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1.
BMJ Glob Health ; 5(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32565430

RESUMO

The evidence produced in mathematical models plays a key role in shaping policy decisions in pandemics. A key question is therefore how well pandemic models relate to their implementation contexts. Drawing on the cases of Ebola and influenza, we map how sociological and anthropological research contributes in the modelling of pandemics to consider lessons for COVID-19. We show how models detach from their implementation contexts through their connections with global narratives of pandemic response, and how sociological and anthropological research can help to locate models differently. This potentiates multiple models of pandemic response attuned to their emerging situations in an iterative and adaptive science. We propose a more open approach to the modelling of pandemics which envisages the model as an intervention of deliberation in situations of evolving uncertainty. This challenges the 'business-as-usual' of evidence-based approaches in global health by accentuating all science, within and beyond pandemics, as 'emergent' and 'adaptive'.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus/epidemiologia , Política de Saúde , Modelos Biológicos , Pneumonia Viral/epidemiologia , Viroses/epidemiologia , Infecções por Coronavirus/imunologia , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/imunologia , Humanos , Imunidade Coletiva , Vírus da Influenza A Subtipo H1N1/fisiologia , Virus da Influenza A Subtipo H5N1/fisiologia , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Pandemias , Pneumonia Viral/imunologia , Incerteza
2.
APMIS ; 128(6): 451-462, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32358920

RESUMO

Bacteria and viruses were analysed in the upper respiratory tract of symptomatic pig farmers and their domestic pigs. Eighty six human nasal and 495 (50 pools) porcine snout swabs were collected in Schleswig-Holstein, Germany. Staphylococcus (S.) aureus (62.8%, 54/86), human rhino- and coronaviruses (HRV, 29.1%, 25/86; HCoV, 16.3%, 14/86) were frequently detected in humans, while Haemophilus parasuis (90.0%, 45/50), Mycoplasma hyorhinis (78.6%, 11/14), Enterovirus G (EV-G, 56.0%, 28/50) and S. aureus (36.0%, 18/50), respectively, were highly prevalent in pigs. The detection of S. aureus in human follow-up samples indicates a carrier status. The methicillin-resistant phenotype (MRSA) was identified in 33.3% (18/54) of nasal swabs and in one of 18 (5.6%) pooled snout swabs that were tested positive for S. aureus. Strains were indicative of the livestock-associated clonal complex CC398, with t011 being the most common staphylococcal protein A type. Enterobacterales and non-fermenters were frequently isolated from swabs. Their detection in follow-up samples suggests a carrier status. All were classified as being non-multiresistant. There was no example for cross-species transmission of viruses. In contrast, transmission of S. aureus through occupational contact to pigs seems possible. The study contributes to the 'One Health' approach.


Assuntos
Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Infecções Estafilocócicas/veterinária , Sus scrofa/microbiologia , Sus scrofa/virologia , Doenças dos Suínos/epidemiologia , Animais , Portador Sadio , Humanos , Gado , Staphylococcus aureus Resistente à Meticilina/genética , Testes de Sensibilidade Microbiana , Mucosa Nasal/microbiologia , Mucosa Nasal/virologia , Doenças Profissionais/microbiologia , Prevalência , Infecções Respiratórias/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/transmissão , Suínos , Doenças dos Suínos/microbiologia , Doenças dos Suínos/transmissão , Doenças dos Suínos/virologia , Viroses/epidemiologia , Viroses/transmissão , Viroses/veterinária
3.
J Clin Virol ; 128: 104436, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32447256

