Major Route Of Transmission Research Articles

P-1964. Pre-exposure Prophylactic Treatment with Ensitrelvir Inhibited SARS-CoV-2 Infection in Hamster Aerosol Transmission Model

Abstract Background Although aerosol virus transmission is the major transmission route for SARS-CoV-2 and there remains a need to control SARS-CoV-2 spread with antivirals, prophylactic effect of pre-exposure antiviral treatments to prevent SARS-CoV-2 aerosol transmission remains to be clarified. In a previous report, we established the SARS-CoV-2 aerosol transmission hamster model (ESWI 2023, Nakashima et al.) (Figure 1). Here, we administered ensitrelvir to naive hamsters (contact) prior to exposure of virus aerosol shed by virus-infected hamsters (index) and evaluated the efficacy of the antivirals on SARS-CoV-2 aerosol infection.Figure 1Experimental aerosol SARS-CoV-2 transmission hamster model Methods Six syrian hamsters were intranasally inoculated with SARS-CoV-2 delta strain (index). Six naïve syrian hamsters (contact) were administered subcutaneously ensitrelvir 250 or 750 mg/kg twelve hours before the cohousing based on ensitrelvir exposure in human. Index and contact hamsters were cohoused in separated two stainless wire cages to prevent direct viral transmission, and in same container allowing aerosol transmission of SARS-CoV-2 for twelve hours on one day post infection. To evaluate viral titers in lung and nasal lavage fluid (NALF), both samples were collected from index hamsters two days post infection and from contact hamsters four days after cohousing, respectively. To evaluate pathogenesis, body weight changes were monitored until ten days post infection and lung weights were measured ten days post infection.Figure 2The effect of prophylactic treatment with ensitrelvir on the viral titers in lungs and NALF in contact hamstersTCID50: median tissue culture infectious dose, NALF: nasal lavage fluid, LLOQ: Lower limit of quantification Results Virus was detected in the lung and NALF of all contact hamsters administered with vehicle, demonstrating efficient aerosol transmission. Pre-exposure prophylactic treatment of contact hamsters with ensitrelvir 750 mg/kg reduced the aerosol transmission (Figure 2). Furthermore, pre-exposure treatment of 750 mg/kg ensitrelvir surpassed body weight loss and lung weight increase of aerosol infected hamsters compared to vehicle-treated hamsters. Conclusion Pre-exposure treatment of hamsters with ensitrelvir prevented hamsters from aerosol virus infection and suppressed body and lung weight changes in hamster SARS-CoV-2 aerosol transmission model. This approach may help protect at-risk individuals who live or work with SARS-CoV-2-infected patients. Disclosures Masaaki Nakashima, PhD, Shionogi&Co., Ltd.: Employee|Shionogi&Co., Ltd.: Stocks/Bonds (Private Company) Haruaki Nobori, PhD, Shionogi & Co., Ltd.: Employee|Shionogi & Co., Ltd.: Stocks/Bonds (Private Company) Takayuki Kuroda, n/a, Shionogi & Co., Ltd.: Employee|Shionogi & Co., Ltd.: Stocks/Bonds (Private Company) Alice Shimba, n/a, Shionogi & Co., Ltd.: Employee|Shionogi & Co., Ltd.: Stocks/Bonds (Private Company) Satoshi Miyagawa, n/a, Shionogi & Co., Ltd.: Employee|Shionogi & Co., Ltd.: Stocks/Bonds (Private Company) Akane Hayashi, n/a, Shionogi & Co., Ltd.: Stocks/Bonds (Private Company)|Shionogi TechnoAdvance Research: Employee Kazumi Matsumoto, n/a, Shionogi TechnoAdvance Research: Employee Kaoru Baba, n/a, Shionogi TechnoAdvance Research: Employee Keita Fukao, MD, SHIONOGI and CO., LTD.: Stocks/Bonds (Private Company)

Exploring frameworks for quantitative risk assessment of antimicrobial resistance along the food chain.

