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2.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(2): 159-164, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32220182

RESUMO

Objective: To investigate the effects of enterovirus 71 (EV71) on mitochondrial dynamics in human Glioma U251 cells. Methods: The EV71 was replicated in Vero cells and the 50% tissue culture infective dose (TCID 50) was calculated based on the Reed-Muench formula. After the U251 cells were infected with EV71, the cellular morphology was assessed through the light microscope. The mitochondrial morphology was detected by MitoTracker Deep Red staining under laser confocal microscopy and the mitochondrial ultrastructure was visualized by transmission electron microscopy. The expressions of mitochondrial fission proteins Drp1, p-Drp1 and fusion protein Opa1 were examined by Western blot. The level of ATP was measured by a commercial ATP assay kit. The generation of mitochondrial superoxide was detected by MitoSOX staining. Results: The TCID 50 of EV71 was 10 -5.4/0.1 mL. Twenty-four or 48 h after EV71 infection, the U251 cells appeared shrunken, round and dead. The laser confocal microscopy and transmission electron microscopy images showed that the EV71 infection induced mitochondrial elongation and cristae damage. Moreover, Western blot analysis demonstrated that the protein expressions of Drp1 and Opa1 were downregulated at both 24 and 48 h after EV71 infection in U251 cells, companied with a significant increase in Drp1 phosphorylation at 48 h after infection ( P<0.05). In addition, a decreased ATP level and elevated mitochondrial superoxide generation were observed in the EV71 infected group, as compared to the control group. Conclusion: Our study demonstrated that infection with EV71 led to changes of mitochondrial morphology and dynamics in U251 cells, which may impair mitochondrial function and contribute to nervous system dysfunction.


Assuntos
Neoplasias Encefálicas/virologia , Enterovirus Humano A , Infecções por Enterovirus , Enterovirus , Glioma/virologia , Dinâmica Mitocondrial , Animais , Chlorocebus aethiops , Enterovirus Humano A/patogenicidade , Infecções por Enterovirus/complicações , Humanos , Sistema Nervoso/fisiopatologia , Sistema Nervoso/virologia , Células Tumorais Cultivadas , Células Vero
3.
Emerg Microbes Infect ; 8(1): 1438-1444, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31571527

RESUMO

During 2014, enterovirus D68 (EV-D68) outbreaks were described globally, causing severe respiratory diseases in children and, in some cases, subsequent paralysis. In this study, the type characterization of enterovirus (EV) detected in respiratory illnesses and the epidemiology and clinical association of EV-D68 infections in Spain over a five-year period were described. A total of 546 EV-positive samples from hospitalized patients with respiratory infections were included. EV-D68 was the most frequently detected type (46.6%, 191/410 typed EV). Other EV from species A (25.1%), B (27.8%) and C (0.5%) were also identified. EV-D68 infections were more associated with bronchitis while EV-A/B types were more frequent in upper respiratory illness (p < 0.01). EV-D68 was also detected in patients with neurological symptoms (nine meningitis/meningoencephalitis and eight acute flaccid paralysis cases). Phylogenetic analysis of 3'-VP1 region showed most Spanish EV-D68 sequences from 2014 to 2016 belonged to subclades B2/B3, as other American and European strains circulating during the same period. However, those detected in 2017 and 2018 clustered to the emerged subclade D1. In summary, different EV can cause respiratory infections but EV-D68 was the most prevalent, with several strains circulating in Spain at least since 2014. Association between EV-D68 infection and neurological disease was also described.


Assuntos
Infecções por Enterovirus/complicações , Infecções por Enterovirus/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/virologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bronquite/epidemiologia , Bronquite/virologia , Pré-Escolar , Enterovirus Humano D/classificação , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Meningite/epidemiologia , Meningite/virologia , Pessoa de Meia-Idade , Paralisia/epidemiologia , Paralisia/virologia , Filogenia , Espanha/epidemiologia
4.
Rinsho Shinkeigaku ; 59(9): 579-583, 2019 Sep 25.
Artigo em Japonês | MEDLINE | ID: mdl-31474644

