Showing papers by "Dean D. Erdman published in 2010"

The burden of hospitalized lower respiratory tract infection due to respiratory syncytial virus in rural Thailand.

Abstract: Background We describe the epidemiology of hospitalized RSV infections for all age groups from population-based surveillance in two rural provinces in Thailand. Methods From September 1, 2003 through December 31, 2007, we enrolled hospitalized patients with acute lower respiratory tract illness, who had a chest radiograph ordered by the physician, from all hospitals in SaKaeo and Nakhom Phanom Provinces. We tested nasopharyngeal specimens for RSV with reverse transcriptase polymerase chain reaction (RT-PCR) assays and paired-sera from a subset of patients with IgG enzyme immunoassay. Rates were adjusted for enrollment. Results Among 11,097 enrolled patients, 987 (8.9%) had RSV infection. Rates of hospitalized RSV infection overall (and radiographically-confirmed pneumonia) were highest among children aged <1 year: 1,067/100,000 (534/100,000 radiographically-confirmed pneumonia) and 1–4 year: 403/100,000 (222/100,000), but low among enrolled adults aged ≥65 years: 42/100,000. Age <1 year (adjusted odds ratio [aOR] = 13.2, 95% confidence interval [CI] 7.7, 22.5) and 1–4 year (aOR = 8.3, 95% CI 5.0, 13.9) were independent predictors of hospitalized RSV infection. Conclusions The incidence of hospitalized RSV lower respiratory tract illness among children <5 years was high in rural Thailand. Efforts to prevent RSV infection could substantially reduce the pneumonia burden in children aged <5 years.

Molecular Epidemiology and Brief History of Emerging Adenovirus 14—Associated Respiratory Disease in the United States

Abstract: Background. First isolated in the Netherlands in 1955 during an outbreak of acute respiratory disease (ARD) among military recruits, human adenovirus 14 (HAdV-14) has historically been considered rare. With no precedent of circulation in North America, HAdV-14 has been isolated from military and civilian cases of ARD of variable severity since 2003 in the United States. Methods. Ninety-nine isolates from military and civilian cases from different geographic locations and circulation periods were characterized by restriction enzyme analysis of viral DNA and select gene sequencing. Results. All examined viruses were found to be identical and to belong to a new genome type designated "HAdV-14pl" (formerly known as "14a"). Comparative alignments of EIA, hexon, and fiber gene sequences with other subspecies B2 HAdVs suggest that HAdV-14p1, like the closely related HAdV-11a, arose from recombination among similar HAdV-11 and HAdV-14 ancestral strains. A deletion of 2 amino acids in the knob region of the fiber protein is the only identified unique characteristic of HAdV-14pl. Conclusion. The current geographic distribution of HAdV-14pl involves at least 15 states in the Unites States. The role of the fiber mutations in the recent emergence of HAdV-14pl ARD in North America warrants further study.

Incidence of respiratory pathogens in persons hospitalized with pneumonia in two provinces in Thailand.

Abstract: Although pneumonia is a leading cause of death from infectious disease worldwide, comprehensive information about its causes and incidence in low- and middle-income countries is lacking Active surveillance of hospitalized patients with pneumonia is ongoing in Thailand Consenting patients are tested for seven bacterial and 14 viral respiratory pathogens by PCR and viral culture on nasopharyngeal swab specimens, serology on acute/convalescent sera, sputum smears and antigen detection tests on urine Between September 2003 and December 2005, there were 1730 episodes of radiographically confirmed pneumonia (34·6% in children aged <5 years); 66 patients (3·8%) died A recognized pathogen was identified in 42·5% of episodes Respiratory syncytial virus (RSV) infection was associated with 16·7% of all pneumonias, 41·2% in children The viral pathogen with the highest incidence in children aged <5 years was RSV (417·1/100,000 per year) and in persons aged ≥50 years, influenza virus A (38·8/100,000 per year) These data can help guide health policy towards effective prevention strategies

Outbreak of Pneumonia Associated with Emergent Human Adenovirus Serotype 14—Southeast Alaska, 2008

