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1.
PLoS One ; 16(1): e0244983, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33400714

RESUMEN

Here we look into the spread of aerosols indoors that may potentially carry viruses. Many viruses, including the novel SARS-CoV-2, are known to spread via airborne and air-dust pathways. From the literature data and our research on the propagation of fine aerosols, we simulate herein the carryover of viral aerosols in indoor air. We demonstrate that a lot of fine droplets released from an infected person's coughing, sneezing, or talking propagate very fast and for large distances indoors, as well as bend around obstacles, lift up and down over staircases, and so on. This study suggests equations to evaluate the concentration of those droplets, depending on time and distance from the source of infection. Estimates are given for the safe distance to the source of infection, and available methods for neutralizing viral aerosols indoors are considered.


Asunto(s)
/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Aerosoles/análisis , Microbiología del Aire , Contaminación del Aire Interior/análisis , /virología , Tos , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Polvo , Humanos , Modelos Teóricos , Estornudo/fisiología , Virosis/prevención & control
2.
Euro Surveill ; 26(3)2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33478622

RESUMEN

When facing an emerging virus outbreak such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a quick reaction time is key to control the spread. It takes time to develop antivirals and vaccines, and implement vaccination campaigns. Therefore, preventive measures such as rapid isolation of cases and identification and early quarantine of cases' close contacts-as well as masks, physical distancing, hand hygiene, surface disinfection and air control-are crucial to reduce the risk of transmission. In this context, disinfectants and antiseptics with proven efficacy against the outbreak virus should be used. However, biocidal formulations are quite complex and may include auxiliary substances such as surfactants or emollients in addition to active substances. In order to evaluate disinfectants' efficacy objectively, meaningful efficacy data are needed. Therefore, the European Committee for Standardisation technical committee 216 'Chemical disinfectants and antiseptics' Working Group 1 (medical area) has developed standards for efficacy testing. The European tiered approach grades the virucidal efficacy in three levels, with corresponding marker test viruses. In the case of SARS-CoV-2, disinfectants with proven activity against vaccinia virus, the marker virus for the European claim 'active against enveloped viruses', should be used to ensure effective hygiene procedures to control the pandemic.


Asunto(s)
Antiinfecciosos Locales/farmacología , Antiinfecciosos Locales/normas , Desinfectantes/farmacología , Desinfectantes/normas , Medicina Preventiva/normas , Virosis/prevención & control , Guías como Asunto , Humanos , Pandemias/prevención & control
5.
Salud Colect ; 16: e2897, 2020 10 17.
Artículo en Español | MEDLINE | ID: mdl-33147400

RESUMEN

Taking into account the latent threat of future pandemics, the objective of this study is to analyze - particularly with respect to medications - the sustainability of the health system, healthcare coverage, budgetary efficiency, and connections with the pharmaceutical patent system. In this context, the pharmaceutical patent system acts as a determining factor, given that promoting its existence stimulates the production of research, but in turn its existence stands in the way of rapid advancements, primarily due to the development of protective legislation concerning patents, which has largely accommodated the industry. Given that the pharmaceutical industry has managed to extend the duration of patents and avoid the incorporation of generics, our analysis focuses on the influence of pharmaceutical patents; this influence has led to reflection on the possibility of combining efforts by forging alliances between numerous companies and the public sector in order to face the challenges posed by new diseases caused by viruses that give rise to epidemics and pandemics.


Asunto(s)
Antivirales , Costos de los Medicamentos , Industria Farmacéutica/organización & administración , Política de Salud , Accesibilidad a los Servicios de Salud/organización & administración , Patentes como Asunto , Virosis/tratamiento farmacológico , Antivirales/economía , Antivirales/uso terapéutico , Medicamentos Genéricos , Salud Global , Humanos , Pandemias , Evaluación de Programas y Proyectos de Salud , Virosis/economía , Virosis/epidemiología , Virosis/prevención & control
6.
mSphere ; 5(5)2020 10 21.
Artículo en Inglés | MEDLINE | ID: mdl-33087516

