Numerous outbreaks of shellfish-borne enteric virus illness have been reported worldwide. Most notable among the outbreaks\\u000a are those involving norovirus illness and hepatitis A. Lessons learned from outbreak investigations indicate that most outbreaks\\u000a are preventable. Anthropogenic sources of contamination will continue to invade shellfish growing waters, and shellfish, by\\u000a their very nature, will continue to bioconcentrate these contaminants, including enteric
Gary P. Richards
The objective of the present work is the description outbreaks caused by bovine viral diarrhea virus (BVDV) in commercial beef cattle ranches in Argentina. Genetic affiliation and their association with the clinical manifestation were carried out with five BVDV isolates from an outbreak of mucosal disease (MD) (Outbreak #1), acute enteritis (Outbreaks #2 and #3) and generalized dermatitis (Outbreaks #4
Anselmo C. Odeón; Guillermo Risatti; Germán G. Kaiser; Mar??a R Leunda; Ernesto Odriozola; Carlos M Campero; Ruben O Donis
Several microbial disease outbreaks in farm stocks of newly cultured sparid fish species, such as common seabream, redbanded seabream, and white seabream, were recorded from 2004 to 2006. This study describes the isolation and characterization of the potential causative agents, either bacteria or viruses, of these outbreaks. The isolated bacterial strains were characterized according to traditional taxonomical analyses and sequencing of a 16S rDNA fragment. Most bacteria were identified as Vibrio spp. and Photobacterium damselae subsp. damselae. The development of cytopathic effects (CPE) on different fish cell lines, the application of specific nested-PCR tests for infectious pancreatic necrosis virus (IPNV), viral nervous necrosis virus (VNNV) and viral hemorrhagic septicemia virus (VHSV), and subsequent sequence analyses were used for virus detection and identification. VNNV, related to the striped jack neural necrosis virus (SJNNV) genotype, and VHSV, related to the genotype Ia, were the only viruses detected. VNNV was isolated from the three fish species under study in five different outbreaks, whereas VHSV was isolated from common seabream and white seabream during two of these outbreaks. IPNV was not detected in any case. PMID:18076001
García-Rosado, Esther; Cano, Irene; Martín-Antonio, Beatriz; Labella, Alejandro; Manchado, Manuel; Alonso, M Carmen; Castro, Dolores; Borrego, Juan J
Investigations of disease outbreaks linked to shellfish consumption have been reported in the scientific literature; however, only few countries systematically collate and report such data through a disease surveillance system. We conducted a systematic review to investigate shellfish-borne viral outbreaks and to explore their distribution in different countries, and to determine if different types of shellfish and viruses are implicated. Six databases (Medline, Embase, Scopus, PubMed, Eurosurveillance Journal and Spingerlink electronic Journal) and a global electronic reporting system (ProMED) were searched from 1980 to July 2012. About 359 shellfish-borne viral outbreaks, alongside with nine ProMED reports, involving shellfish consumption, were identified. The majority of the reported outbreaks were located in East Asia, followed by Europe, America, Oceania, Australia and Africa. More than half of the outbreaks (63.6 %) were reported from Japan. The most common viral pathogens involved were norovirus (83.7 %) and hepatitis A virus (12.8 %). The most frequent type of consumed shellfish which was involved in outbreaks was oysters (58.4 %). Outbreaks following shellfish consumption were often attributed to water contamination by sewage and/or undercooking. Differences in reporting of outbreaks were seen between the scientific literature and ProMED. Consumption of contaminated shellfish represents a risk to public health in both developed and developing countries, but impact will be disproportionate and likely to compound existing health disparities. PMID:23412719
Bellou, M; Kokkinos, P; Vantarakis, A
Outbreaks of neoplastic disease defined as haemangiosarcoma occurred among layer flocks of chickens in Israel. The disease caused bleeding tumours in the skin and internal organs of young layers, followed by anaemia, cessation of egg production and high mortality up to 20%.Avian leukosis virus was isolated from tumour cells which contain several viral DNA copies integrated in the cell genome.
Haim Burstein; Moshe Gilead; Uri Bendheim; Moshe Kotler
Scientists have come one step closer to tracking outbreaks of bartonellosis, a potentially fatal vector-borne disease. Outbreaks of the disease, which was once thought to be found primarily in the high Andes Mountains of Peru, Ecuador, and Colombia, may be related to El Ni˜no events, according to researchers with NASA and the U.S. military.In findings reported on 17 January, climatology and disease prevention researchers said a study conducted in two regions in Peru points to a strong potential link between the 1997-1998 El Niño and an increase in sand flies, which are thought to be the disease host carriers.
Presents a literature review of disease outbreaks related to fish and shellfish, covering publications of 1976-77. This review covers the chemical, bacterial, and viral diseases that are transmitted by fish and shellfish. A list of 50 references is also presented. (HM)
From 1986 to 1988, 24 states and Puerto Rico reported 50 outbreaks of illness due to water that people intended to drink, affecting 25,846 persons. The protozoal parasite Giardia lamblia was the agent most commonly implicated in outbreaks, as it has been for the last 10 years; many of these outbreaks were associated with ingestion of chlorinated but unfiltered surface water. Shigella sonnei was the most commonly implicated bacterial pathogen; in outbreaks caused by this pathogen, water supplies were found to be contaminated with human waste. Cryptosporidium contamination of a chlorinated, filtered public water supply caused the largest outbreak during this period, affecting an estimated 13,000 persons. A large multistate outbreak caused by commercially produced ice made from contaminated well water caused illness with Norwalk-like virus among an estimated 5,000 persons. The first reported outbreak of chronic diarrhea of unknown cause associated with drinking untreated well water occurred in 1987. Twenty-six outbreaks due to recreational water use were also reported, including outbreaks of Pseudomonas dermatitis associated with the use of hot tubs or whirlpools, and swimming-associated shigellosis, giardiasis, and viral illness. Although the total number of reported water-related outbreaks has been declining in recent years, the few large outbreaks due to Cryptosporidium, Norwalk-like agent, Shigella sonnei, and Giardia lamblia caused more cases of illness in 1987 than have been reported to the Water-Related Disease Outbreak Surveillance System for any other year since CDC and the Environmental Protection Agency began tabulating these data in 1971. PMID:2156147
Levine, W C; Stephenson, W T; Craun, G F
Norwalk virus infection is the epidemiologic prototype for outbreaks of food-borne and waterborne gastroenteritis. Around the world, Norwalk virus and Norwalk-like viruses appear to be major causes of food-borne and waterborne illness. Assessment of the overall significance of viral agents to the epidemiology of food-borne and waterborne illness is hampered by the lack of surveillance throughout much of the world. In areas where food-borne and waterborne illness surveillance is conducted, outbreaks of viral gastroenteritis are underreported because of the lack of availability of routine laboratory services to confirm the viral etiology. Routine use of epidemiologic criteria as an alternative to laboratory confirmation will allow better assessments of the importance of viral gastroenteritis until effective laboratory methods can be widely implemented. Outbreaks of viral gastroenteritis have been propagated by contamination of water supplies, raw foods, and ill food handlers. Controlling an outbreak depends on identifying and removing the source of contamination. The demonstrated occurrence of person-to-person transmission and the likely occurrence of transmission of Norwalk-like viruses by aerosol make it necessary to evaluate the potential for transmission by food handlers and servers in every outbreak, regardless of primary source.
Hedberg, C W; Osterholm, M T
ncreasing trade liberalisation, globalisation and international transportation of people and commodities have increased the potential for disease incursion, both plant and animal, in countries like Australia. While a comparatively strict quarantine regime and geographic isolation provide substantial protection in Australia, disease incursions are not uncommon. In recent years, there have been several exotic disease outbreaks including wheat stripe rust, bacterial
Khorshed Alam; John Rolfe
Viruses are important causes of nosocomial infection, but the fact that hospital outbreaks often result from introduction(s) from community-based epidemics, together with the need to initiate specific laboratory testing, means that there are usually insufficient data to allow the monitoring of trends in incidences. The most important defenses against nosocomial transmission of viruses are detailed and continuing education of staff and strict adherence to infection control policies. Protocols must be available to assist in the management of patients with suspected or confirmed viral infection in the health care setting. In this review, we present details on general measures to prevent the spread of viral infection in hospitals and other health care environments. These include principles of accommodation of infected patients and approaches to good hygiene and patient management. They provide detail on individual viral diseases accompanied in each case with specific information on control of the infection and, where appropriate, details of preventive and therapeutic measures. The important areas of nosocomial infection due to blood-borne viruses have been extensively reviewed previously and are summarized here briefly, with citation of selected review articles. Human prion diseases, which present management problems very different from those of viral infection, are not included.
Aitken, Celia; Jeffries, Donald J.
Starting with a case study based on the outbreak of a pulmonary disease in Southwest US, the interactions between human behavior, exposure, and confusing clinical symptoms are highlighted. As we search for the cause, these complications reflect real life difficulty in making diagnoses. The real questions extend beyond what disease has been contracted to cascading effects on the society we live in. * weigh the personal risks of exposure to a potentially fatal virus
Janet Yagoda Shagam (RhizoTech;Biology); Ethel D. Stanley (Beloit College;Biology); Janet M. Decker (University of Arizona;Biology)
Exanthem is defined as multiple, inflammatory skin alteration with a hematogenic, lymphogenic or neurogenic origin. Typically, so called exanthematic children's diseases are measles, mumps, rubella, varicella, erythema infectiosum (fifth disease) and in the past small pox. The pathogenesis of the viral-caused diseases primarily occurs in the vascular connective tissue. The cytopathogenetic effects result in inflammatory tissue reactions with activation of defence mechanism and producing of immune complexes. First symptoms are hyperemia, edema and inflammatory infiltrates with itchy swellings. Virological laboratory diagnosis are necessary especially for the progress of atypical infectious diseases, for persons with immunological or chronical illness and under chemotherapeutical or immunosuppressival treatment. PMID:9471842
Allwinn, R; Doerr, H W
Thirty-two waterborne disease outbreaks were reported to the Centers for Disease Control (CDC) and the Environmental Protection Agency in 1981. The outbreaks occurred in 17 states and involved 4430 cases. This was only 64% of the number of outbreaks that were reported in 1980 and...
Viral dermatopathies of fish bear clinical signs similar to those of dermatopathies from other causes. This article offers an overview to approaching dermatologic presentations in fish, with an emphasis on sampling, diagnosis, and management of viral dermatopathies, building on previous publications. It is vital to recognize clinical signs associated with viral dermatopathies because there are currently no treatments available. Avoidance and prevention is the key to controlling viral diseases in fish. Optimizing husbandry practices and providing appropriate quarantine procedures can help prevent viral disease outbreaks in collection and aquaculture stocks. PMID:24018032
Weber, E P Scott
The global spread of diseases such as swine flu and SARS highlights the difficult decision governments face when presented with evidence of a local outbreak. Reporting the outbreak may bring medical assistance but is also likely to trigger trade sanctions by countries hoping to contain the disease. Suppressing the information may avoid trade sanctions, but increases the likelihood of widespread
Anup Malani; Ramanan Laxminarayan
|The global spread of diseases such as swine flu and SARS highlights the difficult decision governments face when presented with evidence of a local outbreak. Reporting the outbreak may bring medical assistance but is also likely to trigger trade sanctions by countries hoping to contain the disease. Suppressing the information may avoid trade…
Malani, Anup; Laxminarayan, Ramanan
Summary Background We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS). Methods We followed up 75 patients for 3 weeks managed with a standard treatment protocol of ribavirin and corticosteroids, and assessed the pattern of clinical disease, viral load, risk factors for poor clinical outcome, and the
JSM Peiris; CM Chu; VCC Cheng; KS Chan; IFN Hung; LLM Poon; KI Law; BSF Tang; TYW Hon; CS Chan; KH Chan; JSC Ng; BJ Zheng; WL Ng; RWM Lai; Y Guan; KY Yuen
The association of viral infection to ear disease has triggered a great deal of interests. In the present paper, we provide a critical review of the viral hypothesis of ear diseases. Detection of viral antigen and antibody or RNA and DNA in the patients serum, endolymphatic fluid or surgical pathology specimens reveals that virus may have relevance to certain kinds of ear diseases, such as Meniere's disease, idiopathic sudden sensorineural hearing loss, otosclerosis. Bell's palsy and otitis media. The most appealing is the herpesvirus, which can cause latent infection in the neurons, and its reactivation may be the mechanism of recurrent attacks of ear diseases. Currently, antiviral drug treatment plus supportive therapy are the most effective managements dealing with viral infection. Although antiviral vaccine will become a promising preventive strategy in the future. PMID:23937021
Liu, Yuehang; Wang, Zhengmin
A literature review of waterborne disease outbreaks is presented. Legionellosis outbreaks associated with cooling towers, evaporative condensers, showerheads and tap water are discussed. Attempts to control L. pneumophila with 5 mg/L of free chlorine twice weekly were unsuccessful. Investigators suggested that finding L. pneumophila in the absence of Legionnaires' Disease should not be reason for attempts at eradication. Included are 24 references. (JMT)
BACKGROUND: The ability to detect disease outbreaks in their early stages is a key component of efficient disease control and prevention. With the increased availability of electronic health-care data and spatio-temporal analysis techniques, there is great potential to develop algorithms to enable more effective disease surveillance. However, to ensure that the algorithms are effective they need to be evaluated. The
Rochelle E Watkins; Serryn Eagleson; Sam Beckett; Graeme Garner; Bert Veenendaal; Graeme Wright; Aileen J Plant
The protective effect of maternal antibody against many viral diseases has been recognized. The use of maternal immunization has been considered as a means to augment this protection in the young infant against disease. Advantages of maternal immunization include the fact that young infants are most susceptible to infections but least responsive to vaccines, that pregnant women are accessible to
Janet Englund; W. Paul Glezen; Pedro A. Piedra
Waterborne Diseases Outbreak Surveillance System (WBDOSS) is a collaborative effort of the National Center for Infectious Diseases (NCID) of CDC and the U.S. Environmental Protection Agency (EPA) for collecting and periodically reporting data relating to occurrences and causes of...
Background In recent years, there has been a growth in work on the use of information extraction technologies for tracking disease outbreaks from online news texts, yet publicly available evaluation standards (and associated resources) for this new area of research have been noticeably lacking. Objective This study seeks to create a “gold standard” data set against which to test how accurately disease outbreak information extraction systems can identify the semantics of disease outbreak events. Additionally, we hope that the provision of an annotation scheme (and associated corpus) to the community will encourage open evaluation in this new and growing application area. Methods We developed an annotation scheme for identifying infectious disease outbreak events in news texts. An event?in the context of our annotation scheme?consists minimally of geographical (eg, country and province) and disease name information. However, the scheme also allows for the rich encoding of other domain salient concepts (eg, international travel, species, and food contamination). Results The work resulted in a 200-document corpus of event-annotated disease outbreak reports that can be used to evaluate the accuracy of event detection algorithms (in this case, for the BioCaster biosurveillance online news information extraction system). In the 200 documents, 394 distinct events were identified (mean 1.97 events per document, range 0-25 events per document). We also provide a download script and graphical user interface (GUI)-based event browsing software to facilitate corpus exploration. Conclusion In summary, we present an annotation scheme and corpus that can be used in the evaluation of disease outbreak event extraction algorithms. The annotation scheme and corpus were designed both with the particular evaluation requirements of the BioCaster system in mind as well as the wider need for further evaluation resources in this growing research area.
Kawazoe, Ai; Chanlekha, Hutchatai; Collier, Nigel
Emerging and re-emerging infectious diseases have again entered the public arena in recent years. This is due to factors such as evolving lifestyles, ecological and socio-political upheavals, and recent diagnostic advances. Numerous pathogens, including viruses like West Nile, Chikungunya and Japanese encephalitis on the one hand, and hemorrhagic fever viruses like Ebola and Maburg, are particular concerns. Recently, the Corona virus responsible for SARS, which caused an epidemic sufficiently worrisome to challenge crisis management concepts, was successfully isolated. It is in this context that so-called "bird flu'", may be on the verge of causing a human pandemic. Pox and Monkeypox are "virtually emerging" viruses that have potential for use in bioterrorism. The management and treatment of these emerging infectious diseases calls for new approaches, organizations and infrastructures. PMID:17140098
Bricaire, François; Bossi, Philippe
Stochasticity and spatial heterogeneity are of great interest recently in studying the spread of an infectious disease. The presented method solves an inverse problem to discover the effectively decisive topology of a heterogeneous network and reveal the transmission parameters which govern the stochastic spreads over the network from a dataset on an infectious disease outbreak in the early growth phase. Populations in a combination of epidemiological compartment models and a meta-population network model are described by stochastic differential equations. Probability density functions are derived from the equations and used for the maximal likelihood estimation of the topology and parameters. The method is tested with computationally synthesized datasets and the WHO dataset on the SARS outbreak.
The investigation of disease outbreaks in herds and flocks includes the gathering of multiple types of discrete data on the characteristics of the disease and the potential risk factors involving agent, host, and environment. Descriptive statistics such as rates, ratios, and proportions offer the investigator tools for counting the disease occurrence, for communicating the results of the investigation to others, and for further analyzing the patterns of disease in order to identify the true risk factors. Because there are several alternative methods for calculating descriptive statistics, specific definitions of each statistic should be followed so that ambiguity and misinformation are avoided. The practitioner must choose one definition and apply it consistently in disease investigations. Consistency allows for comparison of descriptive statistics from one investigation to another, or from one time to another time within the same herd. Analytic statistics allow for a critical evaluation of the data represented in rates, ratios, and proportions. Statistical tests address the all-important question, "Could these observed associations between disease and potential risk factors have occurred by chance alone?" This question must be addressed so that the wisest intervention decisions can be made. The tools described in this article are useful in routine herd health practice situations as well as the investigation of disease outbreaks and impaired productivity. Descriptive statistics provide a system for counting disease so that the practitioner can evaluate progress in the individual herd. The ability of the practitioner to quantify changes in disease occurrence in the herd provides hard evidence for the producer of the impact of herd health approaches. PMID:3259461
Hueston, W D
Waterborne disease remains a major public health problem in many countries. We report findings on nearly three decades of waterborne disease in Israel and the part these diseases play in the total national burden of enteric disease. During the 1970s and 1980s, Israel's community water supplies were frequently of poor quality according to the microbiological standards at that time, and the country experienced many outbreaks of waterborne enteric disease. New regulations raised water quality standards and made chlorination of community water supplies mandatory, as well as imposing more stringent guidelines on maintaining water sources and distribution systems for both surface water and groundwater. This was followed by improved compliance and water quality, and a marked decline in the number of outbreaks of waterborne disease; no outbreaks were detected between 1992 and 1997. The incidence of waterborne salmonellosis, shigellosis, and typhoid declined markedly as proportions of the total burden of these diseases, but peaked during the time in which there were frequent outbreaks of waterborne disease (1980-85). Long-term trends in the total incidence of reported infectious enteric diseases from all sources, including typhoid, shigellosis, and viral hepatitis (all types) declined, while the total incidence of salmonellosis increased. Mandatory chlorination has had an important impact on improving water quality, in reducing outbreaks of waterborne disease in Israel, and reducing the total burden of enteric disease in the country.
Tulchinsky, T. H.; Burla, E.; Clayman, M.; Sadik, C.; Brown, A.; Goldberger, S.
Several environmental parameters have been linked to outbreaks of coral disease. Here we describe the influence of remotely-sensed summer and winter temperatures, as well as local observations of coral cover, to predict the risk of White Syndrome disease outbreaks on the Great Barrier Reef, Australia. Coral disease is an emerging risk to coral reef ecosystems that is likely to escalate
S. F. Heron; B. L. Willis; W. J. Skirving; C. A. Page; C. M. Eakin; I. R. Miller; T. R. Christensen; D. K. Gledhill; G. Liu; J. A. Morgan; B. A. Parker; A. E. Strong
Recent outbreaks of foot-and-mouth disease virus (FMDV) demonstrate this highly contagious viral infection of cloven hoofed animals continues to be a significant economic problem worldwide. Debate about the most effective way to respond to FMD outbreaks in disease-free countries continues to center ...
We present a group of 18 illegal immigrant stowaways who arrived in a shipboard cargo container suffering from gastroenteritis, dehydration, and malnutrition and showing evidence of viral myocarditis in 3 of 4 fatalities. Our investigation included an evaluation of the 2-week ocean voyage, analysis of medical records and laboratory results of the survivors, autopsies on the decedents, and viral studies on their heart tissue. Of 3 stowaways who died shipboard, 2 showed lymphocytic myocarditis and 1 could not be evaluated histologically due to decomposition. A fourth stowaway died 4 months after arrival with dilated cardiomyopathy and lymphocytic myocarditis. Reverse-transcriptase polymerase chain reaction and nucleotide sequencing of viral isolates from the decedents' heart tissues demonstrated Coxsackie virus B3 genome. We believe that these cases represent an outbreak of viral myocarditis, exacerbated by acute dehydration and malnutrition, due to confinement within the shipping container. Our evidence indicates that close confinement promoted the spread of the virus, and nutritional deprivation increased the stowaways' vulnerability. Furthermore, our observations support the conclusion, based on experimental studies, that nutritionally induced oxidative stress increased the virulence of the etiologic viral agent. In summary, these cases represent a potential infectious disease hazard of illegal immigration. PMID:15166761
Li, Melissa K; Beck, Melinda A; Shi, Qing; Harruff, Richard C
This study was designed to investigate the possible association of high colony counts of legionellae from cooling towers and evaporative condensers with Legionnaires' disease outbreaks. We obtained legionellae counts from samples of cooling towers and evaporative condensers that were the likely sources of two different Legionnaires' disease outbreaks and compared these counts with those from cooling towers that were not
Brian G. Shelton; W. Dana Flanders; George K. Morris
A workshop on viral epidemiology was held on September 29, 1995 at the Medical School of the Universidad Nacional Autónoma de Mexico. The aim of this workshop was to promote interaction among scientists working in viral epidemiology. Eighteen scientists from ten institutions presented their experiences and work. General aspects of the epidemiology of meaningful viral diseases in the country were discussed, and lectures presented on the rota, polio, respiratory syncytial, dengue, papiloma, rabies, VIH and hepatitis viruses. PMID:9504103
Gómez, B; Cabrera, L; Arias, C F
Context Old, evolving, and new infectious agents continually threaten the participation of competitors in sports. Objective To provide an update of the medical literature on infectious disease outbreaks in sport for the last 5 years (May 2005–November 2010). Main Outcome Measure(s) A total of 21 outbreaks or clusters were identified. Results Methicillin-resistant Staphylococcus aureus (n = 7, 33%; mainly community acquired) and tinea (trichophytosis: n = 6, 29%) were the most common pathogens responsible for outbreaks. Skin and soft tissue was the most common site of infection (n = 15, 71%). Conclusions The majority of outbreaks reported occurred in close-contact sports, mainly combat sports (ie, wrestling, judo) and American football. Twelve outbreaks (57%) involved high school or collegiate competitors. Common community outbreak pathogens, such as influenza virus and norovirus, have received little attention.
Collins, Cathal James; O'Connell, Brian; BCh, SI MB
The Colorado Department of Health conducted intensive surveillance for waterborne diseases during the three-year period July 1, 1980-June 30, 1983. Eighteen outbreaks of waterborne illness were investigated. Outbreaks involved from 15 to 1,500 ill persons. Giardia lamblia was con...
The outbreak of the Influenza A (H1N1) virus has led to numerous precautionary school closures in several countries. No research is available on the school teachers' perceptions as a health protective resource in controlling communicable disease outbreaks. The purposes of this study were to examine the risk perception, the perceived understanding…
Wong, Emmy M. Y.; Cheng, May M. H.; Lo, S.K.
|The outbreak of the Influenza A (H1N1) virus has led to numerous precautionary school closures in several countries. No research is available on the school teachers' perceptions as a health protective resource in controlling communicable disease outbreaks. The purposes of this study were to examine the risk perception, the perceived understanding…
Wong, Emmy M. Y.; Cheng, May M. H.; Lo, S.K.
Background Recognized outbreaks of Legionnaires' disease (LD) are rare; when they occur, they provide opportunities to understand the epidemiology of the illness and improve prevention strategies. We investigated a population-based outbreak. Methods After the confirmation of LD in October 1996 in five people in neighbouring towns in southwest Virginia, active surveillance for additional cases was undertaken. A case-control study was
Denise H Benkel; Emily M McClure; Diane Woolard; John V Rullan; Suzanne R Jenkins; Jody H Hershey; Robert F Benson; Janet M Pruckler; Ellen W Brown; Margarette S Kolczak; Robert L Hackler; Betty S Rousec; Robert F Breimanb
An epidemic outbreak of both norovirus (NV) and astrovirus (ASV) occurred on a research ship surveying Tokyo Bay, causing acute gastroenteritis in 26 of its 37 crew members. The presence of viral pathogens in fecal specimens was analyzed, and noroviruses were identified by reverse transcription-PCR in 18 (48.6%) of these specimens. In addition, astroviruses were identified in 14 (37.8%) of the fecal samples from the affected crew members, and multiple viral infections of both NV and ASV were observed in 6 cases. The genogrouping of the NV-positive samples was then examined by dot blot hybridization, and it was determined that all of the isolates were from genogroup II (GII). No bacterial pathogens were subsequently isolated from fecal specimens. Furthermore, a variety of NV strains were identified by sequencing and single-stranded conformational polymorphism (SSCP) analyses of PCR products from the fecal samples. One recombinant NV isolate, Minato/14, was identified as a recombinant NV strain of GII/6 and GII/1. The other NV isolates from this outbreak were classified into three NV genotypes (GII/1 [Minato/10], GII/4 [Minato/33], and GII/5 [Minato/6]). Furthermore, ASVs in positive samples were determined to belong to serotypes 1 and 2 by sequencing analysis. Our findings thus indicate that coinfections with NV and ASV, including a number of NV genotypes, persisted during an outbreak of gastroenteritis in a closed environment.
Sasaki, Yukiko; Kai, Akemi; Hayashi, Yukinao; Shinkai, Takayuki; Noguchi, Yayoi; Hasegawa, Michiya; Sadamasu, Kenji; Mori, Kohji; Tabei, Yukiko; Nagashima, Mami; Morozumi, Satoshi; Yamamoto, Tomoko
An epidemic outbreak of both norovirus (NV) and astrovirus (ASV) occurred on a research ship surveying Tokyo Bay, causing acute gastroenteritis in 26 of its 37 crew members. The presence of viral pathogens in fecal specimens was analyzed, and noroviruses were identified by reverse transcription-PCR in 18 (48.6%) of these specimens. In addition, astroviruses were identified in 14 (37.8%) of the fecal samples from the affected crew members, and multiple viral infections of both NV and ASV were observed in 6 cases. The genogrouping of the NV-positive samples was then examined by dot blot hybridization, and it was determined that all of the isolates were from genogroup II (GII). No bacterial pathogens were subsequently isolated from fecal specimens. Furthermore, a variety of NV strains were identified by sequencing and single-stranded conformational polymorphism (SSCP) analyses of PCR products from the fecal samples. One recombinant NV isolate, Minato/14, was identified as a recombinant NV strain of GII/6 and GII/1. The other NV isolates from this outbreak were classified into three NV genotypes (GII/1 [Minato/10], GII/4 [Minato/33], and GII/5 [Minato/6]). Furthermore, ASVs in positive samples were determined to belong to serotypes 1 and 2 by sequencing analysis. Our findings thus indicate that coinfections with NV and ASV, including a number of NV genotypes, persisted during an outbreak of gastroenteritis in a closed environment. PMID:16517856
Sasaki, Yukiko; Kai, Akemi; Hayashi, Yukinao; Shinkai, Takayuki; Noguchi, Yayoi; Hasegawa, Michiya; Sadamasu, Kenji; Mori, Kohji; Tabei, Yukiko; Nagashima, Mami; Morozumi, Satoshi; Yamamoto, Tomoko
From 1986 to 1988, 24 states and Puerto Rico reported 50 outbreaks of illness due to water that people intended to drink, affecting 25,846 persons. he protozoal parasite Giardia lamblia was the agent most commonly implicated in outbreaks, as it has been for the last 10 years; man...
Several studies provide evidence of a link between vector-borne disease outbreaks and El Niño driven climate anomalies. Less investigated are the effects of the North Atlantic Oscillation (NAO). Here, we test its impact on outbreak occurrences of 13 infectious diseases over Europe during the last fifty years, controlling for potential bias due to increased surveillance and detection. NAO variation statistically influenced the outbreak occurrence of eleven of the infectious diseases. Seven diseases were associated with winter NAO positive phases in northern Europe, and therefore with above-average temperatures and precipitation. Two diseases were associated with the summer or spring NAO negative phases in northern Europe, and therefore with below-average temperatures and precipitation. Two diseases were associated with summer positive or negative NAO phases in southern Mediterranean countries. These findings suggest that there is potential for developing early warning systems, based on climatic variation information, for improved outbreak control and management.
Morand, Serge; Owers, Katharine A.; Waret-Szkuta, Agnes; McIntyre, K. Marie; Baylis, Matthew
Several studies provide evidence of a link between vector-borne disease outbreaks and El Niño driven climate anomalies. Less investigated are the effects of the North Atlantic Oscillation (NAO). Here, we test its impact on outbreak occurrences of 13 infectious diseases over Europe during the last fifty years, controlling for potential bias due to increased surveillance and detection. NAO variation statistically influenced the outbreak occurrence of eleven of the infectious diseases. Seven diseases were associated with winter NAO positive phases in northern Europe, and therefore with above-average temperatures and precipitation. Two diseases were associated with the summer or spring NAO negative phases in northern Europe, and therefore with below-average temperatures and precipitation. Two diseases were associated with summer positive or negative NAO phases in southern Mediterranean countries. These findings suggest that there is potential for developing early warning systems, based on climatic variation information, for improved outbreak control and management. PMID:23639950
Morand, Serge; Owers, Katharine A; Waret-Szkuta, Agnes; McIntyre, K Marie; Baylis, Matthew
In 2012, Texas experienced the largest outbreak of human West Nile encephalitis (WNE) since the introduction of West Nile virus (WNV) in 2002. Despite the large number of WNV infections, data indicated the rate of reported WNE among human cases was no higher than in previous years. To determine whether the increase in WNV human cases could have been caused by viral genetic changes, the complete genomes of 17 isolates made from mosquito pools in Dallas and Montgomery Counties in 2012 were sequenced. The 2012 Texas isolates were found to be composed of two distinct clades, both circulating in Dallas and Montgomery Counties despite a 5-fold higher disease incidence in the former. Although minor genetic differences existed between Dallas and Montgomery WNV populations, there was weak support for population subdivision or adaptive changes. On the basis of these data, alternative explanations for increased WNV disease incidence in 2012 are proposed.
Duggal, Nisha K.; D'Anton, Mary; Xiang, Jeannie; Seiferth, Robyn; Day, Joanne; Nasci, Roger; Brault, Aaron C.
In this review, recent developments in the field of viral diseases of the dog and the cat are discussed. In the dog, infection with the coronavirus type 2 is associated with respiratory signs, while infection of a highly pathogenic strain of the coronavirus type 1 has been identified as the cause of mortality in puppies. A new strain of the canine parvovirus is identified, from which the pathogenicity is not yet completely clarified. Infection with West Nile virus is associated with progressive neurological disease and subclinical infections in dogs. Infection with equine influenza A (H3N8) or a highly related influenza virus can cause severe respiratory disease and mortality in greyhounds and other dogs. Infection with avian influenza A (H5N1) can cause disease and mortality in cats and is mostly subclinical in dogs. A number of outbreaks of highly virulent strains of the calicivirus in cats have been described. PMID:19462619
Bodewes, R; Egberink, H F
Foot and Mouth disease (FMD) is a highly infectious and contagious viral disease affecting cloven-hoofed livestock that was last detected in the United States (US) in 1929. The prevalence of FMD in other countries, as well as the current potential for this virus to be used as a form of agroterrorism, has made preparations for a potential FMD outbreak a national priority. To assist in the evaluation of national preparedness, all 50 states were surveyed via e-mail, telephone and web search to obtain emergency response plans for FMD or for foreign animal diseases in general. Information from 33 states was obtained and analyzed for estimates of personnel resources needed to respond to an outbreak. These estimates were consolidated and enhanced to create a tool that could be used by individual states to better understand the personnel that would be needed to complete various tasks over time during an outbreak response. The estimates were then coupled, post-processing, to the output from FMD outbreaks simulated in California using the Multiscale Epidemiological/Economic Simulation and Analysis (MESA) model at Lawrence Livermore National Laboratory to estimate the personnel resource demands, by task, over the course of an outbreak response.
Simmons, K; Hullinger, P
A study was undertaken to assess the utility of the xTAG respiratory viral panel (RVP) for enhanced laboratory investigation of respiratory outbreaks. Specimens (n = 1,108) from 244 suspected respiratory virus outbreaks in 2006 and 2007 in Alberta, Canada, were included in the study. Testing by direct fluorescent antigen detection (DFA) and various in-house nucleic acid amplification tests (NATs) for common respiratory viruses provided an etiological diagnosis in 177 outbreaks (72.5%), with 524 samples testing positive (47.3%) for a respiratory virus. Two hundred samples from 51 unresolved outbreaks were further tested by RVP retrospectively. Fifty-eight samples from 30 unresolved outbreaks had a respiratory virus detected by RVP (47 picornavirus-positive, 9 coronavirus-positive, and 2 influenza virus A-positive samples). Overall, detection of a viral etiological agent was achieved in 90.8% of outbreaks using a combination of DFA, NATs, and RVP. Use of RVP enhances the laboratory investigation of respiratory virus outbreaks and facilitates appropriate patient and outbreak management.
Wong, Sallene; Pabbaraju, Kanti; Lee, Bonita E.; Fox, Julie D.
Background Accurate and timely detection of public health events of international concern is necessary to help support risk assessment and response and save lives. Novel event-based methods that use the World Wide Web as a signal source offer potential to extend health surveillance into areas where traditional indicator networks are lacking. In this paper we address the issue of systematically evaluating online health news to support automatic alerting using daily disease-country counts text mined from real world data using BioCaster. For 18 data sets produced by BioCaster, we compare 5 aberration detection algorithms (EARS C2, C3, W2, F-statistic and EWMA) for performance against expert moderated ProMED-mail postings. Results We report sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), mean alerts/100 days and F1, at 95% confidence interval (CI) for 287 ProMED-mail postings on 18 outbreaks across 14 countries over a 366 day period. Results indicate that W2 had the best F1 with a slight benefit for day of week effect over C2. In drill down analysis we indicate issues arising from the granular choice of country-level modeling, sudden drops in reporting due to day of week effects and reporting bias. Automatic alerting has been implemented in BioCaster available from http://born.nii.ac.jp. Conclusions Online health news alerts have the potential to enhance manual analytical methods by increasing throughput, timeliness and detection rates. Systematic evaluation of health news aberrations is necessary to push forward our understanding of the complex relationship between news report volumes and case numbers and to select the best performing features and algorithms.
Viruses are the most important cause of infections and a major source of mortality in Kidney Transplant Recipients (KTRs). These patients may acquire viral infections through exogenous routes including community exposure, donor organs, and blood products or by endogenous reactivation of latent viruses. Beside major opportunistic infections due to CMV and EBV and viral hepatitis B and C, several viral diseases have recently emerged in KTRs. New medical practices or technologies, implementation of new diagnostic tools, and improved medical information have contributed to the emergence of these viral diseases in this special population. The purpose of this review is to summarize the current knowledge on emerging viral diseases and newly discovered viruses in KTRs over the last two decades. We identified viruses in the field of KT that had shown the greatest increase in numbers of citations in the NCBI PubMed database. BKV was the most cited in the literature and linked to an emerging disease that represents a great clinical concern in KTRs. HHV-8, PVB19, WNV, JCV, H1N1 influenza virus A, HEV, and GB virus were the main other emerging viruses. Excluding HHV8, newly discovered viruses have been infrequently linked to clinical diseases in KTRs. Nonetheless, pathogenicity can emerge long after the discovery of the causative agent, as has been the case for BKV. Overall, antiviral treatments are very limited, and reducing immunosuppressive therapy remains the cornerstone of management. PMID:23132728
Moal, Valérie; Zandotti, Christine; Colson, Philippe
Public health authorities should be vigilant to the potential for outbreaks deliberately caused by biological agents (bioterrorism). Such events require a rapid response and incorporation of non-traditional partners for disease investigation and outbreak control. The astute application of infectious disease epidemiological principles can promote an enhanced index of suspicion for such events. We discuss epidemiological indicators that should be considered during outbreak investigations, and also examine their application during bioterrorism incidents, an accidental release of an agent, outbreaks of infections that were alleged to have been deliberately initiated, and a model scenario. The Grunow & Finke epidemiological assessment tool is used to examine these historical events and the model scenario. The results received from this analysis, coupled with an understanding of epidemiological clues to unnatural events, and knowledge of how to manage such events, can aid in the improved response and resolution of epidemics. PMID:16893485
Dembek, Z F; Kortepeter, M G; Pavlin, J A
Newcastle disease (ND) is a highly contagious viral disease and is a continuous threat to the poultry industry worldwide. In the early months of 2011, several devastating ND outbreaks occurred in Jordan affecting broilers, layers and breeders. The fusion gene of the isolated Newcastle disease virus (NDV) was partially amplified by RT-PCR, then directly sequenced. The NDV isolates were found to have the motif112RRQKRF117. This motif and a mean death time (MDT) of 46 h are indicative of the velogenic nature of these NDV isolates. Phylogenetic analysis showed that the new NDV strain belongs to the lineage 5d (Aldous et al., 2003) and is closely related to the Chinese strain SG/Liaoning/2009. NDV outbreaks in 2010 and 2011 have been noted in neighboring countries. Based on the high nucleotide similarity between our isolated NDV isolates and the Chinese NDV strain, the origin of these recent NDV isolates might be from China. PMID:22480768
Ababneh, Mustafa M K; Dalab, Abd Elhafeed; Alsaad, Saad R; Al-Zghoul, Mohammad B; Al-Natour, Mohammad Q
Quinolamine (Riker Laboratories, AVS 1018) was eminently promising in the yellow fever virus primate model. Treatment before and after virus infection protected 5 virus inoculated monkeys from disease for 25 days. Two of 3 untreated cynomolgous monkeys in...
G. H. Tignor
Both sheep and goat pox are contagious viral diseases and affect small ruminants and are caused by sheep pox virus and goat pox virus respectively that belong to genus Capripoxvirus of Poxviridae family. Huge economic losses emanating from the disease outbreaks are the results of the wool and hide damage, subsequent production losses and also the morbidities and mortalities associated with the disease. This communication highlights clinico-epidemiological observations from the two sheep pox and one goat pox outbreaks. Grossly, multisystemic nodular lesions, mucopurulent nasal discharges and respiratory symptoms were observed in the affected animals. The morbidity, mortality and case fatality rates were 5.18%, 2.45% and 32.37%, respectively. Histopathological, haematological, molecular and serological techniques and also isolation of virus in embryonated chicken eggs were used for the diagnosis of the diseases. The spatial distribution of the disease signifies the role of common pasturelands used for grazing the animals while temporally all three outbreaks occurred in winters and were probably associated with cold stress and fodder scarcity. This is the first recorded report of Capripoxvirus infection in recent times and it highlights the disease as one of the emerging diseases in the northern state of Himachal Pradesh in India. PMID:21214867
Verma, S; Verma, L K; Gupta, V K; Katoch, V C; Dogra, V; Pal, B; Sharma, M
Outbreak! is an online, interactive educational game that helps students and teachers learn and evaluate clinical microbiology skills. When the game was used in introductory microbiology laboratories, qualitative evaluation by students showed very positiv
Smith, Geoffrey B.; Clark, Sherri
Social network analysis is now widely used to investigate the dynamics of infectious disease spread. Vaccination dramatically disrupts disease transmission on a contact network, and indeed, high vaccination rates can potentially halt disease transmission altogether. Here, we build on mounting evidence that health behaviors - such as vaccination, and refusal thereof - can spread across social networks through a process of complex contagion that requires social reinforcement. Using network simulations that model health behavior and infectious disease spread, we find that under otherwise identical conditions, the process by which the health behavior spreads has a very strong effect on disease outbreak dynamics. This dynamic variability results from differences in the topology within susceptible communities that arise during the health behavior spreading process, which in turn depends on the topology of the overall social network. Our findings point to the importance of health behavior spread in predicting and controlling disease outbreaks.
Campbell, Ellsworth; Salathe, Marcel
Social network analysis is now widely used to investigate the dynamics of infectious disease spread. Vaccination dramatically disrupts disease transmission on a contact network, and indeed, high vaccination rates can potentially halt disease transmission altogether. Here, we build on mounting evidence that health behaviors - such as vaccination, and refusal thereof - can spread across social networks through a process of complex contagion that requires social reinforcement. Using network simulations that model health behavior and infectious disease spread, we find that under otherwise identical conditions, the process by which the health behavior spreads has a very strong effect on disease outbreak dynamics. This dynamic variability results from differences in the topology within susceptible communities that arise during the health behavior spreading process, which in turn depends on the topology of the overall social network. Our findings point to the importance of health behavior spread in predicting and controlling disease outbreaks. PMID:23712758
Campbell, Ellsworth; Salathé, Marcel
This report describes the investigation and control of a community outbreak of Legionnaires' disease in Hereford, UK, in November 2003. Outbreak investigation consisted of epidemiological survey, identification and environmental investigation of potential sources, microbiological analysis of clinical and environmental samples and mapping the location of potential sources and the movement and residence of cases. Each identified source was allocated a 'composite score' based on different zones of exposure and wind direction. Altogether, 28 cases were identified, with an overall case fatality rate of 7%. All cases had epidemiological links to Hereford city centre. The 'composite score' identified a cluster of cooling towers as being the most likely source of the outbreak. Environmental samples from one of the cooling towers in the cluster and clinical samples from two patients were positive for Legionella pneumophilia serogroup 1 and were indistinguishable by molecular sub-typing. In this outbreak, the use of microbiological, environmental and epidemiological techniques facilitated the rapid identification of a cooling tower as the source of this outbreak. This study illustrates the continuing importance of cooling towers as a source of Legionnaires' disease and the utility of obtaining and comparing both clinical and environmental samples. PMID:17513103
Kirrage, David; Reynolds, Gary; Smith, Gillian E; Olowokure, Babatunde
Many human diseases, arising from mutations of disease susceptibility genes (genetic diseases), are also associated with viral infections (virally implicated diseases), either in a directly causal manner or by indirect associations. Here we examine whether viral perturbations of host interactome may underlie such virally implicated disease relationships. Using as models two different human viruses, Epstein-Barr virus (EBV) and human papillomavirus (HPV), we find that host targets of viral proteins reside in network proximity to products of disease susceptibility genes. Expression changes in virally implicated disease tissues and comorbidity patterns cluster significantly in the network vicinity of viral targets. The topological proximity found between cellular targets of viral proteins and disease genes was exploited to uncover a novel pathway linking HPV to Fanconi anemia.
Dricot, Amelie; Padi, Megha; Byrdsong, Danielle; Franchi, Rachel; Lee, Deok-Sun; Rozenblatt-Rosen, Orit; Mar, Jessica C.; Calderwood, Michael A.; Baldwin, Amy; Zhao, Bo; Santhanam, Balaji; Braun, Pascal; Simonis, Nicolas; Huh, Kyung-Won; Hellner, Karin; Grace, Miranda; Chen, Alyce; Rubio, Renee; Marto, Jarrod A.; Christakis, Nicholas A.; Kieff, Elliott; Roth, Frederick P.; Roecklein-Canfield, Jennifer; DeCaprio, James A.; Cusick, Michael E.; Quackenbush, John; Hill, David E.; Munger, Karl; Vidal, Marc; Barabasi, Albert-Laszlo
Many human diseases, arising from mutations of disease susceptibility genes (genetic diseases), are also associated with viral infections (virally implicated diseases), either in a directly causal manner or by indirect associations. Here we examine whether viral perturbations of host interactome may underlie such virally implicated disease relationships. Using as models two different human viruses, Epstein-Barr virus (EBV) and human papillomavirus (HPV), we find that host targets of viral proteins reside in network proximity to products of disease susceptibility genes. Expression changes in virally implicated disease tissues and comorbidity patterns cluster significantly in the network vicinity of viral targets. The topological proximity found between cellular targets of viral proteins and disease genes was exploited to uncover a novel pathway linking HPV to Fanconi anemia. PMID:22761553
Gulbahce, Natali; Yan, Han; Dricot, Amélie; Padi, Megha; Byrdsong, Danielle; Franchi, Rachel; Lee, Deok-Sun; Rozenblatt-Rosen, Orit; Mar, Jessica C; Calderwood, Michael A; Baldwin, Amy; Zhao, Bo; Santhanam, Balaji; Braun, Pascal; Simonis, Nicolas; Huh, Kyung-Won; Hellner, Karin; Grace, Miranda; Chen, Alyce; Rubio, Renee; Marto, Jarrod A; Christakis, Nicholas A; Kieff, Elliott; Roth, Frederick P; Roecklein-Canfield, Jennifer; Decaprio, James A; Cusick, Michael E; Quackenbush, John; Hill, David E; Münger, Karl; Vidal, Marc; Barabási, Albert-László
The aim of this study is to identify general properties of emerging infectious agents that determine the likely success of two simple public health measures in controlling outbreaks, namely (i) isolating symptomatic individuals and (ii) tracing and quarantining their con- tacts. Because these measures depend on the recognition of specific disease symptoms, we investigate the relative timing of infectious- ness
Christophe Fraser; Steven Riley; Roy M. Anderson; Neil M. Ferguson
This work consists of two volumes. olume I is a series of articles based on selected presentations made at the U.S. Environmental Protection Agency (EPA) and Association of State Drinking Water Administrators Workshop on Methods for Investigation of Water-borne Disease Outbreaks ...
