Cause Of Respiratory Disease Research Articles

Estimating the cost-effectiveness of maternal respiratory syncytial virus (RSV) vaccination in Australia: A dynamic and economic modelling analysis.

Respiratory syncytial virus (RSV) is a major cause of respiratory illness, with younger infants at greatest risk of hospitalisation. With the recent approval of a maternal RSV vaccine in Australia, it is timely to evaluate its potential costs and health benefits in Australia. We applied an integrated dynamic and economic evaluation model to estimate specific outcomes of RSV disease and the cost-effectiveness of a year-round maternal RSV vaccination program in Australia. Cost-effectiveness was estimated using the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) gained. From a healthcare system perspective, the maternal vaccination program was estimated to be cost-effective at a vaccine price less than approximately 120 Australian dollars ($AU), assuming a willingness-to-pay (WTP) threshold of $AU 50,000/QALY gained. Most of the estimated cost-savings were from preventing RSV hospitalisations in infants aged <6months. However, while 82% of the cost-savings were from preventing RSV hospitalisations in infants aged <6months, only about 25% of the QALY gains were in this age group. The majority of the other QALY gains came via herd effects from prevention of death in older adults and to a lesser extent, prevention of nonmedically-attended illness in older teens and adults. When predicted cost-savings and QALY gains in those ≥6months of age were excluded, the vaccine price required to meet the assumed WTP threshold fell to $AU 63. A maternal RSV vaccination program in Australia could provide value for money by reducing hospitalisations and associated costs among infants aged <6months, depending on the vaccine price. We have provided evidence that herd effects beyond the target population may be an important consideration in assessing cost-effectiveness of maternal RSV vaccination.

P-720. Are we aware of the RSV problematic in the Dominican Republic?

Abstract Background Respiratory Syncytial Virus (RSV) is a common cause of respiratory illness that could have a severe presentation in infants and elderly patients. As in other LATAM countries, RSV diagnosis is limited due to a lack of testing or access, and there is scarce data on the epidemiology, clinical impact, and mortality. Our aim was to characterize the disease in patients admitted to a hospital setting. Distribution of admitted patients by age Source: Statistical registry of the authors Methods We performed a retrospective review of admitted patients in a tertiary 289-bed hospital with a respiratory molecular panel from January 2022 to December 2023 (n = 715). RSV-positive patients (n = 91) were selected, and their clinical and demographic information, co-morbidities, risk factors, and outcomes were reviewed on their electronic medical record. Microbial frequency in RSV coinfected patients Source: Statistical registry of the authors Results Out of 91 patients, 58.2% (53/91) were male, 75.8% were ≤2 years old, and 8.8% were ≥60 years old. The RSV positivity rate for all ages (0–84 years old) was 12.7% and 53.4% (69/129) for ≤2 years old. All cases were detected near the second semester of each year (May–December 2022 and July–December 2023). Out of 50 patients with RSV as the only pathogen confirmed through testing, 32 developed respiratory complications (bronchiolitis and pneumonia), and 14% required critical care. Whereas 41 patients had the simultaneous presence of other pathogens, among them, 31 patients had ≥2 respiratory viruses detected. The most frequent symptoms in RSV-only patients were cough (79.12%), dyspnea (67.3%), and wheezing (63.74%). Asthma was the most common respiratory comorbidity (16.48%), followed by low birth weight and preterm. The mortality rate was 4/91 (4.39%); among them were 2 patients &amp;lt; 6 months old with congenital cardiopathy and 2 elderly (69/78y) with Klebsiella pneumoniae-bacteremia. Distribution of viral isolates from admitted patient respiratory and pneumonia panel samples. Source: Statistical registry of the authors Conclusion RSV should be considered an all-ages respiratory infection, and it was found alone or in association with other respiratory pathogens mainly near the second semester each year. Studies like these are necessary in low-middle income countries like the Dominican Republic to address the burden of RSV and the impact that the vaccine applied during pregnancy and the elderly can have on disease prevention and complications. We encourage early and affordable diagnostic tests to curb the spread of RSV and reduce admissions. Disclosures Rita A. Rojas-Fermin, MD,FIDSA, Gilead: Advisor/Consultant|Pfizer: Advisor/Consultant|Pfizer: Honoraria