Campylobacter is one of the most reported causes of bacterial gastroenteritis worldwide. Birds are the predominant reservoirs for thermotolerant Campylobacter, therefore consumption of contaminated and undercooked poultry products represents one of the major transmission routes for campylobacteriosis. In addition to foodborne diseases, another relevant public challenge is the silent pandemic of antimicrobial resistance (AMR), impacting also the food chain. The occurrence of antimicrobial-resistant Campylobacter in broiler meat poses a significant threat to public health. In this context, quantitative microbiological risk assessment (QMRA) might support policy-makers in addressing these challenges. Hence, this project aimed to describe the current status of knowledge on occurrence of AMR Campylobacter at a global scale, with focus in estimating the prevalence of fluoroquinolone-resistant Campylobacter isolated from broiler meat at retail level. Following the drafting of a dedicated protocol, a systematic literature review and meta-analysis were conducted. Based on the extracted data, after the determination of the proportion of AMR isolates, the proportions were compared by Campylobacter species, geographical regions, processing step and sampling matrices. Meta-analysis allowed the estimation of the pooled prevalences of resistant isolates by regions and species, combining the findings from different independent studies in a comparable way. In terms of future perspectives, the outcome of this project will support future risk assessment and provide valuable inputs for estimating consumer exposure to AMR Campylobacter via broiler meat consumption. In conclusion, this report will provide a general overview of activities, preliminary results and research performed during the EU-FORA fellowship programme (2023/2024).

Viral Diversity in Mixed Tree Fruit Production Systems Determined through Bee-Mediated Pollen Collection

Commercially cultivated Prunus species are commonly grown in adjacent or mixed orchards and can be infected with unique or commonly shared viruses. Apple (Malus domestica), another member of the Rosacea and distantly related to Prunus, can share the same growing regions and common pathogens. Pollen can be a major route for virus transmission, and analysis of the pollen virome in tree fruit orchards can provide insights into these virus pathogen complexes from mixed production sites. Commercial honey bee (Apis mellifera) pollination is essential for improved fruit sets and yields in tree fruit production systems. To better understand the pollen-associated virome in tree fruits, metagenomics-based detection of plant viruses was employed on bee and pollen samples collected at four time points during the peak bloom period of apricot, cherry, peach, and apple trees at one orchard site. Twenty-one unique viruses were detected in samples collected during tree fruit blooms, including prune dwarf virus (PDV) and prunus necrotic ringspot virus (PNRSV) (Genus Ilarvirus, family Bromoviridae), Secoviridae family members tomato necrotic ringspot virus (genus Nepovirus), tobacco necrotic ringspot virus (genus Nepovirus), prunus virus F (genus Fabavirus), and Betaflexiviridae family member cherry virus A (CVA; genus Capillovirus). Viruses were also identified in composite leaf and flower samples to compare the pollen virome with the virome associated with vegetative tissues. At all four time points, a greater diversity of viruses was detected in the bee and pollen samples. Finally, the nucleotide sequence diversity of the coat protein regions of CVA, PDV, and PNRSV was profiled from this site, demonstrating a wide range of sequence diversity in pollen samples from this site. These results demonstrate the benefits of area-wide monitoring through bee pollination activities and provide new insights into the diversity of viruses in tree fruit pollination ecosystems.

Age, period, and cohort effects of Clonorchis sinensis infection prevalence in the Republic of Korea: Insights and projections.

With decades of containment efforts, the prevalence of C. sinensis infection in Korea has shown a declining trend. However, well-tailored intervention assessments remain challenging, particularly when considering the potential impacts of cohort variations in raw freshwater fish consumption behavior, a major transmission route to humans, on this observed decline. We applied an age-period-cohort modeling approach to nationally representative C. sinensis infection prevalence data from 1981-2012 in Korea to assess age, period, and cohort effects on its secular trend and to project the age-stratified prevalence up to 2023. Our analysis suggests that both cohort and period effects have substantially contributed to the declining prevalence of C. sinensis infection in Korea. Age-stratified projections up to 2023 suggest a decline in prevalence across all age groups, while those aged over 40 are anticipated to maintain prevalences above the elimination threshold of 1%. Our study highlights the importance of incorporating cohort effects into intervention assessments aimed at controlling C. sinensis infection. The effectiveness of interventions remains evident in Korea despite adjusting for the cohort effect. This approach, applicable to other endemic countries, would provide valuable insights for intervention assessments and inform future public health planning to eliminate C. sinensis infection.