RESUMO

Many cases of acute flaccid paralysis occurred during an enterovirus D68 (EV-D68) outbreak in North America in the fall of 2014, and this epidemic has been newly defined as a distinct disease entity named acute flaccid myelitis (AFM). This disease entity is relatively popular among pediatricians, whereas it remains little-known among neurologists in Japan. We reported a 7-year-old girl with AFM, in whom severe limb weakness and respiratory failure developed five days after appearance of respiratory symptoms. Clinical features of our case were mimicked by those of acute axonal motor neuropathy at early stage of the disease, and this resulted in delayed diagnosis of AFM. DNA of EV-D68 was not detected. There are few reported cases of severe AFM, in which artificial ventilation is needed for a long time including both acute and recovery phases of the illness, and functional prognosis of AFM is discussed by literature.


Assuntos
Mielite Transversa/terapia , Insuficiência Respiratória/terapia , Doença Aguda , Criança , Diagnóstico Tardio , Enterovirus Humano D , Infecções por Enterovirus/complicações , Extremidades , Feminino , Humanos , Debilidade Muscular/etiologia , Mielite Transversa/diagnóstico , Mielite Transversa/etiologia , Respiração Artificial , Insuficiência Respiratória/etiologia , Índice de Gravidade de Doença
5.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(8): 796-800, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31416505

RESUMO

OBJECTIVE: To study the clinical effect of carvedilol in the treatment of children with severe hand-foot-mouth disease (HFMD) caused by enterovirus 71 (EV71) infection. METHODS: A retrospective analysis was performed for the clinical data of 86 children with severe HFMD caused by EV71 infection who were admitted to the hospital from April 2016 to August 2017. According to whether carvedilol was used, the children were divided into conventional treatment group with 51 children and carvedilol treatment group with 35 children. A total of 56 healthy children who underwent physical examination at the outpatient service during the same period were enrolled as the control group. The two treatment groups were compared in terms of clinical features and levels of catecholamines (norepinephrine, adrenaline and dopamine), and the levels of catecholamines were compared between these two treatment groups and the control group. RESULTS: Before treatment, the conventional treatment group and the carvedilol treatment group had significantly higher levels of norepinephrine and adrenaline than the control group (P<0.05). After treatment, both the conventional treatment group and the carvedilol treatment group had significant reductions in norepinephrine, adrenaline, blood glucose, systolic pressure, diastolic pressure, heart rate, body temperature and leukocyte count (P<0.05). Compared with the conventional treatment group, the carvedilol treatment group had significantly lower dopamine level, blood glucose, heart rate and respiratory rate after treatment (P<0.05). CONCLUSIONS: Changes in norepinephrine and adrenaline might be involved in the pathogenesis of severe HFMD caused by EV71 infection. Carvedilol, in addition to the conventional treatment, can improve respiration, heart rate and blood glucose in children with severe HFMD caused by EV71 infection.


Assuntos
Carvedilol/uso terapêutico , Enterovirus Humano A , Infecções por Enterovirus , Doença de Mão, Pé e Boca , Criança , China , Infecções por Enterovirus/complicações , Doença de Mão, Pé e Boca/tratamento farmacológico , Doença de Mão, Pé e Boca/etiologia , Humanos , Estudos Retrospectivos
6.
J Biomed Sci ; 26(1): 57, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395054

RESUMO

During recent 20 years, enterovirus A71 (EV-A71) has emerged as a major concern among pediatric infectious diseases, particularly in the Asia-Pacific region. The clinical manifestations of EV-A71 include uncomplicated hand, foot, and mouth disease, herpanina or febrile illness and central nervous system (CNS) involvement such as aseptic meningitis, myoclonic jerk, polio-like syndrome, encephalitis, encephalomyelitis and cardiopulmonary failure due to severe rhombencephalitis. In follow-up studies of patients with EV-A 71 CNS infection, some still have hypoventilation and need tracheostomy with ventilator support, some have dysphagia and need nasogastric tube or gastrostomy feeding, some have limb weakness/astrophy, cerebellar dysfunction, neurodevelopmental delay, lower cognition, or attention deficiency hyperactivity disorder. Long term sequelae may be related to greater severity of CNS involvement or neuron damage, hypoxia and younger age of onset.


