Showing papers by "Dean D. Erdman published in 2016"
TL;DR: Detections of influenza, respiratory syncytial virus, and human metapneumovirus among patients with CAP of all ages probably indicate an etiologic role, whereas detections of parainfluenza, coronaviruses, rhinovirus, and adenovirus require further scrutiny.
Abstract: Background. The clinical significance of viruses detected in patients with community-acquired pneumonia (CAP) is often unclear.
Methods. We conducted a prospective study to identify the prevalence of 13 viruses in the upper respiratory tract of patients with CAP and concurrently enrolled asymptomatic controls with real-time reverse-transcriptase polymerase chain reaction. We compared age-stratified prevalence of each virus between patients with CAP and controls and used multivariable logistic regression to calculate attributable fractions (AFs).
Results. We enrolled 1024 patients with CAP and 759 controls. Detections of influenza, respiratory syncytial virus, and human metapneumovirus were substantially more common in patients with CAP of all ages than in controls (AFs near 1.0). Parainfluenza and coronaviruses were also more common among patients with CAP (AF, 0.5–0.75). Rhinovirus was associated with CAP among adults (AF, 0.93) but not children (AF, 0.02). Adenovirus was associated with CAP only among children <2 years old (AF, 0.77).
Conclusions. The probability that a virus detected with real-time reverse-transcriptase polymerase chain reaction in patients with CAP contributed to symptomatic disease varied by age group and specific virus. Detections of influenza, respiratory syncytial virus, and human metapneumovirus among patients with CAP of all ages probably indicate an etiologic role, whereas detections of parainfluenza, coronaviruses, rhinovirus, and adenovirus, especially in children, require further scrutiny.
214 citations
TL;DR: HAdV-B7 might be reemerging in the United States, according to a report in the journal “Science”.
Abstract: Several human adenoviruses (HAdVs) can cause respiratory infections, some severe. HAdV-B7, which can cause severe respiratory disease, has not been recently reported in the United States but is reemerging in Asia. During October 2013-July 2014, Oregon health authorities identified 198 persons with respiratory symptoms and an HAdV-positive respiratory tract specimen. Among 136 (69%) hospitalized persons, 31% were admitted to the intensive care unit and 18% required mechanical ventilation; 5 patients died. Molecular typing of 109 specimens showed that most (59%) were HAdV-B7, followed by HAdVs-C1, -C2, -C5 (26%); HAdVs-B3, -B21 (15%); and HAdV-E4 (1%). Molecular analysis of 7 HAdV-B7 isolates identified the virus as genome type d, a strain previously identified only among strains circulating in Asia. Patients with HAdV-B7 were significantly more likely than those without HAdV-B7 to be adults and to have longer hospital stays. HAdV-B7 might be reemerging in the United States, and clinicians should consider HAdV in persons with severe respiratory infection.
121 citations
TL;DR: Enhanced surveillance and infection-control practices are needed to prevent outbreaks in healthcare settings, according to a report from the World Health Organization.
Abstract: Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) is a novel respiratory pathogen first reported in 2012. During September 2014-January 2015, an outbreak of 38 cases of MERS was reported from 4 healthcare facilities in Taif, Saudi Arabia; 21 of the 38 case-patients died. Clinical and public health records showed that 13 patients were healthcare personnel (HCP). Fifteen patients, including 4 HCP, were associated with 1 dialysis unit. Three additional HCP in this dialysis unit had serologic evidence of MERS-CoV infection. Viral RNA was amplified from acute-phase serum specimens of 15 patients, and full spike gene-coding sequencing was obtained from 10 patients who formed a discrete cluster; sequences from specimens of 9 patients were closely related. Similar gene sequences among patients unlinked by time or location suggest unrecognized viral transmission. Circulation persisted in multiple healthcare settings over an extended period, underscoring the importance of strengthening MERS-CoV surveillance and infection-control practices.
60 citations
TL;DR: The viruses from Jordan were highly similar to isolates from Riyadh, Saudi Arabia, except for deletions in open reading frames 4a and 3, which indicates transmissibility and pathogenicity of this strain remains to be determined.
Abstract: We characterized Middle East respiratory syndrome coronaviruses from a hospital outbreak in Jordan in 2015. The viruses from Jordan were highly similar to isolates from Riyadh, Saudi Arabia, except for deletions in open reading frames 4a and 3. Transmissibility and pathogenicity of this strain remains to be determined.
39 citations
TL;DR: The authors' identification of cases without recognized risk factors but with similar virus sequences indicates the need for better understanding of risk factors for MERS-CoV transmission, and document the spread and eventual predominance of NRC-2015 in humans in Saudi Arabia during the first half of 2015.
Abstract: BACKGROUND Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe respiratory illness in humans. Fundamental questions about circulating viruses and transmission routes remain. METHODS We assessed routinely collected epidemiologic data for MERS-CoV cases reported in Saudi Arabia during 1 January-30 June 2015 and conducted a more detailed investigation of cases reported during February 2015. Available respiratory specimens were obtained for sequencing. RESULTS During the study period, 216 MERS-CoV cases were reported. Full genome (n = 17) or spike gene sequences (n = 82) were obtained from 99 individuals. Most sequences (72 of 99 [73%]) formed a discrete, novel recombinant subclade (NRC-2015), which was detected in 6 regions and became predominant by June 2015. No clinical differences were noted between clades. Among 87 cases reported during February 2015, 13 had no recognized risks for secondary acquisition; 12 of these 13 also denied camel contact. Most viruses (8 of 9) from these 13 individuals belonged to NRC-2015. DISCUSSIONS Our findings document the spread and eventual predominance of NRC-2015 in humans in Saudi Arabia during the first half of 2015. Our identification of cases without recognized risk factors but with similar virus sequences indicates the need for better understanding of risk factors for MERS-CoV transmission.
