Effectiveness of Physical Distancing: Staying 6 Feet Over to Put Respiratory Viruses 6 Feet Under.

Community transmission of severe acute respiratory illness Coronavirus-2 (SARS-CoV-2) in Arizona was noted in March 2020. It was our hypothesis that the associated implementation of physical distancing and masking led to a decline in circulation and detection of common respiratory viruses. Nasopharyngeal swabs processed with the Biofire, Film Array respiratory panel at Mayo Clinic Arizona were reviewed from January 1, 2017, to July 31, 2020. A total of 13,324 nasopharyngeal swabs were analyzed. Between April and July 2017- 2019 (Period A) a mean of 262 tests were performed monthly, falling to 128 for the corresponding months of 2020 (Period B). A reduction in the monthly mean number of positive tests (Period A 71.5; Period B 2.8) and mean positivity rate (Period A 25.04%; Period B 2.07%) was observed. Rhinovirus/enterovirus was the most prevalent virus, with a monthly mean of 21.6 cases (30.2% of positives) for Period A and 2 cases (72.7% of positives) for Period B. Positivity for a second virus occurred in a mean of 2.1 positive tests (3.3%) in Period A but was absent in Period B. Implementation of distancing and masking coincides with a marked reduction in respiratory virus detection and likely circulation. Data from the fall/winter of 2020 will help clarify the potential role for distancing and masking as a mitigation strategy, not only for SARS-CoV-2 but also in the seasonal battle against common respiratory viruses.

Unilateral phacoemulsification in a captive African elephant (Loxodonta africana).

Background: The following case reports describe the clinical presentation, surgical protocol, post-operative care, and long-term follow-up of an African elephant (Loxodonta Africana) presenting with a unilateral cataract. Case description: A 42-year-old female African elephant presented for the assessment of ocular discomfort and visual deterioration in the left eye. Pre-surgical treatment included topical anti-inflammatory medication for 20 days prior to surgery. On the day of surgery, following anesthetic induction, a two-handed phacoemulsification technique was performed in the left eye. She was left aphakic post-operatively. Nine days post-operatively, the patient had an intact menace response, dazzle reflex, and direct pupillary light reflex. Fundoscopy at that stage was unremarkable. Follow-up information was available for 5 years, from the time of surgery to the present day. Conclusion: Despite remaining aphakic, this case presents a successful visual outcome. To the best of the authors' knowledge, there is no other published report of phacoemulsification in a captive elephant.

CANINE DISTEMPER VIRUS IN A WILD FAR EASTERN LEOPARD ( PANTHERA PARDUS ORIENTALIS).

The critically endangered population of Far Eastern leopards ( Panthera pardus orientalis) may number as few as 60 individuals and is at risk from stochastic processes such as infectious disease. During May 2015, a case of canine distemper virus (CDV) was diagnosed in a wild leopard exhibiting severe neurologic disease in the Russian territory of Primorskii Krai. Amplified sequences of the CDV hemagglutinin gene and phosphoprotein gene aligned within the Arctic-like clade of CDV, which includes viruses from elsewhere in Russia, China, Europe, and North America. Histologic examination of cerebral tissue revealed perivascular lymphoid cuffing and demyelination of the white matter consistent with CDV infection. Neutralizing antibodies against CDV were detected in archived serum from two wild Far Eastern leopards sampled during 1993-94, confirming previous exposure in the population. This leopard population is likely too small to maintain circulation of CDV, suggesting that infections arise from spillover from more-abundant domestic or wild carnivore reservoirs. Increasing the population size and establishment of additional populations of leopards would be important steps toward securing the future of this subspecies and reducing the risk posed by future outbreaks of CDV or other infectious diseases.

Ecosystem carbon density and allocation across a chronosequence of longleaf pine forests.