Abstract: Background In September 2008, an outbreak of pneumonia associated with an emerging human adenovirus (human adenovirus serotype 14 [HAdV-14]) occurred on a rural Southeast Alaska island Nine patients required hospitalization, and 1 patient died Methods To investigate the outbreak, pneumonia case patients were matched to control participants on the basis of age, sex, and community of residence Participants in the investigation and their household contacts were interviewed, and serum samples and respiratory tract specimens were collected Risk factors were evaluated by means of conditional logistic regression Results Among 32 pneumonia case patients, 21 (65%) had confirmed or probable HAdV-14 infection None of 32 matched control participants had evidence of HAdV-14 infection (P< 001 for the difference) Factors independently associated with pneumonia included contact with a known HAdV-14-infected case patient (odds ratio [OR], 183 [95% confidence interval {CI}, ≥20]), current smoking (OR, 67 [95% CI, ≥09]), and having neither traveled off the island nor attended a large public gathering (OR, 147 [95% CI, ≥20]) Fourteen (67%) of 21 HAdV-14-positive case patients belonged to a single network of people who socialized and often smoked together and infrequently traveled off the island HAdV-14 infection occurred in 43% of case-patient household contacts, compared with 5% of control-participant household contacts (P = 005) Conclusions During a community outbreak in Alaska, HAdV-14 appeared to have spread mostly among close contacts and not widely in the community Demographic characteristics and illness patterns among the case patients were similar to those observed in other recent outbreaks of HAdV-14 infection in the United States

Frequent Detection of Human Adenovirus from the Lower Gastrointestinal Tract in Men Who Have Sex with Men

Abstract: Background The association between baseline seropositivity to human adenovirus (HAdV) type 5 and increased HIV acquisition in the Step HIV Vaccine Study has raised questions concerning frequency of acquired and/or persistent Adenovirus infections among adults at high risk of HIV-1 infection. Methodology To evaluate the frequency and pattern of HAdV shedding from the lower GI tract, we retrospectively tested rectal swabs for HAdVs in a cohort of 20 HSV-2 positive HIV-positive Peruvian men who have sex with men (MSM) undergoing rectal swabbing three times/week for 18 consecutive weeks, in a prospective study of HSV-2 suppression in HIV infection. Viral DNA was extracted and amplified using a sensitive multiplex PCR assay that detects all currently recognized HAdV types. Molecular typing of viruses was performed on selected samples by hexon gene sequencing. Baseline neutralizing antibody titers to HAdVs −5, −26, −35 and −48 were also assessed. Principal Findings 15/20 individuals had HAdV detected during follow up. The median frequency of HAdV detection was 30% of samples (range 2.0% to 64.7%). HAdV shedding typically occurred on consecutive days in clustered episodes lasting a median of 4 days (range 1 to 9 days) separated by periods without shedding, suggesting frequent new infections or reactivation of latent infections over time. 8 of the 15 shedders had more than one type detected in follow-up. 20 HAdV types from species B, C, and D were identified, including HAdV-5, −26 and −48, HAdV types under development as potential vaccine candidates. 14/20 subjects were seropositive for HAdV-5; 15/20 for HAdV-26; 3/20 for HAdV-35; and 2/20 for HAdV-48. HAdV shedding did not correlate with CD4 count, plasma HIV-1 viral load, or titers to HAdV-5 or HAdV-35. The sole individual with HAdV-5 shedding was HAdV-5 seropositive. Conclusions HAdV shedding was highly prevalent and diverse, including types presently under consideration as HIV vaccine vectors. Subclinical HAdV infection of the GI tract is common among MSM in Peru; the prevalence of HAdV in the enteric tract should be evaluated in other populations. The association between ongoing recent enteric HAdV and the immune response to recombinant HAdV vaccines should be evaluated.

Acute hemorrhagic conjunctivitis outbreaks caused by coxsackievirus A24v - Uganda and Southern Sudan, 2010.

Abstract: CDC was contacted on June 22, 2010, by the Ugandan Ministry of Health (MoH)/Uganda Virus Research Institute and on July 11 by the Government of Southern Sudan (GOSS) via the CDC Global Disease Detection Regional Center in Kenya to perform diagnostic laboratory testing on conjunctival swabs from persons with \"red eye syndrome.\" Widespread, ongoing outbreaks of acute hemorrhagic conjunctivitis (AHC) have been observed in Uganda and Southern Sudan since spring 2010. AHC becomes a reportable condition in outbreak settings. Case numbers were estimated in Uganda after MoH confirmation of reported cases from district health facilities and, in Southern Sudan, after a medical record review in six health facilities. To date, 6,818 cases from 26 districts in Uganda, and 428 cases in Juba, Southern Sudan, have been counted; however, because most cases are not reported, these totals are considered underestimates.