Summary In this era of globalisation the effective control of animal disease outbreaks requires powerful crisis management tools. In the 1990s software packages for different sectors of the government and agricultural industry began to be developed. In 2004, as a special application for tracking the movement of animals and animal products, the European Union developed the Trade Control and Expert
R. Carmanns; F. J. Conraths
Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Extremes...
A. Anyamba C. J. Tucker E. W. Pak J. E. Pinzon J. L. Small J. R. Eastman K. J. Linthicum K. L. Russell K. M. Collins S. C. Britch
Human enteric viruses and protozoal parasites are important causes of emerging food and waterborne disease. Epidemiologic investigation and detection of the agents in clinical, food, and water specimens, which are traditionally used to establish the cause of disease outbreaks, are either cumbersome, expensive, and frequently unavailable or unattempted for the important food and waterborne enteric viruses and protozoa. However, the recent introduction of regulatory testing mandates, alternative testing strategies, and increased epidemiologic surveillance for food and waterborne disease should significantly improve the ability to detect and control these agents. We discuss new methods of investigating foodborne viral and parasitic disease and the future of these methods in recognizing, identifying, and controlling disease agents.
Jaykus, L. A.
An outbreak of pox disease in Carnivora of the family Felidae occurred in the Moscow Zoo. Two forms of the disease were found: (1) fatal, fulminant pulmonary without skin lesions and (2) dermal with rash. The severity of the dermal form varied from subclinical to lethal. The pulmonary form was characterized by pneumonia and exudative pleuritis, and large concentrations of virus were observed in the lungs and exudate. In addition to Carnivora of the family Felidae, two giant anteaters had a severe form of the disease (dermal with hemorrhages) and died. The agent of the outbreak appeared to be very closely related to cowpox virus; however, pocks developed at a lower temperature than do those that result from infection with cowpox virus. Strains isolated from sick animals were identical to the virus previously isolated from an outbreak of pox among elephants and okapi. The most probable sources of infection were rats that were fed to some of the animals. During the outbreak, a female attendant at the zoo became infected. PMID:191538
Marennikova, S S; Maltseva, N N; Korneeva, V I; Garanina, N
BackgroundAdvanced disease-surveillance systems have been deployed worldwide to provide early detection of infectious disease outbreaks and bioterrorist attacks. New methods that improve the overall detection capabilities of these systems can have a broad practical impact. Furthermore, most current generation surveillance systems are vulnerable to dramatic and unpredictable shifts in the health-care data that they monitor. These shifts can occur during
Ben Y. Reis; Isaac S. Kohane; Kenneth D. Mandl
Background Trypanosoma cruzi, the causative agent of Chagas disease, displays significant genetic variability revealed by six Discrete Typing Units (TcI-TcVI). In this pathology, oral transmission represents an emerging epidemiological scenario where different outbreaks associated to food/beverages consumption have been reported in Argentina, Bolivia, Brazil, Ecuador and Venezuela. In Colombia, six human oral outbreaks have been reported corroborating the importance of this transmission route. Molecular epidemiology of oral outbreaks is barely known observing the incrimination of TcI, TcII, TcIV and TcV genotypes. Methodology and Principal Findings High-throughput molecular characterization was conducted performing MLMT (Multilocus Microsatellite Typing) and mtMLST (mitochondrial Multilocus Sequence Typing) strategies on 50 clones from ten isolates. Results allowed observing the occurrence of TcI, TcIV and mixed infection of distinct TcI genotypes. Thus, a majority of specific mitochondrial haplotypes and allelic multilocus genotypes associated to the sylvatic cycle of transmission were detected in the dataset with the foreseen presence of mitochondrial haplotypes and allelic multilocus genotypes associated to the domestic cycle of transmission. Conclusions These findings suggest the incrimination of sylvatic genotypes in the oral outbreaks occurred in Colombia. We observed patterns of super-infection and/or co-infection with a tailored association with the severe forms of myocarditis in the acute phase of the disease. The transmission dynamics of this infection route based on molecular epidemiology evidence was unraveled and the clinical and biological implications are discussed.
Ramirez, Juan David; Montilla, Marleny; Cucunuba, Zulma M.; Florez, Astrid Carolina; Zambrano, Pilar; Guhl, Felipe
An outbreak of acute febrile illness occurred during August and September 1989 in the Northern Province of Sudan coinciding with a high population density of phlebotomine sandflies. An investigation was conducted to determine whether arboviruses were associated with human illness during this outbreak. Sera were obtained from 185 febrile individuals and tested for IgG and IgM antibody to selected arboviruses by enzyme immunoassay (EIA). The prevalence of IgG antibody was 59% for West Nile (WN), 53% for Sandfly Fever Sicilian (SFS), 32% for Sandfly Fever Naples (SFN), 39% for Yellow Fever (YF), 24% for dengue-2 (DEN-2), 23% for Rift Valley Fever (RVF), 12% for Chikungunya (CHIK) and 5% for Crimean-Congo haemorrhagic Fever (CCHF) viruses. Antibody prevalences tended to increase with age for WN and YF viruses. Antibody rates were about the same for males and females for most of the viruses tested. The prevalence of IgM antibody to SFN was 24% and reciprocal IgM titre exceeded 12,800 for some individuals suggesting that this virus was the cause of recent infection. The prevalence of IgM antibody for the other viruses did not exceed 5%. The study indicated that several arboviruses were endemic and some of them may have caused human disease in the Northern Province of Sudan. PMID:8064945
Watts, D M; el-Tigani, A; Botros, B A; Salib, A W; Olson, J G; McCarthy, M; Ksiazek, T G
Effective control of infectious disease outbreaks is an important public health goal. In a number of recent studies, it has been shown how different intervention measures like travel restrictions, school closures, treatment and prophylaxis might allow us to control outbreaks of diseases, such as SARS, pandemic influenza and others. In these studies, control of a single outbreak is considered. It
Andreas Handel; Ira M. Longini Jr; Rustom Antia
The threat of biological terrorism and warfare may increase as the availability of weaponizable agents increase, the relative production costs of these agents decrease, and, most importantly, there exist terrorist groups willing to use them. Therefore, an important consideration during the current emphasis of heightened surveillance for emerging infectious diseases is the capability to differentiate between natural and intentional outbreaks. Certain attributes of a disease outbreak, while perhaps not pathognomic for a biological attack when considered singly, may in combination with other attributes provide convincing evidence for intentional causation. These potentially differentiating criteria include proportion of combatants at risk, temporal patterns of illness onset, number of cases, clinical presentation, strain/variant, economic impact, geographic location, morbidity/mortality, antimicrobial resistance patterns, seasonal distribution, zoonotic potential, residual infectivity/toxicity, prevention/therapeutic potential, route of exposure, weather/climate conditions, incubation period, and concurrence with belligerent activities of potential adversaries. PMID:10681967
Noah, D L; Sobel, A L; Ostroff, S M; Kildew, J A
The threat of biological terrorism and warfare may increase as the availability of weaponizable agents increases, the relative production costs of these agents decrease, and, most importantly, there exist terrorist groups willing to use them. Therefore, an important consideration during the current period of heightened surveillance for emerging infectious diseases is the ability to differentiate between natural and intentional outbreaks. Certain attributes of a disease outbreak, although perhaps not pathognomonic for a biological attack when considered singly, may combine to provide convincing evidence of intentional causation. These potentially differentiating criteria include proportion of combatants at risk, temporal patterns of illness onset, number of cases, clinical presentation, strain/variant, economic impact, geographic location, morbidity/mortality, antimicrobial resistance patterns, seasonal distribution, zoonotic potential, residual infectivity/toxicity, prevention/therapeutic potential, route of exposure, weather/climate conditions, incubation period, and concurrence with belligerent activities of potential adversaries. PMID:9575761
Noah, D L; Sobel, A L; Ostroff, S M; Kildew, J A
During December 12–29, 1998, seven patients ages 2–18 years were diagnosed with serogroup C meningococcal disease in two neighboring Florida towns with 33,000 residents. We evaluated a mass vaccination campaign implemented to control the outbreak. We maintained vaccination logs and recorded the resources used in the campaign that targeted 2- to 22-year-old residents of the two towns. A total of 13,148 persons received the vaccinations in 3 days. Vaccination coverage in the target population was estimated to be 86% to 99%. Five additional cases of serogroup C meningococcal disease occurred in the community during the year after the campaign began, four in patients who had not received the vaccine. The cost of control efforts was approximately $370,000. Although cases continued to occur, the vaccination campaign appeared to control the outbreak. Rapid implementation, a targeted approach, and high coverage were important to the campaign's success.
Blackmore, Carina; Wiersma, Steven; Lesneski, Cheryll; Gauch, Laurey; Hopkins, Richard S.
BackgroundRecent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Although Rift Valley fever outbreaks have been known to follow periods of above-normal rainfall, the timing of the outbreak events has largely been unknown. Similarly, there
Assaf Anyamba; Kenneth J. Linthicum; Jennifer L. Small; Kathrine M. Collins; Compton J. Tucker; Edwin W. Pak; Seth C. Britch; James Ronald Eastman; Jorge E. Pinzon; Kevin L. Russell
We describe an outbreak of Legionnaires' disease in 2006 in Amsterdam, the Netherlands. Comparisons with the outbreak that took place in 1999 are made to evaluate changes in legionella prevention and outbreak management. The 2006 outbreak was caused by a wet cooling tower. Thirty-one patients were reported. The outbreak was detected two days after the first patient was admitted to hospital, and the source was eliminated five days later. The 1999 outbreak was caused by a whirlpool at a flower show, and 188 patients were reported. This outbreak was detected 14 days after the first patient was admitted to hospital, and two days later the source was traced. Since 1999, the awareness of legionellosis among physicians, the availability of a urinary antigen tests and more efficient early warning and communication systems improved the efficiency of legionellosis outbreak management. For prevention, extensive legislation with clear responsibilities has been put in place. For wet cooling towers, however, legislation regarding responsibility and supervision of maintenance needs to be improved. PMID:18801319
Sonder, G J; van den Hoek, J A; Bovée, L P; Aanhane, F E; Worp, J; Du Ry van Beest Holle, M; van Steenbergen, J E; den Boer, J W; Ijzerman, E P; Coutinho, R A
Between August and October 2003, 15 cases of Legionnaires' disease were detected in the 9th district of Rome. To identify possible sources of Legionella exposure, a matched case-control study was conducted and environmental samples were collected. Hospital discharge records were also retrospectively analysed for the period July-November 2003, and results were compared with the same period during the previous 3 years. The case-control study revealed a significantly increased risk of disease among those frequenting a specific department store in the district (OR 9.8, 95% CI 2.1-46.0), and Legionella pneumophila was isolated from the store's cooling tower. Genotypic and phenotypic analysis of human and environmental isolates demonstrated that the cluster was caused by a single strain of L. pneumophila serogroup 1, and that the cooling tower of the store was the source of infection. The increased number of hospital admissions for microbiologically undiagnosed pneumonia during the study period may indicate that some legionellosis cases were not identified. PMID:16181505
Rota, M C; Pontrelli, G; Scaturro, M; Bella, A; Bellomo, A R; Trinito, M O; Salmaso, S; Ricci, M L
Since 2001 several outbreaks of a new disease associated with Border disease virus (BDV) infection have caused important declines in Pyrenean chamois (Rupicapra pyrenaica) populations in the Pyrenees. The goal of this study was to analyze the post-outbreak BDV epidemiology in the first two areas affected by disease with the aim to establish if the infection has become endemic. We also investigated if BDV infected wild and domestic ruminants sharing habitat with chamois. Unexpectedly, we found different epidemiological scenarios in each population. Since the disease outbreaks, some chamois populations recuperated quickly, while others did not recover as expected. In chamois from the first areas, prevalence was high (73.47%) and constant throughout the whole study period and did not differ between chamois born before and after the BDV outbreak; in all, BDV was detected by RT-PCR in six chamois. In the other areas, prevalence was lower (52.79%) and decreased during the study period; as well, prevalence was significantly lower in chamois born after the disease outbreak. No BDV were detected in this population. A comparative virus neutralisation test performed with four BDV strains and one Bovine viral diarrhoea virus (BVDV) strain showed that all the chamois had BDV-specific antibodies. Pestivirus antibodies were detected in all the rest of analyzed species, with low prevalence values in wild ruminants and moderate values in domestic ruminants. No viruses were detected in these species. These results confirm the hypothesis that outbreaks of BDV infection only affect the Pyrenean chamois, although other wild ruminants can occasionally be infected. In conclusion, two different scenarios have appeared since the first border disease outbreaks in Pyrenean chamois: on the one hand frequent BDV circulation with possible negative impact on population dynamics in some areas and on the other, lack of virus circulation and quick recovery of the chamois population.
Fernandez-Sirera, Laura; Cabezon, Oscar; Allepuz, Alberto; Rosell, Rosa; Riquelme, Cristina; Serrano, Emmanuel; Lavin, Santiago; Marco, Ignasi
To better understand factors associated with confirming the etiologic organism and identifying the food vehicle responsible for foodborne-disease outbreaks, we examined data from outbreaks reported in 1998 and 1999 through active surveillance by Foodborne Disease Active Surveillance Network (FoodNet) surveillance areas in 7 states. In 71% of these outbreaks, no confirmed etiology was identified, and in 46%, no suspected food
Timothy F. Jones; Beth Imhoff; Michael Samuel; Patricia Mshar; Katherine Gibbs Mccombs; Marguerite Hawkins; Valerie Deneen; Michael Cambridge; Sonja J. Olsen
Summary The most important viral disease of farmed deer and bison is malignant catarrhal fever. The other herpesviruses which have been isolated from these species are briefly described. Other viral agents that are recognised in these animals, including adenovirus, parapox, foot and mouth disease, bluetongue, epizootic haemorrhagic disease, bovine virus diarrhoea, rotavirus and coronavirus, are also discussed. Ectoparasites of importance
J. C. Haigh; C. Mackintosh; F. Griffin
The 672 outbreaks of waterborne disease that were reported in the United States between 1946 and 1980 affected more than 150,000 persons. An analysis of the data from these outbreaks provides information on how often and where outbreaks occurred, as well ...
E. C. Lippy S. C. Waltrip
In the past 10 years, an increasing number of outbreaks of enteric disease associated with animals in public settings, such as fairs and petting zoos, have been reported. Fifty-five of these outbreaks that occurred in the United States during 1991- 2005 are reviewed in this article. Lessons learned from these outbreaks and recommendations for prevention are also discussed. Physicians should
Frederick J. Angulo; Nicole Steinmuller; Linda Demma; Jeff B. Bender; Millicent Eidson
In August 1998, a large outbreak of gastroenteritis occurred in a Swiss village of 3500 inhabitants whereof more than 50% were affected. A high contamination of drinking water with faecal coliforms revealed a defect in the waste water system. The objective of the present study was to investigate the outbreak in respect of the presence of human pathogenic viruses. Drinking
D Häfliger; Ph Hübner; J Lüthy
Epidemiology and public health planning will increasingly rely on the analysis of genetic sequence data. In particular, genetic data coupled with dates and locations of sampled isolates can be used to reconstruct the spatiotemporal dynamics of pathogens during outbreaks. Thus far, phylogenetic methods have been used to tackle this issue. Although these approaches have proved useful for informing on the spread of pathogens, they do not aim at directly reconstructing the underlying transmission tree. Instead, phylogenetic models infer most recent common ancestors between pairs of isolates, which can be inadequate for densely sampled recent outbreaks, where the sample includes ancestral and descendent isolates. In this paper, we introduce a novel method based on a graph approach to reconstruct transmission trees directly from genetic data. Using simulated data, we show that our approach can efficiently reconstruct genealogies of isolates in situations where classical phylogenetic approaches fail to do so. We then illustrate our method by analyzing data from the early stages of the swine-origin A/H1N1 influenza pandemic. Using 433 isolates sequenced at both the hemagglutinin and neuraminidase genes, we reconstruct the likely history of the worldwide spread of this new influenza strain. The presented methodology opens new perspectives for the analysis of genetic data in the context of disease outbreaks. PMID:20551981
Jombart, T; Eggo, R M; Dodd, P J; Balloux, F
Epidemiology and public health planning will increasingly rely on the analysis of genetic sequence data. In particular, genetic data coupled with dates and locations of sampled isolates can be used to reconstruct the spatiotemporal dynamics of pathogens during outbreaks. Thus far, phylogenetic methods have been used to tackle this issue. Although these approaches have proved useful for informing on the spread of pathogens, they do not aim at directly reconstructing the underlying transmission tree. Instead, phylogenetic models infer most recent common ancestors between pairs of isolates, which can be inadequate for densely sampled recent outbreaks, where the sample includes ancestral and descendent isolates. In this paper, we introduce a novel method based on a graph approach to reconstruct transmission trees directly from genetic data. Using simulated data, we show that our approach can efficiently reconstruct genealogies of isolates in situations where classical phylogenetic approaches fail to do so. We then illustrate our method by analyzing data from the early stages of the swine-origin A/H1N1 influenza pandemic. Using 433 isolates sequenced at both the hemagglutinin and neuraminidase genes, we reconstruct the likely history of the worldwide spread of this new influenza strain. The presented methodology opens new perspectives for the analysis of genetic data in the context of disease outbreaks.
Jombart, T; Eggo, R M; Dodd, P J; Balloux, F
The rise of aquaculture has been one of the most profound changes in global food production of the past 100 years. Driven by population growth, rising demand for seafood and a levelling of production from capture fisheries, the practice of farming aquatic animals has expanded rapidly to become a major global industry. Aquaculture is now integral to the economies of many countries. It has provided employment and been a major driver of socio-economic development in poor rural and coastal communities, particularly in Asia, and has relieved pressure on the sustainability of the natural harvest from our rivers, lakes and oceans. However, the rapid growth of aquaculture has also been the source of anthropogenic change on a massive scale. Aquatic animals have been displaced from their natural environment, cultured in high density, exposed to environmental stress, provided artificial or unnatural feeds, and a prolific global trade has developed in both live aquatic animals and their products. At the same time, over-exploitation of fisheries and anthropogenic stress on aquatic ecosystems has placed pressure on wild fish populations. Not surprisingly, the consequence has been the emergence and spread of an increasing array of new diseases. This review examines the rise and characteristics of aquaculture, the major viral pathogens of fish and shrimp and their impacts, and the particular characteristics of disease emergence in an aquatic, rather than terrestrial, context. It also considers the potential for future disease emergence in aquatic animals as aquaculture continues to expand and faces the challenges presented by climate change.
Walker, Peter J.; Winton, James R.
When a newspaper report claimed that a serious outbreak of skin disease had occurred in British Army troops stationed at the Bocac Dam, in western Bosnia, all troops at the Bocac Dam location (n = 96), followed by a matched control group of troops (n = 91) at a nearby location, were examined by two investigators. 14% of the study population and 21% of the control group were found to have skin disorders. Most were complaints that are commonly encountered in general medical practice. There was a striking absence of skin infestations. The historical consultation rate for skin disorders had not increased. It was concluded that an outbreak of skin disease had not occurred in British troops guarding the dam. This epidemiological study shows that, even under conditions of modern field hygiene, up to one in five soldiers will have skin disease. Skin infestations, however, have become progressively less common during military campaigns this century, probably because of better personal hygiene, good preventive medicine practices and better access to effective health care.
Croft, A; Smith, H; Creamer, I
Background Diarrheal illness remains a leading cause of global morbidity and mortality, with the majority of deaths occurring in children <5 years of age. Lack of resources often prohibits the evaluation of outbreak characteristics and limits progress in managing this important disease syndrome, particularly in Africa. Relying only on existing medical staff and hospital resources, we assess the use of a questionnaire survey tool to identify baseline outbreak characteristics during recurrent diarrheal outbreaks in Chobe, Botswana. Methods Using historical surveillance data (2006–2009), the temporal pattern of recurrent diarrheal outbreaks was evaluated among patients <5 years of age presenting to health facilities in Chobe District. Using a questionnaire survey tool, medical staff from selected health facilities assessed patients (all ages) presenting with diarrheal disease during two diarrheal outbreaks (2011–2012). Cluster analysis and classification and regression trees (CART) were used to evaluate patient attributes by outbreak. Results We identified a bimodal, annual pattern of acute diarrhea in children <5 years of age across years (Wilcox test, W?=?456.5, p?=?0.052). Historical outbreak periods appeared to coincide with major hydrological phenomena (rainfall/flood recession). Across health facilities, a significant percent of patients in the prospective study were in the ?5 age class (44%, n?=?515 and 35%, n?=?333 in the dry and wet season outbreaks, respectively). Cluster analysis of questionnaire data identified two main branches associated with patient age (<5 and ?5 years of age). Patients did not cluster by outbreak or village. CART examination identified sex and hospitalization as being most predictive of patients <5 years and household diarrhea in patients ?5 years. Water shortages and water quality deficiencies were identified in both outbreaks. Conclusions Diarrhea is a persistent, seasonally occurring disease in Chobe District, Botswana. Lack of variation in outbreak variables suggests the possibility of environmental drivers influencing outbreak dynamics and the potential importance of human-environmental linkages in this region. Public health strategy should be directed at securing improved water service and correcting water quality deficiencies. Public health education should include increased emphasis on sanitation practices when providing care to household members with diarrhea. While global diarrheal disease surveillance is directed at the under-5 age group, this may not be appropriate in areas of high HIV prevalence such as that found in our study area where a large immune-compromised population may warrant increased surveillance across age groups. The approach used in this study provided the first detailed characterization of diarrheal disease outbreaks in the area, an important starting point for immediate intervention and development of working hypotheses for future disease investigations. While data derived from this approach are necessarily limited, they identify critical information on outbreak characteristics in resource poor settings where data gaps continue and disease incidence is high.
Background Haff disease is unexplained rhabdomyolysis caused by consumption of fishery products in the previous 24 h. It was first identified in Europe in 1924 but the condition is extremely rare in China. Here we describe a past outbreak of acute food borne muscle poisoning that occurred in Guangdong Province (South China) in 2009. Methods The first full outbreak of Haff disease reported in Jiangsu Province (East China) in 2010, indicated that the incidence of the disease may be increasing in China. We, therefore first retrospectively reviewed epidemiologic, trace-back, environmental studies, and laboratory analyses, including oral toxicity testing to ascertain risk and chemical analysis to identify toxin(s), from the 2009 Guangdong outbreak. Then we compared data from the 2009 outbreak with data from all other Haff disease outbreaks that were available. Results Clinical symptoms and laboratory findings indicated that the 2009 Guangdong outbreak disease was consistent with rhabdomyolysis. Epidemiologic, trace-back, environmental studies and laboratory analyses implied that the disease was caused by freshwater Pomfrets consumed prior to the onset of symptoms. We also identified common factors between the 2009 Guangdong outbreak and previous Haff disease outbreaks reported around the world, while as with other similar outbreaks, the exact etiological factor(s) of the disease remains unknown. Conclusions The 2009 Guangdong outbreak of ‘muscle poisoning’ was retrospectively identified as an outbreak of Haff disease. This comprised the highest number of cases reported in China thus far. Food borne diseases emerging in this unusual form and the irregular pattern of outbreaks present an ongoing public health risk, highlighting the need for improved surveillance and diagnostic methodology.
Clostridium perfringens is estimated to be the second most common bacterial cause of foodborne illness in the United States, causing one million illnesses each year. Local, state, and territorial health departments voluntarily report C. perfringens outbreaks to the U.S. Centers for Disease Control and Prevention through the Foodborne Disease Outbreak Surveillance System. Our analysis included outbreaks confirmed by laboratory evidence during 1998-2010. A food item was implicated if C. perfringens was isolated from food or based on epidemiologic evidence. Implicated foods were classified into one of 17 standard food commodities when possible. From 1998 to 2010, 289 confirmed outbreaks of C. perfringens illness were reported with 15,208 illnesses, 83 hospitalizations, and eight deaths. The number of outbreaks reported each year ranged from 16 to 31 with no apparent trend over time. The annual number of outbreak-associated illnesses ranged from 359 to 2,173, and the median outbreak size was 24 illnesses. Outbreaks occurred year round, with the largest number in November and December. Restaurants (43%) were the most common setting of food preparation. Other settings included catering facility (19%), private home (16%), prison or jail (11%), and other (10%). Among the 144 (50%) outbreaks attributed to a single food commodity, beef was the most common commodity (66 outbreaks, 46%), followed by poultry (43 outbreaks, 30%), and pork (23 outbreaks, 16%). Meat and poultry outbreaks accounted for 92% of outbreaks with an identified single food commodity. Outbreaks caused by C. perfringens occur regularly, are often large, and can cause substantial morbidity yet are preventable if contamination of raw meat and poultry products is prevented at the farm or slaughterhouse or, after contamination, if these products are properly handled and prepared, particularly in restaurants and catering facilities. PMID:23379281
Grass, Julian E; Gould, L Hannah; Mahon, Barbara E
The role of respiratory viruses in the pathogenesis of Kawasaki disease (KD) remains controversial. In this study we showed that 8.8 % of KD patients had documented respiratory viral infections. Patients with concomitant viral infections had a higher frequency of coronary artery dilatations and were significantly more often diagnosed with incomplete KD. The presence of a concomitant viral infection should not exclude the diagnosis of KD.
Jordan-Villegas, Alejandro; Chang, Michael L.; Ramilo, Octavio; Mejias, Asuncion
The application of electron microscopic techniques in the study of human gastroenteritis led in the 1970's to the identification of new viral agents that had previously escaped detection by routine cell culture procedures. These agents have been the focus...
F. P. Williams
Bioterrorism and emerging infectious diseases such as influenza have spurred research into rapid outbreak detection. One primary thrust of this research has been to identify data sources that provide early indication of a disease outbreak by beingleading indicators relative to other established data sources. Researchers tend to rely on the sample cross-correlation function (CCF) to quantify the association between two
Ronald M. Bloom; David L. Buckeridge; Karen E. Cheng
6%, 21%) of the total cases; 2) closing the drinking-water plant prevented 19% (95% confidence interval: 17%, 21%) of the additional cases of disease that occurred compared with the scenario in which the plant had not been closed, a result primarily driven by conferred immunity that resulted in depletion of the susceptible population; and 3) the outbreak was caused by
Joseph N. S. Eisenberg; Xiudong Lei; Alan H. Hubbard; M. Alan Brookhart; John M. Colford
Summary With the recent, rapid advances in recombinant DNA technology, it has become possible to consider the use of nucleic acid probes in diagnosis of human viral diseases. Several examples are discussed which employ techniques of dot blot hybridization, sandwich hybridization andin situ hybridization. Typing of viral strains using restriction endonuclease digestion as an epidemiological tool is considered. Finally, the
J. K. Kulski; Mary Norval
Most viral infections that affect the central nervous system of ruminants are exotic to Australia. As such, this review focuses on viruses of importance in Australian ruminants, including Akabane virus and the ruminant pestiviruses, bovine viral diarrhoea virus and border disease virus, as well as bluetongue virus. Each virus is discussed in terms of pathogenesis, clinical signs and diagnosis. PMID:21864304
Kessell, Ae; Finnie, Jw; Windsor, Pa
Molecular epidemiology is a science which utilizes molecular biology to define the distribution of disease in a population (descriptive epidemiology) and relies heavily on integration of traditional (or analytical) epidemiological approaches to identify the etiological determinants of this distribution. The study of viral pathogens of aquaculture has provided many exciting opportunities to apply such tools. This review considers the extent to which molecular epidemiological studies have contributed to better understanding and control of disease in aquaculture, drawing on examples of viral diseases of salmonid fish of commercial significance including viral haemorrhagic septicaemia virus (VHSV), salmonid alphavirus (SAV) and infectious salmon anaemia virus (ISAV). Significant outcomes of molecular epidemiological studies include: Improved taxonomic classification of viruses A better understanding of the natural distribution of viruses An improved understanding of the origins of viral pathogens in aquaculture An improved understanding of the risks of translocation of pathogens outwith their natural host range An increased ability to trace the source of new disease outbreaks Development of a basis for ensuring development of appropriate diagnostic tools An ability to classify isolates and thus target future research aimed at better understanding biological function While molecular epidemiological studies have no doubt already made a significant contribution in these areas, the advent of new technologies such as pyrosequencing heralds a quantum leap in the ability to generate descriptive molecular sequence data. The ability of molecular epidemiology to fulfil its potential to translate complex disease pathways into relevant fish health policy is thus unlikely to be limited by the generation of descriptive molecular markers. More likely, full realisation of the potential to better explain viral transmission pathways will be dependent on the ability to assimilate and analyse knowledge from a range of more traditional information sources. The development of methods to systematically record and share such epidemiologically important information thus represents a major challenge for fish health professionals in making the best future use of molecular data in supporting fish health policy and disease control.
Background: Since 1978, CDC, EPA, and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) to capture data on waterborne disease outbreaks associated with recreational water. WBDOSS is the prima...
This paper explores the role of named entities (NEs) in the classification of disease outbreak report. In the annotation schema of BioCaster, a text mining system for public health protection, important concepts that reflect information about infectious diseases were conceptually analyzed with a formal ontological methodology and classified into types and roles. Types are specified as NE classes and roles are integrated into NEs as attributes such as a chemical and whether it is being used as a therapy for some infectious disease. We focus on the roles of NEs and explore different ways to extract, combine and use them as features in a text classifier. In addition, we investigate the combination of roles with semantic categories of disease-related nouns and verbs. Experimental results using naïve Bayes and Support Vector Machine (SVM) algorithms show that: (1) roles in combination with NEs improve performance in text classification, (2) roles in combination with semantic categories of noun and verb features contribute substantially to the improvement of text classification. Both these results were statistically significant compared to the baseline "raw text" representation. We discuss in detail the effects of roles on each NE and on semantic categories of noun and verb features in terms of accuracy, precision/recall and F-score measures for the text classification task. PMID:19171201
Doan, Son; Kawazoe, Ai; Conway, Mike; Collier, Nigel
Acute viral hepatitis is the most common cause of jaundice in pregnancy. The course of most viral hepatitis infections (e.g., hepatitis A, B, C and D) is unaffected by pregnancy, however, a more severe course of viral hepatitis in pregnancy has been observed in patients with hepatitis E. Notwithstanding, opinions differ over the maternal and fetal outcome of pregnancy associated with viral hepatitis. While some authors reported that acute viral hepatitis carries a high risk for both mother and fetus others conclude that non-fulminant viral hepatitis did not influence the course of pregnancy or fetal well-being. Rate of transmission of the virus during pregnancy depends on the virus. For instance, intra-utero transmission of hepatitis A virus is very rare, but perinatal transmission could occur. Conversely sixty percent of pregnant women who acquire acute HBV infections at or near delivery will transmit the HBV virus to their offspring and mother to child transmission of hepatitis E virus infection was established between 33.3 and 50%. Breast-feeding is not contra-indicated in women infected with the hepa-titis A, E or C. However, for acute hepatitis B, with appropriate immunoprophylaxis, including hepatitis B immune globulin and hepatitis B vaccine, breast-feeding of infants of HBV infected mother's poses no additional risk for the transmission of the hepatitis B virus. Finally, whether live or inactivated vaccines are used, vaccination of pregnant women should be considered on the basis of risks versus benefits. Pregnant women who think they may have been exposed to hepatitis B may be given and hepatitis B immunoglobulin (ideally within 72 hours of exposure), as well as the hepatitis B vaccine. PMID:17060891
Mathematical models of viral transmission and control are important tools for assessing the threat posed by deliberate release of the smallpox virus and the best means of containing an outbreak. Models must balance biological realism against limitations of knowledge, and uncertainties need to be accurately communicated to policy-makers. Smallpox poses the particular challenge that key biological, social and spatial factors affecting disease spread in contemporary populations must be elucidated largely from historical studies undertaken before disease eradication in 1979. We review the use of models in smallpox planning within the broader epidemiological context set by recent outbreaks of both novel and re-emerging pathogens.
Ferguson, Neil M.; Keeling, Matt J.; John Edmunds, W.; Gani, Raymond; Grenfell, Bryan T.; Anderson, Roy M.; Leach, Steve
Factors known to trigger the emergence or re-emergence of infectious diseases include globalisation, population growth, migration, international trade, urbanisation, forest destruction, climate change, loss of biodiversity, poverty, famine and war. Epidemics not only lead to disastrous loss of human life but may also have catastrophic economic, political and social consequences. Outbreaks may rapidly jeopardize industry, trade or tourism in countries that are unprepared. Dengue is currently spreading throughout the tropics, while another arbovirus, chikungunya, infected 30 to 75% of the population in some parts of the Indian Ocean region between 2005 and 2006. Chikungunya is now spreading through India, where more than a million people have so far been infected. This viral disease can cause lasting disability, and the first deaths were recently reported in La Réunion and Mayotte. All countries are at risk from emerging or re-emerging diseases, but the consequences are far worse in poor countries. Microbial pathogens and wild mammals, birds and arthropods do not respect man-made borders. There is still time to act against this threat of emerging and re-emerging infectious diseases, through prevention, anticipation, monitoring and research. PMID:17645111
The application of electron microscopic techniques in the study of human gastroenteritis led in the 1970's to the identification of new viral agents that had previously escaped detection by routine cell culture procedures. These agents have been the focus of study by researchers ...
This investigation evaluated the role of Norwalk-like virus (NLV) and other viruses (rotavirus, enteric ade- novirus, and enterovirus) in 11 outbreaks of acute nonbacterial gastroenteritis that occurred in multiple settings in a span of 18 months in New York State. To determine the etiology of illness, patients' stool specimens were analyzed with a combination of reverse-transcription polymerase chain reaction (RT-PCR)
In 2011, human coxsackievirus B5 (CVB5) caused an outbreak of viral encephalitis in Henan, China. Complete genome sequence analysis based on two isolates showed that the 5' half of the genome (nt 1-4540) had high similarity (>97 %) to that of CVB5 strain GU376747, and the 3' half (nt 4700-7402) showed high similarity (>96 %) to that of human coxsackievirus B3 (CVB3) strain GQ141875. These isolates had the highest similarity (97.7 %) to the Changchun strain, based on the complete genome, rather than to other CVB5 strains isolated from Henan in recent years. There were therefore at least two groups of CVB5 circulating in Henan Province, which evolved at different rates. PMID:23624679
Ma, Hongxia; Huang, Xueyong; Kang, Kai; Li, Xingle; Tang, Xiaoyan; Ren, Yunhui; Wang, Youchun; Zhao, Guirang; Xu, Bianli
The identification of undiagnosed disease outbreaks is critical for mobilizing efforts to prevent widespread transmission of novel virulent pathogens. Recent developments in online surveillance systems allow for the rapid communication of the earliest reports of emerging infectious diseases and tracking of their spread. The efficacy of these programs, however, is inhibited by the anecdotal nature of informal reporting and uncertainty of pathogen identity in the early stages of emergence. We developed theory to connect disease outbreaks of known aetiology in a network using an array of properties including symptoms, seasonality and case-fatality ratio. We tested the method with 125 reports of outbreaks of 10 known infectious diseases causing encephalitis in South Asia, and showed that different diseases frequently form distinct clusters within the networks. The approach correctly identified unknown disease outbreaks with an average sensitivity of 76 per cent and specificity of 88 per cent. Outbreaks of some diseases, such as Nipah virus encephalitis, were well identified (sensitivity = 100%, positive predictive values = 80%), whereas others (e.g. Chandipura encephalitis) were more difficult to distinguish. These results suggest that unknown outbreaks in resource-poor settings could be evaluated in real time, potentially leading to more rapid responses and reducing the risk of an outbreak becoming a pandemic. PMID:23389893
Bogich, Tiffany L; Funk, Sebastian; Malcolm, Trent R; Chhun, Nok; Epstein, Jonathan H; Chmura, Aleksei A; Kilpatrick, A Marm; Brownstein, John S; Hutchison, O Clyde; Doyle-Capitman, Catherine; Deaville, Robert; Morse, Stephen S; Cunningham, Andrew A; Daszak, Peter
In 1999, an outbreak of Legionnaires' disease affected many visitors to a flower show in the Netherlands. To identify the source of the outbreak, we performed an environmental investigation, as well as a case-control study among visitors and a serologic cohort study among exhibitors to measure exposure to possible sources. Of 77,061 visitors, 188 became ill (133 confirmed and 55
Boer de J. W; E. P. F. Yzerman; Joop Schellekens; Kamilla D. Lettinga; Hendriek C. Boshuizen; Steenbergen van J. E; Arnold Bosman; Susan Van den Hof; Vliet van H. A; Marcel F. Peeters; Ketel van R. J; Peter Speelman; Jacob L. Kool; M. A. E. Conyn-van Spaendonck
This paper assesses the impact of the 2001 foot-and-mouth disease outbreak in terms of its implications for the discipline of rural studies. In particular, it focuses on the position of agriculture in rural economy and society, the standing of the government after its management of the outbreak, and the performance of the new devolved regional…
Scott, Alister; Christie, Michael; Midmore, Peter
Background Although orf is endemic around the world, there are few descriptions of Orf virus strains and comparisons of these strains. We report the sequence and phylogenetic analysis of the partial B2L gene of Orf virus from two outbreaks of the disease in Greece. The first was an outbreak of genital form of the disease in a flock imported from France, whilst the second was an outbreak of the disease in the udder skin of ewes and around the mouth of lambs in an indigenous flock. Results Phylogenetic analysis was performed on a part (498 bp) of the B2L gene of 35 Parapoxvirus isolates, including the two Orf virus isolates recovered from each of the two outbreaks in the present study. This analysis revealed that the maximum nucleotide and amino-acid variation amongst Orf virus strains worldwide (n = 33) was 8.1% and 9.6%, respectively. The homology of the nucleotide and amino-acid sequences between the two Greek isolates was 99.0% and 98.8%, respectively. The two Greek isolates clustered only with Orf virus strains. Conclusions We suggest that there can be differences between strains based on their geographical origin. However, differences in the origin of strains or in the clinical presentation of the disease may not be associated with their pathogenicity. More work is required to determine if differing clinical presentations are linked to viral strain differences or if other factors, e.g., flock immunity, method of exposure or genetic susceptibility, are more important to determine the clinical presentation of the infection.
Dengue virus (DV) is the most widespread arbovirus, being endemic in over 100 countries, and is estimated to cause 50 million infections annually. Viral factors, such as the genetic composition of the virus strain can play a role in determining the virus virulence and subsequent clinical disease severity. Virus vector competence plays an integral role in virus transmission and is a critical factor in determining the severity and impact of DV outbreaks. Host genetic variations in immune-related genes, including the human leukocyte antigen, have also been shown to correlate with clinical disease and thus may play a role in regulating disease severity. The host's immune system, however, appears to be the primary factor in DV pathogenesis with the delicate interplay of innate and acquired immunity playing a crucial role. Although current research of DV pathogenesis has been limited by the lack of an appropriate animal model, the development of DV therapeutics has been a primary focus of research groups around the world. In the past decade advances in both the development of vaccines and anti-virals have increased in dramatically. This review summarises the current understanding of viral, vector and host factors which contribute to dengue virus pathogenesis and how this knowledge is critically important in the development of pharmaceutical interventions. PMID:23103333
Herrero, Lara J; Zakhary, Andrew; Gahan, Michelle E; Nelson, Michelle A; Herring, Belinda L; Hapel, Andrew J; Keller, Paul A; Obeysekera, Maheshi; Chen, Weiqiang; Sheng, Kuo-Ching; Taylor, Adam; Wolf, Stefan; Bettadapura, Jayaram; Broor, Shobha; Dar, Lalit; Mahalingam, Suresh
SummaryBackground Outbreaks of travel-related Legionnaires' disease present a public-health challenge since rapid, sensitive, and specific diagnostic tests are not widely used and because detection of clusters of disease among travellers is difficult. We report an outbreak of Legionnaires' disease among cruise ship passengers that occurred in April, 1994, but that went unrecognised until July, 1994.Methods After rapid diagnosis of Legionnaires'
D. B Jernigan; J Hofmann; M. S Cetron; J. P Nuorti; B. S Fields; R. F Benson; R. F Breiman; H. B Lipman; R. J Carter; C. A Genese; S. M Paul; P. H Edelstein; I. C Guerrero
Many chronic human diseases may have an underlying autoimmune mechanism. In this review, the author presents a case of autoimmune CIU (chronic idiopathic urticaria) in stable remission after therapy with a retroviral integrase inhibitor, raltegravir (Isentress). Previous reports located using the search terms "autoimmunity" and "anti-viral" and related topics in the pubmed data-base are reviewed suggesting that novel anti-viral agents such as retroviral integrase inhibitors, gene silencing therapies and eventually vaccines may provide new options for anti-viral therapy of autoimmune diseases. Cited epidemiologic and experimental evidence suggests that increased replication of epigenomic viral pathogens such as Epstein-Barr Virus (EBV) in chronic human autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus Erythematosus (SLE), and multiple sclerosis (MS) may activate endogenous human retroviruses (HERV) as a pathologic mechanism. Memory B cells are the reservoir of infection of EBV and also express endogenous retroviruses, thus depletion of memory b-lymphocytes by monoclonal antibodies (Rituximab) may have therapeutic anti-viral effects in addition to effects on B-lymphocyte presentation of both EBV and HERV superantigens. Other novel anti-viral therapies of chronic autoimmune diseases, such as retroviral integrase inhibitors, could be effective, although not without risk. PMID:21871974
Dreyfus, David H
OBJECTIVE: The organization of water supply to and on ships differs considerably from that of water supply on land. Risks of contamination can arise from source water at the port or during loading, storage, or distribution on the ship. The purpose of this article is to review documented outbreaks of waterborne diseases associated with passenger, cargo, fishing, and naval ships to identify contributing factors so that similar outbreaks can be prevented in the future. METHODS: The authors reviewed 21 reported outbreaks of waterborne diseases associated with ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and remedial action are presented. RESULTS: The findings of this review show that the majority of reported outbreaks were associated with passenger ships and that more than 6,400 people were affected. Waterborne outbreaks due to Enterotoxigenic Escherichia coli, noroviruses, Salmonella spp, Shigella sp, Cryptosporidium sp, and Giardia lamblia occurred on ships. Enterotoxigenic E. coli was the pathogen most frequently associated with outbreaks. One outbreak of chemical water poisoning also occurred on a ship. Risk factors included contaminated port water, inadequate treatment, improper loading techniques, poor design and maintenance of storage tanks, ingress of contamination during repair and maintenance, cross-connections, back siphonage, and insufficient residual disinfectant. CONCLUSIONS: Waterborne disease outbreaks on ships can be prevented. The factors contributing to outbreaks emphasize the need for hygienic handling of water along the supply chain from source to consumption. A comprehensive approach to water safety on ships is essential. This may be achieved by the adoption of Water Safety Plans that cover design, construction, operation, and routine inspection and maintenance.
Rooney, Roisin M.; Bartram, Jamie K.; Cramer, Elaine H.; Mantha, Stacey; Nichols, Gordon; Suraj, Rohini; Todd, Ewen C. D.
Thirty-five birds that died with naturally acquired psittacine beak and feather disease (PBFD) were necropsied to identify extracutaneous viral inclusions. Inclusions were found in various tissue sections from 34 of 35 birds. By immunoperoxidase staining, intranuclear and intracytoplasmic inclusion bodies were shown to contain PBFD viral antigen. Inclusion-bearing lesions were widely disseminated but often closely associated with the alimentary tract. Lesions within the palate, esophagus, crop, intestine, bursa of Fabricius, and liver probably serve as sources for viral shedding into the feces. PMID:2094445
Latimer, K S; Rakich, P M; Kircher, I M; Ritchie, B W; Niagro, F D; Steffens, W L; Lukert, P D
In 2001, the Robert Koch Institute (RKI) implemented a new electronic surveillance system (SurvNet) for infectious disease outbreaks in Germany. SurvNet has captured 30,578 outbreak reports in 2001–2005. The size of the outbreaks ranged from 2 to 527 cases. For outbreaks reported in 2002–2005, the median duration from notification of the first case to the local health department until receipt of the outbreak report at RKI was 7 days. Median outbreak duration ranged from 1 day (caused by Campylobacter) up to 73 days (caused by Mycobacterium tuberculosis). The most common settings among the 10,008 entries for 9,946 outbreaks in 2004 and 2005 were households (5,262; 53%), nursing homes (1,218; 12%), and hospitals (1,248; 12%). SurvNet may be a useful tool for other outbreak surveillance systems because it minimizes the workload of local health departments and captures outbreaks even when causative pathogens have not yet been identified.