Forests can partially offset greenhouse gas emissions and contribute to climate change mitigation, mainly through increases in live biomass. We quantified carbon (C) density in 20 managed longleaf pine (Pinus palustris Mill.) forests ranging in age from 5 to 118 years located across the southeastern United States and estimated above- and belowground C trajectories. Ecosystem C stock (all pools including soil C) and aboveground live tree C increased nonlinearly with stand age and the modeled asymptotic maxima were 168 Mg C/ha and 80 Mg C/ha, respectively. Accumulation of ecosystem C with stand age was driven mainly by increases in aboveground live tree C, which ranged from <1 Mg C/ha to 74 Mg C/ha and comprised <1% to 39% of ecosystem C. Live root C (sum of below-stump C, ground penetrating radar measurement of lateral root C, and live fine root C) increased with stand age and represented 4-22% of ecosystem C. Soil C was related to site index, but not to stand age, and made up 39-92% of ecosystem C. Live understory C, forest floor C, downed dead wood C, and standing dead wood C were small fractions of ecosystem C in these frequently burned stands. Stand age and site index accounted for 76% of the variation in ecosystem C among stands. The mean root-to-shoot ratio calculated as the average across all stands (excluding the grass-stage stand) was 0.54 (standard deviation of 0.19) and higher than reports for other conifers. Long-term accumulation of live tree C, combined with the larger role of belowground accumulation of lateral root C than in other forest types, indicates a role of longleaf pine forests in providing disturbance-resistant C storage that can balance the more rapid C accumulation and C removal associated with more intensively managed forests. Although other managed southern pine systems sequester more C over the short-term, we suggest that longleaf pine forests can play a meaningful role in regional forest C management.

Detection of Hepatozoon felis in Ticks Collected from Free-Ranging Amur Tigers ( Panthera tigris altaica), Russian Far East, 2002-12.

We collected 69 ticks from nine, free-ranging Amur tigers ( Panthera tigris altaica) between 2002 and 2011 and investigated them for tick-borne pathogens. DNA was extracted using alkaline digestion and PCR was performed to detect apicomplexan organisms. Partial 18S rDNA amplification products were obtained from 14 ticks from four tigers, of which 13 yielded unambiguous nucleotide sequence data. Comparative sequence analysis revealed all 13 partial 18S rDNA sequences were most similar to those belonging to strains of Hepatozoon felis (>564/572 base-pair identity, >99% sequence similarity). Although this tick-borne protozoon pathogen has been detected in wild felids from many parts of the world, this is the first record from the Russian Far East.

Wheezes and desert breezes: when asthma and valley fever collide.

OBJECTIVE: To evaluate interactive effects of pulmonary coccidioidomycosis and asthma. METHODS: We identified three groups of 33 age- and sex-matched patients: Group 1 (both asthma and coccidioidomycosis), Group 2 (asthma only), and Group 3 (pulmonary coccidioidomycosis only). Predetermined end points included: rate of disseminated coccidioidomycosis, duration of symptoms and antifungal therapy, hospitalization, death, and escalation of asthma therapies. RESULTS: Baseline characteristics were similar across groups. Group 1 patients had worsening asthma outcomes (except forced expiratory volume in 1 s) with coccidioidomycosis. They required more asthma medications (median, 2.0 vs 0.0; p < 0.001), more corticosteroids (mean [SD], 0.9 [4.2] vs 0.3 [0.6]; p < 0.001), and more healthcare visits (mean [SD], 0.2 [0.4] vs 0.1 [0.3]; p = 0.03). Groups 1 and 3 had no differences in coccidioidal end points, including rates of dissemination (1 vs 0; p > 0.99), symptom duration (mean, 15.2 vs 23.6 weeks; p = 0.24), antifungal treatment (n = 21 [63.6%] vs n = 24 [72.7%]; p = 0.60), and treatment duration (median, 26.5 vs 11 weeks; p = 0.09). Ten patients in Group 1 versus none in Group 3 required systemic corticosteroids for coccidioidomycosis (p < 0.001). CONCLUSIONS: Active pulmonary coccidioidomycosis significantly worsens asthma outcomes. Asthma (or its treatment) does not worsen coccidioidal outcomes, despite increasing the likelihood of treatment with systemic corticosteroids.