Detection of Mycoplasma spp. from snakes from five different families

BackgroundMycoplasmas are an important cause of respiratory diseases in tortoises. In snakes, evidence of mycoplasma infections has been found almost exclusively in pythons. To better understand the occurrence of these bacteria in other snake species, samples submitted for routine testing for respiratory pathogens were also tested for mycoplasma by polymerase chain reaction (PCR). A total of 640 samples (mostly oral swabs) from snakes of 5 different families (Boidae n = 114, Colubridae n = 109, Elapidae n = 34, Pythonidae n = 301 and Viperidae n = 82) were included in the study. A genus-specific PCR (PCR1) developed for the detection of Mycoplasma [Mycoplasmopsis] agassizii and a pan-mycoplasma PCR (PCR2) were used. PCR products were sequenced for validation and phylogenetic analysis was performed. The sampled animals were from various owners and collections, all in human care at the time of sampling. Clinical background information was not provided.ResultsUsing PCR1, mycoplasmas were detected in 175 (175/640, 27%) samples (Boidae: 7/114, 6%; Colubridae: 3/109, 3%; Elapidae: 8/34, 24%; Pythonidae: 155/301, 51%; Viperidae: 2/82, 2%). A higher percentage of positive results were obtained using PCR2 (258/640, 40%; Boidae: 9/114, 8%; Colubridae: 25/109, 23%; Elapidae: 19/34, 56%; Pythonidae: 172/301, 57%; Viperidae: 33/82, 40%). The detected bacteria can be divided into at least 6 genetically diverse clusters representing different genera and species based on multiple sequence alignment and phylogenetic analysis.ConclusionsThese results show that diverse mycoplasmas are found in pythons and other snakes. Further investigations are necessary to evaluate the role of various mycoplasmas in respiratory diseases in snakes.

The Epidemiology and Clinical Burdens of Human Parainfluenza Virus Infections Amongst Hospitalized Children Under 5 Years of Age in Jordan: A National Multi-Center Cross-Sectional Study

Human parainfluenza virus (HPIV) is a major cause of respiratory illnesses in children under five years, with clinical manifestations ranging from mild upper respiratory tract infections to severe lower respiratory tract diseases. This multi-center, cross-sectional study investigated the burden, clinical features, and predictors of respiratory viral infections in hospitalized children across four sites in Jordan. Nasopharyngeal specimens from 1000 eligible children were analyzed. In this article, we focused on HPIV infections. The overall HPIV positivity rate was 22.6%, with HPIV-3 accounting for 90.3% of cases. Significant geographic variability was observed, with higher positivity rates in the southern region. HPIV-positive cases frequently presented with symptoms like nasal congestion, tachypnea, and poor feeding. Co-infections with respiratory syncytial virus (RSV) or influenza were associated with worse outcomes, including an increased need for invasive ventilation. The logistic regression identified male gender, asthma, and respiratory acidosis as predictors of complications. Geographic differences in HPIV prevalence and severity were notable, emphasizing the influence of environmental and socioeconomic factors. These findings underscore the urgent need for enhanced HPIV surveillance, targeted public health interventions, and vaccine development to mitigate the disease burden. This study provides critical insights that guide healthcare strategies and improve outcomes in young children at risk of severe HPIV infections.

Major change in swine influenza virus diversity in France owing to emergence and widespread dissemination of a newly introduced H1N2 1C genotype in 2020.