Altmann, Doris; Faensen, Daniel; Porten, Klaudia; Benzler, Justus; Pfoch, Thomas; Ammon, Andrea; Kramer, Michael H.; Claus, Hermann
Objectives This investigation was undertaken in response to an outbreak of suspected shellfish poisoning in Zhejiang Province, China. The objectives of this project were to confirm the outbreak and to identify the aetiology, source and mode of transmission. Methods A probable case was defined as an individual with diarrhea (?3 times/day) plus at least one of the following symptoms: fever (?37.5°C), vomiting, or abdominal pain after consuming seafood between May 23rd and May 28th, 2011. Using a case-control study design, we compared exposures to suspected seafood items and cooking methods between 61 probable cases and 61 controls. Results Over 220 suspected or probable cases of diarrhetic shellfish poisoning (DSP) were identified (incidence of 18 cases per 100,000). The case control study revealed that 100% of cases and 18% of controls had eaten mussels during the exposure period (OR?=??, ?2?=?84.72,P?=?0.000). The number of mussels consumed was related to DSP risk (P?=?0.004, ?2 test for trend). Consumption of other seafood items was not associated with disease. The frequency of diarrhea and vomiting were positively correlated with the number of mussels consumed (r?=?0.424 and r?=?0.562, respectively). The frequency of vomiting and the incubation period were significantly correlated with the total time the mussels were boiled (r?=?0.594 and r?=??0.336, respectively). Mussels from 3 food markets and one family contained Okadaic acid (OA) and Dinophysistoxin-1 (DTX-1). Conclusions This outbreak was attributed to the consumption of mussels contaminated by DSP-toxins (OA and DTX-1) which are produced by different species of dinoflagellates (toxic microalgae) from the genus Dinophysis or Prorocentrum. Suspension of mussel sales and early public announcements were highly effective in controlling the outbreak, although oversight of seafood quality should be a priority to prevent future contamination and outbreaks.
Chen, Jiang; Miu, Renchao; Huang, Liming; Zhou, Xiaoxiao; Fu, Yun; Yan, Rui; Wang, Zhen; Liu, Biyao; He, Fan
Over the past 6 years, a number of zoonotic and vectorborne viral diseases have emerged in Southeast Asia and the Western Pacific. Vectorborne disease agents discussed in this article include Japanese encephalitis, Barmah Forest, Ross River, and Chikungunya viruses. However, most emerging viruses have been zoonotic, with fruit bats, including flying fox species as the probable wildlife hosts, and these
J. S. Mackenzie; K. B. Chua; P. W. Daniels; B. T. Eaton; H. E. Field; R. A. Hall; K. Halpin; C. A. Johansen; P. D. Kirkland; S. K. Lam; P. McMinn; D. J. Nisbet; R. Paru; A. T. Pyke; S. A. Ritchie; P. Siba; D. W. Smith; G. A. Smith; A. F. van den Hurk; L. F. Wang; D. T. Williams
Almost five decades after their first application in diagnostics, dried blood spot (DBS) cards remain to be of key interest in many research areas and clinical applications. The advantages of sample stability during transport and storage, can now be combined with the high sensitivity of novel diagnostic techniques for the measurement and analysis of nucleic acids, proteins and small molecules which may overcome the limitations of the small samples sizes in DBS cards. Here we present a survey of the literature on the use of DBS cards for diagnosis, monitoring and epidemiological studies of virus infections other than HIV, including CMV, HBV, HCV, HAV, HEV, HTLV, EBV, HSV, measles-, rubella- and dengue-virus. The minimal invasiveness of sampling and the relative ease of handling and storing DBS cards is expected to offer additional opportunities to measure and analyze biomarkers of viral disease in resource poor settings or when limited amount of blood can be obtained. Large retrospective studies of virus infections in newborns using stored DBS cards have already been undertaken for screening of congenital infections. In addition, DBS cards have been used prospectively for prevalence studies, outbreak surveillance, mass screening for viral infections, follow-up of chronic infection and its treatment in resource-limited areas. We do not expect that current wet sampling techniques of plasma or serum will be replaced by DBS sampling but it allows extension of sampling in persons and settings that are currently difficult to access or that lack suitable storage facilities. In conclusion, DBS card sampling and storage will aid adequate outbreak management of existing and emerging viral diseases. PMID:22244848
Snijdewind, Ingrid J M; van Kampen, Jeroen J A; Fraaij, Pieter L A; van der Ende, Marchina E; Osterhaus, Albert D M E; Gruters, Rob A
The viral hemorrhagic fever viruses represent a unique group of viruses that can produce large outbreaks of both animal and human disease and produce severe, highly fatal, human illnesses. The viral hemorrhagic fever viruses display a great deal of divers...
S. J. Thomas J. V. Lawler T. P. Endy
Type O virus has been isolated from a natural outbreak of foot-and-mouth in Indian elephant. The history, symptoms and epizootology of this disease in these animals have also been described. PMID:951925
Pyakural, S; Singh, U; Singh, N B
We use 14 microsatellite loci to investigate the impact of a viral disease (Ranavirus) on the population genetic structure of wild common frogs (Rana temporaria). Populations with a history of Ranavirus mortalities (and 83% declines in the number of frogs) were compared with populations with no history of infection. Infected ponds showed significantly elevated F(IS) (homozygote excess), significantly reduced relatedness, and no detectable effect on allelic richness. We hypothesize that the elevated F(IS) and reduced relatedness are consequences of assortative mating, and that allelic richness is maintained by immigration from nearby populations. Simulations indicate that the elevated F(IS) cannot be explained by population size reductions, but can indeed be explained by assortative mating (even if a mate choice locus is unlinked to the genetic markers). While the majority of studies consider demographic outcomes following disease outbreaks, our results indicate that emerging infectious diseases could also result in behavioural changes. PMID:19566676
Teacher, Amber G F; Garner, Trenton W J; Nichols, Richard A
Social media introduce pivotal changes to communication between individuals, organizations and communities. A clear example of the power of social media is the spread of the revolutionary outbreaks in the Arabic countries during 2011, where people used Facebook, YouTube and Skype to communicate, organise meetings and protest actions. Here I report how Doctor-Activists use these social media as an alarm system for 'war disease' outbreaks in the Syrian Spring. Social media are used as an alarm system to attract the attention of international organizations, which should assume their responsibilities and play their part in controlling the outbreak of such war diseases. PMID:23587258
The Principality of Andorra is surrounded by areas in which Pyrenean chamois (Rupicapra pyrenaica pyrenaica) populations were severely affected by infection with border disease virus (BDV) which caused disease outbreaks between 2001 and 2009. Nevertheless, the Andorran chamois populations were not affected during this period. In light of the severe impact of BDV on several of the neighboring Pyrenean chamois populations, we monitored local Andorran populations in an effort to detect pestivirus antibodies and BDV in wild ungulates. In addition, an episode of mortality between 2009 and 2010 in chamois was investigated. We analyzed samples (spleen or serum) from 175 Pyrenean chamois, 284 European mouflon (Ovis orientalis musimon), 13 roe deer (Capreolus capreolus capreolus), and five wild boars (Sus scrofa castilianus). With the exception of three dead chamois found between 2009 and 2010, all samples came from healthy animals hunted during the hunting season. A commercial blocking enzyme-linked immunosorbent assay (ELISA) was used to test sera for antibodies against pestivirus. Positive sera were tested with a comparative virus neutralization test (VNT) using three BDV strains and a bovine viral diarrhea virus strain. Reverse-transcription-polymerase chain reaction (RT-PCR) was performed on all sera and spleen homogenates. Antibodies against pestivirus were detected by ELISA in four of the 69 chamois (5%; 95% CI= 1.29-13.11). The VNT confirmed three of these chamois were infected with a BDV. Viral RNA was detected by RT-PCR in three chamois-one apparently healthy animal hunted in 2009 and two dead animals. Viral sequences showed that the three chamois were infected with a BDV-4, the same genotype that was involved in previous episodes of mortality in the Pyrenees. Although Pyrenean chamois from Andorra had had little contact with the pestiviruses until 2009, in this year BDV was associated with a severe disease outbreak. PMID:23060503
Fernández-Sirera, Laura; Riba, Landry; Cabezón, Oscar; Rosell, Rosa; Serrano, Emmanuel; Lavín, Santiago; Marco, Ignasi
Bovine viral diarrhea virus 1 (BVDV-1) subtype b was isolated from premature Holstein calves from a dairy herd that experienced an outbreak of premature births, late-term abortions, brachygnathism, growth retardation, malformations of the brain and cranium, and rare extracranial skeletal malformations in calves born to first-calf heifers. Experimental inoculation of 3 colostrum-deprived calves aged 2-4 months old with this BVDV isolate resulted in thrombocytopenia, lymphopenia, and leukopenia. Outbreaks of brachygnathism are rarely associated with BVDV, and thrombocytopenia is rarely associated with BVDV-1 strains. PMID:20093701
Blanchard, Patricia C; Ridpath, Julia F; Walker, Jennifer B; Hietala, Sharon K
Links between anomalously high sea temperatures and outbreaks of coral diseases known as White Syndromes (WS) represent a\\u000a threat to Indo-Pacific reefs that is expected to escalate in a changing climate. Further advances in understanding disease\\u000a aetiologies, determining the relative importance of potential risk factors for outbreaks and in trialing management actions\\u000a are hampered by not knowing where or when
J. A. Maynard; K. R. N. Anthony; C. D. Harvell; M. A. Burgman; R. Beeden; H. Sweatman; S. F. Heron; J. B. Lamb; B. L. Willis
Despite advances in water management and sanitation, waterborne disease outbreaks continue to occur in the United States. CDC collects data on waterborne disease outbreaks submitted from all states and territories* through the Waterborne Disease and Outbreak Surveillance System.† During 2009-2010, the most recent years for which finalized data are available, 33 drinking water-associated outbreaks were reported, comprising 1,040 cases of illness, 85 hospitalizations, and nine deaths. Legionella accounted for 58% of outbreaks and 7% of illnesses, and Campylobacter accounted for 12% of outbreaks and 78% of illnesses. The most commonly identified outbreak deficiencies§ in drinking water-associated outbreaks were Legionella in plumbing¶ systems (57.6%), untreated ground water (24.2%), and distribution system deficiencies (12.1%), suggesting that efforts to identify and correct these deficiencies could prevent many outbreaks and illnesses associated with drinking water. In addition to the drinking water outbreaks, 12 outbreaks associated with other nonrecreational water** were reported, comprising 234 cases of illness, 51 hospitalizations, and six deaths. Legionella accounted for 58% of these outbreaks, 42% of illnesses, 96% of hospitalizations, and all deaths. Public health, regulatory, and industry professionals can use this information to target prevention efforts against pathogens, infrastructure problems, and water sources associated with waterborne disease outbreaks. PMID:24005226
The presence of antibodies to eight enteroviruses (ecovirus types 4, 7, and 9, coxsackievirus types A9, B1, B3, B4 and hepatitis A virus (HAY)) and Varicella-zoster virus was determined during a two-year period, 1980/1981 in paired blood samples of 777 pe...
B. Fattal M. Margalith H. I. Shuval Y. Wax A. Morag
Objectives. Rainfall and runoff have been implicated in site-specific waterborne disease outbreaks. Because upward trends in heavy precipitation in the United States are projected to increase with climate change, this study sought to quantify the relationship between precipitation and disease outbreaks. Methods. The US Environmental Protection Agency waterborne disease database, totaling 548 reported outbreaks from 1948 through 1994, and precipitation data of the National Climatic Data Center were used to analyze the relationship between precipitation and waterborne diseases. Analyses were at the watershed level, stratified by groundwater and surface water contamination and controlled for effects due to season and hydrologic region. A Monte Carlo version of the Fisher exact test was used to test for statistical significance. Results. Fifty-one percent of waterborne disease outbreaks were preceded by precipitation events above the 90th percentile (P = .002), and 68% by events above the 80th percentile (P = .001). Outbreaks due to surface water contamination showed the strongest association with extreme precipitation during the month of the outbreak; a 2-month lag applied to groundwater contamination events. Conclusions. The statistically significant association found between rainfall and disease in the United States is important for water managers, public health officials, and risk assessors of future climate change.
Curriero, Frank C.; Patz, Jonathan A.; Rose, Joan B.; Lele, Subhash
Prevention and containment of outbreaks requires examination of the contribution and interrelation of outbreak causative events. An outbreak fault tree was developed and applied to 61 enteric outbreaks related to public drinking water supplies in the EU. A mean of 3.25 causative events per outbreak were identified; each event was assigned a score based on percentage contribution per outbreak. Source and treatment system causative events often occurred concurrently (in 34 outbreaks). Distribution system causative events occurred less frequently (19 outbreaks) but were often solitary events contributing heavily towards the outbreak (a mean % score of 87.42). Livestock and rainfall in the catchment with no/inadequate filtration of water sources contributed concurrently to 11 of 31 Cryptosporidium outbreaks. Of the 23 protozoan outbreaks experiencing at least one treatment causative event, 90% of these events were filtration deficiencies; by contrast, for bacterial, viral, gastroenteritis and mixed pathogen outbreaks, 75% of treatment events were disinfection deficiencies. Roughly equal numbers of groundwater and surface water outbreaks experienced at least one treatment causative event (18 and 17 outbreaks, respectively). Retrospective analysis of multiple outbreaks of enteric disease can be used to inform outbreak investigations, facilitate corrective measures, and further develop multi-barrier approaches. PMID:17890833
Risebro, Helen L; Doria, Miguel F; Andersson, Yvonne; Medema, Gertjan; Osborn, Keith; Schlosser, Olivier; Hunter, Paul R
Predicted increases in coral disease outbreaks associated with climate change have implications for coral reef ecosystems and the people and industries that depend on them. It is critical that coral reef managers understand these implications and have the ability to assess and reduce risk, detect and contain outbreaks, and monitor and minimise impacts. Here, we present a coral disease response framework that has four core components: (1) an early warning system, (2) a tiered impact assessment program, (3) scaled management actions and (4) a communication plan. The early warning system combines predictive tools that monitor the risk of outbreaks of temperature-dependent coral diseases with in situ observations provided by a network of observers who regularly report on coral health and reef state. Verified reports of an increase in disease prevalence trigger a tiered response of more detailed impact assessment, targeted research and/or management actions. The response is scaled to the risk posed by the outbreak, which is a function of the severity and spatial extent of the impacts. We review potential management actions to mitigate coral disease impacts and facilitate recovery, considering emerging strategies unique to coral disease and more established strategies to support reef resilience. We also describe approaches to communicating about coral disease outbreaks that will address common misperceptions and raise awareness of the coral disease threat. By adopting this framework, managers and researchers can establish a community of practice and can develop response plans for the management of coral disease outbreaks based on local needs. The collaborations between managers and researchers we suggest will enable adaptive management of disease impacts following evaluating the cost-effectiveness of emerging response actions and incrementally improving our understanding of outbreak causation.
Beeden, Roger; Maynard, Jeffrey A.; Marshall, Paul A.; Heron, Scott F.; Willis, Bette L.
Respiratory disease is one of the most common causes of illness in the domestic dog. Veterinary clinicians have recognized canine distemper for many years, but minor respiratory complications have not received much attention until recently. Today pet owne...
E. L. Massie
A large class of infectious diseases spread through direct person-to-person contact. Traditional ``compartmental'' modeling in epidemiology assumes that in population groups every individual has an equal chance of spreading the disease to every other. The patterns of these contacts, however, tend to be highly heterogeneous. Explicit models of the patterns of contact among individuals in a community, contact network models, underlie a powerful approach to predicting and controlling the spread of such infectious disease and provide detailed and valuable insight into the fate and control of an outbreak. We use contact network epidemiology to predict the impact of various control policies for both a mildly contagious disease such as SARS and a more highly contagious disease such as smallpox. We demonstrate how integrating these tools into public health decision-making should facilitate more rational strategies for managing newly emerging diseases, bioterrorism and pandemic influenza in situations where empirical data are not yet available to guide decision making.
Pourbohloul, Babak; Meyers, Lauren A.; Newman, Mark E. J.; Skowronski, Danuta M.
Thirteen examples of virus or viruslike related pathoses in non-insect invertebrates are described. From consideration of these examples, it becomes obvious that detailed descriptions of pathogenesis of virus diseases in non-insect invertebrates has not kept pace with the frequen...
In areas where foot-and-mouth disease (FMD) is endemic in wildlife hosts, such as the Kruger National Park (KNP) in South Africa, control measures are in place that ensure that potentially infected antelope and buffalo do not come into close contact with domestic animals. In South Africa several SAT-1 outbreaks occurred nearly simultaneously in cattle and impala between 1971-1981. Phylogenetic analysis based on partial 1D gene nucleotide sequencing indicated that several of these outbreaks were linked and it is probable that disease spread from the intermediary impala antelope host to cattle in close proximity. Evidence was found for the involvement of viruses from a single KNP genotype in precipitating outbreaks in impala over a 10-year period. In addition, several unrelated outbreaks affecting cattle and impala occurred within a single year. Characterisation of outbreak strains from Botswana similarly revealed that a single genotype affected different species over a 10-year period and that transboundary spread of SAT-1 virus occurred on at least one occasion. This retrospective analysis of outbreak strains has clearly demonstrated that FMD control policies that address the role of antelope as intermediaries in disease transmission are crucial as these wildlife species play an important role in disease dissemination. PMID:16155727
Vosloo, W; Bastos, A D S; Boshoff, C I
The role of viruses in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) needs further elucidation. The aim of the present study was to evaluate the molecular epidemiology of viral pathogens in AECOPD. Patients presenting to the Emergency Room with AECOPD needing hospitalization were recruited. Oropharyngeal and sputum samples were collected in order to perform microarrays-based viral testing for the detection of respiratory viruses. A total of 200 (100%) patients were analyzed and from them in 107 (53.5%) a virus was detected. The commonest identified viruses were the human Respiratory Syncytial Virus (subtypes A and B) (40.5%), influenza virus (subtypes A, B, C) (11%), rhinovirus (8%) and human Parainfluenza Virus (subtypes A and B) (7.5%). A bacterial pathogen was isolated in 27 (14%) patients and a dual infection due to a bacterial and a viral pathogen was recognised in 14/107 patients. Patients with AECOPD and a viral infection had a lengthier hospital stay (9.2 ± 4.6 vs 7.6 ± 4.3, p < 0.01) while the severity of the disease was no related with significant differences among the groups of the study population. In conclusion, the isolation of a virus was strongly associated with AECOPD in the examined population. The stage of COPD appeared to have no relation with the frequency of the isolated viruses while dual infection with a viral and a bacterial pathogen was not rare. PMID:21983132
Dimopoulos, G; Lerikou, M; Tsiodras, S; Chranioti, Aik; Perros, E; Anagnostopoulou, U; Armaganidis, A; Karakitsos, P
This paper reviews current use and evolving role of polyclonal and monoclonal antibody products for the prevention and treatment of viral diseases. Antibodies continue to be indicated for prophylaxis either prior to an anticipated exposure especially in situations of travel, or more commonly following an exposure. The predominant indication for use of antibody products is to prevent infection. With the
Leigh A. Sawyer
BACKGROUND: In 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological
Melanie R Taylor; Kingsley E Agho; Garry J Stevens; Beverley Raphael
Any outbreak of an Office International des Épizooties List A disease, such as classical swine fever or foot and mouth disease, has severe consequences for animal welfare, livestock produc- tion, exports of animals and animal products, and the environment. The public concern with the animal welfare effects of methods of disease eradication that result in the destruction of large numbers
Terry L. Whiting
Abstract Background: Passive reporting and laboratory testing delays may limit gastrointestinal (GI) disease outbreak detection. Healthcare systems routinely collect clinical data in electronic medical records (EMRs) that could be used for surveillance. This study's primary objective was to identify data streams from EMRs that may perform well for GI outbreak detection. Methods: Zip code-specific daily episode counts in 2009 were generated for 22 syndromic and laboratory-based data streams from Kaiser Permanente Northern California EMRs, covering 3.3 million members. Data streams included outpatient and inpatient diagnosis codes, antidiarrheal medication dispensings, stool culture orders, and positive microbiology tests for six GI pathogens. Prospective daily surveillance was mimicked using the space-time permutation scan statistic in single and multi-stream analyses, and space-time clusters were identified. Serotype relatedness was assessed for isolates in two Salmonella clusters. Results: Potential outbreaks included a cluster of 18 stool cultures ordered over 5 days in one zip code and a Salmonella cluster in three zip codes over 9 days, in which at least five of six cases had the same rare serotype. In all, 28 potential outbreaks were identified using single stream analyses, with signals in outpatient diagnosis codes most common. Multi-stream analyses identified additional potential outbreaks and in one example, improved the timeliness of detection. Conclusions: GI disease-related data streams can be used to identify potential outbreaks when generated from EMRs with extensive regional coverage. This process can supplement traditional GI outbreak reports to health departments, which frequently consist of outbreaks in well-defined settings (e.g., day care centers and restaurants) with no laboratory-confirmed pathogen. Data streams most promising for surveillance included microbiology test results, stool culture orders, and outpatient diagnoses. In particular, clusters of microbiology tests positive for specific pathogens could be identified in EMRs and used to prioritize further testing at state health departments, potentially improving outbreak detection.
Huang, Jie; Abrams, Allyson M.; Gilliss, Debra; Reed, Mary; Platt, Richard; Huang, Susan S.; Kulldorff, Martin
We present an agent-based simulation model for generating realistic multivariable outbreak signals. The model defines a synthetic population and simulates the dissemination of pathogenic organisms through a municipal water distribution system, the mobility of individuals between geographic locations, their exposure to pathogens through water consumption, and disease progression in infected individuals. We present the results of an initial evaluation of the model – a simulation study replicating the historical outbreak of cryptosporidiosis in Milwaukee in 1993.
Okhmatovskaia, Anya; Verma, Aman D.; Barbeau, Benoit; Carriere, Annie; Pasquet, Romain; Buckeridge, David L.
OBJECTIVES: This study describes the epidemiology of raw milk-associated outbreaks reported to the Centers for Disease Control and Prevention from 1973 through 1992. METHODS: Surveillance data for each reported raw milk-associated outbreak were reviewed. A national survey was conducted to determine the legal status of intrastate raw milk sales for the period 1973 through 1995. RESULTS: Forty-six raw milk-associated outbreaks were reported during the study period; 40 outbreaks (87%) occurred in states where the intrastate sale of raw milk was legal. CONCLUSIONS: Consumption of raw milk remains a preventable cause of foodborne disease outbreaks.
Headrick, M L; Korangy, S; Bean, N H; Angulo, F J; Altekruse, S F; Potter, M E; Klontz, K C
Introduced as a control measure for reducing the rabbit population in Australia, the Myxoma virus produced some unintended effects. A computationally rich Excel workbook based on a SIR model for disease transmission provides an opportunity to explore the use of an infectious disease as a control agent. Modeling the emergence of multiple Myxoma strains offers intriguing insights into the complexities of control. * explore the dynamics of the evolving Myxoma virus on virtual rabbit populations in an Excel workbook
Anton E. Weisstein (Truman State University;Biology)
In France, smallpox and poliomyelitis have almost disappeared thanks to generalized vaccination, no case of small pox has been reported since 1975. 17 cases of poliomyelitis were reported in 1975. These two vaccinations remain compulsory. The prophylaxis of measles, which is a very common disease, is based on vaccination recommended for young children, particularly those living in groups. The frequency of severe forms of flu is reduced by vaccination which is advised in the elderly and in weak or exposed subjects. Rubella raises the problem of contamination of pregnant women. It is recommended to vaccinate young girls and also, after serological reactions, women who are professionally exposed to the disease. Epidemic virus hepatitis (virus A) is increasing in frequency, whereas transfusion hepatitis is becoming less common since the strict application of measures of prophylaxis. The spread of rabies, mainly in the fox, is worrying for public health workers. No case of human rabies has been noted in France. Preventive anti-rabic treatment is applied in the case of a patient bitten by a suspicious animal. PMID:190696
Aquaculture production is increasing rapidly worldwide. However, production has been associated with the emergence of several novel diseases, including viral diseases, that have caused serious problems for producers. Using examples largely from salmon farming in Scotland I review briefly the factors that allow transmission to occur in aquaculture. These include transmission through the water, which is relatively local to the infected farm, and anthropogenic transports (such as transport of fish between sites) that may occur over very long distances. A Disease Management Area (DMA) approach, as developed in Scotland to fight infectious salmon anaemia, can be effective at reducing pathogen transmission and hence disease emergence. PMID:23206337
Murray, Alexander G
For more than a century, antibody has been used for passive parenteral immunization against viral and bacterial pathogens. This approach has been successful for prevention of viral respiratory infection and has led to testing of intranasal or aerosol delivery of antibody to passively immunize the respiratory tract mucosal surface. Mucosal delivery may be advantageous because it allows the antibody to neutralize the virus particles before they initiate infection and because it concentrates the antibody where viral replication takes place. Animal studies have shown the feasibility of passive intranasal immunization against a number of respiratory tract viruses. Development of nasal antibody treatments for humans is under way, and early clinical studies have confirmed that this approach is safe and can be used to prevent respiratory tract disease. Polyclonal human immunoglobulin from pooled plasma preparations can be used to provide broad protection against a number of different pathogens, while monoclonal antibodies or their fragments can be used to target specific viruses.
Weltzin, Richard; Monath, Thomas P.
Background Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Although Rift Valley fever outbreaks have been known to follow periods of above-normal rainfall, the timing of the outbreak events has largely been unknown. Similarly, there is inadequate knowledge on climate drivers of chikungunya outbreaks. We analyze a variety of climate and satellite-derived vegetation measurements to explain the coupling between patterns of climate variability and disease outbreaks of Rift Valley fever and chikungunya. Methods and Findings We derived a teleconnections map by correlating long-term monthly global precipitation data with the NINO3.4 sea surface temperature (SST) anomaly index. This map identifies regional hot-spots where rainfall variability may have an influence on the ecology of vector borne disease. Among the regions are Eastern and Southern Africa where outbreaks of chikungunya and Rift Valley fever occurred 2004–2009. Chikungunya and Rift Valley fever case locations were mapped to corresponding climate data anomalies to understand associations between specific anomaly patterns in ecological and climate variables and disease outbreak patterns through space and time. From these maps we explored associations among Rift Valley fever disease occurrence locations and cumulative rainfall and vegetation index anomalies. We illustrated the time lag between the driving climate conditions and the timing of the first case of Rift Valley fever. Results showed that reported outbreaks of Rift Valley fever occurred after ?3–4 months of sustained above-normal rainfall and associated green-up in vegetation, conditions ideal for Rift Valley fever mosquito vectors. For chikungunya we explored associations among surface air temperature, precipitation anomalies, and chikungunya outbreak locations. We found that chikungunya outbreaks occurred under conditions of anomalously high temperatures and drought over Eastern Africa. However, in Southeast Asia, chikungunya outbreaks were negatively correlated (p<0.05) with drought conditions, but positively correlated with warmer-than-normal temperatures and rainfall. Conclusions/Significance Extremes in climate conditions forced by the El Niño/Southern Oscillation (ENSO) lead to severe droughts or floods, ideal ecological conditions for disease vectors to emerge, and may result in epizootics and epidemics of Rift Valley fever and chikungunya. However, the immune status of livestock (Rift Valley fever) and human (chikungunya) populations is a factor that is largely unknown but very likely plays a role in the spatial-temporal patterns of these disease outbreaks. As the frequency and severity of extremes in climate increase, the potential for globalization of vectors and disease is likely to accelerate. Understanding the underlying patterns of global and regional climate variability and their impacts on ecological drivers of vector-borne diseases is critical in long-range planning of appropriate disease and disease-vector response, control, and mitigation strategies.
Anyamba, Assaf; Linthicum, Kenneth J.; Small, Jennifer L.; Collins, Kathrine M.; Tucker, Compton J.; Pak, Edwin W.; Britch, Seth C.; Eastman, James Ronald; Pinzon, Jorge E.; Russell, Kevin L.
A literature review was conducted to highlight the application and potential benefit of using geographic information systems (GIS) during Legionnaires' disease outbreak investigations. Relatively few published sources were identified, however, certain types of data were found to be important in facilitating the use of GIS, namely: patient data, locations of potential sources (e.g. cooling towers), demographic data relating to the local population and meteorological data. These data were then analysed to gain a better understanding of the spatial relationships between cases and their environment, the cases' proximity to potential outbreak sources, and the modelled dispersion of contaminated aerosols. The use of GIS in an outbreak is not a replacement for traditional outbreak investigation techniques, but it can be a valuable supplement to a response. PMID:23231895
Bull, M; Hall, I M; Leach, S; Robesyn, E
A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010) taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts.
Castanon-Gonzalez, Jorge Alberto; Macias, Alejandro E.; Samaniego, Jose Lino; Buhse, Thomas; Villanueva-Martinez, Sebastian
A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008-2010) taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts. PMID:24069063
Polanco, Carlos; Castañón-González, Jorge Alberto; Macías, Alejandro E; Samaniego, José Lino; Buhse, Thomas; Villanueva-Martínez, Sebastián
The differential diagnosis between viral hepatitis and other liver diseases (particularly obstructive jaundice) is often difficult on purely clinical grounds. Damage to the liver causes changes in the pattern of the serum enzymes and this has led to the development in recent years of a number of enzyme tests. The authors have amassed evidence to show that the most useful of these is determination of the levels of serum glutamic oxalacetic and serum glutamic pyruvic transaminase (SGOT and SGPT), coupled with calculation of the SGOT/SGPT ratio. It is characteristic of viral hepatitis that both levels are greatly increased, but the SGOT/SGPT ratio, normally greater than one, falls considerably below his figure. In a few cases of obstructive jaundice, the serum transaminase picture may initially resemble that in viral hepatitis, but the differential diagnosis can be established by repeating the determinations at intervals. Other enzyme tests, such as determination of alkaline phosphatase and leucylaminopeptidase, may be used to confirm the biliary obstruction. Flocculation tests and electrophoretic determination of the plasma protein picture, while of limited value in the diagnosis of acute viral hepatitis, are useful in conjunction with the serum transaminase test for assessing the activity of the disease and any tendency to progress towards “active” chronic hepatitis or post-hepatic cirrhosis.
De Ritis, Fernando; Giusti, Giuseppe; Piccinino, Felice; Cacciatore, Luigi
We investigated the molecular epidemiology of foot-and-mouth disease virus (FMDV) serotype Asia 1, which caused outbreaks of disease in Asia during 2003–2007. Since 2004, the region affected by outbreaks of this serotype has increased from disease-endemic countries in southern Asia (Afghanistan, India, Iran, Nepal, Pakistan) northward to encompass Kyrgyzstan, Tajikistan, Uzbekistan, several regions of the People’s Republic of China, Mongolia, Eastern Russia, and North Korea. Phylogenetic analysis of complete virus capsid protein 1 (VP1) gene sequences demonstrated that the FMDV isolates responsible for these outbreaks belonged to 6 groups within the Asia 1 serotype. Some contemporary strains were genetically closely related to isolates collected historically from the region as far back as 25 years ago. Our analyses also indicated that some viruses have spread large distances between countries in Asia within a short time.
Valarcher, Jean-Francois; Zakharov, Valery; Scherbakov, Alexey; Zhang, Zhidong; Shang, You-Jun; Liu, Zai-Xin; Liu, Xiang-Tao; Sanyal, Aniket; Hemadri, Divakar; Tosh, Chakradhar; Rasool, Thaha J.; Pattnaik, Bramhadev; Schumann, Kate R.; Beckham, Tammy R.; Linchongsubongkoch, Wilai; Ferris, Nigel P.; Roeder, Peter L.; Paton, David J.
Viral haemorrhagic disease (VHD) of rabbits was introduced into Mexico from the United States of America in November 1988, following the importation of infected carcasses from China. In February 1989, the National System for Animal Health Emergencies was created, and an eradication programme was implemented at that time. The VHD virus was eradicated in 1992, by means of disease control procedures which included active epidemiological surveillance, publicity campaigns, slaughter, cleaning and disinfection of affected premises, the use of sentinel animals, serological monitoring and repopulation. The eradication programme involved the serological sampling of 39,727 rabbits (revealing an incidence of 1.4%) and the slaughter of 121,275 affected rabbits and rabbits at risk of exposure to infection. The final outbreak of the disease was recorded in April 1991. The country maintained strict epidemiological surveillance through serological testing, certification of premises free from the disease, and control of movement of animals and animal products. Mexico was declared free from the disease on 20 January 1993, becoming the first country to have eradicated VHD. The authors propose a model to evaluate the risk of introducing VHD through the importation of animals and animal products. A guide is provided to evaluate each branch of the relevant scenario tree and the principal criteria which indicate the event at each parameter. PMID:9537746
Heneidi Zeckua, A; Zepeda Sein, C; Mateos Poumián, A; Velázquez, G
Extending previous studies the current situation of livestock infectious diseases e.g. parainfluenza 3 virus (PI-3), respiratory sincytial virus (RSV), infectious bovine rhinotracheitis (IBR) and bovine viral diarrhea virus (BVDV) were serologically monitored in 19 randomly selected pedegree cattle farms in Lithuania. From 2006 to 2007 PI-3 and BVBV (n=558), RV and IBR (n=538) using antibody ELISA were tested. In the
The most important viral disease of farmed deer and bison is malignant catarrhal fever. The other herpesviruses which have been isolated from these species are briefly described. Other viral agents that are recognised in these animals, including adenovirus, parapox, foot and mouth disease, bluetongue, epizootic haemorrhagic disease, bovine virus diarrhoea, rotavirus and coronavirus, are also discussed. Ectoparasites of importance in this group in various parts of the world include a variety of ticks, as well as lice, keds, Oestridae, mange mites and fire ants. Helminth parasites include liver flukes (Fascioloides and Fasciola), gastrointestinal nematodes of the family Trichostrongylidae, pulmonary lungworms of the genus Dictyocaulus and extra-pulmonary lungworms of the family Protostrongylidae. Chronic wasting disease is principally important in North America, where the disease occurs in wild cervids in a limited area and has been reported in farmed deer in a small number of states in the United States of America and one province in Canada. These diseases are summarised in terms of their classification, epidemiology, clinical signs, pathology, diagnosis, treatment and control. PMID:11974612
Haigh, J C; Mackintosh, C; Griffin, F
The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program's ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia. PMID:21388561
Witt, Clara J; Richards, Allen L; Masuoka, Penny M; Foley, Desmond H; Buczak, Anna L; Musila, Lillian A; Richardson, Jason H; Colacicco-Mayhugh, Michelle G; Rueda, Leopoldo M; Klein, Terry A; Anyamba, Assaf; Small, Jennifer; Pavlin, Julie A; Fukuda, Mark M; Gaydos, Joel; Russell, Kevin L; Wilkerson, Richard C; Gibbons, Robert V; Jarman, Richard G; Myint, Khin S; Pendergast, Brian; Lewis, Sheri; Pinzon, Jorge E; Collins, Kathrine; Smith, Matthew; Pak, Edwin; Tucker, Compton; Linthicum, Kenneth; Myers, Todd; Mansour, Moustafa; Earhart, Ken; Kim, Heung Chul; Jiang, Ju; Schnabel, Dave; Clark, Jeffrey W; Sang, Rosemary C; Kioko, Elizabeth; Abuom, David C; Grieco, John P; Richards, Erin E; Tobias, Steven; Kasper, Matthew R; Montgomery, Joel M; Florin, Dave; Chretien, Jean-Paul; Philip, Trudy L
The causes of exacerbations of inflammatory bowel disease (IBD) are unknown. The presence of RNA of an enterovirus, norovirus GI, norovirus GII, rotavirus, astrovirus, and sapovirus was sought in stool samples of 50 children (median age 12.9 years) undergoing gastrointestinal endoscopies for IBD or its exclusion (Crohn's disease n?=?18, ulcerative colitis n?=?13, indeterminate colitis n?=?2, non-IBD n?=?17). Viral RNA was found in three fecal samples (norovirus GII n?=?2, sapovirus n?=?1), all in children without IBD. Therefore, enteral viruses may play only a minor role in IBD. PMID:22170557
Kolho, Kaija-Leena; Klemola, Päivi; Simonen-Tikka, Marja-Leena; Ollonen, Marja-Liisa; Roivainen, Merja
Institutional risk factors associated with the occurrence of nosocomial respiratory or gastrointestinal disease outbreaks in 1992 were examined in a case-cohort study of New York State nursing homes conducted in 1993. Facility size, staffing patterns, and employee sick leave policies were the principal effects found in an unconditional logistic regression model. The risk of having respiratory or gastrointestinal disease outbreaks
Jiehui Li; Guthrie S. Birkhead; David S. Strogatz; F. Bruce Coles
We describe an unusual cluster of Corynebacterium striatum infections in 21 patients with chronic obstructive pulmonary disease (COPD) admitted to a medium-size respiratory unit. Eleven isolates from eight patients occurred simultaneously within a month. C. striatum is a potentially pathogenic microorganism with the ability to produce nosocomial infectious outbreaks and respiratory colonization in patients with advanced COPD.
Renom, Feliu; Garau, Margarita; Rubi, Mateu; Ramis, Ferran; Galmes, Antonia; Soriano, Joan B.
During the post-8th International Coral Reef Symposium field trip to the eastern Caribbean region of Panama, 3-5 July 1996, we observed an extensive outbreak of a new and significant disease of the scleractinian corals Montastraea faveolata and M. annularis. The first reported si...
BACKGROUND: The use of restrictive measures such as quarantine draws into sharp relief the dynamic interplay between the individual rights of the citizen on the one hand and the collective rights of the community on the other. Concerns regarding infectious disease outbreaks (SARS, pandemic influenza) have intensified the need to understand public perceptions of quarantine and other social distancing measures.
C Shawn Tracy; Elizabeth Rea; Ross EG Upshur
We use a compartmental model to illustrate a possible mechanism for multiple outbreaks or even sustained periodic oscillations of emerging infectious diseases due to the psychological impact of the reported numbers of infectious and hospitalized individuals. This impact leads to the change of avoidance and contact patterns at both individual and community levels, and incorporating this impact using a simple
Rongsong Liu; Jianhong Wu; Huaiping Zhu
BACKGROUND: The global spread of the severe acute respiratory syndrome (SARS) epidemic has clearly shown the importance of considering the long-range transportation networks in the understanding of emerging diseases outbreaks. The introduction of extensive transportation data sets is therefore an important step in order to develop epidemic models endowed with realism. METHODS: We develop a general stochastic meta-population model that
Vittoria Colizza; Alain Barrat; Marc Barthélemy; Alessandro Vespignani
The appearance of "new" infectious diseases, the reemergence of "old" infectious diseases, and the deliberate introduction of infectious diseases through bioterrorism has highlighted the need for improved and innovative infectious disease surveillance systems. Traditional current surveillance systems are generally based on the recognition of a clear increase in diagnosed cases before an outbreak can be identified. For early detection of bioterrorist-initiated outbreaks, the sensitivity and timeliness of the systems need to be improved. Systems based on syndromic surveillance are being developed using technologies such as electronic reporting and the internet. The reporting sources include community physicians, public health laboratories, emergency departments, intensive care units, district health offices, and hospital admission and discharge systems. The acid test of any system will be the ability to provide analyses and interpretations of the data that will serve the goals of the system. Such analytical methods are still in the early stages of development. PMID:12120460
Green, Manfred S; Kaufman, Zalman
Foot and mouth disease (FMD) is a highly infectious and contagious viral disease affecting bovidae (cattle, zebus, domestic buffaloes, yaks), sheep, goats, swine, all wild ruminants and suidae. Camelidae (camels, dromedaries, llamas, vicunas) have low susceptibility. Foot and mouth disease is caused by a RNS virus of the family Picornaviridae, genus Aphthovirus. There are seven immunologically distinct serotypes: A, O,
OBJECTIVE--To study the source of non-outbreak legionnaires' disease, particularly the role of cooling towers, by comparing the locations of patients' homes in relation to the location of cooling towers. DESIGN--Retrospective, descriptive study of a case series of patients with legionnaires' disease ill between 1978 and 1986 and, for comparison, a case series of patients with lung cancer. A prospectively developed
R S Bhopal; R J Fallon; E C Buist; R J Black; J D Urquhart
A disease in mink has been discovered that has many of the features of collagen diseases in man. Affected animals suffer from wasting with leukopenia and thrombocytopenia as well as plasma cell infiltration, hypergammaglobulinemia, glomerulonephritis, arteritis and amyloidosis. Cell-free filtrates and ultracentrifugates from diseased animals induced the disease in normal mink, and aleutian genotypes were unusually susceptible to infection. This genotype was characterized by abnormal lysosomal structures in all the granule-forming cells, resembling the Chediak-Higashi syndrome of man. Anti-?-globulin factors similar to human rheumatoid factors were reported, although tests for antibodies such as ANF and LE factors have been negative. Arteritis and glomerulonephritis lesions stained positively for ?-globulin, and Coombs-type sensitized red cells have been detected in the majority of affected mink. Some mink develop a monodispersion of hypergammaglobulinemia resembling the serum protein changes in human myeloma. These studies highlight genetic, immunological and microbiological causative factors in a mink disorder resembling human collagen disease. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6
Gordon, Duncan A.; Franklin, Arthur E.; Karstad, Lars
Very little is known about how environmental changes such as increasing temperature affect disease dynamics in the ocean, especially at large spatial scales. We asked whether the frequency of warm temperature anomalies is positively related to the frequency of coral disease across 1,500 km of Australia's Great Barrier Reef. We used a new high-resolution satellite dataset of ocean temperature and 6 y of coral disease and coral cover data from annual surveys of 48 reefs to answer this question. We found a highly significant relationship between the frequencies of warm temperature anomalies and of white syndrome, an emergent disease, or potentially, a group of diseases, of Pacific reef-building corals. The effect of temperature was highly dependent on coral cover because white syndrome outbreaks followed warm years, but only on high (>50%) cover reefs, suggesting an important role of host density as a threshold for outbreaks. Our results indicate that the frequency of temperature anomalies, which is predicted to increase in most tropical oceans, can increase the susceptibility of corals to disease, leading to outbreaks where corals are abundant. PMID:17488183
Bruno, John F; Selig, Elizabeth R; Casey, Kenneth S; Page, Cathie A; Willis, Bette L; Harvell, C Drew; Sweatman, Hugh; Melendy, Amy M
Very little is known about how environmental changes such as increasing temperature affect disease dynamics in the ocean, especially at large spatial scales. We asked whether the frequency of warm temperature anomalies is positively related to the frequency of coral disease across 1,500 km of Australia's Great Barrier Reef. We used a new high-resolution satellite dataset of ocean temperature and 6 y of coral disease and coral cover data from annual surveys of 48 reefs to answer this question. We found a highly significant relationship between the frequencies of warm temperature anomalies and of white syndrome, an emergent disease, or potentially, a group of diseases, of Pacific reef-building corals. The effect of temperature was highly dependent on coral cover because white syndrome outbreaks followed warm years, but only on high (>50%) cover reefs, suggesting an important role of host density as a threshold for outbreaks. Our results indicate that the frequency of temperature anomalies, which is predicted to increase in most tropical oceans, can increase the susceptibility of corals to disease, leading to outbreaks where corals are abundant.
Bruno, John F; Selig, Elizabeth R; Casey, Kenneth S; Page, Cathie A; Willis, Bette L; Harvell, C. Drew; Sweatman, Hugh; Melendy, Amy M
During outbreaks of infectious diseases with high morbidity and mortality, individuals closely follow media reports of the outbreak. Many will attempt to minimize contacts with other individuals in order to protect themselves from infection and possibly death. This process is called social distancing. Social distancing strategies include restricting socializing and travel, and using barrier protections. We use modeling to show that for short-term outbreaks, social distancing can have a large influence on reducing outbreak morbidity and mortality. In particular, public health agencies working together with the media can significantly reduce the severity of an outbreak by providing timely accounts of new infections and deaths. Our models show that the most effective strategy to reduce infections is to provide this information as early as possible, though providing it well into the course of the outbreak can still have a significant effect. However, our models for long-term outbreaks indicate that reporting historic infection data can result in more infections than with no reporting at all. We examine three types of media influence and we illustrate the media influence with a simulated outbreak of a generic emerging infectious disease in a small city. Social distancing can never be complete; however, for a spectrum of outbreaks, we show that leaving isolation (stopping applying social distancing measures) for up to 4 hours each day has modest effect on the overall morbidity and mortality. PMID:23990974
Mummert, Anna; Weiss, Howard
During outbreaks of infectious diseases with high morbidity and mortality, individuals closely follow media reports of the outbreak. Many will attempt to minimize contacts with other individuals in order to protect themselves from infection and possibly death. This process is called social distancing. Social distancing strategies include restricting socializing and travel, and using barrier protections. We use modeling to show that for short-term outbreaks, social distancing can have a large influence on reducing outbreak morbidity and mortality. In particular, public health agencies working together with the media can significantly reduce the severity of an outbreak by providing timely accounts of new infections and deaths. Our models show that the most effective strategy to reduce infections is to provide this information as early as possible, though providing it well into the course of the outbreak can still have a significant effect. However, our models for long-term outbreaks indicate that reporting historic infection data can result in more infections than with no reporting at all. We examine three types of media influence and we illustrate the media influence with a simulated outbreak of a generic emerging infectious disease in a small city. Social distancing can never be complete; however, for a spectrum of outbreaks, we show that leaving isolation (stopping applying social distancing measures) for up to 4 hours each day has modest effect on the overall morbidity and mortality.
