóstico , Infecciones por Coronavirus/diagnóstico , Cartilla de ADN , Humanos , Coronavirus del Síndrome Respiratorio de Oriente Medio/genética , Coronavirus del Síndrome Respiratorio de Oriente Medio/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Ribonucleasa P/genética , Ribonucleasa P/aislamiento & purificación , Virus del SRAS/genética , Virus del SRAS/aislamiento & purificación , Pruebas Serológicas/métodos
10.
J Infect Dev Ctries ; 14(3): 254-264, 2020 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-32235085

RESUMEN

18 years ago, in 2002, the world was astonished by the appearance of Severe Acute Respiratory Syndrome (SARS), supported by a zoonotic coronavirus, called SARS-CoV, from the Guangdong Province of southern China. After about 10 years, in 2012, another similar coronavirus triggered the Middle East Respiratory Syndrome (MERS-CoV) in Saudi Arabia. Both caused severe pneumonia killing 774 and 858 people with 8700 cases of confirmed infection for the former, and 2494 for the latter, causing significant economic losses. 8 years later, despite the MERS outbreak remaining in certain parts of the world, at the end of 2019, a new zoonotic coronavirus (SARS-CoV-2) and responsible of coronavirus Disease (COVID-19), arose from Wuhan, Hubei Province, China. It spread rapidly and to date has killed 3,242 persons with more than 81,000 cases of infection in China and causing over 126,000 global cases and 5,414 deaths in 166 other countries around the world, especially Italy. SARS-CoV-2 would seem to have come from a bat, but the intermediate reservoir continues to be unknown. Nonetheless, as for SARS-CoV and MERS CoV, the Spillover effect linked to animal-human promiscuity, human activities including deforestation, illegal bush-trafficking and bushmeat, cannot be excluded. Recently, however, evidence of inter-human only transmission of SARS-CoV-2 has been accumulated and thus, the outbreak seems to be spreading by human-to-human transmission throughout a large part of the world. Herein we will provide with an update on the main features of COVID-19 and suggest possible solutions how to halt the expansion of this novel pandemic.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Brotes de Enfermedades , Monitoreo Epidemiológico , Salud Global , Pandemias , Neumonía Viral , Zoonosis , Animales , Betacoronavirus , Evolución Biológica , Camelus , China/epidemiología , Quirópteros , Defensa Civil , Enfermedades Transmisibles Emergentes , Coronavirus/genética , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Reservorios de Enfermedades , Actividades Humanas , Italia , Coronavirus del Síndrome Respiratorio de Oriente Medio , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/terapia , Neumonía Viral/transmisión , Virus del SRAS , Síndrome Respiratorio Agudo Grave/epidemiología , Vacunas Virales , Zoonosis/epidemiología
12.
Reprod Health ; 17(1): 43, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32238177

RESUMEN

This century is witnessing dramatic changes in the health needs of the world's populations. The double burden of infectious and chronic diseases constitutes major causes of morbidity and mortality. Over the last two decades, there has been a rise in infectious diseases, including the severe acute respiratory syndrome virus (SARS), the H1N1 pandemic influenza, the Ebolavirus and the Covid-19 virus. These diseases have rapidly spread across the world and have reminded us of the unprecedented connectivity that defines our modern civilization. Though some countries have made substantial progress toward improving global surveillance for emerging infectious diseases (EIDs), the vast majority of Low-and Middle-income Countries (LMICs) with fragile health systems and various system-related bottlenecks remain vulnerable to outbreaks and, as such, experience dramatic social and economic consequences when they are reported. Lessons learned from past outbreaks suggest that gender inequalities are common across a range of health issues relating to Sexual and Reproductive Health and Rights (SRHR), with women being particularly disadvantaged, partially due to the burden placed on them. Though these countries are striving to improve their health systems and be more inclusive to this vulnerable group, the national/ global outbreaks have burdened the overall system and thus paralyzed normal services dedicated to the delivery of Sexual and Reproductive Health (SRH) services. In this paper, we discuss the global commitments to SRH, the impact of the EIDs on the LMICs, the failure in the delivery of SRH services, and the strategies for successful implementation of recovery plans that must address the specific and differentiated needs of women and girls in resource-poor settings.