RESUMO

AIMS: During the ongoing COVID-19 outbreak, co-circulation of other common respiratory viruses can potentially result in co-infections; however, reported rates of co-infections for SARS-CoV-2 vary. We sought to evaluate the prevalence and etiology of all community acquired viral respiratory infections requiring hospitalization during an ongoing COVID-19 outbreak, with a focus on co-infection rates and clinical outcomes. METHODS: Over a 10-week period, all admissions to our institution, the largest tertiary hospital in Singapore, were screened for respiratory symptoms, and COVID-19 as well as a panel of common respiratory viral pathogens were systematically tested for. Information was collated on clinical outcomes, including requirement for mechanical ventilation and in hospital mortality. RESULTS: One-fifth (19.3%, 736/3807) of hospitalized inpatients with respiratory symptoms had a PCR-proven viral respiratory infection; of which 58.5% (431/736) tested positive for SARS-CoV-2 and 42.2% (311/736) tested positive for other common respiratory viruses. The rate of co-infection with SARS-CoV-2 was 1.4% (6/431); all patients with co-infection had mild disease and stayed in communal settings. The in-hospital mortality rate and proportion of COVID-19 patients requiring invasive ventilation was low, at around 1% of patients; these rates were lower than patients with other community-acquired respiratory viruses admitted over the same period (p < 0.01). CONCLUSION: Even amidst an ongoing COVID-19 outbreak, common respiratory viruses still accounted for a substantial proportion of hospitalizations. Coinfections with SARS-CoV-2 were rare, with no observed increase in morbidity or mortality.


Assuntos
Betacoronavirus/isolamento & purificação , Coinfecção/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Pneumonia Viral/epidemiologia , Infecções Respiratórias/epidemiologia , Viroses/epidemiologia , Adulto , Betacoronavirus/genética , Coinfecção/mortalidade , Coinfecção/virologia , Infecções Comunitárias Adquiridas/mortalidade , Infecções Comunitárias Adquiridas/virologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Hospitalização , Humanos , Pacientes Internados , Masculino , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Infecções Respiratórias/mortalidade , Infecções Respiratórias/virologia , Singapura/epidemiologia , Centros de Atenção Terciária , Viroses/mortalidade , Viroses/virologia
4.
Nat Commun ; 11(1): 2164, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32358506

RESUMO

Chronic bee paralysis is a well-defined viral disease of honey bees with a global distribution that until recently caused rare but severe symptomatology including colony loss. Anecdotal evidence indicates a recent increase in virus incidence in several countries, but no mention of concomitant disease. We use government honey bee health inspection records from England and Wales to test whether chronic bee paralysis is an emerging infectious disease and investigate the spatiotemporal patterns of disease. The number of chronic bee paralysis cases increased exponentially between 2007 and 2017, demonstrating chronic bee paralysis as an emergent disease. Disease is highly clustered spatially within most years, suggesting local spread, but not between years, suggesting disease burnt out with periodic reintroduction. Apiary and county level risk factors are confirmed to include scale of beekeeping operation and the history of honey bee imports. Our findings offer epidemiological insight into this damaging emerging disease.


Assuntos
Criação de Abelhas/métodos , Viroses/epidemiologia , Animais , Abelhas/virologia , Inglaterra , Entomologia , Vírus de Insetos/patogenicidade , Filogenia , País de Gales
6.
Harefuah ; 159(3): 191-194, 2020 Mar.
Artigo em Hebraico | MEDLINE | ID: mdl-32186790

RESUMO

INTRODUCTION: Spinal cord injury (SCI) etiology can be either traumatic or non-traumatic. Non-traumatic SCI is of growing importance, with studies indicating increased incidence, partly because of population aging. Approximately 9% of these injuries are secondary to an infectious cause. SCI has significant implications on the patient's quality of life. A successful rehabilitation process focuses on maximizing independence and setting achievable goals according to the patient's needs and desires. The medical staff should be familiar with the natural history of such injuries while taking into consideration the existing support systems available to the patient and minimizing the damage to life cycles as best possible with the aid of a transdisciplinary team approach. In this article, we will review the main viral causes of SCI injury. We will discuss the epidemiology, clinical aspects and the unique meanings of this subgroup in the rehabilitation process.