Assuntos
Enterovirus Humano A/fisiologia , Infecções por Enterovirus/complicações , Doenças do Sistema Nervoso/virologia , Infecções por Enterovirus/virologia , Humanos
7.
Eur J Pediatr ; 178(9): 1305-1315, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31338675

RESUMO

Acute flaccid myelitis is characterized by the combination of acute flaccid paralysis and a spinal cord lesion largely restricted to the gray matter on magnetic resonance imaging. The term acute flaccid myelitis was introduced in 2014 after the upsurge of pediatric cases in the USA with enterovirus D68 infection. Since then, an increasing number of cases have been reported worldwide. Whereas the terminology is new, the clinical syndrome has been recognized in the past in association with several other neurotropic viruses such as poliovirus.Conclusion: This review presents the current knowledge on acute flaccid myelitis with respect to the clinical presentation and its differential diagnosis with Guillain-Barré syndrome and acute transverse myelitis. We also discuss the association with enterovirus D68 and the presumed pathophysiological mechanism of this infection causing anterior horn cell damage. Sharing clinical knowledge and insights from basic research is needed to make progress in diagnosis, treatment, and prevention of this new polio-like disease. What is Known: • Acute flaccid myelitis (AFM) is a polio-like condition characterized by rapid progressive asymmetric weakness, together with specific findings on MRI • AFM has been related to different viral agents, but recent outbreaks are predominantly associated with enterovirus D68. What is New: • Improving knowledge on AFM must increase early recognition and adequate diagnostic procedures by clinicians. • The increasing incidence of AFM urges cooperation between pediatricians, neurologists, and microbiologists for the development of treatment and preventive options.


Assuntos
Viroses do Sistema Nervoso Central/diagnóstico , Enterovirus Humano D , Infecções por Enterovirus/diagnóstico , Mielite/diagnóstico , Doenças Neuromusculares/diagnóstico , Viroses do Sistema Nervoso Central/epidemiologia , Viroses do Sistema Nervoso Central/terapia , Viroses do Sistema Nervoso Central/virologia , Diagnóstico Diferencial , Infecções por Enterovirus/complicações , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/terapia , Saúde Global , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/virologia , Humanos , Mielite/epidemiologia , Mielite/terapia , Mielite/virologia , Mielite Transversa/diagnóstico , Mielite Transversa/virologia , Doenças Neuromusculares/epidemiologia , Doenças Neuromusculares/terapia , Doenças Neuromusculares/virologia , Prognóstico
8.
Int Immunopharmacol ; 75: 105773, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31349155

RESUMO

Enterovirus 71 (EV71) always induces severe hand, foot, and mouth disease with neurological complications, such as encephalitis. Interleukin (IL)-7 augments CD8+ T cells activity in chronic viral infection and cancers. However, few studies have focused on common γ-chain (γc) cytokine expression and regulatory function of IL-7 to CD8+ T cells in EV71 associated encephalitis. In this study, twenty-one patients with EV71 associated encephalitis, twenty-seven patients with febrile convulsion (FC), and twenty healthy individuals were enrolled. γc cytokine (IL-2, IL-4, IL-7 and IL-15) concentration was measured by ELISA. IL-7 receptor α chain (membrane/soluble CD127) expression was also investigated. Purified CD8+ T cells were stimulated with recombinant human IL-7 in vitro. The regulatory activity of IL-7 to CD8+ T cells from peripheral blood and cerebrospinal fluids (CSF) was investigated in direct and indirect contact co-culture with U-87MG cells. IL-7 in the serum and CSF, but not IL-2, IL-4, or IL-15, was significant increased in EV71 associated encephalitis. Both total CD127 mRNA relative level and membrane/soluble CD127 expression was comparable among three groups. IL-7 stimulation promoted CD8+ T cells proliferation, up-regulated perforin/granzyme B level, but reduced programmed death-1 expression in CD8+ T cells from EV71 associated encephalitis patients. Cytotoxicity and interferon-γ production of CD8+ T cells from peripheral blood and CSF was also augmented in response to IL-7 stimulation in both direct and indirect co-culture systems in EV71 associated encephalitis. The present data indicated that IL-7 induced cytolytic and non-cytolytic functions of CD8+ T cells in EV71 associated encephalitis. IL-7 might be considered as one of the immunomodulatory therapeutic candidates for EV71 infection.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Encefalite/imunologia , Enterovirus Humano A , Infecções por Enterovirus/imunologia , Interleucina-7/imunologia , Linfócitos T CD8-Positivos/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Criança , Pré-Escolar , Encefalite/etiologia , Infecções por Enterovirus/complicações , Feminino , Humanos , Lactente , Interleucina-7/farmacologia , Masculino , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/farmacologia
9.
Am J Case Rep ; 20: 668-673, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31073115