31 citations
TL;DR: It is found that the surge in cases reported from Saudi Arabia during July–August 2015 resulted predominantly from secondary transmission largely attributable to an outbreak at a single healthcare facility in Riyadh.
Abstract: During July-August 2015, the number of cases of Middle East respiratory syndrome (MERS) reported from Saudi Arabia increased dramatically. We reviewed the 143 confirmed cases from this period and classified each based upon likely transmission source. We found that the surge in cases resulted predominantly (90%) from secondary transmission largely attributable to an outbreak at a single healthcare facility in Riyadh. Genome sequencing of MERS coronavirus from 6 cases demonstrated continued circulation of the recently described recombinant virus. A single unique frameshift deletion in open reading frame 5 was detected in the viral sequence from 1 case.
23 citations
TL;DR: Virus was detected in the lung and trachea of a deceased patient and it is feared that the virus may have spread to other parts of the body.
Abstract: WU polyomavirus (WUPyV) was detected in a bone marrow transplant recipient with severe acute respiratory distress syndrome who died in 2001. Crystalline lattices of polyomavirus-like particles were observed in the patient's lung by electron microscopy. WUPyV was detected in the lung and other tissues by real-time quantitative PCR and identified in the lung and trachea by immunohistochemistry. A subset of WUPyV-positive cells in the lung had morphologic features of macrophages. Although the role of WUPyV as a human pathogen remains unclear, these results clearly demonstrate evidence for infection of respiratory tract tissues in this patient.
20 citations
TL;DR: References 1.
Abstract: References 1. Platt L, Easterbrook P, Gower E, McDonald B, Sabin K, McGowan C, et al. Prevalence and burden of HCV co-infection in people living with HIV: a global systematic review and meta-analysis. Lancet Infect Dis. 2016;16:797–808. http://dx.doi.org/10.1016/S1473-3099(15)00485-5 2. Joint United Nations Programme on HIV/AIDS. Malawi: HIV and AIDS estimates (2015). [cited 2016 Jul 7]. http://www.unaids.org/ en/regionscountries/countries/malawi 3. Ahmed SD, Cuevas LE, Brabin BJ, Kazembe P, Broadhead R, Verfoeff FH, et al. Seroprevalence of hepatitis B and C in HIV and HIV in Malawian pregnant women. J Infect. 1998;37:248–51. http://dx.doi.org/10.1016/S0163-4453(98)91983-1 4. Maida MJ, Costello Daly C, Hoffman I, Cohen MS, Kumwenda M, Vernazza PL. Prevalence of hepatitis C infection in Malawi and lack of association with sexually transmitted diseases. Eur J Epidemiol. 2000;16:1183–4. http://dx.doi.org/10.1023/A:1010920426795 5. Candotti D, Mundy C, Kadewele G, Nkhoma W, Bates I, Allain JP. Serological and molecular screening for viruses in blood donors from Ntcheu, Malawi: high prevalence of HIV-1 subtype C and of markers of hepatitis B and C viruses. J Med Virol. 2001;65:1–5. http://dx.doi.org/10.1002/jmv.1093 6. Chimphambano C, Komolafe IOO, Muula AS. Prevalence of HIV, HepBsAg and Hep C antibodies among inmates in Chichiri prison, Blantyre, Malawi. Malawi Med J. 2007;19:107–10. 7. Taha TE, Rusie LK, Labrique A, Nyirenda M, Soko D, Kamanga M, et al. Seroprevalence for hepatitis E and other viral hepatitides among diverse populations, Malawi. Emerg Infect Dis. 2015;21:1174–82. http://dx.doi.org/10.3201/eid2107.141748 8. Fox JM, Newton R, Bedaj M, Ada Keding, Molyneux E, Carpenter LM, et al. Prevalence of hepatitis C virus in mothers and their children in Malawi. Trop Med Int Health. 2015;20:638–42. http://dx.doi.org/10.1111/tmi.12465 9. Rao VB, Johari N, du Cros P, Messina J, Ford N, Cooke GS. Hepatitis C seroprevalence and HIV co-infection in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Infect Dis. 2015;15:819–24. http://dx.doi.org/10.1016/ S1473-3099(15)00006-7 10. Graham CS, Baden LR, Yu E, Mrus JM, Carnie J, Heeren T, et al. Influence of human immunodeficiency virus infection on the course of hepatitis C virus infection: a meta-analysis. Clin Infect Dis. 2001;33:562–9. http://dx.doi.org/10.1086/321909
8 citations
TL;DR: In this paper, the authors developed quantitative type-specific real-time PCR (qPCR) assays for HAdV-1, -2, -5 and -6 targeting the hexon gene, which reproducibly detected as few as 5 copies of quantified hexon recombinant plasmids with a linear dynamic range of 8 log units (5-5×107 copies).
6 citations