Mummert, Anna; Weiss, Howard
In Japan we have had two outbreaks of hand, foot, and mouth disease associated with disorders of the central nervous system, one in 1973 and the other in 1978. The isolated virus in both outbreaks was enterovirus 71. Central nervous system disorders were present in 24% of patients in 1973 and in 8% of patients in 1978. These disorders were
Y Ishimaru; S Nakano; K Yamaoka; S Takami
Over a 2-month period, five cases of serogroup C meningococcal disease occurred in Iowa City, Iowa. Two patients were unacquainted university students who had independently visited another university with endemic meningococcal disease. Isolates from these patients had DNA fingerprints identical to those of the isolates responsible for infections on the other campus. Three cases for which the patients' isolates had a different DNA fingerprint were linked to visiting a local tavern. To disrupt the outbreak, the University of Iowa offered free meningococcal vaccine to all students. This report demonstrates that outbreaks of meningococcal disease may be due to more than one circulating strain and illustrates the utility of pulsed-field gel electrophoresis in defining the molecular epidemiology of meningococcal infections.
Edmond, M B; Hollis, R J; Houston, A K; Wenzel, R P
Oral manifestations of diseases caused by bioterrorist agents could be a potential data source for biosurveillance. This study had the objectives of determining the oral manifestations of diseases caused by bioterrorist agents, measuring the prevalence of these manifestations in emergency department reports, and constructing and evaluating a detection algorithm based on them. We developed a software application to detect oral
M. H. Torres-Urquidy; G. Wallstrom; T. K. L. Schleyer
The 1993 Milwaukee Cryptosporidium outbreakposed several questions regarding appropriate managementand prognosis of inflammatory bowel disease patientsacutely infected with this organism. We prospectively identified and monitored 12 patients withstable ulcerative colitis or Crohn's disease whosuffered abrupt clinical decompensation during theoutbreak. All recovered to baseline at =60 days. Inpatients receiving immunosuppressive therapy, meanduration of symptoms was no longer than in patientswithout it.
Mitchell W. Manthey; Albert B. Ross; Konrad H. Soergel
Recent outbreaks of human enterovirus 71 (EV71) infection and EV71-associated hand, foot, and mouth disease (HFMD) in China have affected millions and potentially lead to life-threatening complications in newborns. Furthermore, these outbreaks represent a significant global public health issue in the world. Understanding the epidemiology of HFMD and EV71 infection and their transmission patterns in China is essential for controlling outbreaks. However, no studies on the outbreaks of HFMD and EV71 infection in China during 2010 have been reported. In this report, we carried out an epidemiological analysis to study an outbreak of HFMD and EV71 infection in 2010 in the city of Nanchang in the Jiangxi province of People's Republic of China. From April 7 to May 11, 2010, a total of 109 HFMD cases were reported, and in this report the HFMD cases were studied by both epidemiological and laboratory analyses. The epidemiological study indicates that children aged younger than 8 years old represented more than 90% of the reported cases, with the age group of 1–3 years containing the highest number of cases. Laboratory studies detected a high prevalence of EV71 amongst the cases in our study, suggesting EV71 as a common enterovirus found in HFMD cases in Nanchang. Phylogenetic analysis of the sequence of the VP1 region of four EV71 isolates indicated that the Nanchang strains belong to the C4 subgenotype commonly found in China during outbreaks in 2008 but contain distinct variations from these strains. Our study for the first time characterizes the epidemiology of HFMD and EV71 infection in China in 2010 and furthermore, provides the first direct evidence of the genotype of EV71 circulating in Nanchang, China. Our study should facilitate the development of public health measures for the control and prevention of HFMD and EV71 infection in at-risk individuals in China.
Luo, Jun; Liu, Yingle; Zhu, Yang; Berman, Hillary; Wu, Jianguo
Identification of pathogens or antibody response to pathogens in human and animals modulates the treatment strategies for naive population and subsequent infections. Diseases can be controlled and even eradicated based on the epidemiology and effective prophylaxis, which often depends on development of efficient diagnostics. In addition, combating newly emerging diseases in human as well as animal healthcare is challenging and is dependent on developing safe and efficient diagnostics. Detection of antibodies directed against specific antigens has been the method of choice for documenting prior infection. Other than zoonosis, development of inexpensive vaccines and diagnostics is a unique problem in animal healthcare. The advent of recombinant DNA technology and its application in the biotechnology industry has revolutionized animal healthcare. The use of recombinant DNA technology in animal disease diagnosis has improved the rapidity, specificity and sensitivity of various diagnostic assays. This is because of the absence of host cellular proteins in the recombinant derived antigen preparations that dramatically decrease the rate of false-positive reactions. Various recombinant products are used for disease diagnosis in veterinary medicine and this article discusses recombinant-based viral disease diagnostics currently used for detection of pathogens in livestock and poultry. PMID:20843198
Balamurugan, Vinayagamurthy; Venkatesan, Gnanavel; Sen, Arnab; Annamalai, Lakshmanan; Bhanuprakash, Veerakyathappa; Singh, Raj Kumar
On January 3, 1995, the Florida Department of Health and Rehabilitative Services (HRS) was notified of an outbreak of acute gastroenteritis associated with eating oysters. The subsequent investigation by HRS has identified 34 separate clusters of cases, many of which were associated with oysters harvested during December 29-31 from 13 Mile Area and Cat Point in Apalachicola Bay. Oysters were shipped to other states, but additional clusters of illness associated with these oysters have been reported only in Georgia. Most of these oysters were served steamed or roasted. This report summarizes the preliminary findings of the ongoing investigation of this outbreak.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7808387
Expanding international trade and increased transportation are heavily implicated in the growing threat posed by invasive pathogens to biodiversity and landscapes. With trees and woodland in the UK now facing threats from a number of disease systems, this paper looks to historical experience with the Dutch elm disease (DED) epidemic of the 1970s to see what can be learned about an outbreak and attempts to prevent, manage and control it. The paper draws on an interdisciplinary investigation into the history, biology and policy of the epidemic. It presents a reconstruction based on a spatial modelling exercise underpinned by archival research and interviews with individuals involved in the attempted management of the epidemic at the time. The paper explores what, if anything, might have been done to contain the outbreak and discusses the wider lessons for plant protection. Reading across to present-day biosecurity concerns, the paper looks at the current outbreak of ramorum blight in the UK and presents an analysis of the unfolding epidemiology and policy of this more recent, and potentially very serious, disease outbreak. The paper concludes by reflecting on the continuing contemporary relevance of the DED experience at an important juncture in the evolution of plant protection policy.
Potter, Clive; Harwood, Tom; Knight, Jon; Tomlinson, Isobel
Newcastle disease (ND) is a contagious viral disease of many avian species particularly domestic poultry, and is responsible for devastating outbreaks in the poultry industries around the globe. In spite of its importance and endemicity in Southern Asia, data on the genetic nature of the viruses and epizootiological information of the disease is scarce. In this study, six isolates from an emerging wave of ND outbreaks in the north of Pakistan and two isolates from healthy poultry flocks were biologically and genetically characterized. Based on pathogenicity indices such as intracerebral pathogenicity index (ICPI), mean death time (MDT) and cleavage motifs in the fusion protein, all these isolates were classified as virulent. Phylogenetic analysis of the fusion (F), hemagglutinin-neuraminidase (HN) and matrix (M) genes indicated the emergence of a novel genetic group within lineage 5, distinct from isolates previously reported in the region. Several mutations in the neutralizing epitopes and functionally important motifs of the F and HN genes pose a need for re-evaluation of the currently used vaccine and vaccination practices. The characteristics of Newcastle disease virus (NDV) as virulent (F protein cleavage site, ICPI and MDT) in apparently healthy backyard poultry (BYP) explain that BYP can play crucial role in the epizootiology and spread of the disease. The present investigation provides essential information on the genetic nature of NDV circulating in Pakistan and its implication on disease diagnosis and control. Furthermore, these investigations emphasize the importance of continuous surveillance of ND in developing countries. PMID:22418457
Munir, Muhammad; Cortey, Martí; Abbas, Muhammad; Qureshi, Zafar Ul Ahsan; Afzal, Farhan; Shabbir, Muhammad Zubair; Khan, Muhammad Tanveer; Ahmed, Safia; Ahmad, Saeed; Baule, Claudia; Ståhl, Karl; Zohari, Siamak; Berg, Mikael
The Unexplained Respiratory Disease Outbreak (URDO) working group is a multidisciplinary team composed of approximately 40 scientists from across CDC with expertise in infectious and noninfectious respiratory diseases. The URDO working group was formed in 2004 to streamline CDC response efforts to assist local, state, and international public health officials in investigations of unexplained respiratory disease outbreaks. This report summarizes URDO working group activities from March 2007 through September 2011. During that period, the URDO working group was notified of 57 investigations and facilitated consultations with subject matter experts (in all 57 investigations), laboratory testing at CDC (in 42 investigations), and on-site field investigation support (in eight investigations). Of these 57 investigations, 41 occurred domestically, and 16 occurred internationally. An etiology was identified in 29 (51%) investigations; among these, the most commonly implicated pathogens were noninfluenza respiratory viruses (41%), influenza viruses (17%), Mycoplasma pneumoniae (14%), and Bordetella pertussis (14%). Notification occurred a median of 33 days after illness onset in the first case, which might have limited the ability to collect early laboratory specimens or epidemiologic data. Reducing delays in sample collection, epidemiologic investigations, and consultation with the URDO working group might increase the ability to identify etiologies and lead to more rapid control of these unexplained respiratory disease outbreaks. PMID:22763885
Background Reverse transcription-polymerase chain reaction (RT-PCR) is the main method for laboratory diagnosis of norovirus-associated infectious intestinal disease (IID). However, up to 16% of healthy individuals in the community, with no recent history of IID, may be RT-PCR positive; so it is unclear whether norovirus is actually the cause of illness in an IID case when they are RT-PCR positive. It is important to identify the pathogen causing illness in sporadic IID cases, for clinical management and for community based incidence studies. The aim of this study was to investigate how faecal viral load can be used to determine when norovirus is the most likely cause of illness in an IID case. Methods Real-time RT-PCR was used to determine the viral load in faecal specimens collected from 589 IID cases and 159 healthy controls, who were infected with genogroup II noroviruses. Cycle threshold (Ct) values from the real-time RT-PCR were used as a proxy measure of viral load. Receiver-operating characteristic (ROC) analysis was used to identify a cut-off in viral load for attributing illness to norovirus in IID cases. Results One hundred and sixty-nine IID cases and 159 controls met the inclusion criteria for the ROC analysis. The optimal Ct value cut-off for attributing IID to norovirus was 31. The same cut-off was selected when using healthy controls, or IID cases who were positive by culture for bacterial pathogens, as the reference negative group. This alternative reference negative group can be identified amongst specimens routinely received in clinical virology laboratories. Conclusion We demonstrated that ROC analysis can be used to select a cut-off for a norovirus real time RT-PCR assay, to aid clinical interpretation and diagnose when norovirus is the cause of IID. Specimens routinely received for diagnosis in clinical virology laboratories can be used to select an appropriate cut-off. Individual laboratories can use this method to define in-house cut-offs for their assays, to provide the best possible diagnostic service to clinicians and public health workers. Other clinical and epidemiological information should also be considered for patients with Ct values close to the cut-off, for the most accurate diagnosis of IID aetiology.
SUMMARY This paper provides one of the first assessments of the burden of both the public health investigation and the economic costs associated with an apparent outbreak of Legionnaires' disease (LD) in South East London. In addition to epidemiological, microbiological and environmental investigations, we collected data on the staff time and resources committed by the 11 main organizations responsible for managing the outbreak. Of the overall estimated costs of £455 856, only 14% (£64 264) was spent on investigation and control of the outbreak compared with 86% (£391 592) spent on the hospital treatment of the patients. The time and money spent on public health services in this investigation appear to represent good value for money considering the potential costs of a major outbreak, including the high case-fatality rate in LD generally and the high health-care costs. Further research is needed to determine optimum strategies for the cost-effective use of health system resources in investigations of LD. Whether the threshold for investigation of cases should be based on observed incidence rates or the cost-effectiveness of investigations, or both, should be debated further.
LOCK, K.; MILLETT, C.; HEATHCOCK, R.; JOSEPH, C. A.; HARRISON, T. G.; LEE, J. V.; RAO, G.; SURMAN-LEE, S.
Any outbreak of an Office International des Épizooties List A disease, such as classical swine fever or foot and mouth disease, has severe consequences for animal welfare, livestock production, exports of animals and animal products, and the environment. The public concern with the animal welfare effects of methods of disease eradication that result in the destruction of large numbers of uninfected animals has initiated a reconsideration of disease eradication policy in Europe. In many recent List A disease epizootics, the financial cost of addressing animal welfare concerns in healthy animals has greatly exceeded the cost of stamping out disease in infected herds. In the event of a similar incursion in Canada, the number of animals subject to welfare slaughter will be far greater than the number of infected animals killed. Current national disease eradication plans in Canada do not address the animal welfare component of disease control methods.
Whiting, Terry L.
In 1974, an outbreak of Bornholm disease occurred in Singapore. The period 1st May to 31st July was delineated for study. From the clinical presentation 53 patients were placed into two categories "typical Bornholm disease" and "atypical Bornholm disease". The clinical features of only those in the "typical Bornholm disease" group including those with positive Coxsackie B3 virus isolation were described. The virological studies, both faecal isolation for virus and serology were correlated with clinical diagnosis. Fever and characteristic abdominal or chest pain appear to be constant features of Bornholm disease. Positive faecal virus isolation are significantly high in the "typical Bornholm disease" group. Bornholm disease could be diagnosed clinically with fair accuracy. The importance of diagnosing Bornholm disease is emphasized. PMID:1179480
Chong, A Y; Lee, L H; Wong, H B
Contents: Outbreak of Legionnaires' Disease Among Automotive Plant Workers - Ohio, 2001; Update: Outbreak of Acute Febrile Respiratory Illness Among College Students - Acapulco, Mexico, March 2001; Pregnancy-Related Deaths Among Hispanic, Asian/Pacific Is...
Most mathematical models for the spread of disease use differential equations based on uniform mixing assumptions or ad hoc models for the contact process. Here we explore the use of dynamic bipartite graphs to model the physical contact patterns that result from movements of individuals between specific locations. The graphs are generated by large-scale individual-based urban traffic simulations built on
Stephen Eubank; Hasan Guclu; V. S. Anil Kumar; Madhav V. Marathe; Aravind Srinivasan; Zoltán Toroczkai; Nan Wang
BACKGROUND: During severe acute respiratory syndrome (SARS) outbreak in Toronto, outpatient clinics at SickKids Hospital were closed to prevent further disease transmission. In response, a decision was made by the neonatal neuro-developmental follow up (NNFU) clinic staff to select patients with scheduled appointments to have a mail\\/telephone assessment using Ages and Stages Questionnaire (ASQ) or to postpone\\/skip their visit. The
Nehad Nasef; Karel O'Brien; Lesley Wylie; Sharon Unger
Much of the pre-existing electronic data that could be harnessed for early out- break detection is in free-text format. Natural language processing (NLP) techniques may be useful to biosurveillance by classifying and extracting information described in free- text sources. In the Real-time Outbreak and Disease Surveillance laboratory we are de- veloping and evaluating NLP techniques for surveillance of syndromic presentations
Wendy W. Chapman; John N. Dowling; Oleg Ivanov; Per H. Gesteland; Robert T. Olszewski; U. Espino; Michael M. Wagner
We report an outbreak comprising 50 confirmed cases of Legionnaires' disease in Edinburgh, Scotland, June 2012. In addition, there were 49 suspected cases. Epidemiological evidence suggests that a common outdoor airborne exposure occurred over south-west Edinburgh. This probably emanated from cooling towers in the north-east of the affected area, although not yet clearly linked by scientific evidence. The co-ordinated public health, environmental and clinical response helped prevent ongoing exposure and mitigated associated mortality and morbidity. PMID:22835439
McCormick, D; Thorn, S; Milne, D; Evans, C; Stevenson, J; Llano, M; Donaghy, M
Newly emerging and re-emerging infections are recognized as a global problem and 75% of these are potentially zoonotic (Woolhouse\\u000a & Gowtage-Sequeria, 2005). Emergence of a new “killer” disease in any part of the world is likely to be a threat world wide\\u000a in today’s society with very rapid means of transportation of both human and animal\\/animal products. Recent examples include
Lin-Fa Wang; John S. Mackenzie; Bryan T. Eaton
The 2001 epidemic of foot-and-mouth disease in the United Kingdom triggered a livestock culling campaign that involved the slaughter of more than 6.5 million animals. Three years later, management of the epidemic remains controversial. Some believe that untried control methods based on unvalidated models replaced well-established policy, motivating an unnecessary slaughter. Others hold that rigorous quantitative approaches provided the basis
Rowland R. Kao; R. Paul Kitching; Daniel T. Haydon
In 1971, an outbreak of a hemorrhagic disease occurred in captive and free-ranging white-tailed deer (Odocoileus virginianus) in Mammoth Cave National Park, Kentucky, Clinical signs and gross pathological lesions were consistent with those of epizootic hemorrhagic disease and bluetongue, as were serological and histopathological findings for samples sent to other laboratories. The infection rate among the 104 captive deer was 88-92%, and that among the free-ranging Park deer appeared to be similar. Mortality was negligible in the Park deer, but 65 (62%) of the captive deer died. The deaths were bimodally distributed over a 36-day period, and the mortality rate decreased from 97-100% for deer clinically ill during the first 17 days of the outbreak to 58% for deer first exhibiting clinical signs on day 16 or later. Mortality was equal in males and females, but less in yearlings than among fawns or adults. Winter mortality among survivors of the initial outbreak was associated with low ambient temperatures and sometimes fungal and bacterial abscesses, possibly sequelae or complications of the hemorrhagic disease. The pregnancy and birth rates among surviving does appeared to be normal. PMID:167205
Roughton, R D
Farm slurry can be highly contaminated with viral pathogens. The survival of these pathogens within slurry is important since this material is often distributed onto farm land either directly or after heat treatment. There is clearly some risk of spreading pathogens in the early stages of an outbreak of disease before it has been recognized. The survival of foot-and-mouth disease virus, classical swine fever virus, bovine viral diarrhoea virus and swine influenza virus, which belong to three different RNA virus families plus porcine parvovirus (a DNA virus) was examined under controlled conditions. For each RNA virus, the virus survival in farm slurry under anaerobic conditions was short (generally ? 1 h) when heated (to 55°C) but each of these viruses could retain infectivity at cool temperatures (5°C) for many weeks. The porcine parvovirus survived considerably longer than each of the RNA viruses under all conditions tested. The implications for disease spread are discussed. PMID:22226541
Bøtner, Anette; Belsham, Graham J
Active disease surveillance during epidemics is of utmost importance in detecting and eliminating new cases quickly, and targeting such surveillance to high-risk individuals is considered more efficient than applying a random strategy. Contact tracing has been used as a form of at-risk targeting, and a variety of mathematical models have indicated that it is likely to be highly efficient. However, for fast-moving epidemics, resource constraints limit the ability of the authorities to perform, and follow up, contact tracing effectively. As an alternative, we present a novel real-time Bayesian statistical methodology to determine currently undetected (occult) infections. For the UK foot-and-mouth disease (FMD) epidemic of 2007, we use real-time epidemic data synthesized with previous knowledge of FMD outbreaks in the UK to predict which premises might have been infected, but remained undetected, at any point during the outbreak. This provides both a framework for targeting surveillance in the face of limited resources and an indicator of the current severity and spatial extent of the epidemic. We anticipate that this methodology will be of substantial benefit in future outbreaks, providing a compromise between targeted manual surveillance and random or spatially targeted strategies.
Jewell, C. P.; Keeling, M. J.; Roberts, G. O.
Periodic wildlife rabies epizootics occur in Arctic regions. The original sources of these outbreaks are rarely identified. In 1980, a wildlife epizootic of rabies occurred on the previously rabies-free Svalbard Islands, Norway. After this outbreak of rabies in the arctic fox population (Alopex lagopus), only single cases have been reported from the Islands over the following two decades. Phylogenetic characterization of four viruses isolated from infected arctic foxes from Svalbard from three different time periods suggest that the source of these epizootics could have been migration of this species from the Russian mainland. Arctic fox migration has likely contributed to the establishment of another zoonotic disease, Echinococcus multilocularis, on Svalbard in recent years. PMID:17767407
Johnson, N; Dicker, A; Mork, T; Marston, D A; Fooks, A R; Tryland, M; Fuglei, E; Müller, T
The Biological and Toxin Weapons Convention prohibits the development, production, and stockpiling of biological weapons agents or delivery devices for anything other than peaceful purposes. A protocol currently in the final stages of negotiation adds verification measures to the convention. One of these measures will be international investigation of disease outbreaks that suggest a violation of the convention, i.e., outbreaks that may be caused by use of biological weapons or release of harmful agents from a facility conducting prohibited work. Adding verification measures to the current Biological and Toxin Weapons Convention will affect the international public health and epidemiology communities; therefore, active involvement of these communities in planning the implementation details of the protocol will be important.
Recurrence of hepatitis is a well-documented complication of hepatitis B liver disease, post-transplantation. It is well established also that the earliest hepatocellular change is the appearance of hepatitis B viral (HBV) markers and that the disease is rapidly progressive. In this article on 17 liver transplants in 16 HBV positive patients with long-term follow-ups (100-1234 days), the distinctive pathologic features of this disease are emphasized: the extreme viral load, the steatosis, and/or fibrosis. An attempt to quantitate the magnitude of the viral burden was made and the result was a staggering figure. In one patient, an estimated 10(18) HBV core particles were present in the liver. One of two patterns of progression were noted. In four patients in addition to the massive nuclear hepatitis B core antigen (HBcAg) and cytoplasmic hepatitis B surface antigen (HBsAg) positivity, superimposed hepatitic changes led to diffuse hepatic fibrosis (fibroviral hepatitis B); and in another six patients, extraordinary hepatocellular viral marker positivity and steatosis were the hallmarks (steatoviral hepatitis B). Steatosis is not usually considered a feature of HBV liver pathology. These results suggest that more than one type of posttransfusion recurrent hepatitis B liver disease exists pathologically. Images Figure 1 Figure 2 Figure 3
Phillips, M. J.; Cameron, R.; Flowers, M. A.; Blendis, L. M.; Greig, P. D.; Wanless, I.; Sherman, M.; Superina, R.; Langer, B.; Levy, G. A.
Background Recent findings from a genome wide association investigation in a large cohort of patients with Alzheimer's disease (AD) and non demented controls (CTR) showed that a limited set of genes was in a strong association (p > l0-5) with the disease. Presentation of the hypothesis In this report we suggest that the polymorphism association in 8 of these genes is consistent with a non conventional interpretation of AD etiology. Nectin-2 (NC-2), apolipoprotein E (APOE), glycoprotein carcinoembryonic antigen related cell adhesion molecule- 16 (CEACAM-16), B-cell lymphoma-3 (Bcl-3), translocase of outer mitochondrial membrane 40 homolog (T0MM-40), complement receptor-1 (CR-l), APOJ or clusterin and C-type lectin domain A family-16 member (CLEC-16A) result in a genetic signature that might affect individual brain susceptibility to infection by herpes virus family during aging, leading to neuronal loss, inflammation and amyloid deposition. Implications of the hypothesis We hypothesized that such genetic trait may predispose to AD via complex and diverse mechanisms each contributing to an increase of individual susceptibility to brain viral infections
Short functional peptide motifs cooperate in many molecular functions including protein interactions, protein trafficking, and posttranslational modifications. Viruses exploit these motifs as a principal mechanism for hijacking cells and many motifs are necessary for the viral life-cycle. A virus can accommodate many short motifs in its small genome size providing a plethora of ways for the virus to acquire host molecular machinery. Host enzymes that act on motifs such as kinases, proteases, and lipidation enzymes, as well as protein interaction domains, are commonly mutated in human disease, suggesting that the short peptide motif targets of these enzymes may also be mutated in disease; however, this is not observed. How can we explain why viruses have evolved to be so dependent on motifs, yet these motifs, in general do not seem to be as necessary for human viability? We propose that short motifs are used at the system level. This system architecture allows viruses to exploit a motif, whereas the viability of the host is not affected by mutation of a single motif.
Kadaveru, Krishna; Vyas, Jay; Schiller, Martin R.
Gaillardia plants exhibiting symptoms characteristic of viral and phytoplasmal diseases were collected at botanical gardens and floriculture farms in Lithuania. Cucumber mosaic virus was isolated from diseased plants exhibiting symptoms characterized stunting, color breaking and malformation of flo...
Foot and mouth disease (FMD) is a highly infectious and contagious viral disease affecting bovidae (cattle, zebus, domestic buffaloes, yaks), sheep, goats, swine, all wild ruminants and suidae. Camelidae (camels, dromedaries, llamas, vicunas) have low susceptibility. Foot and mouth disease is caused by a RNS virus of the family Picornaviridae, genus Aphthovirus. There are seven immunologically distinct serotypes: A, O, C, SAT1, SAT2, SAT3, Asia 1. Foot and mouth disease causes significant economic loss both to countries who manage it as an endemic disease (with or without vaccination), as well as those FMD free countries which may become infected. The mortality rate is low in adult animals, but often higher in young due to myocarditis. Foot and mouth disease is endemic in parts of Asia, Africa, the Middle East and South America (sporadic outbreaks in free areas). The Office of International Epizootics (OIE), also referred to the World Organization for Animal Health maintains an official list of free countries and zones.1 The OIE Terrestrial Code (Chapter 2.2.10) provides detailed information on the categories of freedom that can be allocated to a country as well as guidelines for the surveillance for foot and mouth disease (Appendix 3.8.7). In short, countries may be completely free of FMD, free with vaccination or infected with foot and mouth disease virus (FMDV). Source of FMDV include incubating and clinically affected animals with virus present in breath, saliva, faeces, urine, milk and semen. In experimental settings virus has been detected in milk several days before the onset of clinical signs2. Additional sources of virus are meat and by-products in which pH has remained above 6.0 as well as persistently infected carrier animals. Carrier animals may include cattle and water buffalo; convalescent animals and exposed vaccinates (virus persists in the oropharynx for up to 30 months in cattle or longer in buffalo, 9 months in sheep). Pigs do not become carriers. It has been shown that the African Cape buffalo are the major maintenance host of SAT serotypes. FMDV transmission can occur by either direct or indirect contact. Indirect transmission can occur via contaminated animate vectors (humans, etc.), inanimate vectors (vehicles, implements) or airborne transmission. Indirect disease transmission via animate or inanimate vectors can play a major role in disease transmission. Good biosecurity can significantly reduce this type of transmission. Airborne transmission is often debated and is known to be serotype and species specific as well as require specific environmental conditions to occur. Airborne transmission is favored in temperate zones and has been postulated to occur over distances of up to 60 km overland and 300 km by sea. Foot and mouth disease virus is an unenveloped virus which is preserved by refrigeration and freezing and progressively inactivated by temperatures above 50 C. FMDV is highly sensitive to pH change and is inactivated by pH < 6.0 or > 9.0. There are many disinfectants which are effective against FMDV including sodium hydroxide (2%), sodium carbonate (4%), and citric acid (0.2%). FMDV is resistant to iodophores, quaternary ammonium compounds, hypochlorite and phenol, especially in the presence of organic matter. The virus can survive in lymph nodes and bone marrow at neutral pH, but is destroyed in muscle when is pH < 6.0 i.e. after rigor mortis. FMDV can persist in contaminated feed/commodities and the environment for over to 1 month, depending on the temperature and pH conditions. The incubation period for FMD is 2-14 days. Animals transition through latent (infected but not infectious), subclinically infected (infectious but lacking clinical signs) clinically infected and recovered disease states. In cattle clinical signs include pyrexia, reluctance to eat, bruxism, drooling, lameness, treading or stamping of the feet and decreased milk production. Most clinical signs are related to the development and subsequent rupturing of vesicles at the coronary band and in the oral cavity. V
Isolates from the 2002-2003 virulent Newcastle disease virus (v-NDV) outbreak in southern California, Nevada, Arizona, and Texas in the United States were compared to each other along with recent v-NDV isolates from Mexico and Central America and reference avian paramyxovirus type 1 strains. Nucleotide sequencing and phylogenetic analyses were conducted on a 1,195-base genomic segment composing the 3 region of
Janice C. Pedersen; Dennis A. Senne; Peter R. Woolcock; Hailu Kinde; Daniel J. King; Mark G. Wise; Brundaban Panigrahy; Bruce S. Seal
An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality. PMID:17662166
Castilla, J; Barricarte, A; Aldaz, J; García Cenoz, M; Ferrer, T; Pelaz, C; Pineda, S; Baladrón, B; Martín, I; Goñi, B; Aratajo, P; Chamorro, J; Lameiro, F; Torroba, L; Dorronsoro, I; Martínez-Artola, V; Esparza, M J; Gastaminza, M A; Fraile, P; Aldaz, P
The relationship between size of the infecting dose and severity of the resulting disease has been investigated for salmonella infections by reanalysis of data within epidemics for 32 outbreaks, and comparing data between outbreaks for 68 typhoid epidemics and 49 food-poisoning outbreaks due to salmonellas. Attack rate, incubation period, amount of infected food consumed and type of vehicle are used as proxy measures of infecting dose, while case fatality rates for typhoid and case hospitalization rates for food poisoning salmonellas were used to assess severity. Limitations of the data are discussed. Both unweighted and logit analysis models are used. There is no evidence for a dose-severity relationship for Salmonella typhi, but evidence of a correlation between dose and severity is available from within-epidemic or between-epidemic analysis, or both, for Salmonella typhimurium, S. enteritidis, S. infantis, S. newport, and S. thompson. The presence of such a relationship affects the way in which control interventions should be assessed.
Glynn, J. R.; Bradley, D. J.
In September of 2010, Brewer's Bay reef, located in St. Thomas (U.S. Virgin Islands), was simultaneously affected by abnormally high temperatures and the passage of a hurricane that resulted in the mass bleaching and fragmentation of its coral community. An outbreak of a rapid tissue loss disease among coral colonies was associated with these two disturbances. Gross lesion signs and lesion progression rates indicated that the disease was most similar to the Caribbean coral disease white plague type 1. Experiments indicated that the disease was transmissible through direct contact between colonies, and five-meter radial transects showed a clustered spatial distribution of disease, with diseased colonies being concentrated within the first meter of other diseased colonies. Disease prevalence and the extent to which colonies were bleached were both significantly higher on unattached colony fragments than on attached colonies, and disease occurred primarily on fragments found in direct contact with sediment. In contrast to other recent studies, disease presence was not related to the extent of bleaching on colonies. The results of this study suggest that colony fragmentation and contact with sediment played primary roles in the initial appearance of disease, but that the disease was capable of spreading among colonies, which suggests secondary transmission is possible through some other, unidentified mechanism. PMID:23437335
Brandt, Marilyn E; Smith, Tyler B; Correa, Adrienne M S; Vega-Thurber, Rebecca
Myocarditis is considered as a potent predisposing factor for dilated cardiomyopathy (DCM). Molecular biological proof of viral genome and immunohistochemical evaluation of intramyocardial inflammation are substantial in the identification and diagnosis of this pathological condition. Viruses are generally thought to be the common causative agents that trigger myocarditis and, therefore, several investigations are indispensable for the detection of viral genome
Matthias Pauschinger; Kumaran Chandrasekharan; Michel Noutsias; Uwe Kühl; LotharPeter Schwimmbeck; Heinz-Peter Schultheiss
In the Netherlands, outbreaks of Aujeszky's Disease (AD) are controlled by vaccination and movement restriction zones (MRZ). Although this strategy avoids the socio-ethical concerns associated with pre-emptive slaughter, it can easily result in animal welfare problems and negative economic consequences. These arise because movement restrictions result in surpluses of live (vaccinated) piglets on farms. The aim is to provide insight into the development of these surpluses and its impact and to describe how measures that allow early transportation of pigs under certain conditions and to specific destinations (channelling) could reduce these problems. For the analysis, a deterministic simulation model was developed, which calculates surpluses of piglets at multiplier farms during AD outbreaks. This is performed on a weekly basis for two areas (with and without piglet surplus), three outbreak durations (minimum, moderate and long) and three strategies for movement restrictions (strict, transports within the MRZ allowed and transports outside the MRZ allowed). The results show that in case of complete movement restrictions, surpluses of piglets varying in age and vaccination status will quickly arise. These surpluses are larger for longer epidemics and can become as large as 180-340 thousand piglets (45-75% of weekly domestic production) for moderate and long epidemics, respectively. Implementation of channelling strategies that allow earlier transportation within the MRZ can reduce surpluses by about 50% to 100-150 thousand piglets maximum. Strategies that also allow transportation outside the MRZ can reduce surpluses even further to below 100 thousand piglets. It was concluded that channelling of live piglets during AD outbreaks results in a drastic reduction of problems with accommodating ready-for-transport piglets. Moreover, it reduces shortages during movement restrictions and peak supply immediately after removing the restrictions. Channelling could therefore be an important instrument to reduce the economic and animal welfare impacts of containment measures. PMID:22690811
Bosman, K J; Mourits, M C M; Oude Lansink, A G J M; Saatkamp, H W
\\u000a Computer simulations have emerged as important tools in the preparation for outbreaks of infectious disease. To support the\\u000a collaborative planning and responding to the outbreaks, reports from simulations need to be transparent (accessible) with\\u000a regard to the underlying parametric settings. This paper presents a design for generation of simulation reports where the\\u000a background settings used in the simulation models are
Joakim Ekberg; Toomas Timpka; Magnus Morin; Johan Jenvald; James M. Nyce; Elin A. Gursky; Henrik Eriksson
In this study, we analyzed the clinical and molecular epidemiology of invasive serotype 5 (Ser5) pneumococcal isolates in four teaching hospitals in the Barcelona, Spain, area (from 1997 to 2011). Among 5,093 invasive pneumococcal isolates collected, 134 (2.6%) Ser5 isolates were detected. Although the overall incidence of Ser5-related invasive pneumococcal disease (IPD) was low (0.25 cases/100,000 inhabitants), three incidence peaks were detected: 0.63/100,000 in 1999, 1.15/100,000 in 2005, and 0.37/100,000 in 2009. The rates of Ser5 IPD were higher among young adults (18 to 64 years old) and older adults (>64 years old) in the first two peaks, whereas they were higher among children in 2009. The majority (88.8%) of the patients presented with pneumonia. Comorbid conditions were present in young adults (47.6%) and older adults (78.7%), the most common comorbid conditions being chronic obstructive pulmonary disease (20.6% and 38.3%, respectively) and cardiovascular diseases (11.1% and 38.3%, respectively). The mortality rates were higher among older adults (8.5%). All Ser5 pneumococci tested were fully susceptible to penicillin, cefotaxime, erythromycin, and ciprofloxacin. The resistance rates were 48.5% for co-trimoxazole, 6.7% for chloramphenicol, and 6% for tetracycline. Two major related sequence types (STs), ST1223 (n = 65) and ST289 (n = 61), were detected. The Colombia(5)-ST289 clone was responsible for all the cases in the Ser5 outbreak in 1999, whereas the ST1223 clone accounted for 73.8% and 61.5% of the isolates in 2005 and 2009, respectively. Ser5 pneumococci are a frequent cause of IPD outbreaks in the community and involve children and adults with or without comorbidities. The implementation of the new pneumococcal conjugated vaccines (PCV10 and PCV13) might prevent such outbreaks. PMID:23966486
Rolo, Dora; Fenoll, Asunción; Fontanals, Dionísia; Larrosa, Nieves; Giménez, Montserrat; Grau, Immaculada; Pallarés, Román; Liñares, Josefina; Ardanuy, Carmen
This study situates recent popularized accounts of emerging lethal viral strains within the context of a late nineteenth?century rationale for imperialism?i.e., the ideologeme of scenic contamination. Defining non?European lands and peoples as “active” agents capable of “contaminating” the civilized natures of the imperialists who would seek to rule them, this ideologeme justified imperialism as a “defensive” measure designed to control
Jeff D. Bass
Two of the central issues in developing new strategies to interfere with viral infections concern the identification of cellular proteins involved in viral replication and/or antiviral measures and the dissection of the underlying molecular mechanisms. To gain initial insight into the role of host proteins in the life cycle of infectious bursal disease virus (IBDV), a double-stranded RNA virus, we examined the cellular nuclear factor 45 (NF45). NF45 was previously indicated to be involved in the replication process of other types of RNA viruses. Interestingly, by performing immunofluorescence studies, we found that in IBDV-infected cells the mainly nuclear NF45 accumulated at the sites of viral replication in the cytoplasm. NF45 was shown to specifically colocalize with the viral RNA-dependent RNA polymerase VP1, the capsid protein VP2, and the ribonucleoprotein VP3. Immunoprecipitation experiments indicated protein-protein associations between NF45 and VP1, VP2, and VP3. Expression of the individual VP3 or the combination of expression of VP1 and VP3 did not result in a cytoplasmic accumulation of NF45, which, among other data, showed that recruitment of the cellular protein in infected cells functionally correlates with the viral replication process. Since small interfering RNA(siRNA)-mediated downregulation of NF45 resulted in an approximately 5-fold increase of virus yield, our study suggests that NF45, by association with viral proteins, is part of a yet-uncharacterized cellular defense mechanism against IBDV infections.
Stricker, Ruth L. O.; Behrens, Sven-Erik; Mundt, Egbert
Background.?Respiratory syncytial virus (RSV) disease severity was thought to be a result of host immunopathology but alternatively may be driven by high-level viral replication. The relationships between RSV load, viral clearance dynamics, and disease severity have not been carefully evaluated. Methods.?Previously healthy RSV-infected children <2 years old were recruited. RSV load was measured in respiratory secretions by fresh quantitative culture over 3 hospital days. Measures of disease severity were hospital admission, duration of hospitalization, requirement for intensive care, and respiratory failure. Results.?Multivariate logistic regression models revealed independent predictors of increased duration of hospitalization: male sex, lower weight, and higher viral load on any day. Viral loads at day 3 were more significantly associated with requirement for intensive care and respiratory failure than were viral loads at earlier time points. Faster RSV clearance was independently associated with shorter hospitalization. Discussion.?These observations challenge the immunopathology-based pathogenesis paradigm. They also have major therapeutic implications, suggesting that application of antiviral agents early in the disease course, even at a time when viral replication is at its highest, might improve subsequent morbidity by significantly lowering viral load and direct viral cytopathic effects, and aborting the potential downstream immunopathology.
El Saleeby, Chadi M.; Bush, Andy J.; Harrison, Lisa M.; Aitken, Jody A.
In West Alabama, disease outbreaks in 2009 caused by Aeromonas hydrophila have led to an estimated loss of more than $3 million. In 2010, disease outbreak occurred again in West Alabama, causing losses of hundreds of thousands of pounds of market size channel catfish. During the 2010 disease outbrea...
Background In 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological distress during this outbreak. Methods Data were collected using an online survey, with a link directed to the affected population via a number of industry groups. Psychological distress, as determined by the Kessler 10 Psychological Distress Scale, was the main outcome measure. Results In total, 2760 people participated in this study. Extremely high levels of non-specific psychological distress were reported by respondents in this study, with 34% reporting high psychological distress (K10 > 22), compared to levels of around 12% in the Australian general population. Analysis, using backward stepwise binary logistic regression analysis, revealed that those living in high risk infection (red) zones (OR = 2.00; 95% CI: 1.57–2.55; p < 0.001) and disease buffer (amber) zones (OR = 1.83; 95% CI: 1.36–2.46; p < 0.001) were at much greater risk of high psychological distress than those living in uninfected (white zones). Although prevalence of high psychological distress was greater in infected EI zones and States, elevated levels of psychological distress were experienced in horse-owners nationally. Statistical analysis indicated that certain groups were more vulnerable to high psychological distress; specifically younger people, and those with lower levels of formal educational qualifications. Respondents whose principal source of income was from horse-related industry were more than twice as likely to have high psychological distress than those whose primary source of income was not linked to horse-related industry (OR = 2.23; 95% CI: 1.82–2.73; p < 0.001). Conclusion Although, methodologically, this study had good internal validity, it has limited generalisability because it was not possible to identify, bound, or sample the target population accurately. However, this study is the first to collect psychological distress data from an affected population during such a disease outbreak and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.
Taylor, Melanie R; Agho, Kingsley E; Stevens, Garry J; Raphael, Beverley
Outbreaks of acute respiratory disease occurred in several cattle herds in the south-east regions of Norway during the winter and spring of 1995. The present study was conducted to investigate the temporal and spatial dynamics of the occurrence of acute respiratory disease between January and April 1995 in the affected cattle herds, in two neighbouring counties in Norway. This was
Madelaine Norström; Dirk U Pfeiffer; Jorun Jarp
Bovine acute phase proteins (APPs), lipopolysaccharide binding protein (LBP), serum amyloid A (SAA), haptoglobin (Hp) and alpha1-acid glycoprotein (AGP) were evaluated as inflammatory markers during an outbreak of bovine respiratory disease (BRD) caused by bovine respiratory syncytial virus (BRSV). Calves (n=10) presented mild to moderate signs of respiratory disease. Secondary bacterial infections, Pasteurella multocida and Mycoplasma dispar as major species,
Toomas Orro; Tarja Pohjanvirta; Ulla Rikula; Anita Huovilainen; Sakari Alasuutari; Liisa Sihvonen; Sinikka Pelkonen; Timo Soveri
Bioterrorism and emerging infectious diseases such as influenza have spurred research into rapid outbreak detection. One primary thrust of this research has been to identify data sources that provide early indication of a disease outbreak by being leading indicators relative to other established data sources. Researchers tend to rely on the sample cross-correlation function (CCF) to quantify the association between two data sources. There has been, however, little consideration by medical informatics researchers of the influence of methodological choices on the ability of the CCF to identify a lead-lag relationship between time series. We draw on experience from the econometric and environmental health communities, and we use simulation to demonstrate that the sample CCF is highly prone to bias. Specifically, long-scale phenomena tend to overwhelm the CCF, obscuring phenomena at shorter wave lengths. Researchers seeking lead-lag relationships in surveillance data must therefore stipulate the scale length of the features of interest (e.g., short-scale spikes versus long-scale seasonal fluctuations) and then filter the data appropriately--to diminish the influence of other features, which may mask the features of interest. Otherwise, conclusions drawn from the sample CCF of bi-variate time-series data will inevitably be ambiguous and often altogether misleading. PMID:17068353
Bloom, Ronald M; Buckeridge, David L; Cheng, Karen E
The progress and pathogenesis of foot-and-mouth disease virus (FMDV) was studied in infected pigs by observing the development of clinical signs in two separate experiments. Viral loads were determined by real-time quantitative RT-PCR in the liver, spleen, cervical lymph node, mandibular lymph node, retropharyngeal lymph node, soft palate, pharynx, tonsil, tongue and skin (coronary band area). Tissue samples were collected from both inoculated and contact-infected pigs at several time points during infection, and blood samples were collected to assess viraemia and its relationship to tissue viral load. Virus first appeared in the lymph nodes, followed by viraemia and then clinical signs. The results suggested that FMDV accumulated in lymphoid tissue up to six hours after infection, in the tissues drained by the mandibular lymph node and tonsil and then disseminated throughout the body where epithelial cells were the favoured sites of replication. PMID:20045852
Murphy, C; Bashiruddin, J B; Quan, M; Zhang, Z; Alexandersen, S
This paper reports the investigation of a community-acquired outbreak of Legionnaires' disease in the municipalities of Vic and Gurb (Central Region of Catalonia, Spain). There were 55 cases reported in October and November 2005. An epidemiological and environmental investigation was undertaken. Thirty-five case patients (64%) lived in Vic or Gurb, while 36% had visited or worked in Vic or Gurb during the 10 days before onset of symptoms, but no commonly frequented building could be identified. Water probes for culture were obtained from 30 cooling towers. In five cooling towers of two industrial settings in Gurb (plants A and B), Legionella pneumophila (Lp) serogroup 1 was present. Two Lp-1 strains were recovered from cooling towers in plants A and B. The Lp-1 strain from plant A showed a PGFE profile identical with those obtained from three patients. The exposure to Legionella pneumophila apparently occurred in a large area, since 43 of the 55 cases lived, visited or worked within a distance of 1,800 m from plant A, and six cases in a distance between 2,500 and 3,400 m. The inspections of cooling towers in plant A revealed inadequate disinfectant doses of biocide, non-existent maintenance records on weekends and wrong sample points for routine microbial check-ups. Weather conditions in October 2005 template temperature and high humidity (wind conditions are unappreciable) could have been favourable factors in this outbreak together with the flat terrain of Gurb and Vic area, explaining the extensive horizontal airborne dissemination of contaminated aerosols. The outbreak could have been prevented by proper and correct maintenance of the cooling tower at plant A. PMID:17439808
Sala, M R; Arias, C; Oliva, J M; Pedrol, A; Roura, P; Domínguez, A
A communitywide outbreak of gastrointestinal illness due to Giardia lamblia infection occurred in the city of Berlin, New Hampshire, during April and May 1977. The clinical, epidemiologic, and laboratory aspects of this outbreak are described here. In 213 predominantly symptomati...