Propagation and Identification of Viruses

Abstract: 1 Systems for Propagating Viruses 2 Preparation of Reagents for Virus Identification 3 Isolation and Identification of Viruses from Clinical Specimens 4 Acknowledgments Keywords: propagation and identification of viruses; systems for propagating viruses; cell cultures; cell propagation; maintenance of cultures; storage of cells; tissue and organ cultures; releasing virus from culture cells

Molecular Epidemiology of Emerging Adenovirus 14 Associated Respiratory Disease in the United States

Abstract: : First isolated in the Netherlands in 1955 during an outbreak of acute respiratory disease (ARD) among military recruits, human adenovirus 14 (HAdV-14) has historically been considered a rare respiratory HAdV. With no precedent of circulation in North America, HAdV-14 has been isolated in the United States since 2003 from military and civilian cases of ARD of variable severity. Genomic analysis of isolates representing different locations and circulation dates showed all examined viruses to be identical and to belong to a new genome type designated HAdV-14a1. The alignment of E1A, hexon, and fiber gene sequences with those of other B2 HAdVs suggests that HAdV-14a1 has arisen from recombination events between HAdV-11 and HAdV-14p strains. A 6 base pair deletion near the predicted binding site of the fiber gene is, so far, the only distinct genetic characteristic of HAdV-14. The current documented geographic distribution of HAdV-14a1-associated ARD involves 14 US states but no Canadian provinces.

Immunoglobulin M Determinations

Abstract: Since the introduction of the first applications of immunoglobulin M (IgM) determinations in diagnostic virology, a variety of methods have been developed and applied. These methods can generally be separated into three groups: (i) those based on comparing IgM titers before and after chemical inactivation of serum IgM, (ii) those based on the physicochemical separation of IgM from other serum Ig classes, and (iii) those based on solid-phase immunologic detection of IgM antibodies. This chapter discusses the relative merits of each of these approaches. Physicochemical separation methods were originally developed to separate IgM antibodies from other serum Igs to facilitate assay by conventional serological tests, e.g., complement fixation (CF) and hemagglutination inhibition (HI) assays. The major distinguishing features of solid-phase immunoassays are the choice of indicator label and solid phase. Solid-phase immunoassays can be further differentiated into indirect and reverse, or “capture,” forms, based on the orientation of the immunoreactants on the solid phase. The indirect and capture formats have advantages and disadvantages that are described in detail. Compared to the whole virus antigen-based IgM immunoassay, the recombinant protein-based assay offers several distinct advantages. First, the use of infectious virus and special safety precautions used for antigen production are not required. Second, recombinant proteins can be easily standardized and quality controlled. Third, recombinant antigen production is efficient and relatively economical, thus eliminating the generally high production costs associated with virus cultivation.

Reemergence of Human Adenovirus 14

Abstract: This chapter presents a brief overview of human adenovirus (HAdV) infections The HAdVs are classified within the family Adenoviridae, genus Mastadenovirus The chapter describes a new human adenovirus 14 (HAdV-14) variant, its emergence, and clinical and epidemiologic features of infection Acute respiratory illness (ARI) is the most commonly recognized manifestation of HAdV infection and the types that cause ARI are the focus of this chapter, with special emphasis on the species B viruses which are most closely related to HAdV-14 The first HAdV-14 cases were also noted in 2006 from national surveys of military recruits and civilians conducted between 2002 and 2006 The first investigation in Oregon demonstrated the potential for serious complications of infection but also suggested that many more cases were undetected Since no common exposures or contact among cases, with one exception, were identified, unrecognized cases must have accounted for virus spread within the community A small study of HAdV-14-infected patients suggested HAdV-7 neutralizing antibodies provided protection from serious complications of HAdV-14 infection In this study, 7 of 19 (39%) basic military trainees (BMTs) with a mild HAdV-14 illness and 0/16 BMTs hospitalized with HAdV-14 pneumonia had HAdV-7 neutralizing antibodies (P < 0007) There are many examples of the emergence of variant HAdVs The emergent HAdV-14 is readily detected by conventional diagnostic methods used for other HAdVs, including cell culture, immunoassay, and PCR