RESUMEN

Supply shortages of N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic have motivated institutions to develop feasible and effective N95 respirator reuse strategies. In particular, heat decontamination is a treatment method that scales well and can be implemented in settings with variable or limited resources. Prior studies using multiple inactivation methods, however, have often focused on a single virus under narrowly defined conditions, making it difficult to develop guiding principles for inactivating emerging or difficult-to-culture viruses. We systematically explored how temperature, humidity, and virus deposition solutions impact the inactivation of viruses deposited and dried on N95 respirator coupons. We exposed four virus surrogates across a range of structures and phylogenies, including two bacteriophages (MS2 and phi6), a mouse coronavirus (murine hepatitis virus [MHV]), and a recombinant human influenza A virus subtype H3N2 (IAV), to heat treatment for 30 min in multiple deposition solutions across several temperatures and relative humidities (RHs). We observed that elevated RH was essential for effective heat inactivation of all four viruses tested. For heat treatments between 72°C and 82°C, RHs greater than 50% resulted in a >6-log10 inactivation of bacteriophages, and RHs greater than 25% resulted in a >3.5-log10 inactivation of MHV and IAV. Furthermore, deposition of viruses in host cell culture media greatly enhanced virus inactivation by heat and humidity compared to other deposition solutions, such as phosphate-buffered saline, phosphate-buffered saline with bovine serum albumin, and human saliva. Past and future heat treatment methods must therefore explicitly account for deposition solutions as a factor that will strongly influence observed virus inactivation rates. Overall, our data set can inform the design and validation of effective heat-based decontamination strategies for N95 respirators and other porous surfaces, especially for emerging viruses that may be of immediate and future public health concern.IMPORTANCE Shortages of personal protective equipment, including N95 respirators, during the coronavirus (CoV) disease 2019 (COVID-19) pandemic have highlighted the need to develop effective decontamination strategies for their reuse. This is particularly important in health care settings for reducing exposure to respiratory viruses, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. Although several treatment methods are available, a widely accessible strategy will be necessary to combat shortages on a global scale. We demonstrate that the combination of heat and humidity inactivates a range of RNA viruses, including both viral pathogens and common viral pathogen surrogates, after deposition on N95 respirators and achieves the necessary virus inactivation detailed by the U.S. Food and Drug Administration guidelines to validate N95 respirator decontamination technologies. We further demonstrate that depositing viruses onto surfaces when suspended in culture media can greatly enhance observed inactivation, adding caution to how heat and humidity treatment methods are validated.


Asunto(s)
Descontaminación/métodos , Calor , Humedad , Ventiladores Mecánicos , Virosis/prevención & control , Inactivación de Virus , Fenómenos Fisiológicos de los Virus , Betacoronavirus , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Solución Salina , Saliva , Albúmina Sérica Bovina
7.
Biochem Soc Trans ; 48(5): 2173-2184, 2020 10 30.
Artículo en Inglés | MEDLINE | ID: mdl-33119046

RESUMEN

The endoplasmic reticulum (ER), with its expansive membranous system and a vast network of chaperones, enzymes, sensors, and ion channels, orchestrates diverse cellular functions, ranging from protein synthesis, folding, secretion, and degradation to lipid biogenesis and calcium homeostasis. Strikingly, some of the functions of the ER are exploited by viruses to promote their life cycles. During entry, viruses must penetrate a host membrane and reach an intracellular destination to express and replicate their genomes. These events lead to the assembly of new viral progenies that exit the host cell, thereby initiating further rounds of infection. In this review, we highlight how three distinct viruses - polyomavirus, flavivirus, and coronavirus - co-opt key functions of the ER to cause infection. We anticipate that illuminating this virus-ER interplay will provide rational therapeutic approaches to combat the virus-induced diseases.