Mastocytosis associated with a rare germline KIT K509I mutation displays a well-differentiated mast cell phenotype.

BACKGROUND: Mastocytosis associated with germline KIT activating mutations is exceedingly rare. We report the unique clinicopathologic features of a patient with systemic mastocytosis caused by a de novo germline KIT K509I mutation. OBJECTIVES: We sought to investigate the effect of the germline KIT K509I mutation on human mast cell development and function. METHODS: Primary human mast cells derived from CD34(+) peripheral blood progenitors were examined for growth, development, survival, and IgE-mediated activation. In addition, a mast cell transduction system that stably expressed the KIT K509I mutation was established. RESULTS: KIT K509I biopsied mast cells were round, CD25(-), and well differentiated. KIT K509I progenitors cultured in stem cell factor (SCF) demonstrated a 10-fold expansion compared with progenitors from healthy subjects and developed into mature hypergranular mast cells with enhanced antigen-mediated degranulation. KIT K509I progenitors cultured in the absence of SCF survived but lacked expansion and developed into hypogranular mast cells. A KIT K509I mast cell transduction system revealed SCF-independent survival to be reliant on the preferential splicing of KIT at the adjacent exonic junction. CONCLUSION: Germline KIT mutations associated with mastocytosis drive a well-differentiated mast cell phenotype distinct to that of somatic KIT D816V disease, the oncogenic potential of which might be influenced by SCF and selective KIT splicing.

Serosurvey of free-ranging Amur tigers in the Russian Far East.

Wild Amur tigers (Panthera tigris altaica, n=44) from the Russian Far East were tested for antibodies to feline leukemia virus, feline corona virus (FCoV), feline immunodeficiency virus, feline parvovirus (FPV), canine distemper virus (CDV), Toxoplasma gondii, and Bartonella henselae. Antibodies to FCoV, CDV, FPV, and T. gondii were detected in 43, 15, 68, and 42% of tigers, respectively. No differences were detected in antibody prevalence estimates between tigers captured as part of a research program and those captured to mitigate human-tiger conflicts. Domestic dogs (Canis familiaris) were tested as a potential source for CDV; 16% were vaccinated against CDV and 58% of unvaccinated dogs were antibody positive for CDV. A high percentage of tigers were exposed to potential pathogens that could affect the survival of this species. We recommend continued monitoring of wild tigers throughout Asia, development of standardized sampling and postmortem examination procedures, and additional research to better understand potential domestic and wild animal sources for these pathogens.

A novel histologic scoring system to evaluate mucosal biopsies from patients with eosinophilic esophagitis.

BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is characterized by medically/surgically-resistant gastroesophageal reflux symptoms and dense squamous eosinophilia. Studies suggest that histologic assessment of esophageal eosinophilia alone cannot reliably separate patients with EoE from those with gastroesophageal reflux disease (GERD). Our goal was to develop an assay to identify EoE patients and perhaps differentiate EoE from other causes of esophageal eosinophilia. METHODS: A monoclonal antibody specific for an eosinophil secondary granule protein (eosinophil peroxidase [EPX]) was developed and shown to specifically identify intact eosinophils and detect eosinophil degranulation in formalin-fixed specimens. A histopathologic scoring algorithm was developed to analyze data from patient evaluations; the utility of this algorithm was assessed by using archived esophageal tissues from patients with known diagnoses of EoE and GERD as well as controls from 2 tertiary care centers. RESULTS: Intraobserver/interobserver blinded evaluations demonstrated a significant difference (P < .001) between scores of samples taken from control subjects, from patients with esophageal eosinophilia who had a diagnosis of EoE, and from patients with GERD (P < .001). This algorithm also was able to identify patients whose clinical course was suggestive of a diagnosis of EoE, but that nonetheless failed to reach the critical threshold number of > or =15 eosinophils in a high-power (40x) microscopy field. CONCLUSIONS: A novel immunohistochemical scoring system was developed to address an unmet medical need to differentiate histologic specimens from patients with EoE relative to those with GERD. The availability of a unique anti-EPX-specific monoclonal antibody, combined with the ease/rapidity of this staining method and scoring system, will provide a valuable strategy for the assessment of esophageal eosinophilia.