Swine influenza A viruses (swIAVs) are a major cause of respiratory disease in pigs worldwide, presenting significant economic and health risks. These viruses can reassort, creating new strains with varying pathogenicity and cross-species transmissibility. This study aimed to monitor the genetic and antigenic evolution of swIAV in France from 2019 to 2022. Molecular subtyping revealed a marked increase in H1avN2 cases from 2020 onwards, altering the previously stable subtypes' distribution. Whole-genome sequencing and phylogenetic analyses of H1av (1C) strains identified 10 circulating genotypes, including 5 new genotypes. The most predominant genotype from 2020 onwards, denominated H1avN2#E, was characterized by an HA-1C.2.4, an N2-Gent/84, and internal protein-encoding genes belonging to a newly defined subclade within the Eurasian avian-like (EA) lineage termed EA-DK. H1avN2#E emerged in Brittany, the country's most pig-dense region, and rapidly became the most frequently detected swIAV genotype across France. This drastic change in the swIAV lineage proportions at a national scale was unprecedented, making H1avN2#E a unique case for understanding swIAV evolution and spreading patterns. Phylogenetic analyses suggested an introduction of the H1avN2#E genotype from a restricted source, likely originating from Denmark. It spread rapidly with low genetic diversity at the start of the epizootic in 2020, showing increasing diversification in 2021 and 2022 as the inferred population size grew and stabilized, and exhibited reassortments with other enzootic genotypes. Amino acid sequence alignments of H1avN2#E antigenic sites revealed major mutations and deletions compared to commercial vaccine 1C strain (HA-1C.2.2) and previously predominant H1avN1 strains (HA-1C.2.1). Antigenic cartography confirmed significant antigenic distances between H1avN2#E and other 1C strains, suggesting that the new genotype has escaped the pre-existing immunity of the swine population. Epidemiologically, the H1avN2#E virus exhibited epizootic hallmarks with more severe clinical outcomes compared to H1avN1 viruses. These factors likely contributed to the spread of H1avN2#E within the pig population. The rapid rise of H1avN2#E highlighted the dynamic nature of swIAV genetic and antigenic diversity, underscoring the importance of tailored surveillance programs to support risk assessment during potential new outbreaks. It also demonstrates the need to strengthen biosecurity measures when introducing pigs into a herd, including swIAV positivity assessment followed by quarantine, and restrict the trade of swIAV-excreting live swine between European countries.

The Assessment of the Effectiveness of Ultrasound and Near-Infrared Spectroscopy of the Lungs for the Differential Diagnosis of Transient Tachypnea of Newborns and Congenital Pneumonia in Children over 350 Weeks of Gestation. The Prospective Study

Background. The most common cause of respiratory disorders (RD) in the first hours after birth in children older than 35 weeks of gestation are transient tachypnea of the newborns (TTN) and early neonatal infection, in particular, congenital pneumonia (CP). However, in the first 4 hours of life, there are no reliable methods for diagnosing these diseases. The aim of the study is to evaluate the effectiveness of ultrasound (US) and near-infrared spectroscopy (NIRS) of the lungs for the differential diagnosis of TTN and CP in children older than 35 weeks of gestation. Methods. A prospective single-center cohort study based on the Yekaterinburg Clinical Perinatal Center. Newborns older than 35 weeks of gestation with the development of RD in the first 4 hours of life were included, the sample size was 200 children. Upon admission to NICU, he performed studies: US and NIRS of the lungs on the lateral and posterior surfaces of the chest on both sides. A comparative analysis of the score of lung US and NIRS indicators in patients with TTN and CP was carried out. Results. During the study and subsequent analysis of the results, it was revealed that the studied methods for the differential diagnosis of TTN and CP have sensitivity and specificity, respectively: only US of the lungs 75.9% and 57.0%; only lung NIRS 77.6% and 74.6%; US and lung NIRS 86.2% and 84.5% together, the area under the curve 0.898, 95% CI 0.854–0.943, р &lt; 0,001. There is also evidence that the pattern of consolidation in the lungs is significantly more often recorded by US at VP (р &lt; 0,001). Conclusion. The study showed that the combined usage of US and lung NIRS has high sensitivity and specificity for the differential diagnosis of TTN and CP and is a promising method for early diagnosis of these diseases.