Outbreaks of legionnaires' disease (LD) in tourists visiting Italian and Spanish resorts have been recently reported. An unusual number of reports of LD in tourists visiting the US Virgin Islands prompted an investigation of risk factors for development of LD in this area. Twenty-seven cases of LD were identified between 1979 and 1982 through press reports, personal communication, the national LD surveillance system, a review of hospital records, and a mail survey. Twenty-four of 27 persons with the disease had visited St Croix and 12 of them had stayed at a single hotel in 1981. Available evidence suggested that infection was due to Legionella pneumophila serogroup 1; L pneumophila serogroups 1 and 3 and several new Legionella species were isolated from the potable water system at the hotel. Following hyperchlorination of the potable water system, no further cases of LD in hotel visitors have been identified to date. PMID:4062461
Schlech, W F; Gorman, G W; Payne, M C; Broome, C V
Recently, in the USA, virulent mutants of feline calicivirus (FCV) have been identified as the cause of a severe and acute virulent systemic disease, characterised by jaundice, oedema and high mortality in groups of cats. This severe manifestation of FCV disease has so far only been reported in the USA. However, in 2003, an outbreak of disease affected a household of four adult cats and an adult cat from a neighbouring household in the UK. Three of the adult cats in the household and the neighbouring cat developed clinical signs including pyrexia (39.5 to 40.5 degrees C), lameness, voice loss, inappetence and jaundice. One cat was euthanased in extremis, two died and one recovered. A postmortem examination of one of the cats revealed focal cellulitis around the right hock and right elbow joints. The principal finding of histopathological examinations of selected organs from two of the cats was disseminated hepatocellular necrosis with mild inflammatory infiltration. Immunohistology identified FCV antigen in parenchymal and Kupffer cells in the liver of both animals and in alveolar macrophages of one of them. In addition, calicivirus-like particles were observed by electron microscopy within the hepatocytes of one cat. FCV was isolated from two of the dead cats and from the two surviving cats. Sequence analysis showed that they were all infected with the same strain of virus, but that it was different from strains of FCV associated with the virulent systemic disease in cats in the USA. The outbreak was successfully controlled by quarantine in the owner's house. PMID:16632527
Coyne, K P; Jones, B R D; Kipar, A; Chantrey, J; Porter, C J; Barber, P J; Dawson, S; Gaskell, R M; Radford, A D
The aim of the study was to perform molecular genetic analysis based on multi-locus sequence typing in order to identify source of Legionnaires' disease outbreak in town Verkhnyaya Pyshma in July 2007 and genetic profile of the causative agent. Sequence-based typing protocol recommended by European Working Group on Legionella infection (EWGLI) was used. It was not possible to obtain satisfactory results of Fla gene sequencing for all samples. Obtained allelic profiles of other genes were typical for L. pneumophila. Allelic profiles of L. pneumophila isolated from patients were identical and matched with L. pneumophila DNA detected in water from hot water supply of domestic building, but differed from cooling tower's isolates and isolates from showerhead in apartment of one patient. Identity of 5 genes of L. pneumophila isolated from autopsy samples and from hot water of central hot water supply of domestic building confirms aspiration route of infection through hot water contaminated by the microorganism. L. pneumophila detected in water from cooling tower, showerhead in apartment of one patient, and from drainage canal of hot water supply station belonged to other allelic variants and, therefore, are not related with the outbreak. PMID:18464536
Iatsyshina, S B; Astakhova, T S; Romanenko, V V; Platonov, A E; Zhukova, Iu V; Braslavskaia, S I; Tartakovski?, I S; Shipulin, G A
Intensive livestock production systems are particularly vulnerable to natural or intentional (bioterrorist) infectious disease outbreaks. Large numbers of animals housed within a confined area enables rapid dissemination of most infectious agents throughout a herd. Rapid containment is key to controlling any infectious disease outbreak, thus depopulation is often undertaken to prevent spread of a pathogen to the larger livestock population. In that circumstance, a large number of livestock carcasses and contaminated manure are generated that require rapid disposal. Composting lends itself as a rapid-response disposal method for infected carcasses as well as manure and soil that may harbor infectious agents. We designed a bio-contained mortality composting procedure and tested its efficacy for bovine tissue degradation and microbial deactivation. We used materials available on-farm or purchasable from local farm supply stores in order that the system can be implemented at the site of a disease outbreak. In this study, temperatures exceeded 55 degrees C for more than one month and infectious agents implanted in beef cattle carcasses and manure were inactivated within 14 days of composting. After 147 days, carcasses were almost completely degraded. The few long bones remaining were further degraded with an additional composting cycle in open windrows and the final mature compost was suitable for land application. Duplicate compost structures (final dimensions 25 m x 5 m x 2.4 m; L x W x H) were constructed using barley straw bales and lined with heavy black silage plastic sheeting. Each was loaded with loose straw, carcasses and manure totaling approximately 95,000 kg. A 40-cm base layer of loose barley straw was placed in each bunker, onto which were placed 16 feedlot cattle mortalities (average weight 343 kg) aligned transversely at a spacing of approximately 0.5 m. For passive aeration, lengths of flexible, perforated plastic drainage tubing (15 cm diameter) were placed between adjacent carcasses, extending vertically along both inside walls, and with the ends passed though the plastic to the exterior. The carcasses were overlaid with moist aerated feedlot manure (approximately 1.6 m deep) to the top of the bunker. Plastic was folded over the top and sealed with tape to establish a containment barrier and eight aeration vents (50 x 50 x 15 cm) were placed on the top of each structure to promote passive aeration. After 147 days, losses of volume and mass of composted materials averaged 39.8% and 23.7%, respectively, in each structure. PMID:20461054
Reuter, Tim; Xu, Weiping; Alexander, Trevor W; Gilroyed, Brandon H; Inglis, G Douglas; Larney, Francis J; Stanford, Kim; McAllister, Tim A
Intensive livestock production systems are particularly vulnerable to natural or intentional (bioterrorist) infectious disease outbreaks. Large numbers of animals housed within a confined area enables rapid dissemination of most infectious agents throughout a herd. Rapid containment is key to controlling any infectious disease outbreak, thus depopulation is often undertaken to prevent spread of a pathogen to the larger livestock population. In that circumstance, a large number of livestock carcasses and contaminated manure are generated that require rapid disposal. Composting lends itself as a rapid-response disposal method for infected carcasses as well as manure and soil that may harbor infectious agents. We designed a bio-contained mortality composting procedure and tested its efficacy for bovine tissue degradation and microbial deactivation. We used materials available on-farm or purchasable from local farm supply stores in order that the system can be implemented at the site of a disease outbreak. In this study, temperatures exceeded 55°C for more than one month and infectious agents implanted in beef cattle carcasses and manure were inactivated within 14 days of composting. After 147 days, carcasses were almost completely degraded. The few long bones remaining were further degraded with an additional composting cycle in open windrows and the final mature compost was suitable for land application. Duplicate compost structures (final dimensions 25 m x 5 m x 2.4 m; L x W x H) were constructed using barley straw bales and lined with heavy black silage plastic sheeting. Each was loaded with loose straw, carcasses and manure totaling ~95,000 kg. A 40-cm base layer of loose barley straw was placed in each bunker, onto which were placed 16 feedlot cattle mortalities (average weight 343 kg) aligned transversely at a spacing of approximately 0.5 m. For passive aeration, lengths of flexible, perforated plastic drainage tubing (15 cm diameter) were placed between adjacent carcasses, extending vertically along both inside walls, and with the ends passed though the plastic to the exterior. The carcasses were overlaid with moist aerated feedlot manure (~1.6 m deep) to the top of the bunker. Plastic was folded over the top and sealed with tape to establish a containment barrier and eight aeration vents (50 x 50 x 15 cm) were placed on the top of each structure to promote passive aeration. After 147 days, losses of volume and mass of composted materials averaged 39.8% and 23.7%, respectively, in each structure.
Reuter, Tim; Xu, Weiping; Alexander, Trevor W.; Gilroyed, Brandon H.; Inglis, G. Douglas; Larney, Francis J.; Stanford, Kim; McAllister, Tim A.
Vaccines remain the main tool for the control of livestock viral diseases that pose a serious threat to animal and occasionally human health, reduce food security, distort trade in animals and their products, and undermine agricultural development in poor countries. Globalization and climate change increase the likelihood for new patterns of emergence and spread of livestock viruses. Conventionally attenuated and killed virus products have had spectacular success, and recent examples include the global eradication of rinderpest and the control of bluetongue in the UK and northern Europe. However, in many cases, livestock vaccines could benefit from improvement in some properties (e.g. stability, speed of onset and duration of immunity, and breadth of cross-protection to different serotypes or strains) and in some cases are not available at all. Compared with human vaccines, uptake of livestock products is highly cost-sensitive and their use may also need to be compatible with post-vaccination screening methods to determine whether or not animals continue to be infected. Requirements and prospects for new or improved vaccines are described for some priority viral diseases with potential for transboundary spread, particularly for foot-and-mouth disease. PMID:21893540
Paton, David J; Taylor, Geraldine
In anticipation of the need to euthanize large numbers of cattle in the event of a foreign animal disease outbreak, two models of captive bolt gun and various firearms and ammunition loads were tested in order to assess their suitability. In the first phase of the project, two models of captive bolt stunner were used in an abattoir, and assessed for effectiveness. In the second phase, several firearms and ammunition were used on isolated bovine heads and assessed for effectiveness. Little difference was found between the two captive bolt stunners. Of the firearms and ammunition evaluated, the Ruger Mini-14 and the Core-Shot round, a prefragmented projectile, were determined to be most suitable. In situations where large herds of livestock are to be depopulated, and where the restraint required for the use of captive bolt stunners is not practical, there are commercially available firearms and ammunition that are suitable for this purpose.
Baker, H J; Scrimgeour, H J
Methods of delivering viral vectors, particularly recombinant AAV virions, to the central nervous system (CNS) are provided for the treatment of CNS disorders, particularly those disorders which involve the neurotransmitter dopamine. The methods entail providing rAAV virions that comprise a transgene encoding aromatic amino acid decarboxylase (AADC) and administering the virions to the brain of a mammal using a non-manual pump.
Bankiewicz, Krys; Cunningham, Janet
This is a problem-based learning adventure game in which players investigate infectious disease outbreaks. By interacting with professionals in the field and in the laboratory, players learn about the science of infectious disease and real medical science careers. Players can choose to train with an epidemiologist, microbiologist, or veterinarian to learn how these experts work as a team to solve infectious disease outbreaks while using the scientific method. Each expert path has its own learning objectives and stresses different parts of the scientific method. Key topics covered in this game: Scientific method, science process skills, rabies, necropsy, case-control study. Also available in Spanish.
Learning, Center F.
Newcastle Disease virus (NDV) infects domesticated and wild birds throughout the world and has the possibility to cause outbreaks in chicken flocks in future. To assess the evolutionary characteristics of 10 NDV strains isolated from chickens in Kazakhstan during 1998 we investigated the phylogeneti...
Problem/Condition: Since 1978, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) for collecting and reporting data on occurrences and causes...
Human health often depends on environmental variables and is generally subject to widespread and comprehensive surveillance. Compared with other available measures of ecosystem health, human disease incidence may be one of the most useful and practical bioindicators for the often elusive gauge of ecologic well-being. We argue that many subtle ecosystem disruptions are often identified only as a result of detailed epidemiologic investigations after an anomalous increase in human disease incidence detected by routine surveillance mechanisms. Incidence rates for vector-mediated diseases (e.g., arboviral illnesses) and direct zoonoses (e.g., hantaviruses) are particularly appropriate as bioindicators to identify underlying ecosystem disturbances. Outbreak data not only have the potential to act as a pivotal warning system for ecosystem disruption, but may also be used to identify interventions for the preservation of ecologic health. With this approach, appropriate ecologically based strategies for remediation can be introduced at an earlier stage than would be possible based solely on environmental monitoring, thereby reducing the level of “ecosystem distress” as well as resultant disease burden in humans. This concept is discussed using local, regional, and global examples, thereby introducing the concept of multilevel ecosystem interventions.
Cook, Angus; Jardine, Andrew; Weinstein, Philip
Traditional approach of inactivated or live-attenuated vaccine immunization has resulted in impressive success in the reduction and control of infectious disease outbreaks. However, many pathogens remain less amenable to deal with the traditional vaccine strategies, and more appropriate vaccine strategy is in need. Recent discoveries that led to increased understanding of viral molecular biology and genetics has rendered the used of viruses as vaccine platforms and as potential anti-cancer agents. Due to their ability to effectively induce both humoral and cell-mediated immune responses, viral vectors are deemed as an attractive alternative to the traditional platforms to deliver vaccine antigens as well as to specifically target and kill tumor cells. With potential targets ranging from cancers to a vast number of infectious diseases, the benefits resulting from successful application of viral vectors to prevent and treat human diseases can be immense.
In Europe, hemorrhagic fever with renal syndrome results mainly from infection with Puumala virus (PUUV) or Dobrava virus. For 31 patients from a hantavirus disease outbreak in Lower Bavaria, a district in southeast Germany, serodiagnosis was undertaken by enzyme-linked immunosorbent assay, immunofluorescence assay, and immunoblot analysis. In a few of these cases, however, PUUV-specific typing of antibodies by these standard assays failed and a virus neutralization assay under biosafety level 3 conditions was required to verify the infection by this virus type. PUUV RNA was amplified by reverse transcription-PCR from acute-phase sera of three patients and was found to be very closely related to virus sequences obtained from bank voles (Clethrionomys glareolus) trapped in the same area. These findings link the outbreak with a novel PUUV lineage, "Bavaria," circulating in the local rodent population. The Bavaria lineage associated with the outbreak is only distantly related to other PUUV lineages from Germany. PMID:17626170
Schilling, Stefan; Emmerich, Petra; Klempa, Boris; Auste, Brita; Schnaith, Ebbo; Schmitz, Herbert; Krüger, Detlev H; Günther, Stephan; Meisel, Helga
Coral disease is a major threat to the resilience of coral reefs; thus, understanding linkages between disease outbreaks and disturbances predicted to increase with climate change is becoming increasingly important. Coral disease surveys conducted twice yearly between 2008 and 2011 at a turbid inshore reef in the central Great Barrier Reef spanned two disturbance events, a coral bleaching event in 2009 and a severe cyclone (cyclone `Yasi') in 2011. Surveys of coral cover, community structure and disease prevalence throughout this 4-yr study provide a unique opportunity to explore cumulative impacts of disturbance events and disease for inshore coral assemblages. The principal coral disease at the study site was atramentous necrosis (AtN), and it primarily affected the key inshore, reef-building coral Montipora aequituberculata. Other diseases detected were growth anomalies, white syndrome and brown band syndrome. Diseases affected eight coral genera, although Montipora was, by far, the genus mostly affected. The prevalence of AtN followed a clear seasonal pattern, with disease outbreaks occurring only in wet seasons. Mean prevalence of AtN on Montipora spp. (63.8 % ± 3.03) was three- to tenfold greater in the wet season of 2009, which coincided with the 2009 bleaching event, than in other years. Persistent wet season outbreaks of AtN combined with the impacts of bleaching and cyclone events resulted in a 50-80 % proportional decline in total coral cover. The greatest losses of branching and tabular acroporids occurred following the low-salinity-induced bleaching event of 2009, and the greatest losses of laminar montiporids occurred following AtN outbreaks in 2009 and in 2011 following cyclone Yasi. The shift to a less diverse coral assemblage and the concomitant loss of structural complexity are likely to have long-term consequences for associated vertebrate and invertebrate communities on Magnetic Island reefs.
Haapkylä, J.; Melbourne-Thomas, J.; Flavell, M.; Willis, B. L.
Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600-1946); Continental plan for the eradication of the Ae. aegypti (1947-1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971-1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000-2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread. PMID:23042846
Brathwaite Dick, Olivia; San Martín, José L; Montoya, Romeo H; del Diego, Jorge; Zambrano, Betzana; Dayan, Gustavo H
Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600–1946); Continental plan for the eradication of the Ae. aegypti (1947–1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971–1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000–2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread.
Brathwaite Dick, Olivia; San Martin, Jose L.; Montoya, Romeo H.; del Diego, Jorge; Zambrano, Betzana; Dayan, Gustavo H.
Inactivated Marek's disease virus-infected chicken kidney cells and inactivated MSB-1 lymphoblastoid Marek's disease tumor cells were used to immunize chickens as virus- and tumor-associated antigens, respectively. Immune and nonimmune birds were then challenged by exposure to live virulent Marek's disease virus. Both vaccines protected significant numbers of chickens (P less than 0.05) against subsequent tumor development, although viral antigen appeared superior to tumor antigen. After challenge, the early appearance of viral antigen, infected lymphocytes, and degenerative changes in lymphoid organs was inhibited only by the viral antigen vaccine, whereas the early appearance of cells bearing tumor antigen was prevented by both vaccines. These results support the hypothesis that effective immunity in Marek's disease could be directed against either virus replication and spread or events associated with transformation and proliferation of lymphoid cells.
Murthy, K K; Calnek, B W
The contribution of bovine viral diarrhea viruses (BVDV) to the development of bovine respiratory disease is the sum of a number of different factors. These factors include the contribution of acute uncomplicated BVDV infections, the high incidence of respiratory disease in animals persistently inf...
Control of plant diseases caused by viruses, viroids and fastidious prokaryotes involves exclusion, eradication, protection and the use of resistant varieties. Development of serological and molecular techniques allows rapid diagnosis of diseases and reliable detection of causal agents. Accurate ide...
In this review the authors summarize the experimental data on the role of a selected group of metalloproteins, particularly viral (v) and cellular (c) zinc finger proteins (ZFP) and iron containing proteins which are involved in cell proliferation, neovascularization, apoptosis, and viral infection. Furthermore, this review summarizes the data embracing the hypothesis that disruption of certain metalloproteins by novel pharmacological agents is a key factor in controlling viral and proliferative diseases. The primary goal of this review is to show the potential therapeutic applications of ZFP disrupting agents, zinc chelators and iron chelators in the control of viral diseases and cancer. It is known that zinc or iron deficiency, resulting from exposure of culture cells to membrane-permeable Zn2+ or Fe(2+)-chelators, can induced apoptosis in virally transformed cells while normal cells remain unaffected under these conditions. Apoptosis is possibly due to simultaneous inactivation of vZFP, cZFP, and/or iron containing proteins, which are essential for maintenance of cellular and viral structure and which are activated in virally transformed cells. New insights concerning apoptosis, viral metalloproteins, and novel antiviral agents will also be reviewed. From the evidence reviewed, one can infer that development of a variety of drugs that control or neutralize vZFP may lead to a new therapeutic approach directed at controlling and preventing a wide spectrum of viral diseases and cancer. Furthermore, the results suggest that these agents may be useful to prevent transmission of viral diseases. Finally, this review not only points out the limits of our understanding of this system, but also directs scientists to opportunities for future research. PMID:11396187
Fernandez-Pol, J A; Hamilton, P D; Klos, D J
Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects 1% of the population above the age of 60. The cause of the disease remains unknown. The histopathological hallmarks of the disease are intracytoplasmic Lewy bodies and dopaminergic striatal insufficiency secondary to a loss of dopaminergic neurons in the substantia nigra pars compacta (SN). Pharmacological treatment options for PD are
Marina E. Emborg; Nicole Deglon; Liza Leventhal; Patrick Aebischer; Jeffrey H. Kordower
The clinical manifestation of most diseases of the central nervous system results from neuronal dysfunction or loss. Diseases such a stroke, epilepsy and neurodegeneration (e.g. Alzheimer’s disease and Parkinson’s disease) share common cellular and molecular mechanisms (e.g. oxidative stress, endoplasmic reticulum stress, mitochondrial dysfunction) that contribute to the loss of neuronal function. Neurotrophic factors (NTFs) are secreted proteins that regulate multiple aspects of neuronal development including neuronal maintenance, survival, axonal growth and synaptic plasticity. These properties of NTFs make them likely candidates for preventing neurodegeneration and promoting neuroregeneration. One approach to delivering NTFs to diseased neurons is through viral vector-mediated gene delivery. Viral vectors are now routinely used as tools for studying gene function as well as developing gene-based therapies for a variety of diseases. Currently, many clinical trials using viral vectors in the nervous system are underway or completed, and seven of these trials involve NTFs for neurodegeneration. In this review, we discuss viral vector-mediated gene transfer of NTFs to treat neurodegenerative diseases of the central nervous system.
Lim, Seung; Airavaara, Mikko; Harvey, Brandon K.
Reaching farmers with information is important when eradicating outbreaks of contagious diseases, the actions they take related to contacts and biosecurity, as well as early notification of disease can have a significant effect on limiting the spread of disease. The aim of this study was to investigate Swedish pig farmers' disease awareness, information retrieval and if they change their biosecurity routines during an outbreak of an exotic infectious disease, using the experience from the first outbreak of PRRS in Sweden in 2007. Data were collected through a questionnaire to 153 farmers. Our findings indicate that written information which was sent to all farmers was not sufficient. Herd size, as an indicator for the type of farmer, was significantly associated with awareness. Farmers with medium or large herds were more aware there had been an outbreak (OR 32.3, p=0.001), of the means of spread and the signs of disease, and they were more active in information search compared to farmers with small herds. Closeness to the outbreak was important for motivating farmers to actively search for information. The results from this study could be useful when planning information campaigns during future outbreaks and when modelling disease outbreaks. PMID:19376601
Nöremark, Maria; Lindberg, Ann; Vågsholm, Ivar; Sternberg Lewerin, Susanna
We examine the emergence, development, and value of regional infectious disease surveillance networks that neighboring countries worldwide are organizing to control cross-border outbreaks at their source. The regional perspective represented in the paper is intended to serve as an instructive framework for others who decide to launch such networks as new technologies and emerging threats bring countries even closer together. Distinct from more formal networks in geographic regions designated by the World Health Organization (WHO), these networks usually involve groupings of fewer countries chosen by national governments to optimize surveillance efforts. Sometimes referred to as sub-regional, these “self-organizing” networks complement national and local government recognition with informal relationships across borders among epidemiologists, scientists, ministry officials, health workers, border officers, and community members. Their development over time reflects both incremental learning and growing connections among network actors; and changing disease patterns, with infectious disease threats shifting over time from local to regional to global levels. Not only has this regional disease surveillance network model expanded across the globe, it has also expanded from a mostly practitioner-based network model to one that covers training, capacity-building, and multidisciplinary research. Today, several of these networks are linked through Connecting Organizations for Regional Disease Surveillance (CORDS). We explore how regional disease surveillance networks add value to global disease detection and response by complementing other systems and efforts, by harnessing their power to achieve other goals such as health and human security, and by helping countries adapt to complex challenges via multi-sectoral solutions. We note that governmental commitment and trust among participating individuals are critical to the success of regional infectious disease surveillance networks.
Bond, Katherine C.; Macfarlane, Sarah B.; Burke, Charlanne; Ungchusak, Kumnuan; Wibulpolprasert, Suwit
Spring viraemia of carp (SVC) is a fatal viral disease for cyprinid fish, which is caused by spring viraemia of carp virus (SVCV). To date, no SVC outbreak has been reported in China. Between 1998 and 2002, outbreaks of SVC were reported in ornamental and wild fish in Europe and America, imported from multiple sources including China. Based on phylogenetic analysis, the viral strain isolated from America was shown to be originated from Asia. These outbreaks not only resulted in huge economic losses, but also raise an interesting question as to whether SVCV really exists in China and if so, is it responsible for SVC outbreaks? From 2002 to 2006, we screened 6700 samples from ornamental fish farms using the cell culture method of the Office International des Epizooties (OIE), and further verified the presence of SVCV by ELISA and real-time quantitative RT-PCR. Two infected samples were found and the complete genome of SVCV was sequenced from one of the isolates, termed SVCV-C1. Several unique hallmarks of SVCV-C1 were identified, including six amino acid (KSLANA) insertion in the viral RNA-dependent RNA polymerase (L) protein and ten nucleotide insertion in the region between glycoprotein (G) and L genes in European SVCV strains. Phylogenetic tree analysis of the full-length G protein of selected SVCV isolates from the United Kingdom and United States revealed that G proteins could be classified into Ia and Id sub genogroups. The Ia sub genogroup can be further divided into newly defined sub genogroups Ia-A and Ia-B. The isolates derived from the United States and China including the SVCV-C1 belongs to in the Ia-A sub genogroup. The SVCV-C1 G protein shares more than 99% homology with the G proteins of the SVCV strains from England and the United States, making it difficult to compare their pathogenicity. Comparison of the predicted three-dimensional structure based on the published G protein sequences from five SVCV strains revealed that the main differences were in the loops of the pleckstrin homology domains. Since SVCV is highly pathogenic, we speculate that SVC may therefore pose a serious threat to farmed cyprinid fish in China.
Jiang, Yi Nan; Zhang, Ting; Xia, Chun
Global leptospirosis disease burden estimates are hampered by the lack of scientifically sound data from countries with probable high endemicity and limited diagnostic capacities. We describe the seroepidemiologic and clinical characteristics of the leptospirosis outbreak in 2008 in Sri Lanka. Definitive/presumptive case definitions proposed by the World Health Organization Leptospirosis Epidemiology Reference Group were used for case confirmation. Of the 404 possible cases, 155 were confirmed to have leptospirosis. Highest titers of patient seum samples reacted with serovars Pyrogenes (28.7%), Hardjo (18.8%), Javanica (11.5%), and Hebdomadis (11.5%). Sequencing of the 16S ribosomal DNA gene identified six infections: five with Leptospira interrogans and one with L. weilli. In this patient population, acute renal failure was the main complication (14.8%), followed by myocarditis (7.1%) and heart failure (3.9%). The case-fatality rate was 1.3%. This report strengthens the urgent need for increasing laboratory diagnostic capabilities to determine the causes of epidemic and endemic infectious diseases in Sri Lanka, a finding relevant to other tropical regions.
Agampodi, Suneth B.; Peacock, Sharon J.; Thevanesam, Vasanthi; Nugegoda, Danaseela B.; Smythe, Lee; Thaipadungpanit, Janjira; Craig, Scott B.; Burns, Mary Ann; Dohnt, Michael; Boonsilp, Siriphan; Senaratne, Thamarasi; Kumara, Athula; Palihawadana, Paba; Perera, Sahan; Vinetz, Joseph M.
In recent years controversial discussions arose during major animal disease outbreaks in the EU about the ethical soundness of mass culling. In contrast to numerous publications about ethical issues and laboratory animals/animal experiments, literature concerning ethical deliberations in the case of mass culling as a means of outbreak control remain scarce. Veterinarians in charge of decision about and implementation of mass culling actions find themselves in an area of conflict in between the officially required animal disease control policy and a public that is increasingly critical. Those veterinarians are faced with the challenge to defend the relevant decisions against all stakeholders and also themselves. In this context an interdisciplinary workshop was initiated in Switzerland in October 2007 with ethicians and (official) veterinarians from Germany, Switzerland and Austria. With the aim to identify ethical components of animal disease control for official veterinarians, talks and moderated group discussions took place. This article summarizes selected discussion points and conclusions. PMID:19425316
Hartnack, Sonja; Doherr, Marcus G; Grimm, Herwig; Kunzmann, Peter
Rapid detection of outbreaks is recognized as crucial for effective control measures and has particular relevance with the recently increased concern about bioterrorism. Automated analysis of electronically collected laboratory data can result in rapid detection of widespread outbreaks or outbreaks of pathogens with common signs and symptoms. In the Netherlands, an automated outbreak detection system for all types of pathogens has been developed within an existing electronic laboratory-based surveillance system called ISIS. Features include the use of a flexible algorithm for daily analysis of data and presentation of signals on the Internet for interpretation by health professionals. By 2006, the outbreak detection system will analyze laboratory-reported data on all pathogens and will cover 35% of the Dutch population.
Bosman, Arnold; van Straten, Edward; Tinga, Mark; Chaves, Sandra; van Eerden, Liesbeth; van Pelt, Wilfred
Background During severe acute respiratory syndrome (SARS) outbreak in Toronto, outpatient clinics at SickKids Hospital were closed to prevent further disease transmission. In response, a decision was made by the neonatal neuro-developmental follow up (NNFU) clinic staff to select patients with scheduled appointments to have a mail/telephone assessment using Ages and Stages Questionnaire (ASQ) or to postpone/skip their visit. The objective of this study was to compare the developmental assessment and its outcome in two groups of NNFU clinic patients, SARS versus non-SARS, over three standard clinic appointments. Methods We compared the diagnostic accuracy (identification of developmental delay), and patient management (referral for therapy or communication of a new diagnosis) of the strategies used during SARS, April/May 2003, to the standard assessment methods used for patients seen in April/May 2005 (non-SARS). In all cases data were obtained for 3 patient visits: before, during and after these 2 months and were compared using descriptive statistics. Results There were 95 patients in the SARS group and 99 non-SARS patients. The gestational age, sex, entry diagnosis and age at the clinic visit was not different between the groups. The NNFU clinic staff mailed ASQ to 27 families during SARS, 17 (63%) were returned, and 8 of the 17 were then contacted by telephone. Criteria used to identify infants at risk selected for either mailed ASQ or phone interviews were not clearly defined in the patients' charts. There was a significant under identification of developmental delay during SARS (18% versus 45%). Of those who responded to the mailed questionnaire, referrals for therapy rates were similar to non-SARS group. The lost to follow up rate was 24% for the SARS group compared with 7% for non-SARS. There was no difference in the overall rate of developmental delay in the two groups as identified at the 'after' visit. Conclusions Poor advanced planning led to a haphazard assessment of patients during this infectious disease outbreak. Future pandemic plans should consider planning for outpatient care as well as in hospital management of patients.
Preface New technologies have widened our view of “complex diseases”--diseases with both genetic and environmental risk factors. Here, we explore recent genetic and virologic evidence implicating host-virus interactions in three diseases—type 1 diabetes, inflammatory bowel disease, and asthma. In these examples, the viruses implicated in disease are mucosal infections that affect most of the population and that are asymptomatic or mild in many hosts. These findings place a new emphasis on common viral infections as an important environmental factor in complex disease pathogenesis, and they compel us to pursue a better understanding of host interactions with the human virome.
Foxman, Ellen F.; Iwasaki, Akiko
Many epidemiologic studies have shown excessive respiratory disease morbidity in areas of high atmospheric pollution. This study was designed to develop and characterize an animal model and investigate the possible interactive effects of infection and particulate air pollutants u...
Links to the Ongoing Investigations of the Coordinated Outbreak Response and Evaluation (CORE) Network sorted by year. More results from www.fda.gov/food/recalls,%20outbreaks%20&%20emergencies/outbreaks
Because Parkinson’s disease is a progressive degenerative disorder that is mainly confined to the basal ganglia, gene transfer to deliver therapeutic molecules is an attractive treatment avenue. The present review focuses on direct in vivo gene transfer vectors that have been developed to a degree that they have been successfully used in animal model of Parkinson’s disease. Accordingly, the properties of recombinant adenovirus, recombinant adeno-associated virus, herpes simplex virus, and lentivirus are described and contrasted. In order for viral vectors to be developed into clinical grade reagents, they must be manufactured and tested to precise regulatory standards. Indeed, clinical lots of viral vectors can be produced in compliance with current Good Manufacturing Practices (cGMPs) regulations using industry accepted manufacturing methodologies, manufacturing controls, and quality systems. The viral vector properties themselves combined with physiological product formulations facilitate long-term storage and direct in vivo administration.
Burger, Corinna; Snyder, Richard O.
An enhanced methodology for the policy-level prioritization of intervention options during carcass disposal is presented. Pareto charts provide a semiquantitative analysis of opportunities for multiple exposures to human health, animal health, and the wider environment during carcass disposal; they identify critical control points for risk management and assist in waste technology assessment. Eighty percent of the total availability of more than 1300 potential exposures to human, animal, or environmental receptors is represented by 16 processes, these being dominated by on-farm collection and carcass processing, reinforcing the criticality of effective controls during early stages of animal culling and waste processing. Exposures during mass burials are dominated by ground- and surface-water exposures with noise and odor nuisance prevalent for mass pyres, consistent with U.K. experience. Pareto charts are discussed in the context of other visualization formats for policy officials and promoted as a communication tool for informing the site-specific risk assessments required during the operational phases of exotic disease outbreaks. PMID:20536266
Delgado, João; Longhurst, Phil; Hickman, Gordon A W; Gauntlett, Daniel M; Howson, Simon F; Irving, Phil; Hart, Alwyn; Pollard, Simon J T
In September and October 1981 six cases of pneumonia occurred among men working in a power station under construction. Three were identified as cases of legionella pneumonia and two others had serology suggestive of legionella infection. In a sample of 92 men from the site 10 had low levels of antibodies to legionella; a similar sample of men working on an adjacent site showed none with positive serology. In a case control study it was found that cases of pneumonia were more likely than controls to have worked on a part of the site where four small capacity cooling towers were located. Legionella pneumophila serogroup 1 was isolated from the water systems of these four towers but was not found in samples from any other cooling towers or hot or cold water outlets on the site. It would appear that there was airborne spread of the organism from these cooling water systems which had not received conventional treatment to inhibit corrosion and organic growth. This is the first outbreak of legionnaires' disease to be recorded in an industrial setting in the United Kingdom. No cases of legionella infection have occurred on the site since the introduction of control measures.
Morton, S; Bartlett, C L; Bibby, L F; Hutchinson, D N; Dyer, J V; Dennis, P J
The effect of a localized viral infection on the occurrence of graft-vs.-host disease (GVHD) was examined in allogeneic rat bone marrow chimeras (ACI/LEW). Animals without clinical evidence of GVHD, 62 days after bone marrow transplant, were infected in salivary and lacrimal glands with sialodacryoadenitis virus (SDAV), and sacrificed 8-25 days postinfection. Using established histologic criteria, GVHD was found more frequently in salivary and lacrimal glands of SDAV-infected chimeras than uninfected chimeras. Skin and oral mucosa, tissues not infected by the virus, showed no differences in occurrence of GVHD, suggesting that the viral infection induced only local and not systemic GVHD. GVHD and SDAV infection, which are histologically similar, were differentiated by examining tissues for SDAV antigen using immunoperoxidase technique. Histologic changes were present for at least 1 week longer than viral antigen, suggesting they represented GVHD rather than viral infection. GVHD and SDAV infection were also differentiated by looking for a histologic feature characteristic of GVHD and not found in SDAV infection (periductal lymphocytic infiltrate). This was found in SDAV-infected chimeras more frequently than uninfected chimeras, suggesting that the viral infection somehow induced GVHD. Results showed a localized increase in the occurrence of GVHD subsequent to localized viral infection.
Rossie, K.M.; Sheridan, J.F.; Barthold, S.W.; Tutschka, P.J.
Flavobacterium psychrophilum infections cause high mortality among rainbow trout, Oncorhynchus mykiss, fry in Danish fish farms and hatcheries. Hatcheries based entirely on bore-hole water recirculation systems have been suggested as a possibility for eliminating F. psychrophilum or at least keeping the amount of this bacterium low. The occurrence of the bacterium in a bore-hole water recirculation system was compared with a combined bore-hole water and stream water flow-through system in a hatchery where outbreaks of rainbow trout fry syndrome caused by F. psychrophilum often occurred. Broodfish, unfertilized and fertilized eggs, eyed eggs and fry, as well as water samples from the tanks/troughs with broodfish/fry, were examined. Suspect yellow bacterial colonies were either confirmed or rejected as F. psychrophilum by growth characteristics and by PCR. As both virulent and less virulent F. psychrophilum isolates are known, isolates were characterized. The isolates were ribotyped and grouped according to ribotyping patterns. Representatives of the groups were serotyped. Fry isolates were very homogeneous whereas isolates from broodfish were heterogeneous, whether the isolates originated from external surfaces of the fish (mucus from skin and gills, haemorrhages and ulcers) or internal organs. Flavobacterium psychrophilum was isolated from broodfish in both water systems; 56% of investigated broodfish from the borehole/flowthrough system and 36% from the recirculation facility harboured the bacterium. In the recirculation system, the bacterium was isolated from fish (ulcers, milt, liver, abdominal cavity) kept in the system for 11 months. Flavobacterium psychrophilum was found in milt and ovarian fluid as well as on the surface of fertilized eggs, but not inside the eggs. Fry also harboured F. psychrophilum, but in the water recirculation system the bacterium was first isolated from the fry after they had been graded. Flavobacterium psychrophilum was found regularly in other parts of the hatchery (outside the recirculation facility), including at the time of grading, suggesting that the occurrence of F. psychrophilum in the fry recirculation facility was due to contamination from the borehole/flow-through hatchery. It is suggested that the combination of bore-hole water recirculation systems and good management procedures (including egg disinfection) is a possible method for hatcheries to avoid disease outbreaks due to F. psychrophilum. PMID:19238756
Madsen, L; Dalsgaard, I
Fatty acid profile analysis, monoclonal antibody (MAb) subtyping, pulsed-field gel electrophoresis (PFGE), arbitrarily primed polymerase chain reaction (AP-PCR), and ribotyping were used to compare clinical and environmentalLegionella pneumophila serogroup 1 isolates from an outbreak of Legionnaires' disease presumptively associated with cooling towers. According to the Oxford subtyping scheme, the MAb subtype of patients' isolates and of two strains originating from
M. Castellani Pastoris; L. Ciceroni; R. Lo Monaco; P. Goldoni; B. Mentore; G. Flego; L. Cattani; S. Ciarrocchi; A. Pinto; P. Visca
Two outbreaks of intestinal infectious disease occurred due to contaminations of Two-time pressure water supply at Hai-zhou and Tai-ping districts in 1985 and 1986. There were 659 cases, the incidence rate was 55%. The cause of contamination was that the underground water storage tanks were contaminated by domestic sewage, which back-flowed into the tanks through an overflow pipe, connecting the tank with observation well of the sewage system. PMID:2786465
Liu, S Y
Emergency control of disease vectors requires high efficacy, rapid reaction and safe use of biocides in order interrupt transmission\\u000a cycles without harming humans, non-target animals and the environment. In countries with complex emergencies, air-borne large-scale\\u000a vector control is often limited, or impossible, due to questionable security as well as military, safety, equipment, or logistical\\u000a constraints. While facing a potential outbreak
M. K. Faulde; J. J. Scharninghausen; M. Tisch
Summary. ?Newcastle disease virus (NDV) strains, isolated from outbreaks during epizootics between 1992 and 1996 in Western European\\u000a countries, were compared by restriction enzyme cleavage site mapping of the fusion (F) protein gene between nucleotides 334\\u000a and 1682 and by sequence analysis between nucleotides 47 and 435. Both methods revealed that NDV strains responsible for these\\u000a epizootics belong to two distinct
B. Lomniczi; E. Wehmann; J. Herczeg; A. Ballagi-Pordány; E. F. Kaleta; O. Werner; G. Meulemans; P. H. Jorgensen; A. P. Manté; A. L. J. Gielkens; I. Capua; J. Damoser
Viruses pose serious threat to the health and well-being of honey bees, Apis mellifera, the most economically valuable pollinators of agricultural and horticultural crops worldwide. Lately, honey bee viruses have gotten a lot of international attention due to the significant disease status that vir...
Serum amylase and lipase concentrations weredetermined in 78 patients with chronic liver diseases[26 chronic active hepatitis (CAH) and 52 livercirrhosis] and in 15 healthy subjects. Pancreaticisoamylase concentrations and macroamylase complexes wereassayed in hyperamylasemic sera. Serum amylase levelswere abnormally elevated in 27 patients (35%; 22 livercirrhosis, 5 CAH), whereas serum lipase levels were elevated in 16 patients (21%; 15 livercirrhosis, 1
Raffaele Pezzilli; Pietro Andreone; Antonio Maria Morselli-Labate; Claudia Sama; Paola Billi; Carmela Cursaro; Bahjat Barakat; Annagiulia Gramenzi; Manuela Fiocchi; Federico Miglio; Mauro Bernardi
Pathogens causing bovine respiratory tract disease in Finland were investigated. Eighteen cattle herds with bovine respiratory disease were included. Five diseased calves from each farm were chosen for closer examination and tracheobronchial lavage. Blood samples were taken from the calves at the time of the investigation and from 86 calves 3–4 weeks later. In addition, 6–10 blood samples from animals of different ages were collected from each herd, resulting in 169 samples. Serum samples were tested for antibodies to bovine parainfluenza virus-3 (PIV-3), bovine respiratory syncytial virus (BRSV), bovine coronavirus (BCV), bovine adenovirus-3 (BAV-3) and bovine adenovirus-7 (BAV-7). About one third of the samples were also tested for antibodies to bovine virus diarrhoea virus (BVDV) with negative results. Bacteria were cultured from lavage fluid and in vitro susceptibility to selected antimicrobials was tested. According to serological findings, PIV-3, BAV-7, BAV-3, BCV and BRSV are common pathogens in Finnish cattle with respiratory problems. A titre rise especially for BAV-7 and BAV-3, the dual growth of Mycoplasma dispar and Pasteurella multocida, were typical findings in diseased calves. Pasteurella sp. strains showed no resistance to tested antimicrobials. Mycoplasma bovis and Mannheimia haemolytica were not found.
Hartel, H; Nikunen, S; Neuvonen, E; Tanskanen, R; Kivela, S-L; Aho, P; Soveri, T; Saloniemi, H
A variety of nonhuman primate species can be used in model infections for studying hemorrhagic viral and rickettsial diseases. While the rhesus is the most widely used monkey species, it is not always the one of choice. A considerable search (using differ...
W. R. Beisel
DNA of Marek disease virus (MDV) consists of two unique regions UL and US flanked by long inverted repeat regions TRL and IRL, and short inverted repeat regions TRS and IRS, respectively, similar to herpes simplex virus DNA. Comparison of restriction patterns between pathogenic and nonpathogenic MDV DNA was made to identify a region of viral DNA different between these
K. Fukuchi; A. Tanaka; L. W. Schierman; R. L. Witter; M. Nonoyama
Despite the high clinical impact of established and emerging respi- ratory viruses, some critical aspects of the host response to these pathogens still need to be defined. In that context, we aimed at two major issues: first, what are the innate immune mechanisms that control common respiratory viral infections; and second, whether these mechanisms also cause long-term airway disease. Using
Michael J. Holtzman; Jeffrey W. Tyner; Edy Y. Kim; Mindy S. Lo; Anand C. Patel; Laurie P. Shornick; Eugene Agapov; Yong Zhang
Infectious disease outbreaks, epidemics, and subsequent pandemics are not typical disasters in the sense that they often lack clearly delineated phases. As in any event that is biological in nature, its onset may be gradual with signs and symptoms that are so subtle that they go unrecognized, thus missing opportunities to invoke an early response and implement containment strategies. An infectious disease outbreak-whether caused by a novel virus, a particularly virulent influenza strain, or newly emerging or resistant bacteria with the capability of human-to-human transmission--can quickly degrade a community's healthcare infrastructure in advance of coordinated mitigation, preparation, and response activities. The Transitional Medical Model (TMM) was developed to aid communities with these crucial phases of disaster response as well as to assist with the initial steps within the recovery phase. The TMM is a methodology that provides a crosswalk between the routine operations and activities of a community's public health infrastructure with action steps associated with the mitigation, preparedness, response, and recovery phases of an infectious disease outbreak. PMID:20496640
Rega, Paul; Bork, Christopher; Bisesi, Michael; Gold, Jeffrey; Burkholder-Allen, Kelly
The Lisbon's Zoological Garden, Portugal, has maintained for many years a large collection of psittacine birds without any serious health problems. Unexpectedly, in April 1999, a total of nine macaws died after a short period of illness. Clinical signs consisted mainly of anorexia, ruffled feathers and yellowish droppings. A herpesvirus was isolated from brain, trachea, lung, liver, spleen, kidney and intestine of each of the examined dead birds, confirming that all animals succumbed during viraemia. Serotyping of the isolate in cross neutralization tests with reference sera prove that the outbreak was caused by serotype 3 of Pacheco's parrot disease herpesviruses. An autogenous, formalin-inactivated vaccine with adjuvant (aluminium hydroxid gel) was prepared from one of the isolates and injected intramuscularly 14 days and six weeks after the onset of mortality in an attempt to protect the remaining psittacine birds in the zoo from the disease. The autogenous vaccine was well tolerated and was able to rapidly stop virus spread and morbidity and mortality among the psittacine birds. Follow-up studies demonstrate that all nine blood samples from vaccinated birds obtained nine month' after the second vaccination contain neutralizing antibodies. Twenty five month' after vaccination two out of four serum samples were still antibody positive. No herpesvirus was isolated from faecal samples nine and twenty five months after the onset of the outbreak. These data prove that the autogenous vaccine played a major role in containing a severe outbreak of Pacheco's parrot disease in a large collection of psittacine birds. PMID:18077933
Barão Da Cunha, M; Correia, J J; Fagulha, T; Fevereiro, M; Peleteiro, M C; Vollrath, G; Kaleta, E F
The Foodborne Disease Outbreak Surveillance System reviews data on FBDOs, defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. State and local public health departments have primary responsibil...
C. Braden J. Painter M. Lynch R. Woodruff
BACKGROUND: Reverse transcription-polymerase chain reaction (RT-PCR) is the main method for laboratory diagnosis of norovirus-associated infectious intestinal disease (IID). However, up to 16% of healthy individuals in the community, with no recent history of IID, may be RT-PCR positive; so it is unclear whether norovirus is actually the cause of illness in an IID case when they are RT-PCR positive.