Asunto(s)
Coronavirus/fisiología , Retículo Endoplásmico/metabolismo , Flavivirus/fisiología , Interacciones Huésped-Patógeno , Poliomavirus/fisiología , Humanos , Chaperonas Moleculares/metabolismo , Virosis/metabolismo , Virosis/prevención & control , Internalización del Virus , Replicación Viral
9.
Cochrane Database Syst Rev ; 10: CD013686, 2020 10 12.
Artículo en Inglés | MEDLINE | ID: mdl-33047816

RESUMEN

BACKGROUND: Many dental procedures produce aerosols (droplets, droplet nuclei and splatter) that harbour various pathogenic micro-organisms and may pose a risk for the spread of infections between dentist and patient. The COVID-19 pandemic has led to greater concern about this risk. OBJECTIVES: To assess the effectiveness of methods used during dental treatment procedures to minimize aerosol production and reduce or neutralize contamination in aerosols. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases on 17 September 2020: Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (in the Cochrane Library, 2020, Issue 8), MEDLINE Ovid (from 1946); Embase Ovid (from 1980); the WHO COVID-19 Global literature on coronavirus disease; the US National Institutes of Health Trials Registry (ClinicalTrials.gov); and the Cochrane COVID-19 Study Register. We placed no restrictions on the language or date of publication. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on aerosol-generating procedures (AGPs) performed by dental healthcare providers that evaluated methods to reduce contaminated aerosols in dental clinics (excluding preprocedural mouthrinses). The primary outcomes were incidence of infection in dental staff or patients, and reduction in volume and level of contaminated aerosols in the operative environment. The secondary outcomes were cost, accessibility and feasibility. DATA COLLECTION AND ANALYSIS: Two review authors screened search results, extracted data from the included studies, assessed the risk of bias in the studies, and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data. We assessed heterogeneity. MAIN RESULTS: We included 16 studies with 425 participants aged 5 to 69 years. Eight studies had high risk of bias; eight had unclear risk of bias. No studies measured infection. All studies measured bacterial contamination using the surrogate outcome of colony-forming units (CFU). Two studies measured contamination per volume of air sampled at different distances from the patient's mouth, and 14 studies sampled particles on agar plates at specific distances from the patient's mouth. The results presented below should be interpreted with caution as the evidence is very low certainty due to heterogeneity, risk of bias, small sample sizes and wide confidence intervals. Moreover, we do not know the 'minimal clinically important difference' in CFU. High-volume evacuator Use of a high-volume evacuator (HVE) may reduce bacterial contamination in aerosols less than one foot (~ 30 cm) from a patient's mouth (MD -47.41, 95% CI -92.76 to -2.06; 3 RCTs, 122 participants (two studies had split-mouth design); very high heterogeneity I² = 95%), but not at longer distances (MD -1.00, -2.56 to 0.56; 1 RCT, 80 participants). One split-mouth RCT (six participants) found that HVE may not be more effective than conventional dental suction (saliva ejector or low-volume evacuator) at 40 cm (MD CFU -2.30, 95% CI -5.32 to 0.72) or 150 cm (MD -2.20, 95% CI -14.01 to 9.61). Dental isolation combination system One RCT (50 participants) found that there may be no difference in CFU between a combination system (Isolite) and a saliva ejector (low-volume evacuator) during AGPs (MD -0.31, 95% CI -0.82 to 0.20) or after AGPs (MD -0.35, -0.99 to 0.29). However, an 'n of 1' design study showed that the combination system may reduce CFU compared with rubber dam plus HVE (MD -125.20, 95% CI -174.02 to -76.38) or HVE (MD -109.30, 95% CI -153.01 to -65.59). Rubber dam One split-mouth RCT (10 participants) receiving dental treatment, found that there may be a reduction in CFU with rubber dam at one-metre (MD -16.20, 95% CI -19.36 to -13.04) and two-metre distance (MD -11.70, 95% CI -15.82 to -7.58). One RCT of 47 dental students found use of rubber dam may make no difference in CFU at the forehead (MD 0.98, 95% CI -0.73 to 2.70) and occipital region of the operator (MD 0.77, 95% CI -0.46 to 2.00). One split-mouth RCT (21 participants) found that rubber dam plus HVE may reduce CFU more than cotton roll plus HVE on the patient's chest (MD -251.00, 95% CI -267.95 to -234.05) and dental unit light (MD -12.70, 95% CI -12.85 to -12.55). Air cleaning systems One split-mouth CCT (two participants) used a local stand-alone air cleaning system (ACS), which may reduce aerosol contamination during cavity preparation (MD -66.70 CFU, 95% CI -120.15 to -13.25 per cubic metre) or ultrasonic scaling (MD -32.40, 95% CI - 51.55 to -13.25). Another CCT (50 participants) found that laminar flow in the dental clinic combined with a HEPA filter may reduce contamination approximately 76 cm from the floor (MD -483.56 CFU, 95% CI -550.02 to -417.10 per cubic feet per minute per patient) and 20 cm to 30 cm from the patient's mouth (MD -319.14 CFU, 95% CI - 385.60 to -252.68). Disinfectants ‒ antimicrobial coolants Two RCTs evaluated use of antimicrobial coolants during ultrasonic scaling. Compared with distilled water, coolant containing chlorhexidine (CHX), cinnamon extract coolant or povidone iodine may reduce CFU: CHX (MD -124.00, 95% CI -135.78 to -112.22; 20 participants), povidone iodine (MD -656.45, 95% CI -672.74 to -640.16; 40 participants), cinnamon (MD -644.55, 95% CI -668.70 to -620.40; 40 participants). CHX coolant may reduce CFU more than povidone iodine (MD -59.30, 95% CI -64.16 to -54.44; 20 participants), but not more than cinnamon extract (MD -11.90, 95% CI -35.88 to 12.08; 40 participants). AUTHORS' CONCLUSIONS: We found no studies that evaluated disease transmission via aerosols in a dental setting; and no evidence about viral contamination in aerosols. All of the included studies measured bacterial contamination using colony-forming units. There appeared to be some benefit from the interventions evaluated but the available evidence is very low certainty so we are unable to draw reliable conclusions. We did not find any studies on methods such as ventilation, ionization, ozonisation, UV light and fogging. Studies are needed that measure contamination in aerosols, size distribution of aerosols and infection transmission risk for respiratory diseases such as COVID-19 in dental patients and staff.