Prevalence and Genetic Diversity of Respiratory Syncytial Virus Reinfections in Young Thai Children, 2016-2023.

Although a vaccine for respiratory syncytial virus (RSV) is now available for pregnant women and the elderly, RSV remains a significant cause of respiratory illness in children globally. Reinfections by the same or different RSV subgroups in children residing in the tropics are currently under-studied. Therefore, we examined the patterns of RSV infection and reinfection in Thai children aged ≤ 5 years with respiratory symptoms from 2016 to 2023. Screening of 7710 pediatric respiratory specimens identified 1245 RSV-positive samples (16.1%), mostly from the rainy months (July-November). Interestingly, 74 children experienced two infections, and 6 had three infections. Reinfection by different RSV subgroups occurred in 30 children: 21 were initially infected with RSV-B and later with RSV-A, while 9 had the reverse pattern. Reinfections only by either RSV-A or RSV-B were observed in 22 and 2 children, respectively, with one child infected with RSV-A three times. All RSV-A reinfections belonged to the ON1 genotype, while RSV-B reinfections were BA9. Notably, reinfections across different seasons were observed within homologous pairs. These findings suggest a transitory immunity to natural RSV infection and provide the knowledge that may help optimize pediatric vaccination schedule. Ongoing epidemiological data on RSV are essential in monitoring genotype circulation and vaccine effectiveness.

Human parainfluenza virus 3 field strains undergo extracellular fusion protein cleavage to activate entry.

Enveloped viruses cause a wide range of diseases in humans. At the first step of infection, these viruses must fuse their envelope with a cell membrane to initiate infection. This fusion is mediated by viral proteins that require a critical activating cleavage event. It was previously thought that for parainfluenza virus 3, an important cause of respiratory disease and a representative of a group of important pathogens, this cleavage event was mediated by furin in the cell secretory pathways prior to formation of the virions. We show that this is only true for laboratory strain viruses, and that clinical viruses that infect humans utilize extracellular proteases that are only made by a small subset of cells. These results highlight the importance of studying authentic clinical viruses that infect human tissues for understanding natural infection.

Flexible and highly selective NO2 gas sensor based on direct-ink-writing of eco-friendly graphene oxide for smart wearable application

Nitrogen dioxide (NO2) is a major cause of respiratory disorders in outdoor and indoor environments. Real-time NO2 monitoring using nonintrusive wearable devices can save lives and provide valuable health data. This study reports a room-temperature, wearable, and flexible smart NO2 gas sensor fabricated via cost-effective printing technology on a polyimide substrate. The sensor uses alkali lignin with edge-oxidised graphene oxide (EGO-AL) ink, demonstrating a sensitivity of 1.70% ppm⁻1 and a detection limit of 12.70 ppb, with excellent selectivity towards NO2. The high sensing properties are attributed to labile oxygen functional groups from GO and alkali lignin, offering abundant interacting sites for NO2 adsorption and electron transfer. The sensor fully recovers to the baseline after heat treatment at 150 °C, indicating its reusability. Integration into lab coats showcased its wearable application, utilising a flexible printed circuit board to wirelessly alert the wearer via cell phone to harmful NO2 levels (>3 ppm) in the environment. This smart sensing application underscores the potential for practical, real-time air quality monitoring, personal safety enhancement, and health management.

Attenuation of PM2.5-Induced Lung Injury by 4-Phenylbutyric Acid: Maintenance of [Ca2+]i Stability between Endoplasmic Reticulum and Mitochondria.