RESUMO

BACKGROUND Acute flaccid myelitis is an emerging polio-like illness mostly affecting young children, characterized by rapid onset of extremity weakness and paralysis in 1 or more limbs. Certain viruses, including enteroviruses such as EV-68, EV-71, poliovirus, and West Nile virus, can cause this disorder. The largest known outbreak of EVD68 in the United States was in the summer of 2014, causing severe respiratory illness and acute flaccid myelitis, mainly in young children. Furthermore, the US Centers for Disease Control and Prevention noted an increase in the number of patients with clinical symptoms of acute flaccid myelitis in 2018, and 134 confirmed cases by December 2018 were reported in the USA. CASE REPORT The patient in our present study was a 5-year-old female who had significant weakness and paralysis in all 4 extremities due to acute flaccid myelitis. EV-D68 had caused this disorder in this patient in August 2014. Conservative management had not helped her condition. Specific areas of concern were both shoulders and biceps, and the femoral and peroneal nerves in both sides. Of these, the right shoulder function was the worst, at less than grade 3. The patient also had marked atrophy and weakness of the right quadricep muscles. The patient underwent surgical treatment and had steady improvements in all 4 extremity functional movements. CONCLUSIONS We demonstrated that decompression, neurolysis, and nerve transfer surgical procedures can be used successfully to correct the paralyzed upper and lower extremity movements in acute flaccid myelitis patients.


Assuntos
Descompressão Cirúrgica , Mielite/cirurgia , Bloqueio Nervoso , Transferência de Nervo , Paralisia/cirurgia , Pré-Escolar , Enterovirus Humano D , Infecções por Enterovirus/complicações , Feminino , Humanos , Extremidade Inferior/inervação , Mielite/virologia , Paralisia/virologia , Extremidade Superior/inervação
10.
BMJ Case Rep ; 12(4)2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975776

RESUMO

Gallbladder diseases are uncommon in children. Acalculous acute cholecystitis, although rare, is the most frequent form of acute cholecystitis in childhood. In acalculous acute cholecystitis, clinical presentation and laboratory findings are unspecific, making the diagnosis challenging. Abdominal ultrasonography is the first-line exam. Most cases of paediatric acalculous acute cholecystitis have been described in critically ill patients, but can occur in previously healthy children, without underlying diseases or severe conditions. The authors present a clinical report of a child with acalculous acute cholecystitis and enteroviral infection. Diagnosis, treatment, clinical course and prognosis are described. Pathophysiology, aetiology, diagnosis and treatment of acalculous acute cholecystitis are also discussed.


Assuntos
Colecistite Acalculosa/diagnóstico , Infecções por Enterovirus/diagnóstico , Colecistite Acalculosa/complicações , Colecistite Acalculosa/diagnóstico por imagem , Diagnóstico Diferencial , Enterovirus/isolamento & purificação , Infecções por Enterovirus/complicações , Humanos , Lactente , Masculino , Ultrassonografia
11.
BMC Infect Dis ; 19(1): 285, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30917800