Characterization of cauxin in the urine of domestic and big cats.

Cauxin is an abundant protein in feline urine. We have used proteomics strategies to characterize cauxin from the urine of domestic cats and a number of big cat species. Proteins were resolved by gel-based electrophoretic purification and subjected to in-gel digestion with trypsin. The resultant tryptic peptides were mass-measured by matrix-assisted laser desorption ionization time of flight mass spectrometry. Peptides were also resolved by liquid chromatography and analyzed by electrospray ionization and tandem mass spectrometry to generate fragment ion data to infer the amino acid sequence. We identified cauxin polymorphisms and corrected a sequencing artifact in cauxin from the domestic cat. The proteomics data also provided positive evidence for the presence of a cauxin homolog in the urine of big cats (Pantherinae), including the Sumatran tiger, Asiatic lion, clouded leopard, Persian leopard, and jaguar. The levels of cauxin in the urine of all big cats were substantially lower than that in the urine of intact male domestic cats.

Peri-anaesthetic and anaesthetic-related mortality risks in great apes (Hominidae) in zoological collections in the UK and Ireland.

OBJECTIVE: To estimate the risk of death and identify the major risk factors for peri-anaesthetic mortality in great apes (Hominidae) that underwent anaesthesia in zoological collections in the UK and Ireland between 1 January 1990 and 30 June 2005. STUDY DESIGN: confidential, retrospective cohort study. ANIMAL POPULATION: The study population comprised all great apes from 16 zoological collections in the UK and Ireland that were anaesthetised during that period. METHODS: All available anaesthetic records were collected. Outcome at 7 days post-anaesthesia was recorded as alive, dead or euthanased. The risk of peri-anaesthetic mortality was calculated. Multivariable analysis of potential risk factors was performed. RESULTS: A total of 1182 anaesthetic records were collected and analysed. Sixteen peri-anaesthetic deaths occurred, resulting in a peri-anaesthetic mortality risk of 1.35%. Twenty percent of deaths (3/15) occurred during maintenance and 80% (12/15) occurred post-anaesthetic but within 7 days. A subjective assessment suggests at least five anaesthetic-related deaths occurred; in other words an anaesthetic-related mortality risk of 0.42% (5/1182) or above. In the multivariable analysis, health status and age were significantly associated with peri-anaesthetic mortality. Animals assessed as 'sick' pre-anaesthetic were associated with a 26-fold (95% CI 5.55-122.32) increased risk of death compared with animals with a good health status. Animals aged over 30 years were associated with a 30-fold (95% CI 3.44-261.85) increased risk of death, compared with adults aged between 10 and 30 years. CONCLUSIONS AND CLINICAL RELEVANCE: This study has shown that great ape anaesthesia appears to carry a high risk of mortality. Sick and aged patients are at an increased risk of death and particular care should be exercised during their anaesthesia. Standardisation and completeness of anaesthetic records across zoological collections would assist greatly in further studies.

Field use of isoflurane and air anesthetic equipment in wildlife.

Conventional inhalation anesthesia of wildlife species within natural habitats presents significant practical problems. Heavy cylinders of medical grade oxygen are often unavailable in field situations. Equipment has been modified to permit the delivery of isoflurane in ambient air as the carrier and to be fitted with circuitry adaptable for different species and anesthetic situations. Preliminary empirical studies at low altitude in a range of small mammalian and avian species demonstrate the suitability of this combination and these techniques for inducing and maintaining anesthesia in clinically normal patients undergoing relatively minor procedures. The equipment has also been used to deepen and prolong anesthesia in several larger species, including great apes and large cats, after induction with injectable agents. These techniques, in combination with pulse oximetry to detect hypoxemia, provide a cheap, robust, and portable inhalation anesthetic system for field situations that is not dependent on compressed gasses.