Fine particulate matter (PM2.5) is a significant cause of respiratory diseases and associated cellular damage. The mechanisms behind this damage have not been fully explained. This study investigated two types of cellular damage (inflammation and pyroptosis) induced by PM2.5, focusing on their relationship with two organelles (the endoplasmic reticulum and mitochondria). Animal models have demonstrated that PM2.5 induces excessive endoplasmic reticulum stress (ER stress), which is a significant cause of lung damage in rats. This was confirmed by pretreatment with an ER stress inhibitor (4-Phenylbutyric acid, 4-PBA). We found that, in vitro, the intracellular Ca2+ ([Ca2+]i) dysregulation induced by PM2.5 in rat alveolar macrophages was associated with ER stress. Changes in mitochondria-associated membranes (MAMs) result in abnormal mitochondrial function. This further induced the massive expression of NLRP3 and GSDMD-N, which was detrimental to cell survival. In conclusion, our findings provide valuable insights into the relationship between [Ca2+]i dysregulation, mitochondrial damage, inflammation and pyroptosis under PM2.5-induced ER stress conditions. Their interactions ultimately have an impact on respiratory health.

Flow interruption compared to forced oscillatory maneuvers and esophageal balloon/pneumotachography for measurement of respiratory resistance in the horse.

Pulmonary function testing is critical to the diagnosis of equine asthma (EA), an important cause of respiratory disease in the horse, but its clinical use has remained elusive, unfortunately, due to the complexity of reference methods, esophageal balloon/pneumotachography (EBP), and forced oscillatory mechanics (FOM), so we sought a noninvasive, portable method for use in horses through rapid interruption of airflow for equilibration of alveolar pressure with proximal airway pressure, termed flow interruption (FI). Resistance (RINT) was computed as the relationship between the change in pressure at the nose before and immediately after interruption and flow immediately before interruption. A pilot study in five healthy university-owned animals using EBP and FI showed good correspondence between the two methods: RINT (0.33 ± 0.05 cmH2O/L/s) and RL (0.31 ± 0.06 cmH2O/L/s). In two separate populations of client-owned horses, with random assignment of methods to FI versus EBP (n = 8), RINT showed good correlation with RL in horses (rs = 0.995, P = 0.0002) and accords with RL, with no significant difference between RINT and RL. Using FOM (n = 12), RINT (0.67 ± 0.31 cmH2O/L/s) has good correlation with RRS measured with FOM (r = 0.834, P = 0.0001), but is consistently smaller than RRS (0.74 ± 0.33 cmH2O/L/s). Histamine bronchoprovocation (HBP) was performed in a subset of these horses: FI classified one horse in six as less reactive than did EBP, and FI classified one horse in seven as less reactive than did FOM.NEW & NOTEWORTHY We developed and document for the first time the use of flow interruption for the rapid and noninvasive measurement of resistance in equine patients and demonstrated short- and long-term stability and accuracy in comparison with the reference methods.

Use of Respiratory Syncytial Virus Vaccines in Adults Aged ≥60 Years: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2024.

Respiratory syncytial virus (RSV) is a major cause of respiratory illness and hospitalization in older adults during fall and winter in the United States. The 2023-2024 RSV season was the first during which RSV vaccination was recommended for U.S. adults aged ≥60 years, using shared clinical decision-making. On June 26, 2024, the Advisory Committee on Immunization Practices voted to update this recommendation as follows: a single dose of any Food and Drug Administration-approved RSV vaccine (Arexvy [GSK]; Abrysvo [Pfizer]; or mResvia [Moderna]) is now recommended for all adults aged ≥75 years and for adults aged 60-74 years who are at increased risk for severe RSV disease. Adults who have previously received RSV vaccine should not receive another dose. This report summarizes the evidence considered for these updated recommendations, including postlicensure data on vaccine effectiveness and safety, and provides clinical guidance for the use of RSV vaccines in adults aged ≥60 years. These updated recommendations are intended to maximize RSV vaccination coverage among persons most likely to benefit, by clarifying who is at highest risk and by reducing implementation barriers associated with the previous shared clinical decision-making recommendation. Continued postlicensure monitoring will guide future recommendations.