Assuntos
Traumatismos da Medula Espinal/virologia , Viroses/epidemiologia , Humanos , Incidência , Infecções , Qualidade de Vida , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/etiologia , Viroses/complicações
7.
PLoS One ; 15(2): e0229827, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32109265

RESUMO

PaV1 is a pathogenic virus found only to infect Caribbean spiny lobsters Panulirus argus, a major fishing resource. P. argus is a benthic mesopredator and has a complex life history, with several ontogenetic habitat changes. Habitat characteristics and species diversity of surrounding communities may have implications for disease dynamics. This is of more concern for juvenile lobsters, which are more susceptible to PaV1 and are far less mobile than adult lobsters. We targeted a population of juvenile P. argus in a reef lagoon in Mexico, where PaV1 was first observed in 2001. Prevalence has been since irregularly assessed, but in 2016 we began a more systematic assessment, with two sampling periods per year (June and November) in three different zones of the reef lagoon. To examine the relationship between PaV1 prevalence and potential ecological determinants, we assessed habitat complexity, cover of different substrates, and invertebrate community composition in all zones during the first four sampling periods (June and November 2016 and 2017). Habitat complexity and percent cover of some substrates varied with zone and sampling period. This was the case for seagrass and macroalgae, which nevertheless were the dominant substrates. The invertebrate community composition varied with sampling period, but not with zone. Probability of infection decreased with increasing lobster size, consistent with previous studies, but was not affected by zone (i.e., variations in ecological characteristics did not appear to be sufficiently large so as to influence prevalence of PaV1). This result possibly reflects the dominance of marine vegetation and suggests that lobsters can be sampled throughout the reef lagoon to assess PaV1 prevalence. Prevalence was higher in only one of seven sampling periods (November 2017), suggesting that the pathogen has leveled off to an enzootic level.


Assuntos
Palinuridae/virologia , Viroses/epidemiologia , Animais , México , Prevalência
8.
Int Health ; 12(2): 77-85, 2020 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-32040190

RESUMO

BACKGROUND: Strategies are urgently needed to mitigate the risk of zoonotic disease emergence in southern China, where pathogens with zoonotic potential are known to circulate in wild animal populations. However, the risk factors leading to emergence are poorly understood, which presents a challenge in developing appropriate mitigation strategies for local communities. METHODS: Residents in rural communities of Yunnan, Guangxi and Guangdong provinces were recruited and enrolled in this study. Data were collected through ethnographic interviews and field observations, and thematically coded and analysed to identify both risk and protective factors for zoonotic disease emergence at the individual, community and policy levels. RESULTS: Eighty-eight ethnographic interviews and 55 field observations were conducted at nine selected sites. Frequent human-animal interactions and low levels of environmental biosecurity in local communities were identified as risks for zoonotic disease emergence. Policies and programmes existing in the communities provide opportunities for zoonotic risk mitigation. CONCLUSIONS: This study explored the relationship among zoonotic risk and human behaviour, environment and policies in rural communities in southern China. It identifies key behavioural risk factors that can be targeted for development of tailored risk-mitigation strategies to reduce the threat of novel zoonoses.


Assuntos
Animais Selvagens/virologia , Doenças Transmissíveis Emergentes/transmissão , Infecções por Coronavirus/transmissão , Surtos de Doenças/prevenção & controle , Pneumonia Viral/transmissão , População Rural , Viroses/transmissão , Zoonoses/transmissão , Adolescente , Adulto , Animais , Betacoronavirus , China/epidemiologia , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/virologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pesquisa Qualitativa , Fatores de Risco , Síndrome Respiratória Aguda Grave , Viroses/epidemiologia , Adulto Jovem , Zoonoses/epidemiologia , Zoonoses/virologia
9.
BMC Infect Dis ; 20(1): 89, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000695