Gemma Phillips; Ben Lopman; Clarence C Tam; Miren Iturriza-Gomara; David Brown; Jim Gray
The first reported outbreak of bovine viral diarrhea (BVD) in 1946 described a transmissible acute disease characterized by severe leukopenia, high fever, gastrointestinal erosions and hemorrhages. However, in the ensuing years, the most commonly observed acute form of BVD was clinically mild. There was limited viral shed and spread following these acute infections. This led to the assumptions that acute
Julia F. Ridpath; John D. Neill; Stefan Vilcek; Edward J. Dubovi; Suzanne Carman
With the severe acute respiratory syndrome epidemic of 2003 and renewed attention on avian influenza viral pandemics, new surveillance systems are needed for the earlier detection of emerging infectious diseases. We applied a “next-generation” parallel sequencing platform for viral detection in nasopharyngeal and fecal samples collected during seasonal influenza virus (Flu) infections and norovirus outbreaks from 2005 to 2007 in
Shota Nakamura; Cheng-Song Yang; Naomi Sakon; Mayo Ueda; Takahiro Tougan; Akifumi Yamashita; Naohisa Goto; Kazuo Takahashi; Teruo Yasunaga; Kazuyoshi Ikuta; Tetsuya Mizutani; Yoshiko Okamoto; Michihira Tagami; Ryoji Morita; Norihiro Maeda; Jun Kawai; Yoshihide Hayashizaki; Yoshiyuki Nagai; Toshihiro Horii; Tetsuya Iida; Takaaki Nakaya; Peter Sommer
The prevalence of various viral infections was examined in primary accession cases of feline lower urinary tract disease (FLUTD) and healthy control cats in Norway. Urine samples from 102 cats with clinical signs of FLUTD and 73 healthy control cats were tested for the presence of feline calicivirus (FCV), feline coronavirus (FCoV) and feline herpesvirus-1 (FHV-1) by polymerase chain reaction. All urinary samples were negative for FCV and FCoV. One (1%) of the FLUTD cats was found to be positive for FHV-1. The results did not indicate an association between the viral infections examined and signs of FLUTD in the study sample. PMID:22983453
Lund, Heidi Sjetne; Rimstad, Espen; Eggertsdóttir, Anna Vigdís
Reaching farmers with information is important when eradicating outbreaks of contagious diseases, the actions they take related to contacts and biosecurity, as well as early notification of disease can have a significant effect on limiting the spread of disease. The aim of this study was to investigate Swedish pig farmers’ disease awareness, information retrieval and if they change their biosecurity
Maria Nöremark; Ann Lindberg; Ivar Vågsholm; Susanna Sternberg Lewerin
Contents: Surveillance of viral respiratory diseases and rotaviruses in Huntington, West Virginia; Surveillance of Haemophilus influenzae disease; Number of volunteers - summary table; Evaluation of the ts-2 mutant of RSV; Evaluation of meningococcal sero...
R. B. Belshe E. L. Anderson
Transmission of a dangerous infectious disease threatens not merely a local population but the world at large as the result of immigration and increased and faster travel. Any outbreak elicits considerable concern and demands that various precautionary methods be instituted and that the disease be contained as quickly as possible. Recently, an old disease, one that may have been present for centuries and was identified decades ago, reared its ugly head, killing more than 200 people before it was contained. Fortunately, the disease, Marburg hemorrhagic fever, was limited to a small geographic area, but the devastation of lives was much greater than that of many epidemics and was a warning of the numerous factors, including fear, lack of understanding, and deception, that can exacerbate the spread of disease and hinder implementation of restraints. This article reviews the history of the disease caused by Marburg virus and its biological components. PMID:16044395
Ligon, B Lee
Women with viral chronic hepatitis generally do quite well during pregnancy, providing that they have not progressed to decompensated cirrhosis. As a general rule, a stable liver equals a safe pregnancy. However, concern is about how pre-existing chronic liver disease may affect the pregnancy and the unborn baby. This review plans to answer some key questions regarding this issue in order to provide to healthcare professionals updated information of the current knowledge in this field. Besides, a synopsis of the following subject matters are reviewed, for instance, the main risk factors associated with vertical transmission of HBV and HCV in pregnant women chronically infected, the influence of pregnancy on HBV and HCV viral load and the effect of pregnancy on the clinical course of chronic hepatitis. Lastly, it is included a list of recommendations to decrease vertical transmission rates of chronic viral hepatitis as well as some information for the reproduction team. PMID:17060881
An outbreak of human illness caused by Mayaro (MAY) virus occurred in Belterra, Pará, Brazil in the first half of 1978. A total of 55 cases were confirmed, 43 by virus isolation and serology, and 12 by serology alone. The disease in Belterra presented as a distinct clinical syndrome characterized by fever, arthralgia and exanthema. No fatalities could be attributed to MAY virus infection. Arthralgia, accompanied by joint edema in 20% of cases, was a very prominent sign which caused temporary incapacity in many patients. Arthralgia was present in virtually all confirmed cases and persisted in some for at least 2 months, although with decreasing severity. Rash was present in two-thirds of the cases, and was either maculopapular or micropapular. The incidence of rash was higher in children than in adults. Contrary to arthralgia, which started with the onset of clinical illness, rash usually appeared on the 5th day and faded within 3-4 days. Fever, chills, headache, myalgia, lymph-adenopathy and other minor clinical manifestations were also recorded, and generally persisted for from 2-5 days. Leucopenia was a constant finding in all cases. Mild albuminuria was seen in four of 25 patients, and slight thrombocytopenia was seen in 10 of 20 cases. The fact that viremia levels higher tha 5.0 log10/1.0 ml of blood were recorded in 10 patients rises the possibility that man may have be an amplifying host in the MAY virus cycle. The MAY virus illness, as seen in Belterra, has clinical features similar to those observed in persons infected with chikungunya virus. PMID:6266263
Pinheiro, F P; Freitas, R B; Travassos da Rosa, J F; Gabbay, Y B; Mello, W A; LeDuc, J W
Disease outbreaks characterized by reproductive failure and\\/or neurologic disorders, which are commonly referred as “Porcine Reproductive and Neurologic Syndrome (PRNS)”, were observed in many swine farms in Iowa and other states. Although an infectious cause was suspected to account for the disease, no conclusive diagnosis had been reached with respect to conventional infectious agents. Extensive laboratory diagnostic investigation on suspect
Roman M. Pogranichniy; Kent J. Schwartz; Kyoung-Jin Yoon
Rift Valley fever (RVF) is a serious viral disease of animals and humans in Africa and the Middle East that is transmitted by mosquitoes. First isolated in Kenya during an outbreak in 1930, subsequent outbreaks have had a significant impact on animal and human health, as well as national economies. ...
Rift Valley fever (RVF) is a serious viral disease of animals and humans in Africa and the Middle East that is transmitted by mosquitoes. First isolated in Kenya during an outbreak in 1930 subsequent outbreaks have had a significant impact on animal and human health and national economies, and it is...
Epidemiological investigations of an outbreak of Mayaro (MAY) virus which occurred inthe rural village of Belterra, Pará, Brazil are reported. Human cases were first recorded in December 1977 and continued through June 1978. Approximately 20% of the more than 4,000 persons resident in Belterra were infected, and a very high proportion of those infected suffered overt clinical illness. Cases were identified in all areas of Belterra and among all age groups; however, the greatest number of cases was seen among those who resided in close proximity to the forests. Yellow fever (YF) virus was also active in Belterra concurrently with the MAY virus outbreak. Six human cases of YF were identified, of which five were fatal. The YF outbreak ended following YF vaccination of the human population. PMID:6266264
LeDuc, J W; Pinheiro, F P; Travassos da Rosa, A P
The literature of the outbreaks of 'epidemic neuromyasthenia' (ENM) from 1934 to 1955 has been selected to show that the disease affects other people besides young adult females in hospitals and nursing homes. There have been district epidemics, in which the male: female ratio was almost even and several male outbreaks affecting soldiers in barracks. Some outbreaks appear to have
J. G. Parish
The correlation between bovine leukemia virus (BLV) unintegrated DNA, viral expression, and stage of disease was determined in cattle naturally infected with BLV. The concomitant presence of unintegrated BLV DNA with viral transcriptional activity was observed in 53% (18 of 34) of hematologically normal, BLV-seropositive cattle and in 100% (10 of 10) of BLV-seropositive cattle with the preneoplastic syndrome persistent lymphocytosis. In vitro studies suggested that accumulation of unintegrated BLV DNA resulted from a process of reinfection rather than intracellular reverse transcription of newly synthesized BLV RNA. Interestingly, unintegrated BLV DNA was not detected in tumor cells from cattle with BLV-associated lymphocytic leukemia/malignant lymphoma despite viral transcriptional activity in 100% (eight of eight) of these cattle. Thus, the presence of unintegrated BLV DNA differentiated nonneoplastic from neoplastic conditions in BLV-infected cattle. These results demonstrate that unintegrated viral DNA serves as a marker of disease progression in BLV-infected cattle but is not necessarily associated with induction or maintenance of the neoplastic state.
Reyes, R A; Cockerell, G L
Isolates from the 2002-2003 virulent Newcastle disease virus (v-NDV) outbreak in southern California, Nevada, Arizona, and Texas in the United States were compared to each other along with recent v-NDV isolates from Mexico and Central America and reference avian paramyxovirus type 1 strains. Nucleotide sequencing and phylogenetic analyses were conducted on a 1,195-base genomic segment composing the 3? region of the matrix (M) protein gene and a 5? portion of the fusion (F) protein gene including the M-F intergenic region. This encompasses coding sequences for the nuclear localization signal of the M protein and the F protein cleavage activation site. A dibasic amino acid motif was present at the predicted F protein cleavage activation site in all v-NDVs, including the California 2002-2003, Arizona, Nevada, Texas, Mexico, and Central America isolates. Phylogenetic analyses demonstrated that the California 2002-2003, Arizona, Nevada, and Texas viruses were most closely related to isolates from Mexico and Central America. An isolate from Texas obtained during 2003 appeared to represent a separate introduction of v-NDV into the United States, as this virus was even more closely related to the Mexico 2000 isolates than the California, Arizona, and Nevada viruses. The close phylogenetic relationship between the recent 2002-2003 U.S. v-NDV isolates and those viruses from countries geographically close to the United States warrants continued surveillance of commercial and noncommercial poultry for early detection of highly virulent NDV.
Pedersen, Janice C.; Senne, Dennis A.; Woolcock, Peter R.; Kinde, Hailu; King, Daniel J.; Wise, Mark G.; Panigrahy, Brundaban; Seal, Bruce S.
In 1999 an outbreak involving 188 patients with Legionnaires' disease (LD) occurred among visitors to a flower show in the Netherlands. Two enzyme immunoassays (Binax and Biotest) and one immunochromatographic assay (Binax NOW) were tested, using urine samples from LD patients from the 1999 outbreak. Sensitivity was calculated using positive culture and/or seroconversion as the “gold standard” in outbreak-related patients with radiographically confirmed pneumonia who fulfilled the epidemiological critera. The Binax EIA, Biotest EIA, and Binax NOW assay showed overall sensitivities of 69, 71, and 72%, respectively. When the tests were performed with concentrated urine samples, the overall sensitivities increased to 79, 74, and 81%, respectively. Using multiple logistic regression analysis with backward elimination, a statistically significant association was found between clinical severity and test sensitivity for all tests. For patients with mild LD, the test sensitivities ranged from 40 to 53%, whereas for patients with severe LD who needed immediate special medical care, the sensitivities reached 88 to 100%. These findings have major implications for the diagnostic process in patients with mild pneumonia and suggest that patients with mild pneumonia may go underdiagnosed if urine antigen tests alone are used.
Yzerman, Ed P. F.; Boer, Jeroen W. den; Lettinga, Kamilla D.; Schellekens, Joop; Dankert, Jacob; Peeters, Marcel
In 1999 an outbreak involving 188 patients with Legionnaires' disease (LD) occurred among visitors to a flower show in the Netherlands. Two enzyme immunoassays (Binax and Biotest) and one immunochromatographic assay (Binax NOW) were tested, using urine samples from LD patients from the 1999 outbreak. Sensitivity was calculated using positive culture and/or seroconversion as the "gold standard" in outbreak-related patients with radiographically confirmed pneumonia who fulfilled the epidemiological critera. The Binax EIA, Biotest EIA, and Binax NOW assay showed overall sensitivities of 69, 71, and 72%, respectively. When the tests were performed with concentrated urine samples, the overall sensitivities increased to 79, 74, and 81%, respectively. Using multiple logistic regression analysis with backward elimination, a statistically significant association was found between clinical severity and test sensitivity for all tests. For patients with mild LD, the test sensitivities ranged from 40 to 53%, whereas for patients with severe LD who needed immediate special medical care, the sensitivities reached 88 to 100%. These findings have major implications for the diagnostic process in patients with mild pneumonia and suggest that patients with mild pneumonia may go underdiagnosed if urine antigen tests alone are used. PMID:12202558
Yzerman, Ed P F; den Boer, Jeroen W; Lettinga, Kamilla D; Schellekens, Joop; Dankert, Jacob; Peeters, Marcel
Background From June to November 2005, 18 cases of community-acquired Legionnaires' disease (LD) were reported in Rapid City South Dakota. We conducted epidemiologic and environmental investigations to identify the source of the outbreak. Methods We conducted a case-control study that included the first 13 cases and 52 controls randomly selected from emergency department records and matched on underlying illness. We collected information about activities of case-patients and controls during the 14 days before symptom onset. Environmental samples (n = 291) were cultured for Legionella. Clinical and environmental isolates were compared using monoclonal antibody subtyping and sequence based typing (SBT). Results Case-patients were significantly more likely than controls to have passed through several city areas that contained or were adjacent to areas with cooling towers positive for Legionella. Six of 11 case-patients (matched odds ratio (mOR) 32.7, 95% CI 4.7-?) reported eating in Restaurant A versus 0 controls. Legionella pneumophila serogroup 1 was isolated from four clinical specimens: 3 were Benidorm type strains and 1 was a Denver type strain. Legionella were identified from several environmental sites including 24 (56%) of 43 cooling towers tested, but only one site, a small decorative fountain in Restaurant A, contained Benidorm, the outbreak strain. Clinical and environmental Benidorm isolates had identical SBT patterns. Conclusion This is the first time that small fountain without obvious aerosol-generating capability has been implicated as the source of a LD outbreak. Removal of the fountain halted transmission.
O'Loughlin, Rosalyn E; Kightlinger, Lon; Werpy, Matthew C; Brown, Ellen; Stevens, Valerie; Hepper, Clark; Keane, Tim; Benson, Robert F; Fields, Barry S; Moore, Matthew R
In recent foot and mouth disease outbreaks, many healthy animals have been culled to prevent disease transmission. Emergency vaccination is discussed as an alternative to culling of unaffected animals. A spatial and temporal Monte-Carlo simulation model was used to compare preventive culling and emergency vaccination. Different outbreaks are described using additional influence factors such as airborne spread, farm density, type of index-case farm and delay until establishment of the control strategies. The fewest farms were infected establishing a combined strategy including a 1 km preventive culling and 1-10 km emergency vaccination zone around each outbreak farm. Taking the number of culled and vaccinated farms into account, vaccination around the first diagnosed farm combined with the baseline strategy (culling of outbreak farms, protection and surveillance zone, contact tracing) is to be preferred. In the present study, emergency vaccination was an effective control strategy especially in densely populated regions. PMID:21300387
Traulsen, Imke; Rave, Gerhard; Teuffert, Jürgen; Krieter, Joachim
The development of new diagnostic methods based on molecular biology has led to evidence of the important role of respiratory viruses in chronic obstructive pulmonary disease (COPD) exacerbations. Cytokines and chemokines are recognized as key actors in the pathogenesis of COPD. The objective of this study was to evaluate the association between viral infection and host cytokine responses in 57 COPD patients hospitalized with an acute exacerbation. Seventeen cytokines were profiled using a Luminex-Biorad multiplex assay in plasma samples collected in the first 24?h following hospital admission. Stepwise linear regression analysis was performed, taking into account the influence of seven potential confounding factors in the results. Twenty-four out of 57 showed radiological signs of community-acquired pneumonia (CAP) at hospital admission, 25 patients required admission to the intensive care unit (ICU), 20 had a bacterial infection, and 20 showed a detectable respiratory virus in pharyngeal swabs. Regression analysis showed that viral infection correlated with higher levels of interleukin-6 (IL-6) (log value of the coefficient of regression B, p=0.47, 0.044), and monocyte chemoattractant protein-1 (MCP-1) (p=0.43, 0.019), and increased admission to the ICU. Viral infection also correlated with higher levels of interferon-? (IFN-?) (p=0.70, 0.026), which, in turn, was inversely associated with the severity of illness. Finally, viral infection was independently associated with higher levels of tumor necrosis factor-? (TNF-?) (p=0.40, 0.002). Thus our study demonstrates that in patients with COPD exacerbations, viral infection is directly associated with higher systemic levels of cytokines central to the development of the antiviral response, which are also known to contribute to inflammation-mediated tissue damage. These results reveal a potential specific role of viral infection in the pathogenesis of COPD exacerbations. PMID:22746693
Almansa, Raquel; Socias, Lorenzo; Andaluz-Ojeda, David; Martín-Loeches, Ignacio; Bobillo, Felipe; Blanco, Jesús; Rico, Lucia; Berezo, Jose Ángel; Estella, Ángel; Sanchez-Garcia, Monica; San José, Alicia; Herrero, Agueda; Justel, Mar; Roig, Vicente; Del Olmo, Milagros; Rosich, Sara; Rodriguez, Irene; Disdier, Carlos; Eiros, Jose María; Ortiz De Lejarazu, Raúl; Bermejo-Martin, Jesus F
Objective: In 2010, Columbus, Ohio experienced the largest outbreak of pertussis that it has had in the past 25 years. Similar outbreaks are occurring across the nation on an increasing basis. This descriptive study examines the 2010 outbreak and describes the demographics of the affected population. Comparison is made to previous and current pertussis incidence in Ohio and outbreaks elsewhere
Rohde Christopher M. D
Three cases of women with chronic liver inflammation caused by hepatitis B (two) and C (one) viral infections, were followed up to twelve years after diagnosis. As conventional therapy was ineffective and the patients progressed into decompensated liver disease, they were superinfected with massive doses of an attenuated variant (MTH-68/B) of the apathogenic avian Bursal Disease virus (a double-stranded RNA virus from the Birnaviridae family). Clinical symptoms and biochemical abnormalities were resolved in two patients following few months of virus treatment. Cirrhosis was stabilized and significant clinical improvement was achieved in the third patient--who before the virus therapy was moribund with recurring, diuretic-resistant ascites, variceal bleedings, portal encephalopathy and renal failure. To our knowledge, these are the first recorded cases of decompensated chronic viral hepatitis which went to long-lasting remission or were stabilized by superinfection with an apathogenic virus. PMID:10216467
Csatary, L K; Schnabel, R; Bakács, T
In 2003, we identified an outbreak of clinically distinct lesions involving the hands and feet associated with a public wading pool in Edmonton, Alberta, Canada. A total of 85 cases were identified. The management and follow-up of 41 children and 1 adult patients is presented. Skin lesions occurred within a median incubation period of 29 days and approximately 88 days
Marlene T. Dytoc; Lance Honish; Cary Shandro; Patricia T. Ting; Linda Chui; Loretta Fiorillo; Joan Robinson; Anne Fanning; Gerry Predy; Robert P. Rennie
A community outbreak of Legionella pneumonia in the district of Cerdanyola, Mataró (Catalonia, Spain) was investigated in an epidemiological, environmental and molecular study. Each patient was interviewed to ascertain personal risk-factors and the clinical and epidemiological data. Isolates of Legionella from patients and water samples were subtyped by pulsed-field gel electrophoresis. Between 7 August and 25 August 2002, 113 cases of Legionella pneumonia fulfilling the outbreak case definition criteria were reported, with 84 (74%) cases being located within a 500-m radius of the suspected cooling tower source. In this area, the relative risk of being infected was 54.6 (95% CI 25.3-118.1) compared with individuals living far from the cooling tower. Considering the population residing in the Cerdanyola district (28,256 inhabitants) as a reference population, the attack rate for the outbreak was 399.9 cases/100,000 inhabitants, and the case fatality rate was 1.8%. A single DNA subtype was observed among the ten clinical isolates, and one of the subtypes from the cooling tower matched exactly with the clinical subtype. Nine days after closing the cooling tower, new cases of pneumonia caused by Legionella ceased to appear. The epidemiological features of the outbreak, and the microbiological and molecular investigations, implicated the cooling tower as the source of infection. PMID:16774560
Sabria, M; Alvarez, J; Dominguez, A; Pedrol, A; Sauca, G; Salleras, L; Lopez, A; Garcia-Nuñez, M A; Parron, I; Barrufet, M P
Objective To study a novel surveillance system introduced in Mpumalanga Province, a rural area in the north-east of South Africa, in an attempt to address deficiences in the system of notification for infectious conditions that have the potential for causing outbreaks. Methods Hospital-based infection control nurses in all of Mpumalanga's 32 public and private hospitals were trained to recognize, report,
David N. Durrheim; Bernice N. Harris; Rick Speare; Kelvin Billinghurst
The hepatitis B virus (HBV) is a global health problem that causes different types of liver diseases. The high mutation rate of HBV, which results from a lack of proofreading activity of the viral polymerase, leads to the actively adaptive evolution of mutant strains under various selection pressures. This study focuses on the positive selection signals in the whole HBV genome and the association of these selection signals with the disease stages and/or viral genotypes. A total of 486 complete HBV genomes from HBV-infected individuals of different illness categories (i.e., acute, chronic, and severe hepatitis) were analyzed. To obtain a panoramic view of the selection signals, codon-based maximum likelihood analysis, three-dimensional (3D) mapping, and allele frequency comparison were conducted on genotypes B and C HBV from subjects with different stages of hepatitis. A total of 95 selected codons were resolved, and a significantly higher number of positive selection signatures were found in the chronic and severe hepatitis groups compared with the acute groups. Many of the selected codons were associated with either a unique disease stage or a specific genotype. The conservation analysis of the selection signals in the viral core protein (HBcAg) illustrated the occurrence of selected codons in the highly diversified regions. The allele-frequency-based analysis identified eight additional nucleotide substitutions, and the frequencies of these mutations were found to increase with disease progression. Moreover, we found that three substitutions, including A1762T, G1764A, and A2739C, were nearly fixed. The mapping of all of the selected codons and nucleotide substitutions to the functional domains of the viral proteins suggested that more than 60% of the mutations were subject to selection forces from host immune surveillance, antiviral therapy, and replication fitness. PMID:23871771
Xu, Zhe; Wu, Guanghua; Li, Feifei; Bai, Jian; Xing, Wanjin; Zhang, Dake; Zeng, Changqing
Molecular epidemiology is a science which utilizes molecular biology to define the distribution of disease in a population\\u000a (descriptive epidemiology) and relies heavily on integration of traditional (or analytical) epidemiological approaches to\\u000a identify the etiological determinants of this distribution. The study of viral pathogens of aquaculture has provided many\\u000a exciting opportunities to apply such tools. This review considers the extent
GP73 is a novel type II Golgi membrane protein of unknown function that is expressed in the hepatocytes of patients with adult giant-cell hepatitis (Gene 2000;249:53-65). Its expression pattern in human liver disease and the regulation of its expression in hepatocytes have not been systematically studied. The aims of the present study were to compare GP73 protein levels in viral
Raleigh D. Kladney; Xiaoyen Cui; Gary A. Bulla; Elizabeth M. Brunt; Claus J. Fimmel
Viral pathogen discovery is of critical importance to clinical microbiology, infectious diseases, and public health. Genomic approaches for pathogen discovery, including consensus polymerase chain reaction (PCR), microarrays, and unbiased next-generation sequencing (NGS), have the capacity to comprehensively identify novel microbes present in clinical samples. Although numerous challenges remain to be addressed, including the bioinformatics analysis and interpretation of large datasets, these technologies have been successful in rapidly identifying emerging outbreak threats, screening vaccines and other biological products for microbial contamination, and discovering novel viruses associated with both acute and chronic illnesses. Downstream studies such as genome assembly, epidemiologic screening, and a culture system or animal model of infection are necessary to establish an association of a candidate pathogen with disease. PMID:23725672
Chiu, Charles Y
Virulent strains of Newcastle disease virus ([NDV] also known as avian paramyxovirus type 1) can be discriminated from low-virulence strains by the presence of multiple basic amino acid residues at the proteolytic cleavage site of the fusion (F) protein. However, some NDV variants isolated from pigeons (pigeon paramyxovirus type 1 [PPMV-1]) have low levels of virulence, despite the fact that their F protein cleavage sites contain a multibasic amino acid sequence and have the same functionality as that of virulent strains. To determine the molecular basis of this discrepancy, we examined the role of the internal proteins in NDV virulence. Using reverse genetics, the genes encoding the nucleoprotein (NP), phosphoprotein (P), matrix protein (M), and large polymerase protein (L) were exchanged between the nonvirulent PPMV-1 strain AV324 and the highly virulent NDV strain Herts. Recombinant viruses were evaluated for their pathogenicities and replication levels in day-old chickens, and viral genome replication and plaque sizes were examined in cell culture monolayers. We also tested the contributions of the individual NP, P, and L proteins to the activity of the viral replication complex in an in vitro replication assay. The results showed that the replication proteins of Herts are more active than those of AV324 and that the activity of the viral replication complex is directly related to virulence. Although the M protein affected viral replication in vitro, it had only a minor effect on virulence.
Dortmans, J. C. F. M.; Rottier, P. J. M.; Koch, G.; Peeters, B. P. H.
Simian immunodeficiency virus SIVsm causes an asymptomatic infection in its natural host, the sooty mangabey, but induces an immunodeficiency syndrome very similar to human AIDS when transferred to a new host species such as the rhesus macaque. Unexpectedly, SIVsm replication dynamics is comparable in the two species, with rapid accumulation of viral mutations and a high viral load detected in both mangabeys and macaques. In contrast, clear differences are observed in immune parameters. Pathogenic SIV infection in macaques is associated with decreased CD4+ T cell numbers and signs of generalized immune activation, such as increased numbers of cycling and apoptotic T cells, hyperplasic lymphoid tissues, and exacerbated immune responses. Mangabeys with asymptomatic SIV infection show normal T cell regeneration parameters and signs of a moderate immune response, appropriate in the setting of chronic viral infection. The comparative analysis of simian models thus suggests that viral load alone cannot account for progression to disease, and that the capacity of primate lentiviruses to induce abnormal immune activation underlies AIDS pathogenesis. PMID:14766388
Chakrabarti, Lisa A
Dengue virus currently causes 50-100 million infections annually. Comprehensive knowledge about the evolution of Dengue in response to selection pressure is currently unavailable, but would greatly enhance vaccine design efforts. In the current study, we sequenced 187 new dengue virus serotype 3(DENV-3) genotype III whole genomes isolated from Asia and the Americas. We analyzed them together with previously-sequenced isolates to gain a more detailed understanding of the evolutionary adaptations existing in this prevalent American serotype. In order to analyze the phylogenetic dynamics of DENV-3 during outbreak periods; we incorporated datasets of 48 and 11 sequences spanning two major outbreaks in Venezuela during 2001 and 2007-2008 respectively. Our phylogenetic analysis of newly sequenced viruses shows that subsets of genomes cluster primarily by geographic location, and secondarily by time of virus isolation. DENV-3 genotype III sequences from Asia are significantly divergent from those from the Americas due to their geographical separation and subsequent speciation. We measured amino acid variation for the E protein by calculating the Shannon entropy at each position between Asian and American genomes. We found a cluster of 7 amino acid substitutions having high variability within E protein domain III, which has previously been implicated in serotype-specific neutralization escape mutants. No novel mutations were found in the E protein of sequences isolated during either Venezuelan outbreak. Shannon entropy analysis of the NS5 polymerase mature protein revealed that a G374E mutation, in a region that contributes to interferon resistance in other flaviviruses by interfering with JAK-STAT signaling was present in both the Asian and American sequences from the 2007-2008 Venezuelan outbreak, but was absent in the sequences from the 2001 Venezuelan outbreak. In addition to E, several NS5 amino acid changes were unique to the 2007-2008 epidemic in Venezuela and may give additional insight into the adaptive response of DENV-3 at the population level.
Schmidt, DJ; Pickett, BE; Camacho, D; Comach, G; Xhaja, K; Lennon, NJ; Rizzolo, K; de Bosch, N; Becerra, A; Nogueira, ML; Mondini, A; da Silva, EV; Vasconcelos, PF; Munoz-Jordan, JL; Santiago, GA; Ocazionez, R; Gehrke, L; Lefkowitz, EJ; Birren, BW; Henn, MR; Bosch, I
Background Outbreaks of orally transmitted Trypanosoma cruzi continue to be reported in Brazil and are associated with a high mortality rate, mainly due to myocarditis. Methods This study is a detailed report on the disease progression of acute Chagas disease in 13 patients who were infected during two micro-outbreaks in two northeastern Brazilian towns. Clinical outcomes as well as EKG and ECHO results are described, both before and after benznidazole treatment. Results Fever and dyspnea were the most frequent symptoms observed. Other clinical findings included myalgia, periorbital edema, headache and systolic murmur. Two patients died of cardiac failure before receiving benznidazole treatment. EKG and ECHO findings frequently showed a disturbance in ventricular repolarization and pericardial effusion. Ventricular dysfunction (ejection fraction <55%) was present in 27.3% of patients. After treatment, EKG readings normalized in 91.7% of patients. Ventricular repolarization abnormalities persisted in 50% of the patients, while sinus bradycardia was observed in 18%. The systolic ejection fraction normalized in two out of three patients with initially depressed ventricular function, while pericardial effusion disappeared. Conclusions Myocarditis is frequently found and potentially severe in patients with acute Chagas disease. Benznidazole treatment may improve clinical symptoms, as well as EKG and ECHO findings.
Bastos, Claudilson J. C.; Aras, Roque; Mota, Gildo; Reis, Francisco; Dias, Juarez Pereira; de Jesus, Robson Silva; Freire, Miralba Silva; de Araujo, Eline G.; Prazeres, Juliana; Grassi, Maria Fernanda Rios
Background Infectious disease outbreaks in communities can be controlled by early detection and effective prevention measures. Assessing the relative importance of each individual community member with respect to these two processes requires detailed knowledge about the underlying social contact network on which the disease can spread. However, mapping social contact networks is typically too resource-intensive to be a practical possibility for most communities and institutions. Methods Here, we describe a simple, low-cost method - called collocation ranking - to assess individual importance for early detection and targeted intervention strategies that are easily implementable in practice. The method is based on knowledge about individual collocation which is readily available in many community settings such as schools, offices, hospitals, and so on. We computationally validate our method in a school setting by comparing the outcome of the method against computational predictions based on outbreak simulations on an empirical high-resolution contact network. We compare collocation ranking to other methods for assessing the epidemiological importance of the members of a population. To this end, we select subpopulations of the school population by applying these assessment methods to the population and adding individuals to the subpopulation according to their individual rank. Then, we assess how suited these subpopulations are for early detection and targeted intervention strategies. Results Likelihood and timing of infection during an outbreak are important features for early detection and targeted intervention strategies. Subpopulations selected by the collocation ranking method show a substantially higher average infection probability and an earlier onset of symptoms than randomly selected subpopulations. Furthermore, these subpopulations selected by the collocation ranking method were close to the optimum. Conclusions Our results indicate that collocation ranking is a highly effective method to assess individual importance, providing critical low-cost information for the development of sentinel surveillance systems and prevention strategies.
Angiostrongyliasis has been frequently reported from the People's Republic of China during the last decade. An outbreak of angiostrongyliasis among migrant laborers in Guangning, Guangdong Province is described here. A questionnaire was developed to collect epidemiological and clinical information about 17 migrant laborers from the Bai ethnic group in Dali, Yunnan Province. Serum samples were collected and tested by enzyme-linked immunosorbent assay. Rats and mollusks from the same area where patients had collected Pomacea canaliculata were examined for presence of Angiostrongylus cantonensis. All 17 Bai migrant laborers consumed P. canaliculata and six had meningitis 3-19 days after consumption of P. canaliculata. Headache, myalgia and fatigue were the most common symptoms. Blood samples from 5 patients were positive for antibodies to A. cantonensis. The places where the migrant laborers collected P. canaliculata were identified as endemic areas for A. cantonensis. This outbreak highlights the vulnerability of migrants to angiostrongyliasis. PMID:22299428
Deng, Zhuo-Hui; Lv, Shan; Lin, Jin-Yan; Lin, Rong-Xing; Pei, Fu-Quan
In October 2006, following an initially non-statutory disease investigation affecting 12-week-old grey partridges (Perdix perdix), an outbreak of Newcastle disease due to infection with the avian paramyxovirus type 1 virus responsible for the current panzootic in pigeons (PPMV-1) was confirmed in Scotland. Two pens of partridges were affected by signs including loss of condition, diarrhoea, progressive neurological signs and mortality totalling approximately 24 per cent, and laboratory evidence of the infection was obtained only in these groups. The premises had approximately 17,000 poultry including a collection of 375 birds of rare breeds, containing endangered breeds of significant conservation value, which were not culled but subjected to a health monitoring and testing programme. Investigations suggested that a population of feral pigeons living above the affected pens of partridges was the likely source of the outbreak. Laboratory and genetic analyses confirmed that the isolate recovered from the clinically affected partridges was PPMV-1, belonging to genetic lineage 4b. However, the virus could not be isolated from or detected in dead pigeons collected from the affected buildings. PMID:19880861
Irvine, R M; Aldous, E W; Manvell, R J; Cox, W J; Ceeraz, V; Fuller, C M; Wood, A M; Milne, J C; Wilson, M; Hepple, R G; Hurst, A; Sharpe, C E; Alexander, D J; Brown, I H
Respiratory disease is important in horses, particularly in young Thoroughbred racehorses, and inflammation that is detected in the trachea and bronchi (termed inflammatory airway disease [IAD]) is more significant in this population in terms of impact and frequency than other presentations of respiratory disease. IAD, which is characterized by neutrophilic inflammation, mild clinical signs, and accumulation of mucus in the trachea, may be multifactorial, possibly involving infections and environmental and immunological factors, and its etiology remains unclear. This 3-year longitudinal study of young Thoroughbred racehorses was undertaken to characterize the associations of IAD and nasal discharge with viral and bacterial infections. IAD was statistically associated with tracheal infection with Streptococcus pneumoniae (capsule type 3), Streptococcus zooepidemicus, Actinobacillus spp., and Mycoplasma equirhinis and equine herpesvirus 1 and 4 infections, after adjustment for variation between training yards, seasons, and age groups. The association with S. pneumoniae and S. zooepidemicus was independent of prior viral infection and, critically, was dependent on the numbers of organisms isolated. S. pneumoniae was significant only in horses that were 2 years old or younger. The prevalence and incidence of IAD, S. zooepidemicus, and S. pneumoniae decreased in parallel with age, consistent with increased disease resistance, perhaps by the acquisition of immunity. The study provided evidence for S. zooepidemicus and S. pneumoniae playing an important etiological role in the pathogenesis of IAD in young horses.
Wood, J. L. N.; Newton, J. R.; Chanter, N.; Mumford, J. A.
Viral RNA load has been shown to indicate disease stage and predict the rapidity of disease progression in human immunodeficiency virus type 1 (HIV-1)-infected individuals. We had previously demonstrated that feline immunodeficiency virus (FIV) RNA levels in plasma correlate with disease stage in infected cats. Here we expand upon those observations by demonstrating that plasma virus load is 1 to 2 logs higher in cats with rapidly progressive FIV disease than in long-term survivors. Differences in plasma FIV RNA levels are evident by 1 to 2 weeks after infection and are consistent throughout infection. We also evaluated humoral immune responses in FIV-infected cats for correlation with survival times. Total anti-FIV antibody titers did not differ between cats with rapidly progressive FIV disease and long-term survivors. These findings indicate that virus replication plays an important role in FIV disease progression, as it does in HIV-1 disease progression. The parallels in virus loads and disease progressions between HIV-1 and FIV support the idea that the accelerated disease model is well suited for the study of therapeutic agents directed at reducing lentiviral replication.
Diehl, L J; Mathiason-Dubard, C K; O'Neil, L L; Hoover, E A
Background Infection with dengue viruses (DENV) causes a wide range of manifestations from asymptomatic infection to a febrile illness called dengue fever (DF), to dengue hemorrhagic fever (DHF). The in vivo targets of DENV and the relation between the viral burden in these cells and disease severity are not known. Method The levels of positive and negative strand viral RNA in peripheral blood monocytes, T/NK cells, and B cells and in plasma of DF and DHF cases were measured by quantitative RT-PCR. Results Positive strand viral RNA was detected in monocytes, T/NK cells and B cells with the highest amounts found in B cells. Viral RNA levels in CD14+ cells and plasma were significantly higher in DHF compared to DF, and in cases with a secondary infection compared to those undergoing a primary infection. The distribution of viral RNA among cell subpopulations was similar in DF and DHF cases. Small amounts of negative strand RNA were found in a few cases only. The severity of plasma leakage correlated with viral RNA levels in plasma and in CD14+ cells. Conclusions B cells were the principal cells containing DENV RNA in peripheral blood, but overall there was little active DENV RNA replication detectable in peripheral blood mononuclear cells (PBMC). Secondary infection and DHF were associated with higher viral burden in PBMC populations, especially CD14+ monocytes, suggesting that viral infection of these cells may be involved in disease pathogenesis.
Srikiatkhachorn, Anon; Wichit, Sineewanlaya; Gibbons, Robert V.; Green, Sharone; Libraty, Daniel H.; Endy, Timothy P.; Ennis, Francis A.; Kalayanarooj, Siripen; Rothman, Alan L.
Diagnosis of psittacine beak and feather disease (PBFD) viral infection, avian polyomavirus infection, adenovirus infection and herpesvirus infection in psittacine tissues using DNA in situ hybridization
The evaluation of the usefulness of DNA probes in a diagnostic setting to identify nuclear inclusions in selected viral infections (psittacine beak and feather disease viral infection, avian polyomavirus infection, adenovirus infection and Pacheco's parrot disease) is reported. A DNA in situ hybridization method was used to detect viral nucleic acid in sections of paraffin?embedded tissues coming from birds naturally
A. Ramis; K. S. Latimer; F. D. Niagro; R. P. Campagnoli; B. W. Ritchie; Denise Pesti
Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non–genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks.
Kroneman, Annelies; van Duynhoven, Yvonne; Boshuizen, Hendriek; van Pelt, Wilfrid; Koopmans, Marion
OBJECTIVES: To support already established epidemiological links between inmates of Glenochil prison positive for HIV infection by using molecular techniques and thus provide evidence of the extent of acquisition during a recent outbreak of the disease resulting from needle sharing. To identify possible sources of the outbreak, and to demonstrate the ability of the methodology to make further links beyond the original outbreak. DESIGN: Viral sequences obtained from the blood of HIV positive prisoners previously identified by standard epidemiological methods were compared with each other and with sequences from other Scottish patients. SETTING: Glenochil prison for men, central Scotland. SUBJECTS: Adult inmates and their possible contacts. RESULTS: Phylogenetic analysis of viral sequences in two different genomic regions showed that 13 of the 14 HIV positive prisoners had been infected from a common source. Previous research had shown that six of these had acquired their infection in Glenochil; molecular evidence suggests that more than double this number were infected while incarcerated. Virus from two long term HIV positive patients who were in the prison at the time of the outbreak but who were not identified in the original or subsequent surveys was sufficiently different to make it unlikely that they were the source. A viral sequence from heterosexual transmission from one inmate showed the ability of these techniques to follow the infection through different routes of infection. CONCLUSION: The number of prisoners infected with HIV during the 1993 outbreak within Glenochil prison was more than twice that previously shown. This shows the potential for the spread of bloodborne diseases within prisons by injecting drugs.
Yirrell, D. L.; Robertson, P.; Goldberg, D. J.; McMenamin, J.; Cameron, S.; Leigh Brown, A. J.
From January 1983 through January 1985, 88 cases of early adult syphilis and five cases of congenital syphilis were identified among residents of a southwestern Indian reservation. The male-to-female ratio of primary and secondary syphilis cases was 1.7: 1; over 90 per cent of women were of childbearing age. Using community health workers to determine the social circles of infected persons was effective in identifying persons at risk; treatment of partners of infected persons prior to development of seroreactivity contributed to the successful control of this outbreak.
Gerber, A R; King, L C; Dunleavy, G J; Novick, L F
BACKGROUND: Caenorhabditis elegans has previously been used as a host model to determine the virulence of clinical methicillin-resistant Staphylococcus aureus isolates. In the present study, methicillin-susceptible S aureus (MSSA) strains associated with an outbreak in a neonatal intensive care unit (NICU) were investigated using the C elegans model. METHODS: Two distinct outbreak clones, MSSA type-C and MSSA type-G, were identified by pulsed-field gel electrophoresis in a MSSA outbreak during a seven-month period in the NICU of the Sunnybrook Health Sciences Centre (Toronto, Ontario). MSSA type-C was associated with severe infection, while type-G was associated with less invasive disease. Four representative type-C isolates, three type-G and three infant-colonized isolates unrelated to the outbreak, were sent to Calgary (Alberta), for the double-blinded virulence tests in the C elegans host model and for further molecular characterization. RESULTS: The invasive outbreak strains (type-C) demonstrated highly nematocidal activity, the noninvasive outbreak strains (type-G) an intermediate virulence, and the outbreak-unrelated colonization isolates demonstrated avirulence or low virulence in the C elegans model, with mean killing rates of 93.0%, 61.0% and 14.4% by day 9, respectively, for these three group strains. Different group MSSA strains had their own unique genetic profiles and virulence gene profiles, but all isolates within the same group (type-C or type-G) shared identical genetic characteristics and virulence gene patterns. CONCLUSIONS: The present blinded evaluation demonstrated that the nematocidal activities of MSSA strains correlated well with the clinical manifestation in an MSSA outbreak in the NICU, supporting C elegans as a robust host model to study the pathogenesis of S aureus.
Wu, Kaiyu; Simor, Andrew E; Vearncombe, Mary; McClure, Jo-Ann; Zhang, Kunyan
Following the detection of infectious hematopoietic necrosis virus (IHNV) in France in April 1987, a serological survey was conducted of the rainbow trout Oncorhynchus mykiss (formerly Salmo gairdneri) from an infected cultured stock previously known to be contaminated with viral hemorrhagic septicemia virus (VHSV) for 3 years. The work lasted from April to December 1987, at which time all the
A.-M. Hattenberger-Baudouy; M. Danton; G. Merle; C. Torchy; P. De Kinkelin
While measles virus (MV) continues to have a significant impact on human health, causing 150,000-200,000 deaths worldwide each year, the number of fatalities that can be attributed to MV-triggered central nervous system (CNS) diseases are on the order of a few hundred individuals annually (World Health Organization 2009). Despite this modest impact, substantial effort has been expended to understand the basis of measles-triggered neuropathogenesis. What can be gained by studying such a rare condition? Simply stated, the wealth of studies in this field have revealed core principles that are relevant to multiple neurotropic pathogens, and that inform the broader field of viral pathogenesis. In recent years, the emergence of powerful in vitro systems, novel animal models, and reverse genetics has enabled insights into the basis of MV persistence, the complexity of MV interactions with neurons and the immune system, and the role of immune and CNS development in virus-triggered disease. In this review, we highlight some key advances, link relevant measles-based studies to the broader disciplines of neurovirology and viral pathogenesis, and propose future areas of study for the field of measles-mediated neurological disease. PMID:20419352
O'Donnell, Lauren A; Rall, Glenn F
The calicivirus rabbit hemorrhagic disease virus (RHDV), which replicates predominantly in the livers of infected rabbits, cannot be propagated in tissue culture. To enable the performance of in vitro studies, rabbit hepatocytes were isolated by liver perfusion and gradient centrifugation. After inoculation with purified RHDV, more than 50% of the cells proved to be infected. Protein analyses led to the detection of 13 RHDV-specific polypeptides within the infected cells. These proteins were assigned to defined regions of the viral genome, resulting in a refined model of RHDV genome organization.