Maternal Immunization Decision-Making Among Pregnant and Lactating People in Kenya: A Qualitative Exploration of Peer Influences on Vaccine Decision-Making for a Future RSV Vaccine

IntroductionRespiratory syncytial virus (RSV) is a leading cause of respiratory illness in infants globally, with new maternal RSV vaccines on the horizon. Vaccine decision-making during pregnancy is shaped by individual, interpersonal, community, and societal factors. This study explored key interpersonal influences on maternal vaccine decision-making among pregnant and lactating people (PLP) and community members in Kenya.MethodsThis qualitative study conducted in-depth interviews with six pregnant people, 18 lactating people, and 10 community members in one rural and one urban county in Kenya. Data were analyzed using a grounded theory approach.ResultsParticipants identified the pregnant person themself, male partners, other family members, peers, and healthcare providers (HCPs) as key influences on the maternal immunization decision-making process. The majority of interviewed PLP believed that decision-making during pregnancy should be left to themselves due to autonomy and their role as the primary caregiver. Community members, including male partners, also identified pregnant people as the key decision-maker. While some PLP said they deferred to male partners to make vaccine decisions, more felt that men were not as informed on maternal and child issues as themselves or other female peers and relatives. HCPs emerged as important influences and information sources for PLP during decision-making.DiscussionUnderstanding who influences vaccine-decision making during pregnancy will help inform demand generation strategies, and in turn, uptake of future maternal vaccines, including RSV vaccines. Given the strong role HCPs and peers have in the decision-making process, targeting key potential influences is essential to improve vaccine acceptance.

Evaluating Two Sampling Methods for Mycoplasma Bovis Diagnosis in American Bison (Bison bison).

Mycoplasma bovis is a bacterial pathogen endemic to cattle. In the early 2000s, M. bovis emerged as a cause of respiratory disease in American bison (Bison bison), causing significant morbidity and mortality. Bison herds that experience an outbreak of M. bovis are at higher risk for subsequent outbreaks, suggesting that chronic, subclinical infections can be established. Antemortem testing is therefore crucial to disease management; however, the precise sampling method to maximize detection of M. bovis in bison is unknown. We evaluated two sample types-superficial nasal swabs and deep nasopharyngeal swabs-collected from apparently healthy or symptomatic bison from January 2021 through December 2022. We used real-time PCR to detect M. bovis in 76/938 bison (8.1%) from 11 herds. For bison testing positive on at least one swab type, M. bovis was detected in 63/76 (82.8%) deep nasopharyngeal swabs and 29/73 (38.1%) superficial nasal swabs. Agreement between swabs for positive bison was 21% (n=16, kappa coefficient 0.319). We conclude that deep nasopharyngeal swabbing is more sensitive than superficial nasal swabbing for detection of M. bovis in bison and that low agreement between methods may be related to stage of infection. We further tested pooled samples by PCR and found that pooling of up to five samples can be effective to increase throughput and minimize costs. Management of wild bison relies on the ability to relocate animals to maintain gene flow and healthy populations. Sensitive and specific diagnostic tests are needed to inform decisions and minimize risk of transmission, especially from subclinical carriers. This study provides valuable insight that will inform best practices for M. bovis testing, thereby supporting the conservation of bison as healthy wildlife, which in turn promotes ecological restoration, safeguards cultural practices of Tribal Nations, and upholds the bison as a unique American icon.

Investigation of the epidemiology, pathogenicity and immunogenicity of Bordetella bronchiseptica isolated from cats and dogs in China from 2021 to 2023