Asunto(s)
Microbiología del Aire , Infecciones Bacterianas/prevención & control , Control de Infección Dental/métodos , Enfermedades Profesionales/prevención & control , Virosis/prevención & control , Adolescente , Adulto , Aerosoles , Anciano , Filtros de Aire , Niño , Preescolar , Recuento de Colonia Microbiana/métodos , Odontología , Desinfectantes , Humanos , Control de Infección Dental/economía , Control de Infección Dental/instrumentación , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Dique de Goma , Succión , Adulto Joven
10.
Cell ; 183(2): 315-323.e9, 2020 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-32941801

RESUMEN

BCG vaccination in children protects against heterologous infections and improves survival independently of tuberculosis prevention. The phase III ACTIVATE trial assessed whether BCG has similar effects in the elderly. In this double-blind, randomized trial, elderly patients (n = 198) received BCG or placebo vaccine at hospital discharge and were followed for 12 months for new infections. At interim analysis, BCG vaccination significantly increased the time to first infection (median 16 weeks compared to 11 weeks after placebo). The incidence of new infections was 42.3% (95% CIs 31.9%-53.4%) after placebo vaccination and 25.0% (95% CIs 16.4%-36.1%) after BCG vaccination; most of the protection was against respiratory tract infections of probable viral origin (hazard ratio 0.21, p = 0.013). No difference in the frequency of adverse effects was found. Data show that BCG vaccination is safe and can protect the elderly against infections. Larger studies are needed to assess protection against respiratory infections, including COVID-19 (ClinicalTrials.gov NCT03296423).


Asunto(s)
Vacuna BCG/efectos adversos , Vacuna BCG/inmunología , Infecciones del Sistema Respiratorio/prevención & control , Anciano , Anciano de 80 o más Años , Vacuna BCG/administración & dosificación , Método Doble Ciego , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Infecciones del Sistema Respiratorio/inmunología , Virosis/inmunología , Virosis/prevención & control
11.
Appl Microbiol Biotechnol ; 104(19): 8089-8104, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32813065