MHealth interventions to improve public knowledge of HPV-associated oropharyngeal cancer in the UK

In the United Kingdom (UK), the current prevalence rates of oropharyngeal cancer linked to human papillomavirus (HPV) are 6.29% and 2.04% in men and women, respectively. Over the years, the burden of this disease has increased in the UK, and this is mainly due to the rising prevalence of HPV infection in the UK. Research evidence has shown that over 70% of oropharyngeal cancers in the UK are linked to HPV. Oral sex is the major route of transmission of HPV, and over 63% of UK young adults are found to have a positive history of oral sex practice. However, only a minority of the UK population are aware of HPV-associated oropharyngeal cancer; this therefore calls for more public health efforts to increase awareness and knowledge on HPV-associated oropharyngeal cancer in the UK. While the use of technology-based, clinic-based, and community-based interventions have been employed to improve public awareness and knowledge on the role of HPV-associated oropharyngeal cancer, mobile health (mhealth) interventions have not been seriously explored despite existing robust evidence on the effective roles of mhealth in improving awareness and knowledge in diverse diseases. This article therefore calls for the adoption and use of mhealth interventions in educating the UK’s population on HPV-associated oropharyngeal cancer. The use of mhealth interventions in this regard is highly viable as its implementation closely aligns with the country’s National Health Service (NHS) commitment towards the digital transformation of the UK’s healthcare system.

Relationship between Exhaled Aerosol and Carbon Dioxide Emission Across Respiratory Activities.

Respiratory particles produced during vocalized and nonvocalized activities such as breathing, speaking, and singing serve as a major route for respiratory pathogen transmission. This work reports concomitant measurements of exhaled carbon dioxide volume (VCO2) and minute ventilation (VE), along with exhaled respiratory particles during breathing, exercising, speaking, and singing. Exhaled CO2 and VE measured across healthy adult participants follow a similar trend to particle number concentration during the nonvocalized exercise activities (breathing at rest, vigorous exercise, and very vigorous exercise). Exhaled CO2 is strongly correlated with mean particle number (r = 0.81) and mass (r = 0.84) emission rates for the nonvocalized exercise activities. However, exhaled CO2 is poorly correlated with mean particle number (r = 0.34) and mass (r = 0.12) emission rates during activities requiring vocalization. These results demonstrate that in most real-world environments vocalization loudness is the main factor controlling respiratory particle emission and exhaled CO2 is a poor surrogate measure for estimating particle emission during vocalization. Although measurements of indoor CO2 concentrations provide valuable information about room ventilation, such measurements are poor indicators of respiratory particle concentrations and may significantly underestimate respiratory particle concentrations and disease transmission risk.

University closures can reduce the risk of severe acute respiratory syndrome coronaviruses-2 transmission via close contact amongst Chinese students by over 60%

During the COVID-19 pandemic, Chinese universities implemented many interventions against SAR-CoV-2 transmission. Close contact is thought to be a major transmission route. However, the effect of university closure-related interventions on infection risk amongst students is still poorly understood. In July 2022, we conducted an online survey of 2,400 university students in Beijing and Shanghai. Combined with real human behaviours, we evaluated the infection risk via close contact during both periods of university closures and non-closures. During the non-closure period, undergraduate and postgraduate students spent the longest close contact time in classrooms and graduate student offices, averaging 1.9 h and 2.2 h, respectively. During university closures, students spent the longest close contact time in residences (dormitories and homes), reaching up to 2.8 h. Catering places and residences were the two main indoor environments for viral exposure via close contact. Viral exposure did not differ significantly by education background or gender ( p > 0.05) but did by intervention levels in university or community ( p < 0.05). The infection risk decreased by 30.0% for resident students and 63.6% for non-resident students during university closures. The findings could provide scientific support for intervention policy-making during public health emergencies such as COVID-19 pandemic.