RESUMO

BACKGROUND: Outbreaks of acute undifferentiated febrile illness (AUFI) are common in Nepal, but the exact etiology or risk factors for them often go unrecognized. Diseases like influenza, enteric fever and rickettsial fevers account for majority of such outbreaks. Optimal diagnostic tests to inform treatment decisions are not available at the point-of-care. A proper epidemiological and clinical characterization of such outbreaks is important for appropriate treatment and control efforts. METHODS: An investigation was initiated as a response to increased presentation of patients at Patan Hospital from Chalnakhel locality in Dakchinkali municipality, Kathmandu with AUFI from June 10 to July 1, 2016. Focused group discussion with local inhabitants and the epidemiological curve of febrile patients at local primary health care centre confirmed the outbreak. The household-survey was conducted in the area with questionnaire administered on patients to characterize their illnesses and their medical records were reviewed. A different set of questionnaire was administered on the patients and controls to investigate the association with common risk factors. Water samples were collected and analyzed microbiologically. RESULTS: Eighty one patients from 137 households suffered from febrile illness within 6 weeks window before the investigation. All the 67 sampled patients with acute fever had a generalized illness without a discernible focus of infection. Only 38% of the patients had received a clinical diagnosis while the rest were treated empirically without a diagnosis. Three patients had blood culture confirmed enteric fever. Forty-two (63%) patients had been administered antibiotics, most commonly, ofloxacin, cefixime or azithromycin with a mean fever clearance time of 4 days. There was no definite association between several risk factors and fever. Fecal contamination was noted in tap water samples. CONCLUSION: Based on the pattern of illness, this outbreak was most likely a mixture of self-limiting viral infections and enteric fever. This study shows that even in the absence of a confirmed diagnosis, a detailed characterization of the illness at presentation and the recovery course can suggest the diagnosis and help in formulating appropriate recommendation for treatment and control.


Assuntos
Antibacterianos/uso terapêutico , Febre/epidemiologia , Febre/etiologia , Febre Tifoide/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Azitromicina/uso terapêutico , Cefixima/uso terapêutico , Criança , Surtos de Doenças , Feminino , Febre/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Ofloxacino/uso terapêutico , Fatores de Risco , Febre Tifoide/tratamento farmacológico , Febre Tifoide/etiologia , Viroses/tratamento farmacológico , Viroses/epidemiologia , Viroses/etiologia , Adulto Jovem
10.
Lancet Infect Dis ; 20(2): e27-e37, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32006517

RESUMO

Fever is one of the most common reasons for seeking health care globally and most human pathogens are zoonotic. We conducted a systematic review to describe the occurrence and distribution of zoonotic causes of human febrile illness reported in malaria endemic countries. We included data from 53 (48·2%) of 110 malaria endemic countries and 244 articles that described diagnosis of 30 zoonoses in febrile people. The majority (17) of zoonoses were bacterial, with nine viruses, three protozoa, and one helminth also identified. Leptospira species and non-typhoidal salmonella serovars were the most frequently reported pathogens. Despite evidence of profound data gaps, this Review reveals widespread distribution of multiple zoonoses that cause febrile illness. Greater understanding of the epidemiology of zoonoses in different settings is needed to improve awareness about these pathogens and the management of febrile illness.


Assuntos
Doenças Endêmicas , Febre/epidemiologia , Febre/etiologia , Zoonoses/epidemiologia , Zoonoses/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/patologia , Criança , Pré-Escolar , Feminino , Helmintíase/epidemiologia , Helmintíase/patologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Infecções por Protozoários/epidemiologia , Infecções por Protozoários/patologia , Viroses/epidemiologia , Viroses/patologia , Adulto Jovem
11.
PLoS One ; 15(2): e0228544, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32027687