RESUMO

BACKGROUND: Hand, foot and mouth disease (HFMD) is a transmissible infectious disease caused by human enteroviruses (EV). Here, we described features of children with severe HFMD caused by EV-A71 or coxsackievirus A16 (CV-A16) in Shanghai, China. METHODS: Severe EV-A71 or CV-A16 caused HFMD children admitted to the Xinhua Hospital from January 2014 and December 2016, were recruited retrospectively to the study. Symptoms and findings at the time of hospitalization, laboratory tests, treatments, length of stay and residual findings at discharge were systematically recorded and analyzed. RESULTS: Of 19,995 children visited clinic service with probable HFMD, 574 children (2.87%) were admitted, 234 children (40.76%) were confirmed with EV-A71 (90/574) or CV-A16 (144/574) disease. Most (91.02%) of the patients were under 5 years. Initial clinical symptoms of EV-A71 and CV-A16 cases were: fever > 39 °C in 81 (90%) and 119 (82.63%), vomiting in 31 (34.44%) and 28 (19.44%), myoclonic twitching in 19 (21.11%) and 11(7.64%), startle in 21 (23.33%) and 20 (13.69%), respectively. Serum levels of interleukin-1ß (IL-1ß), IL-2, IL-6, IL-8, interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α) were significantly upregulated in severe HFMD subjects. Forty-seven children (20.08%) treated with intravenous gamma globulin (IVIG) showed decreased duration of illness episodes. All children were discharged without complications. CONCLUSIONS: EV-A71 and CV-A16 accounted 40.76% of admitted HFMD during 2014 to 2016 in Xinhua Hospital. IVIG appeared to be beneficial in shortening the duration of illness episodes of severe HFMD.


Assuntos
Infecções por Coxsackievirus/epidemiologia , Infecções por Coxsackievirus/terapia , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/terapia , Enterovirus , Doença de Mão, Pé e Boca/epidemiologia , Doença de Mão, Pé e Boca/terapia , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , Enterovirus/fisiologia , Enterovirus Humano A/fisiologia , Infecções por Enterovirus/complicações , Infecções por Enterovirus/diagnóstico , Feminino , Doença de Mão, Pé e Boca/diagnóstico , Doença de Mão, Pé e Boca/microbiologia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
13.
BMJ ; 364: l231, 2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30760441

RESUMO

OBJECTIVE: To determine whether infection with human enterovirus or adenovirus, both common intestinal viruses, predicts development of coeliac disease. DESIGN: Case-control study nested within Norwegian birth cohort recruited between 2001 and 2007 and followed to September 2016. SETTING: Norwegian population. PARTICIPANTS: Children carrying the HLA genotype DR4-DQ8/DR3-DQ2 conferring increased risk of coeliac disease. EXPOSURES: Enterovirus and adenovirus detected using real time polymerase chain reaction in monthly stool samples from age 3 to 36 months. MAIN OUTCOME MEASURE: Coeliac disease diagnosed according to standard criteria. Coeliac disease antibodies were tested in blood samples taken at age 3, 6, 9, and 12 months and then annually. Adjusted odds ratios from mixed effects logistic regression model were used to assess the relation between viral infections before development of coeliac disease antibodies and coeliac disease. RESULTS: Among 220 children, and after a mean of 9.9 (SD 1.6) years, 25 children were diagnosed as having coeliac disease after screening and were matched to two controls each. Enterovirus was found in 370 (17%) of 2135 samples and was significantly more frequent in samples collected before development of coeliac disease antibodies in cases than in controls (adjusted odds ratio 1.49, 95% confidence interval 1.07 to 2.06; P=0.02). The association was restricted to infections after introduction of gluten. High quantity samples (>100 000 copies/µL) (adjusted odds ratio 2.11, 1.24 to 3.60; P=0.01) and long lasting infections (>2 months) (2.16, 1.16 to 4.04; P=0.02) gave higher risk estimates. Both the commonly detected enterovirus species Enterovirus A and Enterovirus B were significantly associated with coeliac disease. The association was not found for infections during or after development of coeliac disease antibodies. Adenovirus was not associated with coeliac disease. CONCLUSIONS: In this longitudinal study, a higher frequency of enterovirus, but not adenovirus, during early childhood was associated with later coeliac disease. The finding adds new information on the role of viral infections in the aetiology of coeliac disease.