Asunto(s)
Enfermedades Transmisibles Emergentes , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Salud Reproductiva , Derechos Sexuales y Reproductivos , Derechos de la Mujer , Betacoronavirus , Países en Desarrollo , Brotes de Enfermedades , Salud Global , Recursos en Salud , Humanos , Servicios de Salud Reproductiva , Desarrollo Sostenible , Salud de la Mujer
16.
West J Emerg Med ; 21(2): 184-190, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-32191174

RESUMEN

2019 Novel Coronavirus (2019-nCoV) is an emerging infectious disease closely related to MERS-CoV and SARS-CoV that was first reported in Wuhan City, Hubei Province, China in December 2019. As of January 2020, cases of 2019-nCoV are continuing to be reported in other Eastern Asian countries as well as in the United States, Europe, Australia, and numerous other countries. An unusually high volume of domestic and international travel corresponding to the beginning of the 2020 Chinese New Year complicated initial identification and containment of infected persons. Due to the rapidly rising number of cases and reported deaths, all countries should be considered at risk of imported 2019-nCoV. Therefore, it is essential for prehospital, clinic, and emergency department personnel to be able to rapidly assess 2019-nCoV risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) Tool, originally conceived for the initial detection and management of Ebola virus and later adjusted for other infectious agents, can be adapted for any emerging infectious disease. This paper reports a modification of the 3I Tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system. Upon confirmation of a suspected 2019-nCoV case, affected persons must immediately be placed in airborne infection isolation and the appropriate public health agencies notified. This modified 3I Tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing persons with suspected or confirmed 2019-nCoV.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Técnicas de Apoyo para la Decisión , Diagnóstico Diferencial , Servicio de Urgencia en Hospital , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , China , Técnicas de Laboratorio Clínico , Enfermedades Transmisibles Emergentes , Infecciones por Coronavirus/epidemiología , Servicios Médicos de Urgencia , Europa (Continente) , Humanos , Neumonía Viral/epidemiología , Factores de Riesgo , Viaje
17.
J Infect Public Health ; 13(4): 644-646, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32199792

RESUMEN

The outbreak of Coronavirus Disease 2019 (COVID-19) causing novel coronavirus-infected pneumonia (NCIP), has affected the lives of 71,429 people globally. Originating in China, the disease has a rapid progression to other countries. Research suggests remarkable genomic resemblance of 2019-nCoV with Severe Acute Respiratory Syndrome (SARS) which has a history of a pandemic in 2002. With evidence of nosocomial spread, a number of diligent measures are being employed to constrain its propagation. Hence, the Public Health Emergency of International Concern (PHEIC) has been established by the World Health Organization (WHO) with strategic objectives for public health to curtail its impact on global health and economy.


Asunto(s)
Betacoronavirus , Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Animales , China/epidemiología , Enfermedades Transmisibles Emergentes/virología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Brotes de Enfermedades/estadística & datos numéricos , Salud Global/estadística & datos numéricos , Humanos , Pandemias/estadística & datos numéricos , Neumonía Viral/transmisión , Neumonía Viral/virología , Virus del SRAS , Síndrome Respiratorio Agudo Grave/virología , Zoonosis/epidemiología , Zoonosis/virología
18.
Emerg Microbes Infect ; 9(1): 747-756, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32196430

RESUMEN

The three unprecedented outbreaks of emerging human coronavirus (HCoV) infections at the beginning of the twenty-first century have highlighted the necessity for readily available, accurate and fast diagnostic testing methods. The laboratory diagnostic methods for human coronavirus infections have evolved substantially, with the development of novel assays as well as the availability of updated tests for emerging ones. Newer laboratory methods are fast, highly sensitive and specific, and are gradually replacing the conventional gold standards. This presentation reviews the current laboratory methods available for testing coronaviruses by focusing on the coronavirus disease 2019 (COVID-19) outbreak going on in Wuhan. Viral pneumonias typically do not result in the production of purulent sputum. Thus, a nasopharyngeal swab is usually the collection method used to obtain a specimen for testing. Nasopharyngeal specimens may miss some infections; a deeper specimen may need to be obtained by bronchoscopy. Alternatively, repeated testing can be used because over time, the likelihood of the SARS-CoV-2 being present in the nasopharynx increases. Several integrated, random-access, point-of-care molecular devices are currently under development for fast and accurate diagnosis of SARS-CoV-2 infections. These assays are simple, fast and safe and can be used in the local hospitals and clinics bearing the burden of identifying and treating patients.


Asunto(s)
Betacoronavirus , Técnicas de Laboratorio Clínico , Enfermedades Transmisibles Emergentes/diagnóstico , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Antígenos Virales/análisis , Betacoronavirus/genética , Betacoronavirus/inmunología , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/mortalidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Brotes de Enfermedades , Humanos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Pruebas en el Punto de Atención , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Pruebas Serológicas , Síndrome Respiratorio Agudo Grave/diagnóstico , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/mortalidad , Manejo de Especímenes
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