Konig, Matthias; Thiel, Heinz-Jurgen; Meyers, Gregor
We report the investigation of a community-acquired outbreak of Legionnaires' disease. An epidemiological, environmental, and meteorological investigation was undertaken. Fifty-five cases were reported in October and November 2005. The exposure occurred in a large area, with 12 cases (21.8%) located between 1,800 and 3,400 metres from the source. Water sample cultures showed that Legionella pneumophila serogroup 1 (Lp-1) was present in five cooling towers in two industrial locations in Gurb (plants A and B). Two Lp-1 strains were recovered from plants A and B, but only Lp-1 strains from plant A showed a pulsed-field gel electrophoresis (PFGE) profile identical to those obtained from three of the cases. Inspection of the cooling towers in plant A revealed inadequate maintenance. Weather conditions in October 2005, with mostly high temperatures and high humidity, together with the flat terrain could have been favouring factors. This study showed a community outbreak from a cooling tower as a common source in a large area. Climate and terrain could explain the dissemination of contaminated aerosols. PMID:18752009
Ferré, M R Sala; Arias, C; Oliva, J M; Pedrol, A; García, M; Pellicer, T; Roura, P; Domínguez, A
An outbreak of Legionnaires' disease (LD) occurred in Lidköping, Sweden, in August 2004. A cooling tower was identified as the probable source of infection. During the outbreak period an unexpected 3-6-fold increase in pneumonia patients was noted at the local hospital. During 7 weeks LD was diagnosed in 15 patients by urinary antigen and/or sputum culture. Additionally, 15 LD patients were diagnosed later by serology. Patients with LD were generally younger, more healthy, and more often smokers compared to other pneumonia patients. On admittance they had more severe symptoms with high fever and raised CRP levels, and more often hyponatraemia, gastrointestinal and CNS symptoms. A causative agent besides Legionella was found in 2 patients only. A significant titre rise for Mycoplasma and/or Chlamydophila pneumoniae was found in 13 of 29 tested patients with confirmed LD. We conclude that the clinical diagnosis of LD is difficult and that available diagnostic methods detect only a minority of patients in the acute phase. Therefore in severe pneumonia, empirically targeted therapy should be instituted on clinical grounds irrespective of the results of diagnostic tests. The observation of increased antibody levels for M. and C. pneumoniae suggests an unspecific immune reaction and merits further study. PMID:17366051
Hugosson, Anna; Hjorth, Martin; Bernander, Sverker; Claesson, Berndt E B; Johansson, Agneta; Larsson, Helena; Nolskog, Peter; Pap, Judit; Svensson, Nils; Ulleryd, Peter
During an outbreak of foot-and-mouth disease (FMD) in southern England in 2007, a case-control study was conducted to identify risk factors for infection and to investigate the relative impact of risk factors on transmission between the infected farms. Seven of the eight case farms in the outbreak and 22 control farms participated. Data were collected via questionnaires and subjected to comparative statistical analysis. Case farms were further classified as primary or secondary according to the likely source of infection during the study. On primary case farms, it was plausible that infection had been introduced directly from the original source. On secondary case farms, FMD infection was more likely to have originated from another infected premises. Calving occurred more frequently on case farms than on control farms during the risk period, and the two primary case farms had a larger proportion of youngstock than the other farms. Secondary case farms (n=5) had a higher composite environmental risk score and a lower biosecurity score than control farms. PMID:21493486
Ellis-Iversen, J; Smith, R P; Gibbens, J C; Sharpe, C E; Dominguez, M; Cook, A J C
Results in entomological and vertebrate host investigations made during dual outbreaks of Mayaro (MAY) and yellow fever (YF) viruses in Belterra, Pará, Brazil in 1978 are reported. Over 9,000 insects representing 26 species were assayed in 396 pools for the presence of arboviruses. Pools of Haemagogus janthinomys Dyar yielded the only isolates of either MAY or YF virus. The minimum field infection rate for nine isolates of MAY virus from Hg. janthinomys was 1:82, and for two isolates of YF virus was 1:368. Analysis of collection data showed Hg. janthinomys to be attracted to man as a blood source and present in all habitats sampled, although most abundant in the forest canopy. Twelve hundred bird sera and 584 mammal sera were tested by hemagglutination-inhibition (HI) tests for antibody to MAY virus. Highest MAY antibody prevalence rates were found among marmosets (Calithrix argentata, 32 positive of 119 tested, 27%). Mayaro virus was also isolated from the blood of a sylvan marmoset captured at the peak of the MAY virus outbreak. Experimental infection of marmosets with MAY virus confirmed that a substantial viremia follows infection with this virus. Marmosets were also found with HI antibody to YF virus (5/119, 4%). The results presented indicate that Hg. janthinomys was the principal vector of both MAY and YF viruses and that marmosets were the main amplifying hosts for MAY virus, and perhaps for YF virus as well. PMID:6266265
Hoch, A L; Peterson, N E; LeDuc, J W; Pinheiro, F P
As part of an intensified monitoring program for foodborne disease outbreaks in Finland, waterborne outbreaks were investigated for viruses. The diagnostic procedure included analysis of patients' stool samples by electron microscopy and reverse transcription–polymerase chain reaction (RT-PCR) for noroviruses and astroviruses. When these test results were positive for a virus, the water sample was analyzed. Virus concentration was based on positively charged filters from 1-L samples. Of the total 41 waterborne outbreaks reported during the observation period (1998–2003), samples from 28 outbreaks were available for analysis. As judged by RT-PCR results from patient samples, noroviruses caused 18 outbreaks. In 10 outbreaks, the water sample also yielded a norovirus. In all but 1 instance, the amplicon sequence was identical to that recovered from the patients. The ubiquity of waterborne norovirus outbreaks calls for measures to monitor water for viruses.
Miettinen, Ilkka T.; von Bonsdorff, Carl-Henrik
Following the terrorist attacks of September 11 and the anthrax attacks in 2001, public health entities implemented automated surveillance systems based on disease syndromes for early detection of bioterror events and to increase timeliness of responses. Despite widespread adoption, syndromic surveillance systems' ability to provide early notification of outbreaks is unproven, and there is little documentation on their role in outbreak response. We hypothesized that biosurveillance is used in practice to augment classical outbreak investigations, and we used case studies conducted in 2007-08 to determine (1) which steps in outbreak investigations were best served by biosurveillance, and (2) which steps presented the greatest opportunities for improvement. The systems used in the case studies varied in how they functioned, and there were examples in which syndromic systems had identified outbreaks before other methods. Biosurveillance was used successfully for all steps of outbreak investigations. Key advantages of syndromic systems were sensitivity, timeliness, and flexibility and as a source of data for situational awareness. Limitations of biosurveillance were a lack of specificity, reliance on chief complaint data, and a lack of formal training for users. Linking syndromic data to triage notes and medical chart data would substantially increase the value of biosurveillance in the conduct of outbreak investigations and reduce the burden on health department staff. PMID:23448272
Kaydos-Daniels, S Cornelia; Rojas Smith, Lucia; Farris, Tonya R
From 1998 to 2008, 1229 foodborne outbreaks caused by Bacillus cereus, Clostridium perfringens, and Staphylococcus aureus were reported in the United States; 39% were reported with a confirmed etiology. Vomiting was commonly reported in B. cereus (median, 75% of cases) and S. aureus outbreaks (median, 87%), but rarely in C. perfringens outbreaks (median, 9%). Meat or poultry dishes were commonly implicated in C. perfringens (63%) and S. aureus (55%) outbreaks, and rice dishes were commonly implicated in B. cereus outbreaks (50%). Errors in food processing and preparation were commonly reported (93%), regardless of etiology; contamination by a food worker was only common in S. aureus outbreaks (55%). Public health interventions should focus on these commonly reported errors to reduce the occurrence of outbreaks caused by B. cereus, C. perfringens, and S. aureus in the United States. PMID:23592829
Bennett, Sarah D; Walsh, Kelly A; Gould, L Hannah
Background Animal disease monitoring and surveillance are crucial for ensuring the health of animals, humans and the environment. Many studies have investigated the utility of monitoring syndromes associated with data from veterinary laboratory submissions, but no research has focused on how negative test results from a veterinary diagnostic laboratory data can be used to improve our knowledge of disease outbreaks. For example, if a diagnostic laboratory was seeing a disproportionate number of negative test results for a known disease could this information be an indication of a novel disease outbreak? The objective of this study was to determine the association between the porcine circovirus associated disease (PCVAD) outbreak in Ontario 2004–2006 and the results of porcine reproductive and respiratory syndrome virus (PPRSV) enzyme-linked immunosorbent assay (ELISA) and the results of PRRSV polymerase chain reaction (PCR) diagnostic tests requested by veterinarians. Results Retrospective data were collected from the Animal Health Laboratory (AHL) at the University of Guelph, Guelph, Ontario Canada and were comprised of weekly counts of PRRSV ELISA and PRRSV PCR diagnostic tests requested by swine practitioners from 2000–2007. The results of the PRRSV ELISA and PRRSV PCRs were analysed separately in two models using logistic regression with the dependent variables being: the weekly probability of PRRSV ELISA positivity, and the weekly probability of PRRSV PCR positivity, respectively. The weekly probability of PRRSV PCR positivity decreased during the PVCAD outbreak (OR=0.66, P=0.01). The weekly probability of PRRSV ELISA positivity was not associated with the PCVAD outbreak. Conclusions The results of this study showed that during the PCVAD outbreak in Ontario from December 2004-May 2006, the probability of a positive PRRSV PCR at the AHL decreased. We conclude that when a decrease in test positivity occurs for a known disease, it may suggest that a new disease agent is emerging in the population. Hence, monitoring the test results of commonly used first-order tests for a known disease (e.g. PRRSV) has the potential to be a unique form of syndromic data for the timely identification of novel disease outbreaks in swine populations.
Since the revisions to the International Health Regulations (IHR) in 2005, much attention has been turned to how states, particularly developing states, will address core capacity requirements. The question often examined is how states with poor health systems can strengthen their capacity to identify and verify public health emergencies of international concern. A core capacity requirement is that by 2012 states will have a surveillance and response network that operates from the local community to the national level. Much emphasis has turned to the health system capacity required for this task. In this article, I seek to understand the political capacity to perform this task. This article considers how the world's two most populous states, 1 China and India, have sought to communicate outbreak events in times of crisis and calm. I consider what this reporting performance tells us of their capacity to meet their IHR obligations given the two countries differing political institutions. PMID:22788710
Davies, Sara E
It is well established that natural killer (NK) cells confer resistance to many viral diseases, but in only a few instances the molecular mechanisms whereby NK cells recognize virus-infected cells are known. Here we show that CD94, a molecule preferentially expressed by NK cells, is essential for the resistance of C57BL/6 mice to mousepox, a disease caused by the Orthopoxvirus ectromelia virus. Ectromelia virus-infected cells expressing the major histocompatibility complex (MHC) class Ib molecule Qa-1(b) are specifically recognized by the activating receptor formed by CD94 and NKG2E. Because CD94-NKG2 receptors and their ligands are highly conserved in rodents and humans, a similar mechanism may exist during human infections with the smallpox and monkeypox viruses, which are highly homologous to ectromelia virus. PMID:21439856
Fang, Min; Orr, Mark T; Spee, Pieter; Egebjerg, Thomas; Lanier, Lewis L; Sigal, Luis J
Plasmids are circular deoxyribonucleic acid molecules that exist in bacteria, usually independent of the chromosome. The study of plasmids is important to medical microbiology because plasmids can encode genes for antibiotic resistance or virulence factors. Plasmids can also serve as markers of various bacterial strains when a typing system referred to as plasmid profiling, or plasmid fingerprinting is used. In these methods partially purified plasma deoxyribonucleic acid species are separated according to molecular size by agarose gel electrophoresis. In a second procedure, plasmid deoxyribonucleic acid which has been cleaved by restriction endonucleases can be separated by agarose gel electrophoresis and the resulting pattern of fragments can be used to verify the identity of bacterial isolates. Because many species of bacteria contain plasmids, plasmid profile typing has been used to investigate outbreaks of many bacterial diseases and to trace inter- and intra-species spread of antibiotic resistance. Images
Mayer, L W
Enterovirus 71 (EV71) caused a large outbreak in Taiwan in 1998 with 78 deaths, and smaller outbreaks recurred in 2000 and 2001. The outbreak was recognized because of a large number of hand, foot, and mouth disease cases and the rapid deaths of children with the disease. Virologic and pathologic studies indicated that EV71 was the most important agent relat-
Tzou-Yien Lin; Shiing-Jer Twu; Mei-Shang Ho; Luan-Yin Chang; Chin-Yun Lee
Viral infectious diseases such as influenza have been a great burden to public health. The airborne transmission route is an important venue for the spread of many respiratory viral diseases. Many airborne viruses have been shown to be sensitive to ambient humidity, yet the mechanisms responsible for this phenomenon remain elusive. A thorough understanding of this phenomenon may provide insight into the temporal and spatial distribution of diseases. For instance, studies have repeatedly suggested ambient humidity as an important environmental determinant in the transmission of influenza in temperate regions. Further, knowing how to optimize humidity so as to minimize virus survival may have practical implications for disease prevention. In this talk, we will discuss multiple mechanisms that may account for the association between humidity and viability of viruses in aerosols, including water activity, surface inactivation, salt toxicity, and conformational changes to the virus in response to varying pH. As a case study, we will discuss our work on the effect of relative humidity (RH) on survival of influenza A virus (IAV) and how it may contribute to the transmission patterns of seasonal flu around the world. We measured the change in viability of IAV in droplets at various RHs. Results suggest three potential regimes defined by humidity: physiological (~100% RH) with high viability, concentrated (~50% to near 100% RH) with lower viability, and dry (<~50% RH) with high viability. Based on these results, we propose a mechanistic basis for the dependence of IAV's transmission on humidity. In temperate regions, the increase in influenza activity in winter may be due to enhanced transmission via the aerosol route thanks to IAV's higher viability in droplets at low RH. In tropical regions, transmission could be enhanced due to high viability of IAV at extremely high RH (rainy season), as observed in our study, possibly through both the aerosol route and the contact route.
Yang, Wan; Marr, Linsey; Elankumaran, Subbiah
PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting data related to waterborne-d...
Thirteen enterovirus 71 (EV71) isolates were obtained from both fatal and non-fatal infections of patients seen in Peninsula Malaysia and in Sarawak during an outbreak of hand, foot and mouth disease (HFMD) in Malaysia in 1997, with incidences of fatal brainstem encephalomyelitis. The isolates were identified using immunofluorescence staining, neutralization assays, and partial sequencing of the 5? untranslated regions (UTR).
Sazaly AbuBakar; Hui-Yee Chee; Muhannad F. Al-Kobaisi; Jiang Xiaoshan; Kaw Bing Chua; Sai Kit Lam
The susceptibility, immune response and protection to challenge following vaccination in racing pigeons was assessed using the 2002-03 exotic Newcastle disease (END) virus responsible for the most recent major outbreak in southern California. Immunologically naïve pigeons appeared resistant to dise...
Exotic Newcastle disease virus (NDV) isolated from chickens during the 2002-2003 California outbreak was inoculated into 4-week-old SPF White Leghorn chickens, 3-week-old SPF Beltsville White turkeys, 6-week-old commercial Broad Breast White turkeys, and 10 to 20-week-old racing pigeons. Birds were ...
Exotic Newcastle disease virus (NDV) isolated from chickens during the 2002-2003 California outbreak was inoculated into 4-week-old specific-pathogen-free (SPF) White Leghorn chickens, 3-week-old SPF Beltsville White turkeys, 6-week-old commercial Broad Breasted White turkeys, and 10- to 20-week-old...
An outbreak of White Muscle Disease, WMD, or Nutritional Muscular Dystrophy is reported in a flock of 56 Red Friesian calves, where 18 calves of 4 to 5 months of age died in a pe- riod of 45 days. The signs observed were tachypnea, difficulty to walk, tachycardia, dilated jugular veins, temperature 38- 39°C. Signs of alterations of the nervous
Pedro A. Contreras; Enrique Paredes; Fernando Wittwer; Sergio Carrillo
Theiler's virus causes a persistent infection and a demyelinating disease of mice which is a model for mul- tiple sclerosis. Susceptibility to viral persistence maps to several loci, including the interferon gamma locus. Inactivating the gene coding for the interferon gamma receptor makes 129\\/Sv mice susceptible to persistent infection and clinical disease, whereas inactivating the interferon gamma gene makes C57BL\\/6
STEPHANIE AUBAGNAC; MICHEL BRAHIC; JEAN-FRANCOIS BUREAU
BACKGROUND: Currently applied indicator organism systems, such as coliforms, are not fully protective of public health from enteric viruses in water sources. Waterborne disease outbreaks have occurred in systems that tested negative for coliforms, and positive coliform results do not necessarily correlate with viral risk. It is widely recognized that bacterial indicators do not co-occur exclusively with infectious viruses, nor
Jennifer S Griffin; Jeanine D Plummer; Sharon C Long
GP73 is a novel type II Golgi membrane protein of unknown function that is expressed in the hepatocytes of patients with adult giant-cell hepatitis (Gene 2000;249:53-65). Its expression pattern in human liver disease and the regulation of its expression in hepatocytes have not been systematically studied. The aims of the present study were to compare GP73 protein levels in viral and nonviral human liver disease and in normal livers, to identify its cellular sources, and to study the regulation of its expression in hepatoma cells in vitro. GP73 protein levels were quantitated in explant livers of patients with well-defined disease etiologies and compared with the levels in normal donor livers. GP73-expressing cells were identified immunohistochemically. GP73 expression in vitro was studied by Western blotting and immunofluorescence microscopy in HepG2 and SK-Hep-1 cells and in the HepG2-derived, hepatitis B virus (HBV)-transfected HepG2215 and HepG2T14.1 cell lines. Whole organ levels of GP73 were low in normal livers. Significant increases were found in liver disease due to viral causes (HBV, HCV) or nonviral causes (alcohol-induced liver disease, autoimmune hepatitis). In normal livers, GP73 was constitutively expressed by biliary epithelial cells but not by hepatocytes. Hepatocyte expression of GP73 was dramatically up-regulated in diseased livers, regardless of the etiology, whereas biliary epithelial cell expression did not change appreciably. GP73 was present at high levels in HepG2215 cells (a cell line that supports active HBV replication), but was absent in HepG2T14.1 cells (an HBV-transfected cell line that does not support HBV replication) and in HBV-free HepG2 cells. In SK-Hep-1 cells, GP73 expression was increased in response to interferon gamma (IFN-gamma), and inhibited by tumor necrosis factor alpha (TNF-alpha). In conclusion, increased expression of GP73 in hepatocytes appears to be a general feature of advanced liver disease, and may be regulated via distinct pathways that involve hepatotropic viruses or cytokines. PMID:12029628
Kladney, Raleigh D; Cui, Xiaoyen; Bulla, Gary A; Brunt, Elizabeth M; Fimmel, Claus J
Background Despite being one of the first documented, there is little known of the causative agent or environmental stressors that promote white-band disease (WBD), a major disease of Caribbean Acropora palmata. Likewise, there is little known about the spatiality of outbreaks. We examined the spatial patterns of WBD during a 2004 outbreak at Buck Island Reef National Monument in the US Virgin Islands. Methodology/Principal Findings Ripley's K statistic was used to measure spatial dependence of WBD across scales. Localized clusters of WBD were identified using the DMAP spatial filtering technique. Statistics were calculated for colony- (number of A. palmata colonies with and without WBD within each transect) and transect-level (presence/absence of WBD within transects) data to evaluate differences in spatial patterns at each resolution of coral sampling. The Ripley's K plots suggest WBD does cluster within the study area, and approached statistical significance (p?=?0.1) at spatial scales of 1100 m or less. Comparisons of DMAP results suggest the transect-level overestimated the prevalence and spatial extent of the outbreak. In contrast, more realistic prevalence estimates and spatial patterns were found by weighting each transect by the number of individual A. palmata colonies with and without WBD. Conclusions As the search for causation continues, surveillance and proper documentation of the spatial patterns may inform etiology, and at the same time assist reef managers in allocating resources to tracking the disease. Our results indicate that the spatial scale of data collected can drastically affect the calculation of prevalence and spatial distribution of WBD outbreaks. Specifically, we illustrate that higher resolution sampling resulted in more realistic disease estimates. This should assist in selecting appropriate sampling designs for future outbreak investigations. The spatial techniques used here can be used to facilitate other coral disease studies, as well as, improve reef conservation and management.
Lentz, Jennifer A.; Blackburn, Jason K.; Curtis, Andrew J.
Background Detection of outbreaks of hospital-acquired infections is often based on simple rules, such as the occurrence of three new cases of a single pathogen in two weeks on the same ward. These rules typically focus on only a few pathogens, and they do not account for the pathogens' underlying prevalence, the normal random variation in rates, and clusters that may occur beyond a single ward, such as those associated with specialty services. Ideally, outbreak detection programs should evaluate many pathogens, using a wide array of data sources. Methods and Findings We applied a space-time permutation scan statistic to microbiology data from patients admitted to a 750-bed academic medical center in 2002–2006, using WHONET-SaTScan laboratory information software from the World Health Organization (WHO) Collaborating Centre for Surveillance of Antimicrobial Resistance. We evaluated patients' first isolates for each potential pathogenic species. In order to evaluate hospital-associated infections, only pathogens first isolated >2 d after admission were included. Clusters were sought daily across the entire hospital, as well as in hospital wards, specialty services, and using similar antimicrobial susceptibility profiles. We assessed clusters that had a likelihood of occurring by chance less than once per year. For methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE), WHONET-SaTScan–generated clusters were compared to those previously identified by the Infection Control program, which were based on a rule-based criterion of three occurrences in two weeks in the same ward. Two hospital epidemiologists independently classified each cluster's importance. From 2002 to 2006, WHONET-SaTScan found 59 clusters involving 2–27 patients (median 4). Clusters were identified by antimicrobial resistance profile (41%), wards (29%), service (13%), and hospital-wide assessments (17%). WHONET-SaTScan rapidly detected the two previously known gram-negative pathogen clusters. Compared to rule-based thresholds, WHONET-SaTScan considered only one of 73 previously designated MRSA clusters and 0 of 87 VRE clusters as episodes statistically unlikely to have occurred by chance. WHONET-SaTScan identified six MRSA and four VRE clusters that were previously unknown. Epidemiologists considered more than 95% of the 59 detected clusters to merit consideration, with 27% warranting active investigation or intervention. Conclusions Automated statistical software identified hospital clusters that had escaped routine detection. It also classified many previously identified clusters as events likely to occur because of normal random fluctuations. This automated method has the potential to provide valuable real-time guidance both by identifying otherwise unrecognized outbreaks and by preventing the unnecessary implementation of resource-intensive infection control measures that interfere with regular patient care. Please see later in the article for the Editors' Summary
Stelling, John; Placzek, Hilary; Kulldorff, Martin; Kleinman, Ken; O'Brien, Thomas F.; Calderwood, Michael S.; Vostok, Johanna; Dunn, Julie; Platt, Richard
Foot-and-mouth disease (FMD) outbreaks recently affected 2 countries (Japan and South Korea) in eastern Asia that were free of FMD without vaccination. Analysis of viral protein 1 nucleotide sequences indicated that FMD serotype A and O viruses that caused these outbreaks originated in mainland Southeast Asia to which these viruses are endemic. PMID:22377196
Knowles, Nick J; He, Jijun; Shang, Youjun; Wadsworth, Jemma; Valdazo-González, Begoña; Onosato, Hiroyuki; Fukai, Katsuhiko; Morioka, Kazuki; Yoshida, Kazuo; Cho, In-Soo; Kim, Su-Mi; Park, Jong-Hyeon; Lee, Kwang-Nyeong; Luk, Geraldine; Borisov, Vladimir; Scherbakov, Alexey; Timina, Anna; Bold, Dashzeveg; Nguyen, Tung; Paton, David J; Hammond, Jef M; Liu, Xiangtao; King, Donald P
Foot-and-mouth disease (FMD) outbreaks recently affected 2 countries (Japan and South Korea) in eastern Asia that were free of FMD without vaccination. Analysis of viral protein 1 nucleotide sequences indicated that FMD serotype A and O viruses that caused these outbreaks originated in mainland Southeast Asia to which these viruses are endemic.
Knowles, Nick J.; He, JiJun; Shang, Youjun; Wadsworth, Jemma; Valdazo-Gonzalez, Begona; Onosato, Hiroyuki; Fukai, Katsuhiko; Morioka, Kazuki; Yoshida, Kazuo; Cho, In-Soo; Kim, Su-Mi; Park, Jong-Hyeon; Lee, Kwang-Nyeong; Luk, Geraldine; Borisov, Vladimir; Scherbakov, Alexey; Timina, Anna; Bold, Dashzeveg; Nguyen, Tung; Paton, David J.; Hammond, Jef M.; Liu, Xiangtao
Farm animals remain at risk of endemic, exotic and newly emerging viruses. Vaccination is often promoted as the best possible solution, and yet for many pathogens, either there are no appropriate vaccines or those that are available are far from ideal. A complementary approach to disease control may be to identify genes and chromosomal regions that underlie genetic variation in disease resistance and response to vaccination. However, identification of the causal polymorphisms is not straightforward as it generally requires large numbers of animals with linked phenotypes and genotypes. Investigation of genes underlying complex traits such as resistance or response to viral pathogens requires several genetic approaches including candidate genes deduced from knowledge about the cellular pathways leading to protection or pathology, or unbiased whole genome scans using markers spread across the genome. Evidence for host genetic variation exists for a number of viral diseases in cattle including bovine respiratory disease and anecdotally, foot and mouth disease virus (FMDV). We immunised and vaccinated a cattle cross herd with a 40-mer peptide derived from FMDV and a vaccine against bovine respiratory syncytial virus (BRSV). Genetic variation has been quantified. A candidate gene approach has grouped high and low antibody and T cell responders by common motifs in the peptide binding pockets of the bovine major histocompatibility complex (BoLA) DRB3 gene. This suggests that vaccines with a minimal number of epitopes that are recognised by most cattle could be designed. Whole genome scans using microsatellite and single nucleotide polymorphism (SNP) markers has revealed many novel quantitative trait loci (QTL) and SNP markers controlling both humoral and cell-mediated immunity, some of which are in genes of known immunological relevance including the toll-like receptors (TLRs). The sequencing, assembly and annotation of livestock genomes and is continuing apace. In addition, provision of high-density SNP chips should make it possible to link phenotypes with genotypes in field populations without the need for structured populations or pedigree information. This will hopefully enable fine mapping of QTL and ultimate identification of the causal gene(s). The research could lead to selection of animals that are more resistant to disease and new ways to improve vaccine efficacy.
Glass, Elizabeth J.; Baxter, Rebecca; Leach, Richard J.; Jann, Oliver C.
Farm animals remain at risk of endemic, exotic and newly emerging viruses. Vaccination is often promoted as the best possible solution, and yet for many pathogens, either there are no appropriate vaccines or those that are available are far from ideal. A complementary approach to disease control may be to identify genes and chromosomal regions that underlie genetic variation in disease resistance and response to vaccination. However, identification of the causal polymorphisms is not straightforward as it generally requires large numbers of animals with linked phenotypes and genotypes. Investigation of genes underlying complex traits such as resistance or response to viral pathogens requires several genetic approaches including candidate genes deduced from knowledge about the cellular pathways leading to protection or pathology, or unbiased whole genome scans using markers spread across the genome. Evidence for host genetic variation exists for a number of viral diseases in cattle including bovine respiratory disease and anecdotally, foot and mouth disease virus (FMDV). We immunised and vaccinated a cattle cross herd with a 40-mer peptide derived from FMDV and a vaccine against bovine respiratory syncytial virus (BRSV). Genetic variation has been quantified. A candidate gene approach has grouped high and low antibody and T cell responders by common motifs in the peptide binding pockets of the bovine major histocompatibility complex (BoLA) DRB3 gene. This suggests that vaccines with a minimal number of epitopes that are recognised by most cattle could be designed. Whole genome scans using microsatellite and single nucleotide polymorphism (SNP) markers has revealed many novel quantitative trait loci (QTL) and SNP markers controlling both humoral and cell-mediated immunity, some of which are in genes of known immunological relevance including the toll-like receptors (TLRs). The sequencing, assembly and annotation of livestock genomes and is continuing apace. In addition, provision of high-density SNP chips should make it possible to link phenotypes with genotypes in field populations without the need for structured populations or pedigree information. This will hopefully enable fine mapping of QTL and ultimate identification of the causal gene(s). The research could lead to selection of animals that are more resistant to disease and new ways to improve vaccine efficacy. PMID:21621277
Glass, Elizabeth J; Baxter, Rebecca; Leach, Richard J; Jann, Oliver C
Evaluating the impact of different social networks on the spread of respiratory diseases has been limited by a lack of detailed data on transmission outside the household setting as well as appropriate statistical methods. Here, from data collected during a H1N1 pandemic (pdm) influenza outbreak that started in an elementary school and spread in a semirural community in Pennsylvania, we quantify how transmission of influenza is affected by social networks. We set up a transmission model for which parameters are estimated from the data via Markov chain Monte Carlo sampling. Sitting next to a case or being the playmate of a case did not significantly increase the risk of infection; but the structuring of the school into classes and grades strongly affected spread. There was evidence that boys were more likely to transmit influenza to other boys than to girls (and vice versa), which mimicked the observed assortative mixing among playmates. We also investigated the presence of abnormally high transmission occurring on specific days of the outbreak. Late closure of the school (i.e., when 27% of students already had symptoms) had no significant impact on spread. School-aged individuals (6–18 y) facilitated the introduction and spread of influenza in households, but only about one in five cases aged >18 y was infected by a school-aged household member. This analysis shows the extent to which clearly defined social networks affect influenza transmission, revealing strong between-place interactions with back-and-forth waves of transmission between the school, the community, and the household.
Cauchemez, Simon; Bhattarai, Achuyt; Marchbanks, Tiffany L.; Fagan, Ryan P.; Ostroff, Stephen; Ferguson, Neil M.; Swerdlow, David; Sodha, Samir V.; Moll, Maria E.; Angulo, Frederick J.; Palekar, Rakhee; Archer, W. Roodly; Finelli, Lyn
Background Meningococcal meningitis is a major health problem in the “African Meningitis Belt” where recurrent epidemics occur during the hot, dry season. In Niger, a central country belonging to the Meningitis Belt, reported meningitis cases varied between 1,000 and 13,000 from 2003 to 2009, with a case-fatality rate of 5–15%. Methodology/Principal Findings In order to gain insight in the epidemiology of meningococcal meningitis in Niger and to improve control strategies, the emergence of the epidemics and their diffusion patterns at a fine spatial scale have been investigated. A statistical analysis of the spatio-temporal distribution of confirmed meningococcal meningitis cases was performed between 2002 and 2009, based on health centre catchment areas (HCCAs) as spatial units. Anselin's local Moran's I test for spatial autocorrelation and Kulldorff's spatial scan statistic were used to identify spatial and spatio-temporal clusters of cases. Spatial clusters were detected every year and most frequently occurred within nine southern districts. Clusters most often encompassed few HCCAs within a district, without expanding to the entire district. Besides, strong intra-district heterogeneity and inter-annual variability in the spatio-temporal epidemic patterns were observed. To further investigate the benefit of using a finer spatial scale for surveillance and disease control, we compared timeliness of epidemic detection at the HCCA level versus district level and showed that a decision based on threshold estimated at the HCCA level may lead to earlier detection of outbreaks. Conclusions/Significance Our findings provide an evidence-based approach to improve control of meningitis in sub-Saharan Africa. First, they can assist public health authorities in Niger to better adjust allocation of resources (antibiotics, rapid diagnostic tests and medical staff). Then, this spatio-temporal analysis showed that surveillance at a finer spatial scale (HCCA) would be more efficient for public health response: outbreaks would be detected earlier and reactive vaccination would be better targeted.
Paireau, Juliette; Girond, Florian; Collard, Jean-Marc; Mainassara, Halima B.; Jusot, Jean-Francois
Foot-and-mouth disease (FMD) is a highly contagious viral disease of cloven-hoofed animals. An outbreak of FMD can have a significant economic impact because of the restrictions on international trade of susceptible animals and their products with FMD-free countries. In this chapter we discuss vario...
Various forms of viral hepatitis have been identified as being sexually transmitted infections (STIs), whereas other forms\\u000a are transmitted primarily via oralfecal routes. The most common forms of viral hepatitis are hepatitis A, B, and C. Hepatitis\\u000a A virus (HAV) infection is most often a benign self-limiting disease; however, it can progress to fulminant liver failure.\\u000a Fecal-oral transmission though contact
Michelle L. Geller; Jeremy R. Herman
A generic, stochastic spreadsheet model was developed to calculate the number of cases within the first 100 days of a propagating epidemic and with the ability to incorporate generic control measures. Foot-and-mouth disease (FMD) epidemics were simulated with a range of assumptions about the number of cases incubating the disease on day 1 and the efficiency of control measures. Particularly severe epidemics resulted from scenarios with low efficiency of control measures and high numbers incubating. Control measures that prevented 0.8 of cases from resulting in new cases were able to reduce substantially the cumulative number of cases. The results of various scenarios using the model were compared to the number of cases of FMD in the first 100 days of the 2001 outbreak in the UK, with specific reference to cases in Cumbria and Anglesey. Potential practical and educational applications of the model are discussed. PMID:14975391
Ap Dewi, I; Molina-Flores, B; Edwards-Jones, G
Highlights from the past years' literature on the topics of animal-induced injuries and diseases, neonatal jaundice, immunizations, and viral infections are discussed from the perspective of the general pediatrician. An effort is made to place recent advances in care or understanding of clinical problems into the context of the pediatric office practice. The current reality of health care-be it managed care, care for the underserved, or the recent pressures on academic and hospital-based medicine-does not alter the importance of the delivery of quality care at the office level. Although it is now popular to define quality of health care in cute advertising copy, as if we are selling durable goods, excellence in pediatric office-based practice continues to require broad strokes of medical knowledge coupled with a unswerving commitment to and advocacy for the needs and well-being of infants, children, and young adults. PMID:8954278
Gerson, W T
Nipah virus, a novel paramyxovirus, closely related to Hendra virus emerged in northern part of Peninsular Malaysia in 1998. The virus caused an outbreak of severe febrile encephalitis in humans with a high mortality rate, whereas, in pigs, encephalitis and respiratory diseases but with a relatively low mortality rate. The outbreak subsequently spread to various regions of the country and
Kaw Bing Chua
DISEASE imposes considerable constraints on the productivity and profitability of the livestock industry. Pig producers have probably suffered more than other sectors from the devastating effects of a succession of infectious disease outbreaks over the past 30 years. Many of these have been highly contagious viral diseases, including transmissible gastroenteritis (TGE), swine influenza (SI), Aujeszky's disease (AD), and porcine respiratory
Geoff Pritchard; Ian Dennis; Jake Waddilove
White spot syndrome virus (WSSV) is the most important pathogen in shrimp farming systems worldwide including the Mekong Delta, Vietnam. The genome of WSSV is characterized by the presence of two major 'indel regions' found at ORF14/15 and ORF23/24 (WSSV-Thailand) and three regions with variable number tandem repeats (VNTR) located in ORF75, ORF94 and ORF125. In the current study, we investigated whether or not the number of repeat units in the VNTRs correlates with virus outbreak status and/or shrimp farming practice. We analysed 662 WSSV samples from individual WSSV-infected Penaeus monodon shrimp from 104 ponds collected from two important shrimp farming regions of the Mekong Delta: Ca Mau and Bac Lieu. Using this large data set and statistical analysis, we found that for ORF94 and ORF125, the mean number of repeat units (RUs) in VNTRs was significantly lower in disease outbreak ponds than in non-outbreak ponds. Although a higher mean RU number was observed in the improved-extensive system than in the rice-shrimp or semi-intensive systems, these differences were not significant. VNTR sequences are thus not only useful markers for studying WSSV genotypes and populations, but specific VNTR variants also correlate with disease outbreaks in shrimp farming systems. PMID:22913744
Hoa, T T T; Zwart, M P; Phuong, N T; de Jong, M C M; Vlak, J M
Cyanobacterial toxins (i.e. microcystins) produced within the microbial mat of coral black band disease (BBD) have been implicated in disease pathogenicity. This study investigated the presence of toxins within BBD lesions and other cyanobacterial patch (CP) lesions, which, in some instances ( approximately 19%), facilitated the onset of BBD, from an outbreak site at Pelorus Island on the inshore, central Great Barrier Reef (GBR). Cyanobacterial species that dominated the biomass of CP and BBD lesions were cultivated and identified, based on morphology and 16S rRNA gene sequences, as Blennothrix- and Oscillatoria-affiliated species, respectively, and identical to cyanobacterial sequences retrieved from previous molecular studies from this site. The presence of the cyanotoxins microcystin, cylindrospermopsin, saxitoxin, nodularin and anatoxin and their respective gene operons in field samples of CP and BBD lesions and their respective culture isolations was tested using genetic (PCR-based screenings), chemical (HPLC-UV, FTICR-MS and LC/MS(n)) and biochemical (PP2A) methods. Cyanotoxins and cyanotoxin synthetase genes were not detected in any of the samples. Cyanobacterial species dominant within CP and BBD lesions were phylogenetically distinct from species previously shown to produce cyanotoxins and isolated from BBD lesions. The results from this study demonstrate that cyanobacterial toxins appear to play no role in the pathogenicity of CP and BBD at this site on the GBR. PMID:20455937
Glas, Martin S; Motti, Cherie A; Negri, Andrew P; Sato, Yui; Froscio, Suzanne; Humpage, Andrew R; Krock, Bernd; Cembella, Allan; Bourne, David G
An outbreak of Chagas disease occurred in Mazagão, Amapá, Brazilian Amazon in 1996. Seventeen of 26 inhabitants presented symptoms compatible with acute Chagas disease and were submitted to parasitological and serological tests. All 17 were positive in at least one parasitological test and 11 were also IgM or IgG anti-Trypanosoma cruzi positive. The nine asymptomatic patients were negative for parasites and one was positive for IgG anti-T. cruzi. Sixty-eight triatomines were captured (66 Rhodnius pictipes; two Panstrongylus geniculatus); 45 were infected with T. cruzi (43 R. pictipes; two P. geniculatus). Thirteen trypanosomatid strains were isolated: eight from humans and five from R. pictipes. Four were genotyped as T. cruzi I (two from humans; two from R. pictipes), seven as T. cruzi Z3 (six from humans; one from R. pictipes) and two as T. cruzi Z3 and T. rangeli (from R. pictipes). Treatment started for all patients leading to a decrease in parasitaemia in 16 during the follow-up period (6 months, 1, 5 and 7 years). All were serologically negative 7 years post-treatment. There was an overlap of genotypes in the same ecotope, raising the possibility of transmission through the oral route and the need for early therapeutic intervention for better patient management in the Brazilian Amazon. PMID:19118852
Valente, Sebastião Aldo da Silva; da Costa Valente, Vera; das Neves Pinto, Ana Yecê; de Jesus Barbosa César, Maria; dos Santos, Marivaldo Picanço; Miranda, Clóvis Omar Sá; Cuervo, Patrícia; Fernandes, Octavio
An outbreak of acute hemorrhagic conjunctivitis (AHC) occurred in Yunnan Province, China between August and September in 2007. A total of 3,597 cases were officially reported and the incidence rate reached 1390.94/100,000. Descriptive epidemiological analysis of the outbreak was conducted using the data from National Disease Supervision Information Management System (NDSIMS). To determine the causative agent for this outbreak and to analyze their genetic features, 30 conjunctival swabs and 19 paired serum specimens of acute and convalescent phase were collected from 30 patients with AHC, and viral isolation, molecular typing, antibody assay and phylogenetic analysis were performed. 11 virus strains were isolated from 30 conjunctival swabs. Amplification and sequencing of the VP4 region of these strains identified that coxsackievirus A24 variant (CA24v) could be the causative agent of the AHC outbreak and this was further confirmed by subsequent virus neutralizing antibody test on 19 paired serum specimens. Phylogenetic analysis based on the 3C regions showed that the Yunnan CA24v strains belonged to Group 3 and clustered with the strains isolated from worldwide AHC outbreaks after 2002. Phylogenetic analysis based on the partial VP1 revealed that the Yunnan strains differed from the strains isolated from AHC outbreak in Guangdong of China in 2007 with 2.8 - 3.0% nucleotide divergence, suggesting that two different lineages of CA24v caused the independent AHC outbreaks in Yunnan and Guangdong, respectively.
Early surveillance of notifiable infectious diseases is a key element for their control by public health agencies. The goal of syndromic disease surveillance is to identify emerging infectious risks to public health in real or near real time as a method of early detection, trend monitoring, and false-alarm avoidance. This article reviews temporal, spatial, and spatial–temporal aberration detection techniques that
Dongmei Chen; John Cunningham; Kieran Moore; Jie Tian
Very little is known about how environmental changes such as increasing temperature affect disease dynamics in the ocean, especially at large spatial scales. We asked whether the frequency of warm temperature anomalies is positively related to the frequency of coral disease across 1,500 km of Australia's Great Barrier Reef. We used a new high-resolution satellite dataset of ocean temperature and
John F. Bruno; Elizabeth R. Selig; Kenneth S. Casey; Cathie A. Page; Bette L. Willis; C. Drew Harvell; Hugh Sweatman; Amy M. Melendy
Unusual disease lesions were observed in Montipora corals on the fringing reef of Magnetic Island (Great Barrier Reef, Australia) following a period of high water temperature in early January 2002. Tissue death in Montipora spp. appeared as a black layer that spread rapidly across the colony surface, though this appeared as the final phase of disease progression (with three previous
D. G. Bourne
... The Signals and Surveillance Team is all about early detection that will limit or prevent illness linked to dietary supplements, cosmetics, and foods ... More results from www.fda.gov/food/recallsoutbreaksemergencies/outbreaks
Epidemiological and clinical characteristics of 210 cases of Lyme disease in Westchester County, New York, reported during 1982 and 1983 are described. Most cases occurred during summer months in individuals under age 40 (male: female ratio 1:2 to 1). Symptoms included skin rash (75 per cent), joint pain or swelling (50 per cent), Bell's palsy (11 per cent), and aseptic meningitis (3 per cent). With greater public and medical awareness of this tick-borne disease, Lyme disease is being recognized with increasing frequency characteristic of an emerging epidemic in Westchester County.
Williams, C L; Curran, A S; Lee, A C; Sousa, V O
BACKGROUND: Comprehensive understanding of molecular mechanisms underlying viral infection is a major challenge towards the discovery of new antiviral drugs and susceptibility factors of human diseases. New advances in the field are expected from systems-level modelling and integration of the incessant torrent of high-throughput \\
Vincent Navratil; Benoit de Chassey; Chantal Rabourdin Combe; Vincent Lotteau
The prevalence of bovine viral diarrhea virus (BVDV) infections was determined in 2 groups of stocker calves with acute respiratory disease. Both studies used calves assembled after purchase from auction markets by an order buyer and transported to feedyards, where they were held for approximately 30 d. In 1 study, the calves were mixed with fresh ranch calves from a single ranch. During the studies, at day 0 and at weekly intervals, blood was collected for viral antibody testing and virus isolation from peripheral blood leukocytes (PBLs), and nasal swabs were taken for virus isolation. Samples from sick calves were also collected. Serum was tested for antibodies to bovine herpesvirus-1 (BHV-1), BVDV1a, 1b, and 2, parainfluenza 3 virus (PI3V), and bovine respiratory syncytial virus (BRSV). The lungs from the calves that died during the studies were examined histopathologically, and viral and bacterial isolation was performed on lung homogenates. BVDV was isolated from calves in both studies; the predominant biotype was noncytopathic (NCP). Differential polymerase chain reaction (PCR) and nucleic acid sequencing showed the predominant subtype to be BVDV1b in both studies. In 1999, NCP BVDV1b was detected in numerous samples over time from 1 persistently infected calf; the calf did not seroconvert to BVDV1a or BVDV2. In both studies, BVDV was isolated from the serum, PBLs, and nasal swabs of the calves, and in the 1999 study, it was isolated from lung tissue at necropsy. BVDV was demonstrated serologically and by virus isolation to be a contributing factor in respiratory disease. It was isolated more frequently from sick calves than healthy calves, by both pen and total number of calves. BVDV1a and BVDV2 seroconversions were related to sickness in selected pens and total number of calves. In the 1999 study, BVDV-infected calves were treated longer than noninfected calves (5.643 vs 4.639 d; P = 0.0902). There was a limited number of BVDV1a isolates and, with BVDV1b used in the virus neutralization test for antibodies in seroconverting calves' serum, BVDV1b titers were higher than BVDV1a titers. This study indicates that BVDV1 strains are involved in acute respiratory disease of calves with pneumonic Mannheimia haemolytica and Pasteurella multocida disease. The BVDV2 antibodies may be due to cross-reactions, as typing of the BVDV strains revealed BVDV1b or 1a but not BVDV2. The BVDV1b subtype has considerable implications, as, with 1 exception, all vaccines licensed in the United States contain BVDV1a, a strain with different antigenic properties. BVDV1b potentially could infect BVDV1a-vaccinated calves.
Fulton, Robert W.; Ridpath, Julia F.; Saliki, Jeremiah T.; Briggs, Robert E.; Confer, Anthony W.; Burge, Lurinda J.; Purdy, C. W.; Loan, Raymond W.; Duff, Glenn C.; Payton, Mark E.