Assuntos
Doença Celíaca/virologia , Infecções por Enterovirus/complicações , Autoanticorpos/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Fezes/virologia , Feminino , Genótipo , Humanos , Lactente , Estudos Longitudinais , Masculino , Noruega/epidemiologia , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco
15.
Diabetologia ; 62(5): 744-753, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30675626

RESUMO

In type 1 diabetes, pancreatic beta cells are destroyed by chronic autoimmune responses. The disease develops in genetically susceptible individuals, but a role for environmental factors has been postulated. Viral infections have long been considered as candidates for environmental triggers but, given the lack of evidence for an acute, widespread, cytopathic effect in the pancreas in type 1 diabetes or for a closely related temporal association of diabetes onset with such infections, a role for viruses in type 1 diabetes remains unproven. Moreover, viruses have rarely been isolated from the pancreas of individuals with type 1 diabetes, mainly (but not solely) due to the inaccessibility of the organ. Here, we review past and recent literature to evaluate the proposals that chronic, recurrent and, possibly, persistent enteroviral infections occur in pancreatic beta cells in type 1 diabetes. We also explore whether these infections may be sustained by different virus strains over time and whether multiple viral hits can occur during the natural history of type 1 diabetes. We emphasise that only a minority of beta cells appear to be infected at any given time and that enteroviruses may become replication defective, which could explain why they have been isolated from the pancreas only rarely. We argue that enteroviral infection of beta cells largely depends on the host innate and adaptive immune responses, including innate responses mounted by beta cells. Thus, we propose that viruses could play a role in type 1 diabetes on multiple levels, including in the triggering and chronic stimulation of autoimmunity and in the generation of inflammation and the promotion of beta cell dysfunction and stress, each of which might then contribute to autoimmunity, as part of a vicious circle. We conclude that studies into the effects of vaccinations and/or antiviral drugs (some of which are currently on-going) is the only means by which the role of viruses in type 1 diabetes can be finally proven or disproven.


Assuntos
Antivirais/uso terapêutico , Diabetes Mellitus Tipo 1/virologia , Infecções por Enterovirus/prevenção & controle , Pâncreas/fisiopatologia , Vacinas Virais/uso terapêutico , Imunidade Adaptativa , Autoimunidade , Bancos de Espécimes Biológicos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Infecções por Enterovirus/complicações , Infecções por Enterovirus/tratamento farmacológico , Humanos , Imunidade Inata , Células Secretoras de Insulina/metabolismo , Pâncreas/virologia , Vacinas Virais/economia
16.
BMC Infect Dis ; 19(1): 32, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621623

RESUMO

BACKGROUND: Viruses are commonly found in patients with acute respiratory infections (ARIs). However, the viral etiologies and clinical characteristics of outpatients with ARIs are poorly understood in China. Here, we identified the viral etiologies in outpatients with ARIs in Huzhou, China. RESULTS: Our results indicated that of 426 outpatients, 246 were positive for viruses. Of them, 221 were positive for a single virus, including influenza A, which comprised H3N2 (28.5%) and pandemic H1N1 (2009) (19.0%), enterovirus (10.4%), and influenza B (8.6%). Other single viruses were detected at less than 8.0%. Twenty-five patients were positively coinfected with two viruses. The prevalent viruses in coinfections were rhinovirus and H3N2 virus (28.0%). Viruses were major pathogens in young children (< 5 years) (75.0%). Coinfections were prevalent in older adults (11.9%) and young children (9.5%). Virus-positive outpatients presented higher temperatures and more sore throat, fatigue and shortness of breath than virus-negative outpatients. ARIs and most virus detections peaked during the winter, but enteroviruses emerged between April and September. CONCLUSION: Viruses are major agents of ARIs among outpatients in Huzhou, China. There was a variation in the distribution of viruses across different age groups and seasons. These findings are beneficial for planning prevention and treatment services for outpatients with ARIs.