Bordetella bronchiseptica (Bb) is recognized as a leading cause of respiratory diseases in dogs and cats. However, epidemiological data on Bb in dogs and cats in China are still limited, and there is no commercially available vaccine. Live vaccines containing Bb that are widely used abroad are generally effective but can establish latency and potentially reactivate to cause illness in some immunodeficient vaccinated recipients, raising safety concerns. In this study, 34 canine-derived and two feline-derived Bb strains were isolated from 1809 canine and 113 feline nasopharyngeal swab samples collected from eight provinces in China from 2021 to 2023. The PCR results showed that the percentage of positive Bb was 22.94% (441/1922), and more than 90% of the Bb isolates had four virulence factor-encoding genes (VFGs), namely, fhaB, prn, betA and dnt. All the isolated strains displayed a multidrug-resistant phenotype. The virulence of 10 Bb strains isolated from dogs with respiratory symptoms was tested in mice, and we found that eight isolates were highly virulent. Furthermore, the eight Bb isolates with high virulence were inactivated and intramuscularly injected into mice, and three Bb strains (WH1218, WH1203 and WH1224) with the best protective efficacy were selected. Dogs immunized with these three strains exhibited strong protection against challenge with the Bb field strain WH1218. Ultimately, the WH1218 strain with the greatest protection in dogs was selected as the vaccine candidate. Dogs and cats that received a vaccine containing 109 CFU of the inactivated WH1218 strain showed complete protection against challenge with the Bb field strain WH1218. This study revealed that Bb is an important pathogen that causes respiratory diseases in domestic dogs and cats in China, and all the isolates exhibited multidrug resistance. The present work contributes to the current understanding of the prevalence, antimicrobial resistance, and virulence genes of Bb in domestic dogs and cats. Additionally, our results suggest that the WH1218 strain is a promising candidate safe and efficacious inactivated Bb vaccine.

Mycoplasma ovipneumoniae in farmed whitetailed deer

Mycoplasma ovipneumoniae is an infectious cause of respiratory disease, previously assumed to cause disease only in members of the subfamily Caprinae (sheep, goats, muskox). This bacteri­um has sporadically been isolated from other species, including captive white-tailed deer (WTD); however, little is known about the incidence or significance of M. ovipneumoniae in this spe­cies. Chronic respiratory disease is a common problem in captive WTD, and due to the fastidious nature of M. ovipneumoniae, in­fections with this bacterium may be overlooked as a contributing factor. The objective of this study is to characterize the incidence of M. ovipneumoniae infection and its association with respira­tory disease in an intensively managed captive WTD herd. Ad­ditionally, future multi-locus and full genome sequence analyses will elucidate relatedness between M. ovipneumoniae isolates from WTD and other species.

Discovery of the tigecycline resistance gene cluster tmexCD3-toprJ1 in Pasteurella multocida strains isolated from pigs in China

Pasteurella multocida is a leading cause of respiratory disorders in pigs. However, the genotypes and antimicrobial resistance characteristics of P. multocida from pigs in China have not been reported frequently. In this study, we investigated 381 porcine strains of P. multocida collected in China between 2013 and 2022. These strains were assigned to capsular genotypes A (69.55%, n = 265), D (27.82%, n =106), and F (2.62%, n = 10); or lipopolysaccharide genotypes L1 (1.31%, n = 5), L3 (24.41%, n = 93), and L6 (74.28%, n = 283). Overall, P. multocida genotype A:L6 (46.46%) was the most-commonly identified type, followed by D:L6 (27.82%), A:L3 (21.78%), F:L3 (2.62%), and A:L1 (1.31%). Antimicrobial susceptibility testing showed that a relatively high proportion of strains were resistant to tetracycline (66.67%, n = 254), and florfenicol (35.17%, n = 134), while a small proportion of strains showed resistance phenotypes to enrofloxacin (10.76%, n = 41), ampicillin (8.40%, n = 32), tilmicosin (7.09%, n = 27), and ceftiofur (2.89%, n = 11). Notably, Illumina short-read and Nanopore long-read sequencing identified a chromosome-borne tigecycline-resistance gene cluster tmexCD3-toprJ1 in P. multocida. The structure of this cluster was highly similar to the respective structures found in several members of Proteus or Pseudomonas. It is assumed that the current study identified the tmexCD3-toprJ1 cluster for the first time in P. multocida.