RESUMO

BACKGROUND: The individual and combined contribution of viral prevalence in the community to Emergency Department (ED) visits and hospitalizations with respiratory tract infections (RTIs), chronic obstructive pulmonary disease (COPD) and asthma is unclear. METHODS: A retrospective analysis on daily viral positive tests and daily ED visits and hospitalizations between 01/01/2003 to 31/12/2013 in Ontario, Canada. Viral data was collected from the Centre for Immunization and Respiratory Infectious Diseases (CIRID). The Canadian Institute for Health Information reports daily ED visits and hospitalizations for RTIs, COPD and asthma as a primary diagnosis. RESULTS: There were 4,365,578 ED visits with RTIs of which 321,719 (7.4%) were admitted to hospital; 817,141 ED visits for COPD of which 260,665 (31.9%) were admitted and 649,666 ED visits with asthma of which 68,626 (10.6%) were admitted. The percentage of positive tests to influenza A and B, respiratory syncytial virus (RSV), parainfluenza and adenovirus prevalence explained 57.4% of ED visits and 63.8% of hospitalizations for RTI, 41.4% of ED visits and 39.2% of hospitalizations with COPD but only 1.5% of ED visits and 2.7% of hospitalizations for asthma. The further addition of human metapneumovirus, rhinovirus and coronavirus over the final 3 years accounted for 66.7% of ED visits and 74.4% of hospitalizations for RTI, 52.5% of visits and 48.2% of hospitalizations for COPD, and only 13.3% of visits and 10.4% of hospitalizations for asthma. CONCLUSIONS: Community respiratory viral epidemics are major drivers of ED visits and hospitalizations with RTIs and COPD but only a modest contributor to asthma.


Assuntos
Asma/epidemiologia , Serviço Hospitalar de Emergência , Hospitalização/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Infecções Respiratórias/epidemiologia , Viroses/epidemiologia , Asma/complicações , Infecções Comunitárias Adquiridas/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , História do Século XXI , Hospitalização/tendências , Humanos , Ontário/epidemiologia , Prevalência , Doença Pulmonar Obstrutiva Crônica/complicações , Estudos Retrospectivos
12.
PLoS One ; 15(2): e0228056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32059033

RESUMO

INTRODUCTION: Pneumonia in children is a common disease yet determining its aetiology remains elusive. OBJECTIVES: To determine the a) aetiology, b) factors associated with bacterial pneumonia and c) association between co-infections (bacteria + virus) and severity of disease, in children admitted with severe pneumonia. METHODS: A prospective cohort study involving children aged 1-month to 5-years admitted with very severe pneumonia, as per the WHO definition, over 2 years. Induced sputum and blood obtained within 24 hrs of admission were examined via PCR, immunofluorescence and culture to detect 17 bacteria/viruses. A designated radiologist read the chest radiographs. RESULTS: Three hundred patients with a mean (SD) age of 14 (±15) months old were recruited. Significant pathogens were detected in 62% of patients (n = 186). Viruses alone were detected in 23.7% (n = 71) with rhinovirus (31%), human metapneumovirus (HMP) [22.5%] and respiratory syncytial virus (RSV) [16.9%] being the commonest. Bacteria alone was detected in 25% (n = 75) with Haemophilus influenzae (29.3%), Staphylococcus aureus (24%) and Streptococcus pneumoniae (22.7%) being the commonest. Co-infections were seen in 13.3% (n = 40) of patients. Male gender (AdjOR 1.84 [95% CI 1.10, 3.05]) and presence of crepitations (AdjOR 2.27 [95% CI 1.12, 4.60]) were associated with bacterial infection. C-reactive protein (CRP) [p = 0.007]) was significantly higher in patients with co-infections but duration of hospitalization (p = 0.77) and requirement for supplemental respiratory support (p = 0.26) were not associated with co-infection. CONCLUSIONS: Bacteria remain an important cause of very severe pneumonia in developing countries with one in four children admitted isolating bacteria alone. Male gender and presence of crepitations were significantly associated with bacterial aetiology. Co-infection was associated with a higher CRP but no other parameters of severe clinical illness.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Pneumonia Bacteriana/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Coinfecção/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Índice de Gravidade de Doença , Viroses/epidemiologia
13.
PLoS One ; 15(2): e0228451, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32017805