Assuntos
Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Coinfecção/epidemiologia , Coinfecção/virologia , Enterovirus/isolamento & purificação , Infecções por Enterovirus/complicações , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/virologia , Feminino , Humanos , Lactente , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Prevalência , Estudos Retrospectivos , Rhinovirus/isolamento & purificação , Estações do Ano , Adulto Jovem
17.
Antiviral Res ; 161: 108-115, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30503887

RESUMO

Enterovirus D68 (EV-D68) is a causative agent of recent outbreaks of severe respiratory illness, pneumonia and acute flaccid myelitis (AFM) worldwide. The study of the pathogenesis, vaccines and anti-viral drugs for EV-D68 infection has been reported. Given the previously described mouse model of EV-D68, we sought to establish a neonatal mice model inducing both pneumonia and AFM. The neonatal BALB/c mice were inoculated intraperitoneally with the EV-D68 strain (named15296-virus) which was produced by the reverse genetics method. The infected mice displayed limb paralysis, tachypnea and even death, which were similar to the clinical symptoms of human infections. Moreover, the results of histopathologic examination and immunohistochemical staining showed acidophilic necrosis in the muscle, the spinal cord and alveolar wall thickening in the lung, indicating that EV-D68 exhibited strong tropism to the muscles, spinal cord and lung. Furthermore, the results of real-time PCR also suggested that the viral loads in the blood, spinal cord, muscles and lung were higher than those in other tissues at different time points post-infection. Additionally, the neonatal mouse model was used for evaluating the EV-D68 infection. The results of the anti-serum passive and maternal antibody protection indicated that the neonatal mice could be protected against the EV-D68 challenge, and displayed that both the serum of 15296-virus and prototype-virus (Fermon) were performing a certain cross-protective activity against the 15296-virus challenge. In summary, the above results proved that our neonatal mouse model possessed not only the interstitial pneumonia and AFM simultaneously but also a potentiality to evaluate the protective effects of EV-D68 vaccines and anti-viral drugs in the future.


Assuntos
Anticorpos Antivirais/uso terapêutico , Viroses do Sistema Nervoso Central/virologia , Infecções por Enterovirus/complicações , Imunização Passiva , Doenças Pulmonares Intersticiais/virologia , Mielite/virologia , Doenças Neuromusculares/virologia , Animais , Animais Recém-Nascidos , Modelos Animais de Doenças , Enterovirus Humano D/patogenicidade , Infecções por Enterovirus/imunologia , Feminino , Dose Letal Mediana , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Carga Viral , Tropismo Viral
18.
Pediatr Infect Dis J ; 38(1): 16-21, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30234793

RESUMO

BACKGROUND: Enterovirus-D68 (EV-D68) is a respiratory virus within the genus Enterovirus and the family of Picornaviridae. Genetically, it is closely related to rhinovirus that replicates in the respiratory tract and causes respiratory disease. Since 2014, EV-D68 has been associated with the neurologic syndrome of acute flaccid myelitis (AFM). METHODS: In October 2016, questionnaires were sent out to a European network including 66 virologists and clinicians, to develop an inventory of EV-D68-associated AFM cases in Europe. Clinical and virologic information of case patients was requested. In addition, epidemiologic information on EV testing was collected for the period between March and October 2016. RESULTS: Twenty-nine cases of EV-D68-associated AFM were identified, from 12 different European countries. Five originated from France, 5 from Scotland and 3 each from Sweden, Norway and Spain. Twenty-six were children (median age 3.8 years), 3 were adults. EV-D68 was detected in respiratory materials (n = 27), feces (n = 8) and/or cerebrospinal fluid (n = 2). Common clinical features were asymmetric flaccid limb weakness, cranial nerve deficits and bulbar symptoms. On magnetic resonance imaging, typical findings were hyperintensity of the central cord and/or brainstem; low motor amplitudes with normal conduction velocities were seen on electromyography. Full clinical recovery was rare (n = 3), and 2 patients died. The epidemiologic data from 16 European laboratories showed that of all EV-D68-positive samples, 99% was detected in a respiratory specimen. CONCLUSIONS: For 2016, 29 EV-D68-related AFM cases were identified in mostly Western Europe. This is likely an underestimation, because case identification is dependent on awareness among clinicians, adequate viral diagnostics on respiratory samples and the capability of laboratories to type EVs.