RESUMEN

Interspecies transmissions of viruses between animals and humans may result in unpredictable pathogenic potential and new transmissible diseases. This mechanism has recently been exemplified by the discovery of new pathogenic viruses, such as the novel severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) pandemic, Middle-East respiratory syndrome-coronavirus epidemic in Saudi Arabia, and the deadly outbreak of Ebola in West Africa. The. SARS-CoV-2 causes coronavirus disease-19 (COVID-19), which is having a massive global impact in terms of economic disruption, and, above all, human health. The disease is characterized by dry cough, fever, fatigue, myalgia, and dyspnea. Other symptoms include headache, sore throat, rhinorrhea, and gastrointestinal disorders. Pneumonia appears to be the most common and severe manifestation of the infection. Currently, there is no vaccine or specific drug for COVID-19. Further, the development of new antiviral requires a considerable length of time and effort for drug design and validation. Therefore, repurposing the use of natural compounds can provide alternatives and can support therapy against COVID-19. In this review, we comprehensively discuss the prophylactic and supportive therapeutic role of probiotics for the management of COVID-19. In addition, the unique role of probiotics to modulate the gut microbe and assert gut homeostasis and production of interferon as an antiviral mechanism is described. Further, the regulatory role of probiotics on gut-lung axis and mucosal immune system for the potential antiviral mechanisms is reviewed and discussed.Key points• Gut microbiota role in antiviral diseases• Factors influencing the antiviral mechanism• Probiotics and Covid-19.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Probióticos/uso terapéutico , Animales , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Tracto Gastrointestinal/microbiología , Humanos , Inmunidad Mucosa , Pulmón/inmunología , Pulmón/microbiología , Pulmón/virología , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Probióticos/metabolismo , Infecciones del Sistema Respiratorio/microbiología , Virosis/prevención & control , Virosis/terapia , Virosis/transmisión , Vitamina D/fisiología , Zinc/metabolismo
12.
Int J Infect Dis ; 98: 275-280, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32619762

RESUMEN

OBJECTIVE: Vaccination coverage is decreasing worldwide, favoring the potential reemergence of vaccine-preventable diseases. In this study, we performed a longitudinal characterization of vaccination coverage in Brazil and compared the profiles between the distinct regions in the country to test whether there has been a substantial change over the last 5 years. METHODS: De-identified publicly available data were retrieved from the repository of the Brazilian Ministry of Health, comprising detailed information on vaccination coverage in all age groups between 1994 and 2019. The vaccination coverage for the whole country and for each Brazilian region, by year, was examined, and a time-series pattern analysis was performed. RESULTS: A significant decrease in overall vaccination coverage across the country regions was observed between 2017 and 2019, especially in childhood immunization. A reduction in BCG, hepatitis B, influenza, and rotavirus vaccine coverage was observed. Conversely, vaccines against measles, mumps, rubella, varicella, and meningococcus showed an increase in coverage. Region-specific changes in vaccination patterns within the study period were observed. CONCLUSIONS: A substantial reduction in vaccination coverage was detected in Brazil, a country already highly susceptible to the emergence of epidemic infectious diseases. Continuing evaluation of the immunization program actions may help to improve vaccination coverage and prevent new epidemics.


Asunto(s)
Vacunas Virales/administración & dosificación , Virosis/prevención & control , Virus/inmunología , Brasil/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Vacunación/economía , Cobertura de Vacunación , Vacunas Virales/economía , Virosis/economía , Virosis/epidemiología , Virosis/virología , Virus/genética
13.
Int J Mol Sci ; 21(14)2020 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-32698494

RESUMEN

Single-stranded RNA viruses such as alphaviruses, flaviviruses, measles viruses and rhabdoviruses are characterized by their capacity of highly efficient self-amplification of RNA in host cells, which make them attractive vehicles for vaccine development. Particularly, alphaviruses and flaviviruses can be administered as recombinant particles, layered DNA/RNA plasmid vectors carrying the RNA replicon and even RNA replicon molecules. Self-amplifying RNA viral vectors have been used for high level expression of viral and tumor antigens, which in immunization studies have elicited strong cellular and humoral immune responses in animal models. Vaccination has provided protection against challenges with lethal doses of viral pathogens and tumor cells. Moreover, clinical trials have demonstrated safe application of RNA viral vectors and even promising results in rhabdovirus-based phase III trials on an Ebola virus vaccine. Preclinical and clinical applications of self-amplifying RNA viral vectors have proven efficient for vaccine development and due to the presence of RNA replicons, amplification of RNA in host cells will generate superior immune responses with significantly reduced amounts of RNA delivered. The need for novel and efficient vaccines has become even more evident due to the global COVID-19 pandemic, which has further highlighted the urgency in challenging emerging diseases.