RESUMO

Viral reactivation occurs frequently in the context of immunodeficiency and immunosuppression after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and can cause severe complications. The aim of this single-center retrospective analysis was to characterize viral infections in the first year after HSCT, to investigate risk factors and to study the impact of viral infections on transplantation outcome. This will facilitate the identification of at-risk patients and the development of new preventive strategies. 107 pediatric allo-HSCT from January 2005 through December 2015 were analyzed for infections with Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), adenovirus (ADV), herpes simplex virus (HSV) and varicella zoster virus (VZV). Viral infections were detected after 68.2% of transplantations. The viruses most commonly encountered were HHV-6 (36/107) and EBV (30/107). Severe viral disease was rare (7/107) and none of the patients died as result of viral reactivation. Important risk factors for viral infections were higher age at HSCT, donor type and occurrence of acute graft-versus-host disease (aGvHD). Especially for EBV, transplant from an unrelated donor and in-vivo T-cell depletion (TCD) had a significant effect on infection rates, whereas for CMV the strongest effect was seen by donor and recipient serostatus with recipient seropositivity most predictive for reactivation. The occurrence of severe aGvHD was associated with EBV and ADV infections. For HSV, the recipient serostatus was identified as prognostic factor for HSV infections, while we found higher age at time of HSCT as risk factor for VZV infections. The overall survival of patients with or without viral infections did not differ significantly. Interestingly, when looking at the 85 patients in our cohort who had received an HSCT for a malignant disease, a tendency towards lower relapse rates was seen in patients affected by viral infections (HR 0.51, 95% CI 0.25 - 1.06, p = 0.072). Viral reactivations are common after pediatric allo-HSCT, though severe complications were rare in our collective. Determining risk factors for viral reactivations may help to identify patients in need of intensified monitoring and to individualize preventive strategies.


Assuntos
Doença Enxerto-Hospedeiro/epidemiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Ativação Viral , Viroses/epidemiologia , Adenoviridae/fisiologia , Adolescente , Adulto , Criança , Pré-Escolar , Citomegalovirus/fisiologia , Feminino , Doença Enxerto-Hospedeiro/virologia , Herpesvirus Humano 3/fisiologia , Herpesvirus Humano 4/fisiologia , Herpesvirus Humano 6/fisiologia , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Medição de Risco , Simplexvirus/fisiologia , Análise de Sobrevida , Transplante Homólogo/efeitos adversos , Viroses/virologia , Adulto Jovem
14.
PLoS One ; 15(2): e0226936, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32101559

RESUMO

AIMS: To investigate seasonality and association of increased enterovirus and influenza activity in the community with ventricular fibrillation (VF) risk during first ST-elevation myocardial infarction (STEMI). METHODS: This study comprised all consecutive patients with first STEMI (n = 4,659; aged 18-80 years) admitted to the invasive catheterization laboratory between 2010-2016, at Copenhagen University Hospital, Rigshospitalet, covering eastern Denmark (2.6 million inhabitants, 45% of the Danish population). Hospital admission, prescription, and vital status data were assessed using Danish nationwide registries. We utilized monthly/weekly surveillance data for enterovirus and influenza from the Danish National Microbiology Database (2010-2016) that receives copies of laboratory tests from all Danish departments of clinical microbiology. RESULTS: Of the 4,659 consecutively enrolled STEMI patients, 581 (12%) had VF before primary percutaneous coronary intervention. In a subset (n = 807), we found that VF patients experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with the patients without VF (OR 3.39, 95% CI 1.76-6.54). During the study period, 2,704 individuals were diagnosed with enterovirus and 19,742 with influenza. No significant association between enterovirus and VF (OR 1.00, 95% CI 0.99-1.02), influenza and VF (OR 1.00, 95% CI 1.00-1.00), or week number and VF (p-value 0.94 for enterovirus and 0.89 for influenza) was found. CONCLUSION: We found no clear seasonality of VF during first STEMI. Even though VF patients had experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with patients without VF, no relationship was found between enterovirus or influenza exposure and occurrence of VF.