HIV Incidence and Transactional Sex Among Men Who Have Sex With Men in Ningbo, China: Prospective Cohort Study Using a WeChat-Based Platform.

Sexual transmission among men who have sex with men (MSM) has become the major HIV transmission route. However, limited research has been conducted to investigate the association between transactional sex (TS) and HIV incidence in China. This study aims to investigate HIV incidence and distinguish sociodemographic and sexual behavioral risk factors associated with HIV incidence among MSM who engage in TS (MSM-TS) in China. We conducted a prospective cohort study using a WeChat-based platform to evaluate HIV incidence among Chinese MSM, including MSM-TS in Ningbo, recruited from July 2019 until June 2022. At each visit, participants completed a questionnaire and scheduled an appointment for HIV counseling and testing on the WeChat-based platform before undergoing offline HIV tests. HIV incidence density was calculated as the number of HIV seroconversions divided by person-years (PYs) of follow-up, and univariate and multivariate Cox proportional hazards regression was conducted to identify factors associated with HIV incidence. A total of 932 participants contributed 630.9 PYs of follow-up, and 25 HIV seroconversions were observed during the study period, resulting in an estimated HIV incidence of 4.0 (95% CI 2.7-5.8) per 100 PYs. The HIV incidence among MSM-TS was 18.4 (95% CI 8.7-34.7) per 100 PYs, which was significantly higher than the incidence of 3.2 (95% CI 2.1-5.0) per 100 PYs among MSM who do not engage in TS. After adjusting for sociodemographic characteristics, factors associated with HIV acquisition were MSM-TS (adjusted hazard ratio [aHR] 3.93, 95% CI 1.29-11.93), having unprotected sex with men (aHR 10.35, 95% CI 2.25-47.69), and having multiple male sex partners (aHR 3.43, 95% CI 1.22-9.64) in the past 6 months. This study found a high incidence of HIV among MSM-TS in Ningbo, China. The risk factors associated with HIV incidence include TS, having unprotected sex with men, and having multiple male sex partners. These findings emphasize the need for developing targeted interventions and providing comprehensive medical care, HIV testing, and preexposure prophylaxis for MSM, particularly those who engage in TS.

Climate change, flooding, and HIV transmission in Africa: Potential relationships and a call for action

AbstractThe increasing effects of climate change have intensified floods globally, especially in Africa, where millions of people live in poverty and are highly vulnerable to flooding. Climate change disproportionately affects the vulnerable, who are least equipped to handle its consequences, by exacerbating their situation. One such consequence is the potential for increased human immunodeficiency virus (HIV) transmission. Africa has been disproportionately affected by the HIV epidemic. It now faces the additional challenge of a changing climate and floods, which are capable of increasing HIV transmission in Africa through several pathways. They can force population displacement and migration, leading to the expansion of sexual networks among people living with HIV (PLWHIV). They may also create conditions conducive to the spread of other infections. Floods can cause food insecurity, which can result in various sexual behaviors that expose people to HIV infection. As global warming is linked to a decrease in African food production capacity, the effect of food insecurity on HIV may be prominent in countries where transactional sexual means is a major route of HIV transmission. Floods can also hinder the provision of HIV services, such as pre‐ and postexposure prophylaxis and antiretroviral therapy distribution, which may worsen the health outcomes of PLWHIV and promote HIV transmission, particularly in rural and remote communities. It is crucial to develop a climate‐resilient framework, including education, sustained access to HIV services, and promotion of social welfare for HIV prevention and treatment, to address the complex relationship between HIV, floods, and climate change.

Prevalence and associated factors for hepatitis B infection among pregnant women attending antenatal clinic at SOS Hospital in Mogadishu, Somalia.