Asunto(s)
Neoplasias/prevención & control , ARN Viral/genética , Vacunas Sintéticas/inmunología , Vacunas Virales/inmunología , Virosis/prevención & control , Animales , Vectores Genéticos/genética , Humanos , Ratones , Neoplasias/virología , Vacunación , Virus/genética
14.
Indian J Public Health ; 64(Supplement): S192-S200, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32496254

RESUMEN

Background: There is paucity of evidence on the effectiveness of facemask use in COVID-19 in community settings. Objectives: We aimed to estimate the effectiveness of facemask use alone or along with hand hygiene in community settings in reducing the transmission of viral respiratory illness. Methods: We searched PubMed and Embase for randomized controlled trials on facemask use in community settings to prevent viral respiratory illnesses published up to April 25, 2020. Two independent reviewers were involved in synthesis of data. Data extraction and risk-of-bias assessment were done in a standard format from the selected studies. Outcome data for clinically diagnosed or self-reported influenza-like illness (ILI) was recorded from individual studies. Pooled effect size was estimated by random-effects model for "facemask only versus control" and "facemask plus hand hygiene versus control." Results: Of the 465 studies from PubMed and 437 studies from Embase identified from our search, 9 studies were included in qualitative synthesis and 8 studies in quantitative synthesis. Risk of bias was assessed as low (n = 4), medium (n = 3), or high (n = 1) risk. Interventions included using a triple-layered mask alone or in combination with hand hygiene. Publication bias was not significant. There was no significant reduction in ILI either with facemask alone (n = 5, pooled effect size: -0.17; 95% confidence interval [CI]: -0.43-0.10; P = 0.23; I2 = 10.9%) or facemask with handwash (n = 6, pooled effect size: (n=6, pooled effect size: -0.09; 95% CI: -0.58 to 0.40; P = 0.71, I2 = 69.4%). Conclusion: : Existing data pooled from randomized controlled trials do not reveal a reduction in occurrence of ILI with the use of facemask alone in community settings.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Desinfección de las Manos , Máscaras/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Infecciones por Coronavirus/transmisión , Humanos , India , Neumonía Viral/transmisión , Ensayos Clínicos Controlados Aleatorios como Asunto , Infecciones del Sistema Respiratorio/prevención & control , Infecciones del Sistema Respiratorio/transmisión , Virosis/prevención & control , Virosis/transmisión
16.
Nat Rev Microbiol ; 18(8): 461-471, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32528128

RESUMEN

Most viral pathogens in humans have animal origins and arose through cross-species transmission. Over the past 50 years, several viruses, including Ebola virus, Marburg virus, Nipah virus, Hendra virus, severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory coronavirus (MERS-CoV) and SARS-CoV-2, have been linked back to various bat species. Despite decades of research into bats and the pathogens they carry, the fields of bat virus ecology and molecular biology are still nascent, with many questions largely unexplored, thus hindering our ability to anticipate and prepare for the next viral outbreak. In this Review, we discuss the latest advancements and understanding of bat-borne viruses, reflecting on current knowledge gaps and outlining the potential routes for future research as well as for outbreak response and prevention efforts.


Asunto(s)
Biodiversidad , Quirópteros/virología , Enfermedades Transmisibles Emergentes/virología , Virosis/virología , Fenómenos Fisiológicos de los Virus , Zoonosis/virología , Animales , Enfermedades Transmisibles Emergentes/prevención & control , Enfermedades Transmisibles Emergentes/transmisión , Brotes de Enfermedades/prevención & control , Humanos , Investigación/tendencias , Virosis/prevención & control , Zoonosis/prevención & control , Zoonosis/transmisión
17.
Front Immunol ; 11: 1221, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32574271

RESUMEN

Lactoferrin is a nutrient classically found in mammalian milk. It binds iron and is transferred via a variety of receptors into and between cells, serum, bile, and cerebrospinal fluid. It has important immunological properties, and is both antibacterial and antiviral. In particular, there is evidence that it can bind to at least some of the receptors used by coronaviruses and thereby block their entry. Of importance are Heparan Sulfate Proteoglycans (HSPGs) and the host receptor angiotensin-converting enzyme 2 (ACE2), as based on other activities lactoferrin might prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from attaching to the host cells. Lactoferrin (and more specifically enteric-coated LF because of increased bioavailability) may consequently be of preventive and therapeutic value during the present COVID-19 pandemic.