Assuntos
Influenza Humana/epidemiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Fibrilação Ventricular/epidemiologia , Viroses/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Adulto Jovem
15.
Virol J ; 17(1): 9, 2020 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-31973727

RESUMO

Yellow fever (YF) is an acute viral disease, affecting humans and non-human primates (NHP), caused by the yellow fever virus (YFV). Despite the existence of a safe vaccine, YF continues to cause morbidity and mortality in thousands of people in Africa and South America. Since 2016, massive YF outbreaks have taken place in Brazil, reaching YF-free zones, causing thousands of deaths of humans and NHP. Here we reviewed the main epidemiological aspects, new clinical findings in humans, and issues regarding YFV infection in vectors and NHP in Brazil. The 2016-2019 YF epidemics have been considered the most significant outbreaks of the last 70 years in the country, and the number of human cases was 2.8 times higher than total cases in the previous 36 years. A new YFV lineage was associated with the recent outbreaks, with persistent circulation in Southeast Brazil until 2019. Due to the high number of infected patients, it was possible to evaluate severity and death predictors and new clinical features of YF. Haemagogus janthinomys and Haemagogus leucocelaenus were considered the primary vectors during the outbreaks, and no human case suggested the occurrence of the urban transmission cycle. YFV was detected in a variety of NHP specimens presenting viscerotropic disease, similar to that described experimentally. Further studies regarding NHP sensitivity to YFV, YF pathogenesis, and the duration of the immune response in NHP could contribute to YF surveillance, control, and future strategies for NHP conservation.


Assuntos
Febre Amarela , Vírus da Febre Amarela , Aedes/virologia , Animais , Brasil/epidemiologia , Culicidae/virologia , Surtos de Doenças , Reservatórios de Doenças/virologia , Epidemias , Humanos , Mosquitos Vetores/virologia , Primatas/virologia , Viroses/epidemiologia , Febre Amarela/epidemiologia , Febre Amarela/prevenção & controle , Febre Amarela/transmissão , Vírus da Febre Amarela/imunologia , Vírus da Febre Amarela/isolamento & purificação , Vírus da Febre Amarela/patogenicidade , Zoonoses/epidemiologia , Zoonoses/transmissão , Zoonoses/virologia
16.
Mayo Clin Proc ; 95(1): 169-183, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31902413

RESUMO

In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.


Assuntos
Vacinação em Massa , Infecções Pneumocócicas/prevenção & controle , Viroses/prevenção & controle , Adulto , Humanos , Vacinação em Massa/métodos , Vacinação em Massa/organização & administração , Infecções Pneumocócicas/epidemiologia , Serviços Preventivos de Saúde/normas , Estados Unidos , Cobertura Vacinal/métodos , Cobertura Vacinal/estatística & dados numéricos , Viroses/epidemiologia
17.
PLoS One ; 15(1): e0227127, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923263

RESUMO

If viruses or other pathogens infect a single host, the outcome of infection may depend on the initial basic reproduction number R0, the expected number of host cells infected by a single infected cell. This article shows that sometimes, phylogenetic models can estimate the initial R0, using only sequences sampled from the pathogenic population during its exponential growth or shortly thereafter. When evaluated by simulations mimicking the bursting viral reproduction of HIV and simultaneous sampling of HIV gp120 sequences during early viremia, the estimated R0 displayed useful accuracies in achievable experimental designs. Estimates of R0 have several potential applications to investigators interested in the progress of infection in single hosts, including: (1) timing a pathogen's movement through different microenvironments; (2) timing the change points in a pathogen's mode of spread (e.g., timing the change from cell-free spread to cell-to-cell spread, or vice versa, in an HIV infection); (3) quantifying the impact different initial microenvironments have on pathogens (e.g., in mucosal challenge with HIV, quantifying the impact that the presence or absence of mucosal infection has on R0); (4) quantifying subtle changes in infectability in therapeutic trials (either human or animal), even when therapies do not produce total sterilizing immunity; and (5) providing a variable predictive of the clinical efficacy of prophylactic therapies.