Hepatitis B virus (HBV) remains a leading cause of chronic hepatitis, maternal complications, and neonatal deaths in sub-Saharan Africa. Mother-to-child transmission is a major route of HBV transmission in endemic areas. This study aimed to determine the prevalence of hepatitis B infection and its associated factors among pregnant women attending Antenatal Care clinics at SOS Hospital in Mogadishu, Somalia. The research followed a cross-sectional design, and the participants were chosen through systematic random sampling, including every fifth outpatient. Each participant provided a blood sample for standard testing, and their consent was obtained before conducting Hepatitis B screening using the ELISA method. In our study of 384 pregnant women, 43 individuals (11.2%) tested positive for HBsAg. The frequency of HBsAg seropositivity was significantly higher in subjects with no education when compared to those with primary education (AOR = 0.1, 95% CI: 0.01-0.96, p = 0.046). Caesarian Section (AOR = 0.02, 95% CI: 0.004-0.0103, p = 0.001), blood transfusion (AOR = 11.6, 95% CI: 3.44-38.08, p = 0.001), previous dental procedures (AOR = 0.1, 95% CI: 0.04-0.38, p = 0.001), and unsafe injections in the past (AOR = 0.3, 95% CI: 0.09-0.91, p = 0.035) were identified as significant risk factors for hepatitis positivity. The study found a higher prevalence of hepatitis B compared to previous studies. Factors such as blood transfusion, dental procedures, Caesarian Section, and unsafe injections were associated with hepatitis B infection. It is essential to raise awareness, promote preventive measures, and implement routine screening for pregnant women so as to stop the transmission of hepatitis B to their children.

Knowledge of HIV transmission during pregnancy among women of reproductive age in Ghana

IntroductionHuman immunodeficiency virus (HIV) remains a significant health challenge affecting many people including those from sub-Saharan Africa (SSA). Even though HIV can be transmitted through various means, mother-to-child transmission (MTCT) remains the major route of transmission in children under the age of five. This study examined the correlates of knowledge of HIV transmission during pregnancy among reproductive-age women in Ghana.MethodsData for this study were obtained from the 2014 Ghana Demographic and Health Survey. The sample consisted of 9,106 women aged 15 to 49 years. We conducted both descriptive and multivariable logistic regression analyses to determine the prevalence and factors associated with knowledge of HIV transmission during pregnancy. The results were presented using frequencies, percentages, and adjusted odds ratios (aOR) with their corresponding 95% confidence intervals (CI).ResultsApproximately, 69.41% of women of reproductive age knew of HIV transmission during pregnancy. Women who had two (aOR = 1.32, 95% CI [1.01, 1.72]) or three (aOR = 1.37, 95% CI [1.07, 1.76]) births were more knowledgeable of HIV transmission during pregnancy. Women who read the newspaper (aOR = 1.56, 95% CI [1.31, 1.86]), listened to the radio (aOR = 1.23, 95% CI [1.05, 1.45]), lived in rural areas (aOR = 1.30, 95% CI [1.09, 1.54]) or ever been tested for HIV (aOR = 1.20, 95% CI [1.05, 1.37]) were more likely to be knowledgeable of HIV transmission during pregnancy than their counterparts in the reference categories. Compared to those in the Western Region, women in the Upper East (aOR = 0.45, 95% CI [0.32, 0.63]), Upper West (aOR = 0.54, 95% CI [0.35, 0.85]), Ashanti (aOR = 0.75, 95% CI [0.58, 0.97]) and Greater Accra Regions (aOR = 0.74, 95% CI [0.56, 0.98]) were less knowledgeable of HIV transmission during pregnancy.ConclusionsThe study highlights a gap in the knowledge of HIV transmission during pregnancy among women in Ghana. Continuous public education is required to educate women on HIV transmission from mothers to their children during pregnancy and how this may be interrupted. Such programs should involve the use of the media and take into consideration the demographic and geographic characteristics highlighted as determinants in this study. This will ultimately contribute to the reduction of MTCT of HIV in Ghana.