Asunto(s)
Proteoglicanos de Heparán Sulfato/metabolismo , Lactoferrina/fisiología , Lactoferrina/uso terapéutico , Peptidil-Dipeptidasa A/metabolismo , Receptores Virales/metabolismo , Animales , Antibacterianos/uso terapéutico , Infecciones Bacterianas/prevención & control , Suplementos Dietéticos , Humanos , Lactoferrina/metabolismo , Receptores de Superficie Celular/metabolismo , Virosis/prevención & control
18.
BMC Infect Dis ; 20(1): 359, 2020 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-32434480

RESUMEN

BACKGROUND: Substantial numbers of patients are now receiving either immunosuppressive therapies or chemotherapy. There are significant risks in such patients of developing opportunistic infections or re-activation of latent infections, with higher associated morbidity and mortality. The aim of this quality improvement project was to determine how effective 5 different specialties were in assessing and mitigating risks of developing opportunistic infections or re-activation of latent infections in patients undergoing immunosuppressive therapies. METHODS: This was a single centre audit where records of patients attending clinics providing immunosuppressive therapies were reviewed for the following: evidence of screening for blood-borne virus [BBV] infections, varicella and measles immunity, latent/active TB or hypogammaglobulinaemia, and whether appropriate vaccines had been advised or various infection risks discussed. These assessments were audited against both national and international guidelines, or a cross-specialty consensus guideline where specific recommendations were lacking. Two sub-populations were also analysed separately: patients receiving more potent immunosuppression and black and minority ethnic [BME] patients,. RESULTS: For the 204 patients fulfilling the inclusion criteria, BBV, varicella/measles and latent TB screening was inconsistent, as was advice for vaccinations, with few areas complying with specialty or consensus guidelines. Less than 10% of patients in one specialty were tested for HIV. In BME patients screening for HIV [60%], measles [0%] and varicella [40%] immunity and latent [30%] or active [20%] TB was low. Only 38% of patients receiving potent immunosuppression received Pneumocystis prophylaxis, with 3 of 4 specialties providing less than 15% of patients in this category with prophylaxis. CONCLUSIONS: Compliance with guidelines to mitigate risks of infection from immunosuppressive therapies was either inconsistent or poor for most specialties. New approaches to highlight such risks and assist appropriate pre-immunosuppression screening are needed.


Asunto(s)
Enfermedades Transmisibles/diagnóstico , Adhesión a Directriz , Inmunosupresión/efectos adversos , Adulto , Varicela/diagnóstico , Varicela/prevención & control , Control de Enfermedades Transmisibles , Enfermedades Transmisibles/etiología , Inglaterra , Femenino , Hospitales/estadística & datos numéricos , Humanos , Huésped Inmunocomprometido , Inmunosupresores , Masculino , Sarampión/diagnóstico , Sarampión/prevención & control , Persona de Mediana Edad , Neumonía por Pneumocystis/diagnóstico por imagen , Neumonía por Pneumocystis/prevención & control , Estudios Retrospectivos , Vacunación , Virosis/diagnóstico , Virosis/prevención & control
19.
Artículo en Inglés | MEDLINE | ID: mdl-32450013

RESUMEN

Because viruses still represent a significant threat to human and animal health worldwide, the development of effective weapons against viral infections remains a top priority for the biopharmaceutical industry. This article reviews the dietary and pharmaceutical applications of polysaccharides (PS), first of all chitosan, in the prevention and treatment of viral diseases, focusing more particularly on solid or gel micro/nanoparticulate systems. The intrinsic antiviral activity of PS and their immunostimulatory effects, implemented in animal and human diets, are first surveyed. Then the review discusses the potential of PS-based particles as carriers of antiviral drugs and vaccines, with emphasis on the adjuvant potency of PS in solid vaccine formulations. The gap between the abundance of academic studies in this area and the lack of actual antiviral formulations dispensed to human patients is underlined, notwithstanding a number of branded products on the market.