Assuntos
Número Básico de Reprodução , Efeito Fundador , Estatística como Assunto/métodos , Viroses/epidemiologia , Vírus/patogenicidade , Sequência de Aminoácidos , Animais , Proteína gp120 do Envelope de HIV/genética , Infecções por HIV/epidemiologia , Humanos , Modelos Genéticos , Filogenia
18.
Int J Infect Dis ; 90: 151-160, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31672657

RESUMO

BACKGROUND: Despite the considerable disease burden caused by the disease, rotavirus vaccine has not been introduced into routine national immunization schedule, and norovirus vaccines are being developed without a comprehensive understanding of gastroenteritis epidemiology. To bridge this knowledge gap, we investigated the disease burden of viral gastroenteritis in rural China. METHODS: Between October 2011 and December 2013, population-based surveillance was conducted in Zhengding and Sanjiang counties in China. Stool samples were collected from children <5 years of age with diarrhea. All specimens were tested for rotaviruses, noroviruses, sapoviruses, enteric adenoviruses, and astroviruses. RESULTS: The most common pathogen causing diarrhea was rotavirus (54.7 vs 45.6 cases/1,000 children/year in Zhengding and Sanjiang, respectively), followed by norovirus (28.4 vs 19.3 cases/1,000 children/year in Zhengding and Sanjiang, respectively). The highest incidence of these viruses was observed in children 6-18 months of age. Among the 5 viral pathogens, rotaviruses caused the most severe illness, followed by noroviruses. CONCLUSION: Rotavirus and norovirus are the 2 most important viral pathogens causing childhood diarrhea in both northern and southern China; they should be the major targets for viral gastroenteritis prevention strategies among children in China.


Assuntos
Gastroenterite/virologia , Viroses/virologia , Vírus/isolamento & purificação , Pré-Escolar , China/epidemiologia , Diarreia/epidemiologia , Diarreia/virologia , Fezes/virologia , Feminino , Gastroenterite/epidemiologia , Humanos , Incidência , Lactente , Masculino , Vigilância da População , População Rural/estatística & dados numéricos , Viroses/epidemiologia , Vírus/classificação , Vírus/genética
19.
Transbound Emerg Dis ; 67(1): 33-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31461573

RESUMO

Multiple species of viruses circulate in wild mammals, some of them potentially causing zoonosis. Most of the suspected viral zoonotic diseases affecting human patients remain unidentified with regard to their aetiological agent. The aim of this study is to summarize the state of knowledge of the viral richness associated with wild mammals in Mexico throughout 1900-2018 and their relationship with human cases. We compiled two databases, one of them containing all available published studies on potentially zoonotic viruses in wild mammals and another with human cases related to zoonotic viruses. The database on wild mammals covers the period of 1900-2018; the human case database spans 2000-2013. We calculated the richness of viral potential zoonotic agents and evaluated their geographical distribution. We found 262 records of 42 potential zoonotic viral species associated with 92 wild mammal species in 28 states across Mexico. Records of human viral cases were only found in 29 states, which did not overlap with the reports in wild mammals. We detected 25.6% (42/164) of viral zoonotic agents reported worldwide. This analysis opens a relevant topic of discussion for public health attention.


Assuntos
Doenças Transmissíveis Emergentes/virologia , Bases de Dados Factuais , Mamíferos/virologia , Viroses/virologia , Vírus/isolamento & purificação , Zoonoses/virologia , Animais , Animais Selvagens , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/transmissão , Reservatórios de Doenças/virologia , Humanos , Registros Médicos , México/epidemiologia , Viroses/epidemiologia , Viroses/transmissão , Zoonoses/epidemiologia , Zoonoses/transmissão
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