Evaluation of the dynamics of oral pathogenic microbiota in COVID-19 patients by genomic sequencing after application of foam with antimicrobial action

Relevance. The COVID-19 pandemic caused by the SARS-CoV-2 virus has demonstrated the critical importance of understanding the mechanisms of transmission and finding effective methods of prevention. Particular attention has been paid to the role of oral hygiene, as the oral cavity serves as a major route of transmission. Studies show that the composition of the oral microbiota can influence the course and outcome of COVID-19 disease. Therefore, there is a need to study the effects of oral antiseptics on the microbiome, which may offer new opportunities for the prevention and treatment of this disease.Objective. The aim of this study is to evaluate the effectiveness of the oral cleansing foam «Parodontol PROF» in reducing the pathogenic microflora of the oral cavity in patients with COVID-19 and to assess its effect on the risk of secondary infections.Materials and methods. The study was conducted on the basis of the Clinical Medical Centre «Kuskovo» of Russian University of Medicine. It included 450 patients with a confirmed diagnosis of COVID-19. The participants were divided into two groups: the test group used oral cleansing foam, while the control group used no additional oral hygiene. Comparative analyses of the taxonomic composition of the oropharyngeal microbiota and dental plaque before and after the use of the cleansing foam were performed.Results. The study showed that patients who regularly used the cleansing foam «Parodontol PROF» had a significant decrease in the representation of pathogens, including Mycoplasma, and an increase in the number of beneficial commensals such as Lactococcus and Lactobacillus. These changes indicate the potential efficacy of this product to improve oral hygiene and reduce the risk of secondary infections.Conclusion. The study supports the hypothesis that improving oral hygiene with specialised antiseptic agents, such as a cleansing foam, may help to reduce pathogenic microflora in the oral cavity in patients with COVID-19. This, in turn, may reduce the risk of pathogen migration into the lower respiratory tract and the development of secondary infections. The findings emphasise the importance of further research in this area and the development of comprehensive approaches to oral hygiene management in the context of infectious diseases.

Toxoplasmosis in cats from a dairy-producing region in Hidalgo, Mexico

Considering that the ingestion of cat feces containing Toxoplasma gondii oocysts is a major transmission route for toxoplasmosis, this work is aimed to assess the presence of T. gondii in cats dwelling in dairy production facilities at the Tizayuca Agro-Industrial Complex (CAIT, by its acronym in Spanish) in Hidalgo, Mexico. Blood samples from stray and owned cats were assayed by indirect ELISA, and samples from various tissues were collected at post-mortem examination of positive cats for DNA extraction, PCR, histopathologic studies, and immunohistochemistry. A questionnaire was applied in each dairy production unit to estimate cat ownership. From 70 animals studied (22 stray and 48 owned), 12 (17.1 %) were seropositive (7 stray and 5 owned). No differences were found for age or sex according to the questionnaires, but ingesting raw food was a risk factor (P < 0.01). Of the 12 positive cats, 5 were euthanized; of these, five tissue samples from 4 cats were positive for the B1 and 529 bp repetitive sequences by qPCR and conventional PCR. No macro- or microscopic lesions suggestive of T. gondii infection were found in cats.

Interactions between chaperone and energy storage networks during the evolution of Legionella pneumophila under heat shock.

Waterborne transmission of the bacterium Legionella pneumophila has emerged as a major cause of severe nosocomial infections of major public health impact. The major route of transmission involves the uptake of aerosolized bacteria, often from the contaminated hot water systems of large buildings. Public health regulations aimed at controlling the mesophilic pathogen are generally concerned with acute pasteurization and maintaining high temperatures at the heating systems and throughout the plumbing of hot water systems, but L. pneumophila is often able to survive these treatments due to both bacterium-intrinsic and environmental factors. Previous work has established an experimental evolution system to model the observations of increased heat resistance in repeatedly but unsuccessfully pasteurized L. pneumophila populations. Here, we show rapid fixation of novel alleles in lineages selected for resistance to heat shock and shifts in mutational profile related to increases in the temperature of selection. Gene-level and nucleotide-level parallelisms between independently-evolving lineages show the centrality of the DnaJ/DnaK chaperone system in the heat resistance of L. pneumophila. Inference of epistatic interactions through reverse genetics shows an unexpected interaction between DnaJ/DnaK and the polyhydroxybutyrate-accumulation energy storage mechanism used by the species to survive long-term starvation in low-nutrient environments.