Observations of Respiratory Syncytial Virus (RSV) Nucleic Acids in Wastewater Solids Across the United States in the 2022-2023 Season: Relationships with RSV Infection Positivity and Hospitalization Rates.

Respiratory syncytial virus (RSV) is a leading cause of respiratory illness and hospitalization, but clinical surveillance detects only a minority of cases. Wastewater surveillance could determine the onset and extent of RSV circulation in the absence of sensitive case detection, but to date, studies of RSV in wastewater are few. We measured RSV RNA concentrations in wastewater solids from 176 sites during the 2022-2023 RSV season and compared those to publicly available RSV infection positivity and hospitalization rates. Concentrations ranged from undetectable to 107 copies per gram. RSV RNA concentration aggregated at state and national levels correlated with infection positivity and hospitalization rates. RSV season onset was determined using both wastewater and clinical positivity rates using independent algorithms for 14 states where both data were available at the start of the RSV season. In 4 of 14 states, wastewater and clinical surveillance identified RSV season onset during the same week; in 3 states, wastewater onset preceded clinical onset, and in 7 states, wastewater onset occurred after clinical onset. Wastewater concentrations generally peaked in the same week as hospitalization rates but after case positivity rates peaked. Differences in onset and peaks in wastewater versus clinical data may reflect inherent differences in the surveillance approaches.

Bronchiolitis in an infant due to influenza A, necropsy findings: a case report

The influenza virus is an important cause of respiratory disease in infants and presents challenging differential diagnoses to investigate. This is a case report that involves a necroscopic study of a 2-month-old male infant, without previous comorbidities, with a serological diagnosis of influenza A and histopathological presentation of non-obliterating bronchiolitis. Infants are considered a high-risk group for flu complications due to the immaturity of the immune system and the ability to respond to respiratory infections. Furthermore, the severity of infection in infants may be worsened by the difficulty in quickly considering and treating the symptoms of the disease.

Epidemiology of influenza in Nigeria: A secondary analysis of the sentinel surveillance data in Nigeria from 2010 – 2020

BackgroundInfluenza is a leading cause of morbidity and mortality globally. Little is known of the true burden and epidemiology of influenza in Africa. Nigeria has a sentinel surveillance system for influenza virus (IFV). This study seeks to describe the epidemiological characteristics of influenza cases in Nigeria through secondary data analysis of the sentinel surveillance data from 2010 to 2020. MethodologyA retrospective secondary data analysis of data collected from patients with influenza-like illness (ILI) and severe acute respiratory infection (SARI) in the four Nigeria Influenza Sentinel Surveillance sites from January 2010 to December 2020. Data was cleaned and analyzed using Microsoft Excel and Epi info 7.2 for frequencies and proportions. The results of the analysis were summarized in tables and charts. ResultsA total of 13,828 suspected cases of influenza were recorded at the sentinel sites during the study period. About 10.3% (1421/13,828) of these tested positive for IFV of which 1243 (87.5%) were ILI patients, 175 (12.3%) SARI patients, and 3 (0.2%) novel H1N1 patients. Males accounted for 54.2% (770/1421) of the confirmed cases. The median age of confirmed cases was 3 years (range: <1month–97 years). Children 0–4 years accounted for 69.3% (985/1421) of all cases. The predominant subtypes were B lineage not determined (32.3%), A/H1N1 pdm09 (28.8%) and A/H3 (23.0%). There were periods of sustained transmission in most years with 2011 having the highest number of cases. Overall, there were more cases around January to March and August to November. Heart disease and chronic shortness of breath were the most common co-morbidities identified among confirmed cases. ConclusionInfluenza remains a significant cause of respiratory illness, especially among children aged less than 4 years. Influenza cases occur all year round with irregular seasonality in Nigeria. Children less than 4 years and those with co-morbidities should be prioritized for vaccination. Vaccine composition in the country should take cognizance of the prevailing strains which are type B (lineage not determined), A/H1N1 pdm09 and A/H3.