Assuntos
Viroses do Sistema Nervoso Central/virologia , Infecções por Enterovirus/complicações , Infecções por Enterovirus/epidemiologia , Mielite/virologia , Doenças Neuromusculares/virologia , Adolescente , Adulto , Viroses do Sistema Nervoso Central/epidemiologia , Criança , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Enterovirus Humano D/patogenicidade , Infecções por Enterovirus/líquido cefalorraquidiano , Europa (Continente)/epidemiologia , Fezes/virologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Hipotonia Muscular/virologia , Mielite/epidemiologia , Doenças Neuromusculares/epidemiologia , Paralisia/virologia , Sistema Respiratório/virologia , Inquéritos e Questionários , Adulto Jovem
19.
Brain Dev ; 41(2): 214-216, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30224162

RESUMO

Transient Cerebral Arteriopathy (TCA) is one of the main causes of childhood stroke. Here we present an unusual case of Arterial Ischemic Stroke (AIS) caused by a TCA of posterior flow and originally located in the right thalamus. The detection of enterovirus in the cerebrospinal fluid allowed us to suppose a probable post infectious etiology. The course of symptoms was self-limited and the child had a complete clinical recovery after five days. A new ischemic lesion on the antero-inferior paravermian region of the left cerebellum was revealed by a following brain Magnetic Resonance Imaging (MRI) three months later and these findings were reported by further brain MRI control performed after 15 months. Comparing follow up Magnetic Resonance Angiography (MRA) with previous High Resolution Vessel Wall Magnetic Resonance Imaging (HRMI), we found a vessel narrowing at the level of the Posterior Inferior Cerebellar Artery that might explain the arteriopathy process. In conclusion, clinical and radiological course allow us to speculate that this multifocal cerebral arteriopathy might be a transient lesion due to enterovirus infection. To our knowledge, there are only three articles describing TCA enterovirus-related, and brain MRA was performed in only one case; in addition, no one with the involvement of the posterior circulation.


Assuntos
Isquemia Encefálica/virologia , Doenças Arteriais Cerebrais/virologia , Infecções por Enterovirus/complicações , Artéria Cerebral Posterior/diagnóstico por imagem , Acidente Vascular Cerebral/virologia , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Encéfalo/virologia , Isquemia Encefálica/diagnóstico por imagem , Doenças Arteriais Cerebrais/diagnóstico por imagem , Pré-Escolar , Humanos , Imagem por Ressonância Magnética , Masculino , Acidente Vascular Cerebral/diagnóstico por imagem
20.
Pediatr Blood Cancer ; 66(1): e27448, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30270558

RESUMO

BACKGROUND: Enteroviruses (EV) are a large group of Picornaviruses associated with respiratory, gastrointestinal, and neurologic symptoms in the immunocompetent host. Little is known about the epidemiologic and clinical impact in pediatric hematologic/oncologic patients. PROCEDURE: From 2001 through 2017, different clinical specimens were collected from pediatric hematologic/oncologic patients and were tested for enteroviral RNA. RESULTS: Of 13 004 specimens collected from 761 patients, 38 (0.3%) obtained from 14 patients (1.8%) tested positive for EV RNA. Viral shedding was observed without viremia and vice versa. None of 80 cerebrospinal fluid specimens obtained from 60 patients with neurologic symptoms were positive for EV RNA. None of 14 patients positive for EV RNA showed EV-specific symptoms. In 11/14 patients, EV RNA was found to be negative in the follow-up specimen. The remaining patient with a severe primary immune deficiency showed repeated positive EV RNA results for >5 years. CONCLUSIONS: In this pediatric hematologic/oncologic cohort, EV infection occurred rarely and without related symptoms. Specimens concurrently obtained from one patient are commonly not in accordance with each other. In the vast majority of patients, EV RNA appears to turn negative in the follow-up specimen. EV infections seem to have a low impact in this patient cohort.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/isolamento & purificação , Neoplasias Hematológicas/virologia , Adolescente , Adulto , Áustria/epidemiologia , Criança , Pré-Escolar , Infecções por Enterovirus/complicações , Infecções por Enterovirus/diagnóstico , Feminino , Seguimentos , Neoplasias Hematológicas/epidemiologia , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
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