Molecular Detection of Toxoplasma gondii Oocytes in Soil Samples from Guilan Province, Northern Iran.

Soil is an appropriate substrate for the storage and transmission of oocytes of Toxoplasma gondii. Ingestion of soil contaminated with T. gondii oocysts is a major transmission route of human and animal toxoplasmosis. The present study was carried out to investigate soil contamination with T. gondii oocysts in urban and rural areas of Guilan Province, northern Iran. Overall, 208 soil samples were collected from 16 cities and villages in Guilan Province, northern Iran from Oct 2020 to Nov 2021. Soil samples were investigated using modified sucrose flotation technique. Real-time polymerase chain reaction was used to detect presence of T. gondii DNAs in the samples. Positive samples were further analyzed using nested polymerase chain reaction for GRA6 gene. Moreover, six selected positive samples were used for amplifying and sequencing of the GRA6 gene. Overall, 31 samples were positive for T. gondii with frequency of 14.9% and ranging from 10.9% in rural areas to 16.3% in urban areas. Statistical analysis showed significant differences between the seasons (P=0.003). The phylogenetic analysis illustrated that our six sequences were similar and closely related to Type I strain of T. gondii. Results showed relatively high levels (14.9%) of T. gondii oocytes in soil samples of Guilan Province, northern Iran, which provided essential data for the effective prevention and control of toxoplasmosis in the region.

RISING BURDEN OF HEPATITIS C VIRUS (HCV) IN PAKISTAN: A CROSS SECTIONAL STUDY ON MULTITRANSFUSED BETA THALASSEMIA TYPE MAJOR PATIENTS

Background: Hepatitis C virus (HCV) is a serious health issue which infected 3.3% of world’s population. The major transmission route of this virus is blood and blood products. Thalaseemic patients are dependent upon blood transfusions throughout their life and are at high risk of getting HCV infections. Objectives: The aim of the study was to estimate the presence of hepatitis C virus in multitransfused thalaseemic population of capital twin cities of Pakistan. Patients and Methods: The study was conducted from November 2021 to April 2022 and 262 multitransfused beta thalaseemic from the capital twin cities of Pakistan were enrolled for analysis. The presence of hepatitis C virus, alanine amino transferase (ALT) level, serum creatinine, hepatomegaly, splenomegaly and splenectomy were analyzed. Results: The overall prevalence of Hepatitis C virus was 55.73% observed with 100% of patients greater than 20 years of age have HCV infection. The average ALT in HCV positive thalaseemic patients was observed 98U/L and average creatinine values were 0.39 mg/dl. 82.20% of HCV positive thalaseemic patients have hepatomegaly with average increase of 4.33 cm in liver size. Splenomegaly was observed in 67.12% of HCV positive thalaseemic patients with average increase of 4.46 cm in spleen size. Splenectomy was observed in 15.75% of cases. Conclusion: The presence of HCV is very high in thalaseemic population of Pakistan. The chance of getting HCV infections also increases with the increase in age of thalaseemic patient. Raised ALT and hepatomegaly was observed in majority of HCV positive thalaseemic patients. There is a strong need to properly screen the blood before transfusions to decrease the future load of HCV from Pakistan.