The prevalence of bovine viral diarrhea virus (BVDV) infections was determined in 2 groups of stocker calves with acute respiratory disease. Both studies used calves assembled after purchase from auction markets by an order buyer and transported to feedyards, where they were held for approximately 30 d. In 1 study, the calves were mixed with fresh ranch calves from a single ranch. During the studies, at day 0 and at weekly intervals, blood was collected for viral antibody testing and virus isolation from peripheral blood leukocytes (PBLs), and nasal swabs were taken for virus isolation. Samples from sick calves were also collected. Serum was tested for antibodies to bovine herpesvirus-1 (BHV-1), BVDV1a, 1b, and 2, parainfluenza 3 virus (PI3V), and bovine respiratory syncytial virus (BRSV). The lungs from the calves that died during the studies were examined histopathologically, and viral and bacterial isolation was performed on lung homogenates. BVDV was isolated from calves in both studies; the predominant biotype was noncytopathic (NCP). Differential polymerase chain reaction (PCR) and nucleic acid sequencing showed the predominant subtype to be BVDV1b in both studies. In 1999, NCP BVDV1b was detected in numerous samples over time from 1 persistently infected calf; the calf did not seroconvert to BVDV1a or BVDV2. In both studies, BVDV was isolated from the serum, PBLs, and nasal swabs of the calves, and in the 1999 study, it was isolated from lung tissue at necropsy. BVDV was demonstrated serologically and by virus isolation to be a contributing factor in respiratory disease. It was isolated more frequently from sick calves than healthy calves, by both pen and total number of calves. BVDV1a and BVDV2 seroconversions were related to sickness in selected pens and total number of calves. In the 1999 study, BVDV-infected calves were treated longer than noninfected calves (5.643 vs 4.639 d; P = 0.0902). There was a limited number of BVDV1a isolates and, with BVDV1b used in the virus neutralization test for antibodies in seroconverting calves' serum, BVDV1b titers were higher than BVDV1a titers. This study indicates that BVDV1 strains are involved in acute respiratory disease of calves with pneumonic Mannheimia haemolytica and Pasteurella multocida disease. The BVDV2 antibodies may be due to cross-reactions, as typing of the BVDV strains revealed BVDV1b or la but not BVDV2. The BVDV1b subtype has considerable implications, as, with 1 exception, all vaccines licensed in the United States contain BVDV1a, a strain with different antigenic properties. BVDV1b potentially could infect BVDV1a-vaccinated calves. PMID:12146890
Fulton, Robert W; Ridpath, Julia F; Saliki, Jeremiah T; Briggs, Robert E; Confer, Anthony W; Burge, Lurinda J; Purdy, C W; Loan, Raymond W; Duff, Glenn C; Payton, Mark E
Viruses are major drivers of global biogeochemistry and the etiological agents of many diseases. They are also the winners in the game of life: there are more viruses on the planet than cellular organisms and they encode most of the genetic diversity on the planet. In fact, it is reasonable to view life as a viral incubator. Nevertheless, most ecological and evolutionary theories were developed, and continue to be developed, without considering the virosphere. This means these theories need to be to reinterpreted in light of viral knowledge or we need to develop new theory from the viral point-of-view. Here we briefly introduce our viral planet and then address a major outstanding question in biology: why is most of life viral? A key insight is that during an infection cycle the original virus is completely broken down and only the associated information is passed on to the next generation. This is different for cellular organisms, which must pass on some physical part of themselves from generation to generation. Based on this premise, it is proposed that the thermodynamic consequences of physical information (e.g., Landauer's principle) are observed in natural viral populations. This link between physical and genetic information is then used to develop the Viral Information Hypothesis, which states that genetic information replicates itself to the detriment of system energy efficiency (i.e., is viral in nature). Finally, we show how viral information can be tested, and illustrate how this novel view can explain existing ecological and evolutionary theories from more fundamental principles. PMID:23482918
Rohwer, Forest; Barott, Katie
1. The significance of airborne transmission in epidemics of infectious diseases in the livestock production industry remains unclear. The study therefore investigated the shedding route (faeces vs. exhaled air) of a vaccine strain of infectious bursal disease virus (IBDV) by broilers and the emission of airborne virus. 2. The experimental room contained 526 broilers which were orally inoculated at the age of 20?d. The airborne virus was sampled by three different bioaerosol samplers: Andersen six-stage impactor, all-glass impinger (AGI-30) and OMNI-3000. 3. Infected broilers started to shed virus in faeces on d 5 post inoculation (PI), and stopped shedding on d 12 PI. The faecal virus remained detectable for at least two d after drying under broiler room conditions. No virus was detected in the air exhaled by broilers. 4. Airborne virus was collected on d 5, 8 and 12 PI at 20?cm above the floor, and on d 8 and 12 PI in exhausted air. The emission rates of IBDV were 4·0 log10 50% tissue culture infectious dose (TCID50)/bird/d on d 8 PI, and 4·5 log10 TCID50/bird/d on d 12 PI. 5. We concluded that broilers shed IBDV mainly through their faeces. The presence of indoor airborne virus is associated with the viral presence in faeces. The successful recovery of airborne virus in exhausted air indicates there is a potential risk of virus spreading to the ambient environment via air. PMID:23444858
Zhao, Y; Aarnink, A J A; Cambra-Lopez, M; Fabri, T
Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection affect >500 million people worldwide and are significant causes of liver cirrhosis and hepatocellular carcinoma. The pathogenesis of HBV and HCV infection can vary widely with respect to the outcome of initial infection to self-resolving acute or chronic disease, the extent of viremia and liver inflammation during chronic infection, and the eventual development of liver cirrhosis and hepatocellular carcinoma. The host immune response is an important factor in the variable consequences of these infections, because the innate and adaptive intrahepatic antiviral responses are an intricate balance of immune effector cells and cytokines that control virus replication but can also cause liver damage. IL-22 is an important cytokine that plays a pleiotropic protective, but sometimes also pathological, role in several tissues/organs, including the liver. Therefore, IL-22 is likely to be an important factor in the pathogenesis and clinical outcome of HBV and HCV infection. However, the precise beneficial, and possible detrimental, effects of this cytokine may vary among different disease states that are associated with distinct inflammatory microenvironments. This review summarizes our understanding of the protective and pathological activities of IL-22, with an emphasis on the liver, and discusses the implications of these effects as they relate to viral hepatitis. PMID:23159948
Cobleigh, Melissa A; Robek, Michael D
The genome of Marek's disease virus (MDV) has been predicted to encode a secreted glycoprotein, vLIP, which bears significant homology to the ?/? hydrolase fold of pancreatic lipases. Here it is demonstrated that MDV vLIP mRNA is produced via splicing and that vLIP is a late gene, due to its sensitivity to inhibition of DNA replication. While vLIP was found to conserve several residues essential to hydrolase activity, an unfavorable asparagine substitution is present at the lipase catalytic triad acid position. Consistent with structural predictions, purified recombinant vLIP did not show detectable activity on traditional phospholipid or triacylglyceride substrates. Two different vLIP mutant viruses, one bearing a 173-amino-acid deletion in the lipase homologous domain, the other having an alanine point mutant at the serine nucleophile position, caused a significantly lower incidence of Marek's disease in chickens and resulted in enhanced survival relative to two independently produced vLIP revertants or parental virus. These data provide the first evidence that vLIP enhances the replication and pathogenic potential of MDV. Furthermore, while vLIP may not serve as a traditional lipase enzyme, the data indicate that the serine nucleophile position is nonetheless essential in vivo for the viral functions of vLIP. Therefore, it is suggested that this particular example of lipase homology may represent the repurposing of an ?/? hydrolase fold toward a nonenzymatic role, possibly in lipid bonding.
Kamil, Jeremy P.; Tischer, B. Karsten; Trapp, Sascha; Nair, Venugopal K.; Osterrieder, Nikolaus; Kung, Hsing-Jien
Rapid progress in DNA synthesis and sequencing is spearheading the deliberate, large-scale genetic alteration of organisms. These new advances in DNA manipulation have been extended to the level of whole-genome synthesis, as evident from the synthesis of poliovirus, from the resurrection of the extinct 1918 strain of influenza virus and of human endogenous retroviruses and from the restructuring of the phage T7 genome. The largest DNA synthesized so far is the 582,970 base pair genome of Mycoplasma genitalium, although, as yet, this synthetic DNA has not been ‘booted’ to life. As genome synthesis is independent of a natural template, it allows modification of the structure and function of a virus’s genetic information to an extent that was hitherto impossible. The common goal of this new strategy is to further our understanding of an organism’s properties, particularly its pathogenic armory if it causes disease in humans, and to make use of this new information to protect from, or treat, human viral disease. Although only a few applications of virus synthesis have been described as yet, key recent findings have been the resurrection of the 1918 influenza virus and the generation of codon- and codon pair–deoptimized polioviruses.
Wimmer, Eckard; Mueller, Steffen; Tumpey, Terrence M; Taubenberger, Jeffery K
Foot-and-mouth desease (FMD), a highly contagious viral disease of cattle, sheep, pigs and other cloven-hoofed animals has recently caused devastating epidemics world-wide. In the three South African Territories (SAT) types of foot-and-mouth disease virus (FMDV), the aetiological agent display grea...
A recombinant protein-based enzyme-linked immunosorbent assay (RP ELISA) exists for the detection of antibodies to foot-and-mouth disease virus (FMDV) type A. In this study, the efficacy of the RP ELISA was compared to that of other current tests by examining sera collected in the field during an FMD type A outbreak in South Korea in 2010. The RP ELISA detected early antibodies to FMDV with the same sensitivity as the liquid-phase blocking ELISA (LPB ELISA), identifying FMD farm outbreaks correctly on a herd basis. In addition, the two assays exhibited a high correlation coefficient (?(2)=0.83) when testing thirty seven sera from one outbreak farm exhibiting various antibody titers. The sensitivity and specificity of the RP ELISA relative to the LPB ELISA were 84% and 97%, respectively, and excellent agreement (kappa=0.82) was observed between the two tests. Taken together, the RP ELISA should be a useful alternative to the LPB ELISA for the detection of early antibodies to FMDV type A during an outbreak. PMID:22001272
Ko, Young-Joon; Lee, Hyang-Sim; Park, Jong-Hyeon; Lee, Kwang-Nyeong; Kim, Su-Mi; Cho, In-Soo; Joo, Hoo-Don; Paik, Sang-Gi; Paton, David J; Parida, Satya
We compared CSF HIV viral load in 33 asymptomatic HIV seropositive patients, 11 patients with incipient minor motor deficits\\u000a (MMD), 11 patients with sustained MMD, and 16 patients with HIV–associated dementia. Patients with incipient MMD showed significantly\\u000a higher CSF viral load than asymptomatic patients. Demented patients also had higher CSF viral loads than asymptomatic patients.\\u000a This phenomenon is independent of
Hans-Jürgen von Giesen; Ortwin Adams; Hubertus Köller; Gabriele Arendt
Naturally occurring foot-and-mouth disease (FMD) in wildlife is a relatively mild condition but occasionally it can be devastating as has been documented in impala in South Africa and in mountain gazelles in Israel. This report describes pathological changes in an adult male gazelle with FMD from an outbreak in the Nature Reserve of Ramot-Issachar region and the lower Galilee in Israel. The outbreak was characterised by the malignant form of the disease, which is uncommon among domestic animals. Lesions observed included, ulceration in the oral cavity, oesophagus and ruminal pillars, coronitis, multifocal cardiac necrosis and pancreatic necrosis and inflammation. Pneumonia, caused by Muellerius capillaries was an incidental finding. PMID:20649158
Berkowitz, A; Waner, T; King, R; Yadin, H; Perle, S
SUMMARY Trypanosoma cruzi I, a discrete typing unit (DTU) found in human infections in Venezuela and other countries of the northern region of South America and in Central America, has been recently classified into five intra-DTU genotypes (Ia, Ib, Ic, Id, Ie) based on sequence polymorphisms found in the spliced leader intergenic region. In this paper we report the genotype identification of T. cruzi human isolates from one outbreak of acute orally acquired Chagas disease that occurred in a non-endemic region of Venezuela and from T. cruzi triatomine and rat isolates captured at a guava juice preparation site which was identified as the presumptive source of infection. The genotyping of all these isolates as TcId supports the view of a common source of infection in this oral Chagas disease outbreak through the ingestion of guava juice. Implications for clinical manifestations and dynamics of transmission cycles are discussed. PMID:23544849
Díaz-Bello, Z; Thomas, M C; López, M C; Zavala-Jaspe, R; Noya, O; DE Noya, B Alarcón; Abate, T
The WSWRD in NRMRL/ORD has had a successful collaborative relationship with the Cetners for Disease Control & Prevention (CDCP) for over twenty years. When invited, EPA has supplied technical assistance and advice on traking causative events, evaluation of drinking water problems...
Summary This paper demonstrates how currently underutilised economic modelling techniques can enrich the analysis of animal disease problems. Increasingly, analyses of animal health programmes are expected to address a range of economic and social questions. These expectations can be addressed by better integration of epidemiological modelling with economic techniques whose application to animal health has not been thoroughly discussed in
G. Y. Miller; A. Winter-Nelson
In 2008, a northwest Texas feedlot underwent an outbreak of bovine viral diarrhea virus (BVDV) disease causing high morbidity and mortality involving two lots of calves (Lots A and B). Severe mucosal surface lesions were observed grossly in the oral cavity, larynx and esophagus. Mucosal lesions vari...
Abstract Background MicroRNAs are short RNAs (~22 nt) expressed by plants, animals and viruses that regulate gene expression post-transcriptionally, and their importance is highlighted by distinct patterns of expression in many physiological processes, including development, hematopoeisis, stress resistance, and disease. Our group has characterized the microRNAs encoded by the avian herpesviruses; namely, oncogenic Marek’s disease (MD) virus (MDV1), non-oncogenic MDV (MDV2) herpesvirus of turkeys (HVT), and infectious laryngotracheitis virus (ILTV). Methods MicroRNAs encoded by the avian herpesviruses were identified using next generation sequencing technologies (454, Illumina). Results The microRNAs of each the avian herpesviruses have unique sequences, but the genomic locations are similar, in that the microRNAs tend to be clustered in the rapidly evolving repeat regions of the viral genomes. For a given viral species the microRNA sequence is highly conserved in different strains with the exception of a virulence-associated polymorphism in the putative promoter of the MDV1 microRNAs upstream of the meq oncogene. These microRNAs are relatively highly expressed in tumors produced by very virulent MDV1 isolates compared to tumors produced by less virulent strains. MDV1 and HVT encode homologs of the host microRNA, miR-221, which targets a gene important in cell cycle regulation. MDV1 encodes a microRNA (mdv1-miR-M4) that shares a seed sequence with miR-155, a microRNA important in immune function. Mdv-miR-M4 is highly expressed in MDV induced tumors, while miR-155 is present at very low levels. Conclusions MicroRNAs are highly conserved among different field strains of MDV1, and they are expressed in lytic and latent infections and in MDV1-derived tumors. This suggests that these small molecules are very important to the virus, and roles in immune evasion, anti-apoptosis, or proliferation are likely.
Vector-borne infectious diseases, such as malaria, dengue, chikungunya, and West Nile fevers are increasingly identified as major global human health threats in developing and developed countries. The success or failure of vector control rests mainly on the nature and scale of the behavioural response of exposed populations. Large-scale adoption of recommended protective behaviour represents a critical challenge that cannot be addressed without a better understanding of how individuals perceive and react to the risk of infection. Recently, French overseas territories faced large-scale outbreaks: an epidemic of chikungunya fever in La Re' union and Mayotte (2005-2006) and four successive outbreaks of dengue fever in one Caribbean island, Martinique (1995-2007). To assess how these populations perceived and responded to the risk, and how the nature and scale of protection affected their clinical status, socio-epidemiological surveys were conducted on each island during the outbreaks. These surveys address three crucial and interconnected questions relevant to the period after persons infected by the virus were identified: which factors shape the risk of acquiring disease? Which socio- demographic characteristics and living conditions induce a higher likelihood of infection? What is the impact of risk perception on protective behaviours adopted against mosquito bites? Grounded on the results of these surveys, a general framework is proposed to help draw out the knowledge needed to reveal the factors associated with higher probability of infection as an outbreak emerges. The lessons learnt can inform health authorities' efforts to improve risk communication programmes, both in terms of the target and content of messages, so as to explore new strategies for ensuring sustainable protective behaviour. The authors compare three epidemics of vector-borne diseases to elucidate psychosocial factors that determine how populations perceive and respond to the risk of infectious disease. PMID:22460287
Setbon, M; Raude, J
Vector-borne infectious diseases, such as malaria, dengue, chikungunya, and West Nile fevers are increasingly identified as major global human health threats in developing and developed countries. The success or failure of vector control rests mainly on the nature and scale of the behavioural response of exposed populations. Large-scale adoption of recommended protective behaviour represents a critical challenge that cannot be addressed without a better understanding of how individuals perceive and react to the risk of infection. Recently, French overseas territories faced large-scale outbreaks: an epidemic of chikungunya fever in La Re? union and Mayotte (2005–2006) and four successive outbreaks of dengue fever in one Caribbean island, Martinique (1995–2007). To assess how these populations perceived and responded to the risk, and how the nature and scale of protection affected their clinical status, socio-epidemiological surveys were conducted on each island during the outbreaks. These surveys address three crucial and interconnected questions relevant to the period after persons infected by the virus were identified: which factors shape the risk of acquiring disease? Which socio- demographic characteristics and living conditions induce a higher likelihood of infection? What is the impact of risk perception on protective behaviours adopted against mosquito bites? Grounded on the results of these surveys, a general framework is proposed to help draw out the knowledge needed to reveal the factors associated with higher probability of infection as an outbreak emerges. The lessons learnt can inform health authorities’ efforts to improve risk communication programmes, both in terms of the target and content of messages, so as to explore new strategies for ensuring sustainable protective behaviour. The authors compare three epidemics of vector-borne diseases to elucidate psychosocial factors that determine how populations perceive and respond to the risk of infectious disease.
Setbon, M; Raude, J
Two outbreaks of hand-foot-and-mouth disease (HFMD) occurred in Taiwan between 1998 and 2000. Enteroviruses were isolated from a total of 1,892 patients in this laboratory during this period. Of the virus isolates, enterovirus 71 (EV71) was diagnosed in 44.4% of the patients (132 of 297) in 1998, 2% (13 of 646) in 1999, and 20.5% (195 of 949) in 2000.
Jen-Ren Wang; Yen-Chang Tuan; Huey-Pin Tsai; Jing-Jou Yan; Ching-Chuan Liu; Ih-Jen Su
In MedMyst: Animal Alert!, players learn about a mysterious disease that is affecting people in a distant tropical region. Players can choose to work as an epidemiologist, microbiologist, or veterinarian to determine what is making people sick. Animal Alert! can be played after Disease Defenders or independently of that mission. While role-playing as an expert, players will learn how epidemiologists, microbiologists, and veterinarians work as a team to solve infectious disease outbreaks. Each expert path has its own learning objectives.
Learning, Center F.
Background Comprehensive understanding of molecular mechanisms underlying viral infection is a major challenge towards the discovery of new antiviral drugs and susceptibility factors of human diseases. New advances in the field are expected from systems-level modelling and integration of the incessant torrent of high-throughput "-omics" data. Results Here, we describe the Human Infectome protein interaction Network, a novel systems virology model of a virtual virus-infected human cell concerning 110 viruses. This in silico model was applied to comprehensively explore the molecular relationships between viruses and their associated diseases. This was done by merging virus-host and host-host physical protein-protein interactomes with the set of genes essential for viral replication and involved in human genetic diseases. This systems-level approach provides strong evidence that viral proteomes target a wide range of functional and inter-connected modules of proteins as well as highly central and bridging proteins within the human interactome. The high centrality of targeted proteins was correlated to their essentiality for viruses' lifecycle, using functional genomic RNAi data. A stealth-attack of viruses on proteins bridging cellular functions was demonstrated by simulation of cellular network perturbations, a property that could be essential in the molecular aetiology of some human diseases. Networking the Human Infectome and Diseasome unravels the connectivity of viruses to a wide range of diseases and profiled molecular basis of Hepatitis C Virus-induced diseases as well as 38 new candidate genetic predisposition factors involved in type 1 diabetes mellitus. Conclusions The Human Infectome and Diseasome Networks described here provide a unique gateway towards the comprehensive modelling and analysis of the systems level properties associated to viral infection as well as candidate genes potentially involved in the molecular aetiology of human diseases.
In order to detect infectious bursal disease virus (IBDV), bursal tissue was collected from 10 IBD-suspected birds from a 30-day-old, IBDV-vaccinated commercial broiler chicken flock of 2000 birds exhibiting clinical signs suggestive of infectious bursal disease (IBD). The presence of IBDV was confirmed by partial amplification of the VP2 gene by reverse transcription and polymerase chain reaction. Isolates were identified as very virulent strains of IBDV (vvIBDV) by nucleotide sequence analysis. The comparison of the VP2 nucleotide sequences among the isolates revealed the presence of single-nucleotide polymorphisms in the VP2 gene of IBDV in the same flock. The comparative analysis indicated that these viruses were genetically close to the vvIBDVs previously detected in India. Our analysis provided information about the existence of vvIBDV in Central India. PMID:22366141
Singh, Azad; Bedekar, Megha Kadam; Sharma, Rakesh; Sarkhel, Bikash Chandra; Singh, Sanjeev; Jain, Sudhir Kumar
Noroviruses are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide, and a major cause of foodborne illness. In the United States, approximately 21 million illnesses attributable to no...
A. J. Hall B. Lopman C. Yen G. W. Park J. Vinje N. Gregoricus U. Parashar
BACKGROUND: Shiga toxins 1 and 2 (Stx1 and Stx2) are bacteriophage-encoded proteins that have been associated with hemorrhagic colitis, hemolytic uremic syndrome and other severe disease conditions. Stx1 and Stx2 are genetically and immunologically distinct but share the same compound toxin structure, method of entry and enzymatic function. RESULTS: Phylogenetic analysis was performed using Stx1 and Stx2 amino acid and
James E Lee; Junelina Reed; Malcolm S Shields; Kathleen M Spiegel; Larry D Farrell; Peter P Sheridan
Filarioid parasites represent major health hazards with important medical, veterinary, and economic implications, and considerable potential to affect the everyday lives of tens of millions of people globally (World Health Organization, 2007). Scenarios for climate change vary latitudinally and regionally and involve direct and indirect linkages for increasing temperature and the dissemination, amplification, and invasiveness of vector-borne parasites. High latitude regions are especially influenced by global climate change and thus may be prone to altered associations and dynamics for complex host-pathogen assemblages and emergence of disease with cascading effects on ecosystem structure. Although the potential for substantial ecological perturbation has been identified, few empirical observations have emanated from systems across the Holarctic. Coincidental with decades of warming, and anomalies of high temperature and humidity in the sub-Arctic region of Fennoscandia, the mosquito-borne filarioid nematode Setaria tundra is now associated with emerging epidemic disease resulting in substantial morbidity and mortality for reindeer and moose. We describe a host-parasite system that involves reindeer, arthropods, and nematodes, which may contribute as a factor to ongoing declines documented for this ungulate species across northern ecosystems. We demonstrate that mean summer temperatures exceeding 14 degrees C drive the emergence of disease due to S. tundra. An association between climate and emergence of filarioid parasites is a challenge to ecosystem services with direct effects on public health, sustainability of free-ranging and domestic ungulates, and ultimately food security for subsistence cultures at high latitudes. PMID:20422252
Laaksonen, Sauli; Pusenius, Jyrki; Kumpula, Jouko; Venäläinen, Ari; Kortet, Raine; Oksanen, Antti; Hoberg, Eric
Newcastle disease (ND) is a highly contagious, severe disease of poultry caused by pathogenic strains of Newcastle disease virus (NDV; or avian paramyxovirus-1). NDV is endemic in wild birds worldwide and one of the economically most important poultry pathogens. Most of the published strains are outbreak-associated strains, while the apathogenic NDV strains that occur in wild birds, posing a constant threat to poultry with their capability to convert into more virulent forms, have remained less studied. We screened for NDV RNA in cloacal and oropharyngeal samples from wild waterfowl in Finland during the years 2006 to 2010: 39 of 715 birds were positive (prevalence, 5.5%). The partial or full-length F genes of 37 strains were sequenced for phylogenetic purposes. We also characterized viruses derived from three NDV outbreaks in Finland and discuss the relationships between these outbreak-associated and the wild-bird-associated strains. We found that all waterfowl NDV isolates were lentogenic strains of class I or class II genotype I. We also isolated a genetically distinct class I strain (teal/Finland/13111/2008) grouping phylogenetically together with only strain HIECK87191, isolated in Northern Ireland in 1987. Together they seem to form a novel class I genotype genetically differing from other known NDVs by at least 12%.
Ek-Kommonen, Christine; Vaananen, Veli-Matti; Alasaari, Jukka; Vaheri, Antti; Vapalahti, Olli
Objectives This study aims to develop a method for calculating infection time lines for disease outbreaks on farms was developed using the 2010/2011 foot-and-mouth disease (FMD) epidemic in the Republic of Korea. Methods Data on farm demography, the detection date of FMD, the clinical history for the manifestation of lesions, the presence of antibodies against FMD virus (including antibodies against the structural and nonstructural proteins of serotype O), vaccination status (O1 Manisa strain), the number of reactors and information on the slaughter of infected animals were utilized in this method. Results Based on estimates of the most likely infection date, a cumulative detection probability that an infected farm would be identified on a specific day was determined. Peak infection was observed between late December and early January, but peak detection occurred in mid-January. The early detection probability was highest for pigs, followed by cattle (dairy, then beef) and small ruminants. Nearly 90% of the infected pig farms were detected by Day 11 post-infection while 13 days were required for detection for both dairy and beef cattle farms, and 21 days were necessary for small ruminant (goat and deer) farms. On average, 8.1 ± 3.1 days passed prior to detecting the presence of FMD virus on a farm. The interval between infection and detection of FMD was inversely associated with the intensity of farming. Conclusion The results of our study emphasize the importance of intensive clinical inspection, which is the quickest method of detecting FMD infection and minimizing the damage caused by an epidemic.
Yoon, Hachung; Yoon, Soon-Seek; Kim, Han; Kim, Youn-Ju; Kim, Byounghan; Wee, Sung-Hwan
This paper investigates the early viral dynamics of foot-and-mouth disease (FMD) within infected pigs. Using an existing within-host model, we investigate whether individual variation can be explained by the effect of the initial dose of FMD virus. To do this, we consider the experimental data on the concentration of FMD virus genomes in the blood (viral load). In this experiment, 12 pigs were inoculated with one of three different doses of FMD virus: low; medium; or high. Measurements of the viral load were recorded over a time course of approximately 11 days for every 8 hours. The model is a set of deterministic differential equations with the following variables: viral load; virus in the interstitial space; and the proportion of epithelial cells available for infection, infected and uninfected. The model was fitted to the data for each animal individually and also simultaneously over all animals varying only the initial dose. We show that the general trend in the data can be explained by varying only the initial dose. The higher the initial dose the earlier the development of a detectable viral load.
Howey, Richard; Quan, Melvyn; Savill, Nicholas J.; Matthews, Louise; Alexandersen, S?ren; Woolhouse, Mark
Six cases of fowl cholera in growing turkeys and 3 in adult breeder chickens of the broiler type as well as one case each of a Pasteurella (P.) multocida-associated disease in ducklings and goslings were described in consideration of own laboratory findings and available informations of the case history. Furthermore a report is given on a treatment strategy successfully used in turkeys with highly acute fowl cholera. All the P. multocida strains isolated culturally could be assigned to the subspecies multocida. In one case Bordetella avium, Salmonella (S.) arizonae and S. hadar were additionally cultured form part of turkeys submitted. P. multocida and Moraxella (Pasteurella) anatipestifer could be determined as the causative agents of the disease of ducklings and goslings. P. multocida strains from turkeys were identified serologically as serovars A:3.4 (3x), F:3.4 (2x) and A:3 (1x); those from the breeder chickens as A:3 (3x); and one each from ducklings and goslings as F:3.4 and -:3. (uncapsulated). No death occurred in turkeys with clinical signs of a highly acute fowl cholera if the treatment of the affected birds was started with an intravenous injection of sulfadimethoxine and continued with a combination of sulfachlorpyridazine (SCP) and trimethoprim (TMP) given in the drinking water for 5 days. However relapse occurred 2-3 days after withdrawal of the drug, although the therapy was clinically highly effective. The recurrence of the disease could be prevented reliably if the turkeys were vaccinated with an effective oil-based bacterin and subsequently treated with the SCP-TMP combination given in drinking water over a 12 day period. PMID:1953629
Hinz, K H; Lüders, H
Primary immunodeficiencies (PIDs) are commonly characterized by an increased susceptibility to specific infections and, in certain instances, a higher than usual incidence of malignancies. Although improved diagnosis and early treatment of PIDs have reduced early morbidity and mortality from infection, the development of cancer remains a significant cause of premature death. The emergence of cancer in patients with PIDs often results from impairments in the immune response that lead to weakened surveillance against oncogenic viruses, premalignant or malignant cells, or both. Here we review the clinical and biologic features of several PIDs associated with enhanced susceptibility to viral infections and cancer, including X-linked lymphoproliferative disease; IL-2-inducible T-cell kinase deficiency; epidermodysplasia verruciformis; warts, hypogammaglobulinemia, infections, and myelokathexis syndrome; autosomal recessive hyper-IgE syndrome; X-linked agammaglobulinemia; and common variable immunodeficiency. It is of importance that we gain in-depth insights into the fundamental molecular nature of these unique PIDs to better understand the pathogenesis of virus-associated malignancies and to develop innovative therapeutic strategies. PMID:21514636
Rezaei, Nima; Hedayat, Mona; Aghamohammadi, Asghar; Nichols, Kim E
The occurrence of major zoonotic disease outbreaks in Sub-Saharan Africa has had a significant impact on the already constrained public health systems. This has, as a result, justified the need to identify creative strategies to address threats from emerging and re-emerging infectious diseases at the human-animal-environmental interface, and implement robust multi-disease public health surveillance systems that will enhance early detection and response. Additionally, enhanced reporting and timely investigation of all suspected notifiable infectious disease threats within the health system is vital. Field epidemiology and laboratory training programs (FELTPs) have made significant contributions to public health systems for more than 10 years by producing highly skilled field epidemiologists. These epidemiologists have not only improved disease surveillance and response to outbreaks, but also improved management of health systems. Furthermore, the FETPs/FELTPs have laid an excellent foundation that brings clinicians, veterinarians, and environmental health professionals drawn from different governmental sectors, to work with a common purpose of disease control and prevention. The emergence of the One Health approach in the last decade has coincided with the present, paradigm, shift that calls for multi-sectoral and cross-sectoral collaboration towards disease surveillance, detection, reporting and timely response. The positive impact from the integration of FETP/FELTP and the One Health approach by selected programs in Africa has demonstrated the importance of multi-sectoral collaboration in addressing threats from infectious and non- infectious causes to man, animals and the environment. PMID:22359701
Monday, Busuulwa; Gitta, Sheba Nakacubo; Wasswa, Peter; Namusisi, Olivia; Bingi, Aloysius; Musenero, Monica; Mukanga, David
The occurrence of major zoonotic disease outbreaks in Sub-Saharan Africa has had a significant impact on the already constrained public health systems. This has, as a result, justified the need to identify creative strategies to address threats from emerging and re-emerging infectious diseases at the human-animal-environmental interface, and implement robust multi-disease public health surveillance systems that will enhance early detection and response. Additionally, enhanced reporting and timely investigation of all suspected notifiable infectious disease threats within the health system is vital. Field epidemiology and laboratory training programs (FELTPs) have made significant contributions to public health systems for more than 10 years by producing highly skilled field epidemiologists. These epidemiologists have not only improved disease surveillance and response to outbreaks, but also improved management of health systems. Furthermore, the FETPs/FELTPs have laid an excellent foundation that brings clinicians, veterinarians, and environmental health professionals drawn from different governmental sectors, to work with a common purpose of disease control and prevention. The emergence of the One Health approach in the last decade has coincided with the present, paradigm, shift that calls for multi-sectoral and cross-sectoral collaboration towards disease surveillance, detection, reporting and timely response. The positive impact from the integration of FETP/FELTP and the One Health approach by selected programs in Africa has demonstrated the importance of multi-sectoral collaboration in addressing threats from infectious and non- infectious causes to man, animals and the environment.
Monday, Busuulwa; Gitta, Sheba Nakacubo; Wasswa, Peter; Namusisi, Olivia; Bingi, Aloysius; Musenero, Monica; Mukanga, David
Limited data regarding the susceptibility of Actinobacillus pleuropneumoniae to antimicrobials has been published during recent years. Accordingly, the aim of the present study was to investigate the distribution of MICs for the isolates of A. pleuropneumoniae from diseased pigs in the Czech Republic between 2007 and 2009. A total of 242 isolates were tested for susceptibility to 16 antimicrobial agents by a broth microdilution method. A low degree of resistance was observed for florfenicol (0.8%), amoxicillin and clavulanic acid (0.8%), tilmicosin (1.2%), tiamulin (1.7%) and ampicillin (3.3%), whereas resistance to tetracycline was detected more frequently, 23.9% of isolates. Interestingly, resistance to florfenicol has not yet been reported in any study investigating antimicrobial resistance of A. pleuropneumoniae. By PCR the presence of the floR gene was confirmed in all florfenicol resistant isolates. PMID:21316872
Kucerova, Z; Hradecka, H; Nechvatalova, K; Nedbalcova, K
Few studies have evaluated the contribution of multiple virus and bacterial infections in acute exacerbation of chronic obstructive pulmonary disease. This study estimated the burden of multiple viral and bacterial respiratory infections in moderate to very severe chronic obstructive pulmonary disease patients that were prospectively followed-up during a 12-month pilot study. Clinical data were collected monthly and sputum was collected at the time of each acute exacerbation event. Classical culture techniques for bacteria and multiplex polymerase chain reaction (PCR) and microarray detection assays were performed to identify viral and atypical bacterial pathogens in the sputum. Overall, 51 patients were included and 45 acute exacerbation events were investigated clinically and microbiologically. Among the 45 acute exacerbation events, 44% had evidence of viral infection involving human rhinovirus (HRV) and metapneumovirus (hMPV) in 20% and 18%, respectively. Intracellular bacteria were not found in sputum by PCR. Common bacterial pathogens were identified in 42% of acute exacerbation patients, most frequently Branhamella catarrhalis, Streptococcus pneumoniae and Haemophilus influenzae. Viral or virus and bacteria co-infections were detected in 27% of acute exacerbation events (n?=?12) with HRV and hMPV involved in 92% of cases. Patients with co-infections did not present greater clinical severity scores at exacerbation and more recurrence of acute exacerbation events at 3 and 6 months than those with single infections (P?>?0.4). These results suggest that HRV and hMPV may be contributors or cofactors of AECOPD. These findings indicate that viral or virus and bacterial co-infections do not impact significantly on the clinical severity of acute exacerbation of chronic obstructive pulmonary disease and recurrence at 3 and 6 months. PMID:23447038
Perotin, Jeanne-Marie; Dury, Sandra; Renois, Fanny; Deslee, Gaëtan; Wolak, Aurore; Duval, Véronique; De Champs, Christophe; Lebargy, François; Andreoletti, Laurent
This study was conducted to evaluate the modes of transmission of aseptic meningitis (AM) and hand-foot-mouth disease (HFMD) using a case-control and a case-crossover design. We recruited 205 childhood AM and 116 HFMD cases and 170 non-enteroviral disease controls from three general hospitals in Gyeongju, Pohang, and Seoul between May and August in both 2002 and 2003. For the case-crossover design, we established the hazard and non-hazard periods as week one and week four before admission, respectively. In the case-control design, drinking water that had not been boiled, not using a water purifier, changes in water quality, and contact with AM patients were significantly associated with the risk of AM (odds ratio [OR]=2.8, 2.9, 4.6, and 10.9, respectively), while drinking water that had not been boiled, having a non-water closet toilet, changes in water quality, and contact with HFMD patients were associated with risk of HFMD (OR=3.3, 2.8, 6.9, and 5.0, respectively). In the case-crossover design, many life-style variables such as contact with AM or HFMD patients, visiting a hospital, changes in water quality, presence of a skin wound, eating out, and going shopping were significantly associated with the risk of AM (OR=18.0, 7.0, 8.0, 2.2, 22.3, and 3.0, respectively) and HFMD (OR=9.0, 37.0, 11.0, 12.0, 37.0, and 5.0, respectively). Our findings suggest that person-to-person contact and contaminated water could be the principal modes of transmission of AM and HFMD.
Park, Sue K.; Park, Boyoung; Ki, Moran; Kim, Ho; Lee, Kwan; Jung, Cheoll; Sohn, Young Mo; Choi, Sung-Min; Kim, Doo-Kwun; Lee, Dong Seok; Ko, Joon Tae; Kim, Moon Kyu
Selective breeding provides an approach to increase resistance of rainbow trout ( Onchorhynchus mykiss) to the diseases, enteric redmouth disease, rainbow trout fry syndrome, and viral haemorrhagic septicaemia
In this study, we reasoned that if we challenged rainbow trout with the causative agents of enteric redmouth disease (ERM), rainbow trout fry syndrome (RTFS), and viral haemorrhagic septicaemia (VHS), we would: 1) detect additive genetic variation for resistance to ERM, RTFS, and VHS; and 2) find that resistance of the trout to ERM and RTFS are favourably correlated genetically,
Mark Henryon; Peer Berg; Niels J. Olesen; Torben E. Kjær; Wilhelmina J. Slierendrecht; Alfred Jokumsen; Ivar Lund
During 2009, an outbreak of hand, foot, and mouth disease (HFMD) enrolled 490 people in Henan Province, causing the death of two children. In order to investigate the pathogens responsible for this outbreak and characterize their genetic characteristics, a total of 508 clinical specimens (stool, throat swab, and vesicle fluid) were collected from the Center for Disease Control and Prevention of Henan Province. Virological investigations (virus isolation, conventional reverse transcription PCR, and real-time reverse transcription PCR) and phylogenetic analysis were performed. It was found that human enterovirus 71 (EV71) was the main pathogen causing this outbreak, while Coxsackievirus A16 (CoxA16) played only a subsidiary role. Phylogenetic analysis of 24 EV71 isolates collected during the period from March 11 to July 24, 2009 showed that they belonged to subgenotypes C4 and C5. Our study for the first time characterizes the epidemiology of HFMD and EV71 infection in Henan Province in 2009 and provides the first direct evidence of the genotype of EV71 circulating in Henan Province at that time. Our study should facilitate the development of public health measures for the control and prevention of HFMD and EV71 infection in at-risk individuals in China. PMID:23080402
Fan, Xingliang; Jiang, Jun; Liu, Yanjing; Huang, Xueyong; Wang, Pengzhi; Liu, Licheng; Wang, Junzhi; Chen, Weijun; Wu, Weili; Xu, Bianli
Pyrrolizidine alakloids (PAs) are known to cause hepatic veno-occlusive disease (VOD). Outbreaks have occurred in Western Afghanistan since 1974, the latest in February 2008. We conducted an outbreak investigation using a case-control design. Sixty-seven cases of VOD were compared with 199 community controls. Consumption of bread was strongly associated with disease (adjusted odds ratio: 35.8 [95%CI: 7.6–168.2]). Toxic doses of PA were found in plant extracts and in samples of wheat flour taken from the study area. Compared to wheat flour there was 1000 times less PA in milk and whey and in water samples the PA content was zero. Although direct analysis was not possible, contaminated wheat flour used to make bread was the likely source of PA causing the outbreak. Eating a more varied diet including meat and fruit may be protective. Prevention and control measures will rely on community awareness and agricultural interventions to ensure safety of the food supply.
Kakar, Faizullah; Akbarian, Zarif; Leslie, Toby; Mustafa, Mir Lais; Watson, John; van Egmond, Hans P.; Omar, Mohammad Fahim; Mofleh, Jawad
A number of different types of human enteric viruses cause waterborne outbreaks when individuals are exposed to contaminated drinking and recreational waters. Members of the enterovirus group cause numerous diseases, including gastroenteritis, encephalitis, meningitis, myocard...
The spread of zoonotic infectious diseases may increase due to climate factors such as temperature, humidity and precipitation. This is also true for hantaviruses, which are globally spread haemorrhagic fever viruses carried by rodents. Hantaviruses are frequently transmitted to humans all over the world and regarded as emerging viral diseases. Climate variations affect the rodent reservoir populations and rodent population peaks coincide with increased number of human cases of hantavirus infections. In northern Sweden, a form of haemorrhagic fever called nephropathia epidemica (NE), caused by the Puumala hantavirus (PUUV) is endemic and during 2006-2007 an unexpected, sudden and large outbreak of NE occurred in this region. The incidence was 313 cases/100,000 inhabitants in the most endemic areas, and from January through March 2007 the outbreak had a dramatic and sudden start with 474 cases in the endemic region alone. The PUUV rodent reservoir is bank voles and immediately before and during the peak of disease outbreak the affected regions experienced extreme climate conditions with a record-breaking warm winter, registering temperatures 6-9 degrees C above normal. No protective snow cover was present before the outbreak and more bank voles than normal came in contact with humans inside or in close to human dwellings. These extreme climate conditions most probably affected the rodent reservoir and are important factors for the severity of the outbreak. PMID:20052429
Evander, Magnus; Ahlm, Clas
Bornaviruses, which chronically infect many species, can cause severe neurological diseases in some animal species; their association with human neuropsychiatric disorders is, however, debatable. The epidemiology of Borna disease virus (BDV), as for other members of the family Bornaviridae, is largely unknown, although evidence exists for a reservoir in small mammals, for example bank voles (Myodes glareolus). In addition to the current exogenous infections and despite the fact that bornaviruses have an RNA genome, bornavirus sequences integrated into the genomes of several vertebrates millions of years ago. Our hypothesis is that the bank vole, a common wild rodent species in traditional BDV-endemic areas, can serve as a viral host; we therefore explored whether this species can be infected with BDV, and if so, how the virus spreads and whether viral RNA is transcribed into DNA in vivo. We infected neonate bank voles intracerebrally with BDV and euthanized them 2 to 8 weeks post-infection. Specific Ig antibodies were detectable in 41%. Histological evaluation revealed no significant pathological alterations, but BDV RNA and antigen were detectable in all infected brains. Immunohistology demonstrated centrifugal spread throughout the nervous tissue, because viral antigen was widespread in peripheral nerves and ganglia, including the mediastinum, esophagus, and urinary bladder. This was associated with viral shedding in feces, of which 54% were BDV RNA-positive, and urine at 17%. BDV nucleocapsid gene DNA occurred in 66% of the infected voles, and, surprisingly, occasionally also phosphoprotein DNA. Thus, intracerebral BDV infection of bank vole led to systemic infection of the nervous tissue and viral excretion, as well as frequent reverse transcription of the BDV genome, enabling genomic integration. This first experimental bornavirus infection in wild mammals confirms the recent findings regarding bornavirus DNA, and suggests that bank voles are capable of bornavirus transmission.
Kinnunen, Paula Maria; Inkeroinen, Hanna; Ilander, Mette; Kallio, Eva Riikka; Heikkila, Henna Pauliina; Koskela, Esa; Mappes, Tapio; Palva, Airi; Vaheri, Antti; Kipar, Anja; Vapalahti, Olli
Summary Background Human infection with an avian influenza A virus (subtype H5N1) was reported recently in Hong Kong. We describe the clinical presentation of the first 12 patients and options for rapid viral diagnosis. Methods Case notes of 12 patients with virus-culture- confirmed influenza A H5N1 infection were analysed. The clinical presentation and risk factors associated with severe disease were
KY Yuen; PKS Chan; M Peiris; DNC Tsang; TL Que; KF Shortridge; PT Cheung; ETF Ho; R Sung; AFB Cheng
Summary. ?Four cattle persistently infected with non-cytopathic (NCP) bovine viral diarrhea (BVD) virus were challenged with cytopathic\\u000a (CP) BVD virus that was antigenically different from the persistent virus. Two of the animals were injected with dexamethasone\\u000a (DM) and then challenged. They developed mucosal disease on days 21 and 33 post-challenge. CP-BVD viruses were isolated from\\u000a their lymph nodes but not from
H. Sentsui; T. Nishimori; R. Kirisawa; A. Morooka
Two viral pathogens, namely, porcine reproductive and respiratory syndrome virus (PRRSV) and foot and mouth disease virus\\u000a (FMDV), were selected as models for multiple pathogen detection in a cDNA microarray. Two signature regions selected from\\u000a ORF2 (around 500 bp) and ORF5 (around 600 bp) of PRRVS (America serotype), and one signature region from structural genes\\u000a VP1 (around 500 bp) of
Y.-C. Liu; G. S. Huang; M.-C. Wu; M.-Y. Hong; K.-P. Hsiung
Plasmacytoid dendritic cells (pDCs) are important mediators of antiviral immunity through their ability to produce large amounts of type I interferons (IFNs) on viral infection. This function of pDCs is linked to their expression of Toll-like receptor 7 (TLR7) and TLR9, which sense viral nucleic acids within the early endosomes. Exclusion of self nucleic acids from TLR-containing early endosomes normally
Michel Gilliet; Wei Cao; Yong-Jun Liu
Background Respiratory syncytial virus (RSV) is a leading cause of bronchiolitis and pneumonia in young children worldwide, and no vaccine is currently available. Inactivated RSV vaccines tested in the 1960's led to vaccine-enhanced disease upon viral challenge, which has undermined RSV vaccine development. RSV infection is increasingly being recognized as an important pathogen in the elderly, as well as other individuals with compromised pulmonary immunity. A safe and effective inactivated RSV vaccine would be of tremendous therapeutic benefit to many of these populations. Principal Findings In these preclinical studies, a mouse model was utilized to assess the efficacy of a novel, nanoemulsion-adjuvanted, inactivated mucosal RSV vaccine. Our results demonstrate that NE-RSV immunization induced durable, RSV-specific humoral responses, both systemically and in the lungs. Vaccinated mice exhibited increased protection against subsequent live viral challenge, which was associated with an enhanced Th1/Th17 response. In these studies, NE-RSV vaccinated mice displayed no evidence of Th2 mediated immunopotentiation, as has been previously described for other inactivated RSV vaccines. Conclusions These studies indicate that nanoemulsion-based inactivated RSV vaccination can augment viral-specific immunity, decrease mucus production and increase viral clearance, without evidence of Th2 immune mediated pathology.
Lindell, Dennis M.; Morris, Susan B.; White, Maria P.; Kallal, Lara E.; Lundy, Phillip K.; Hamouda, Tarek; Baker, James R.; Lukacs, Nicholas W.