Asunto(s)
Adyuvantes Inmunológicos/administración & dosificación , Sistemas de Liberación de Medicamentos/métodos , Polisacáridos/administración & dosificación , Polisacáridos/inmunología , Vacunas Virales/administración & dosificación , Vacunas Virales/inmunología , Virosis/prevención & control , Adyuvantes Inmunológicos/farmacología , Animales , Antivirales/administración & dosificación , Humanos , Polisacáridos/farmacología , Virosis/inmunología , Virosis/terapia
20.
Cochrane Database Syst Rev ; 4: CD013597, 2020 04 28.
Artículo en Inglés | MEDLINE | ID: mdl-32343408

RESUMEN

BACKGROUND: Handwashing is important to reduce the spread and transmission of infectious disease. Ash, the residue from stoves and fires, is a material used for cleaning hands in settings where soap is not widely available. OBJECTIVES: To assess the benefits and harms of hand cleaning with ash compared with hand cleaning using soap or other materials for reducing the spread of viral and bacterial infections. SEARCH METHODS: On 26 March 2020 we searched CENTRAL, MEDLINE, Embase, WHO Global Index Medicus, and the WHO International Clinical Trials Registry Platform. SELECTION CRITERIA: We included all types of studies, in any population, that examined hand cleaning with ash compared to hand cleaning with any other material. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and full texts, and one review author extracted outcome data and assessed risk of bias, which another review author double-checked. We used the ROBINS-I tool for observational studies, we used RoB 2.0 for three interventional studies, and we used GRADE to assess the certainty of the evidence. We planned to synthesise data with random-effects meta-analyses. Our prespecified outcome measures were overall mortality, number of cases of infections (as defined in the individual studies), severity of infectious disease, harms (as reported in the individual studies), and adherence. MAIN RESULTS: We included 14 studies described in 19 records using eight different study designs, but only one randomised trial. The studies were primarily conducted in rural settings in low- and lower-middle-income countries. Six studies reported outcome data relevant to our review. A retrospective case-control study and a cohort study assessed diarrhoea in children under the age of five years and self-reported reproductive tract symptoms in women, respectively. It was very uncertain whether the rate of hospital contacts for moderate-to-severe diarrhoea in children differed between households that cleaned hands using ash compared with households cleaning hands using soap (RR 0.97, 95% CI 0.84 to 1.11; very low-certainty evidence). Similarly, it was very uncertain whether the rate of women experiencing symptoms of reproductive tract infection differed between women cleaning hands with ash compared with cleaning hands using soap (RR 0.48, 95% CI 0.12 to 1.86; very low-certainty evidence) or when compared with handwashing with water only or not washing hands (RR 0.50, 95% CI 0.13 to 1.96; very low-certainty evidence). Four studies reported on bacteriological counts after hand wash. We rated all four studies at high risk of bias, and we did not synthesise data due to methodological heterogeneity and unclear outcome reporting. AUTHORS' CONCLUSIONS: Based on the available evidence, the benefits and harms of hand cleaning with ash compared with soap or other materials for reducing the spread of viral or bacterial infections are uncertain.


Asunto(s)
Infecciones Bacterianas/prevención & control , Higiene de las Manos/métodos , Material Particulado/uso terapéutico , Virosis/prevención & control , Adolescente , Adulto , Infecciones Bacterianas/epidemiología , Betacoronavirus , Estudios de Casos y Controles , Preescolar , Estudios de Cohortes , Culinaria , Infecciones por Coronavirus/prevención & control , Diarrea/epidemiología , Heces/microbiología , Femenino , Fuego , Mano/microbiología , Humanos , Masculino , Pandemias/prevención & control , Material Particulado/efectos adversos , Neumonía Viral/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Infecciones del Sistema Genital/epidemiología , Autoinforme , Jabones , Virosis/epidemiología
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