Hepatitis B virus genotypes associated with pregnant women in Northern Thailand

BackgroundMother-to-child transmission of hepatitis B virus (HBV) is the major route of transmission causing persistent infection. The prevalence of HBV infection and HBV genotypes found in different geographical areas varies from country to country. Therefore, this study was conducted to identify the HBV genotypes in HBV-infected pregnant women in Northern Thailand. MethodsStored blood samples that were collected from 145 HBsAg-positive pregnant women who gave birth at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand from 2017 to 2020 were analyzed. The partial nucleotide sequence of the S gene of HBV was amplified by nested PCR and sequenced. All sequences were analyzed phylogenetically together with the reference strains to define the HBV genotypes. ResultsA total of 31 blood samples from 145 HBsAg-positive pregnant women were positive for HBV by nested PCR. The detected HBV strains were identified as presumptive subgenotypes C1 (77.4%; 24/31), B9 (9.7%; 3/31), C2 (3.2%; 1/31), B2 (3.2%; 1/31), B4 (3.2%; 1/31), and presumptive B4/C2 recombinant subgenotype (3.2%; 1/31). ConclusionsThe findings revealed that presumptive subgenotype C1 was the most common subgenotype circulating in pregnant women in Northern Thailand and accounted for 77.4% of cases, followed by presumptive subgenotypes B9, C2, B2, and B4. Furthermore, this study reported, for the first time in Thailand, the HBV genotypes and presumptive subgenotypes, particularly subgenotype B9 circulating in pregnant women.

Rapid detection of human cytomegalovirus by multienzyme isothermal rapid amplification and lateral flow dipsticks.

Human cytomegalovirus (HCMV) is the most common viral infection seen in newborns. The major route of transmission for acquired human cytomegalovirus infection is breast milk from mothers who are HCMV seropositive to the infants. Thus, a rapid, economical, and simple method to perform HCMV test in breast milk is crucial and necessary for preventing acquired HCMV infection, especially in underdeveloped regions with limited laboratory resources. In this study, an effective technique for the detection of HCMV was constructed by combining multienzyme isothermal rapid amplification (MIRA) and lateral flow chromatography strip (LFD). Primers for the conserved HCMV sequence UL83 were utilized for MIRA-LFD testing. Our results showed that the entire MIRA reaction could be completed in 12 minutes at 37°C, and LFD outcomes could be observed visibly after 10 minutes. The detection sensitivity of this method reached 50 copy/μl. Samples of breast milk were examined to compare MIRA-LFD and conventional qPCR. The accuracy of MIRA-LFD was 100%. The straightforward, rapid, economic features of the test can provide the significant advantages for the prevention of breast milk-acquired cytomegalovirus infection, particularly in resource-limited locations with high seroprevalence of cytomegalovirus.

Ocular manifestations in HIV patients attending a tertiary care hospital in Eastern India and correlation of posterior segment lesions with CD4+ counts.

We aimed to study the ocular manifestations in human immunodeficiency virus (HIV)-infected patients and the correlation of posterior segment lesions with CD4+ counts. This hospital-based, cross-sectional study enrolled HIV-positive patients attending the ophthalmology department of a tertiary care hospital in Eastern India. Complete demographic information was obtained for each patient. Comprehensive ophthalmic evaluation was done in each case. A total of 184 HIV-positive patients were enrolled in the study. Ocular manifestations were detected in 62 cases. The prevalence of ocular manifestations in the present study was 33.69%. Mean age of patients included in the study was 34.8 ± 10.77 years. Prevalence of ocular manifestations was highest in the age group of 30-39 years (41.93%). Highest prevalence of ocular manifestations was noted in patients with low level of education and poor socioeconomic status. Sexual transmission was the major route of HIV transmission (in 92% of cases). Posterior segment lesions were seen in 69.35% of cases. HIV retinopathy was the most common posterior segment manifestation noted in 25 eyes. Significant positive correlation was noted between severities of posterior segment findings and CD4+ counts, which we found to increase with decrease in CD4+ counts (P < 0.001). Detailed ophthalmic evaluation including fundus examination is must in all cases of HIV/acquired immunodeficiency syndrome (AIDS) patients as it may help in early diagnosis, treatment, and prevention of sight-threatening complications due to opportunistic infections.

Microbiological characteristics, transmission routes, and mitigation measures in bronchoscope-associated investigations: Summary of Centers for Disease Control and Prevention (CDC) consultations, 2014-2022.

In this summary of US Centers for Disease Control and Prevention (CDC) consultations with state and local health departments concerning their bronchoscope-associated investigations from 2014 through 2022, bronchoscope reprocessing gaps and exposure to nonsterile water sources appeared to be the major routes of transmission of infectious pathogens, which were primarily water-associated bacteria.