Prevalence Of Virus Infection Research Articles

169. AT-752, an Oral Guanosine Nucleotide Prodrug, Exhibits Potent in Vitro Activity Against Flaviviruses and Prevents Disease Progression in a Dengue Mouse Model

BackgroundThe increasing global prevalence of human Dengue virus infection and the potential for life-threatening sequelae highlight the significance of this unmet medical need. Here we report the potent in vitro activity of AT-281, the free base form of AT-752, against Dengue virus and other flaviviruses and the in vivo efficacy of AT-752 in a mouse model of Dengue viral disease.MethodsAntiviral activities of serial dilutions of AT-281 were evaluated in infected Huh-7 cells. Effective concentrations of AT-281 required to inhibit virus yield reduction by 90% (EC90) and to prevent cytopathic effect by 50% (EC50) were determined, respectively, by visual examination and by neutral red staining, as was cytotoxicity. AG129 (α-, β- and γ-interferon knock-out) mice received an oral dose of AT‐752 (1000 mg/kg) 4 h before s.c. inoculation with Dengue virus type 2 (strain D2Y98P, 1x105 virus particles) followed by b.i.d. doses (500 mg/kg) for 7 days starting 1 h post‐inoculation (p.i.). Six groups each (n=5) of treated and control mice were scheduled to be sacrificed on days 4, 6, 7, 8, 10 and 21 p.i. with serum and spleen viral RNA levels determined by plaque assay. AT-281 efficacy was evaluated based on overall health score, survival, weight loss and viral load in serum and spleen.Results In vitro EC90 values for AT-281 against Dengue, West Nile and Yellow Fever viruses ranged from 0.26 to 0.64 µM and EC50 values for Zika and Japanese encephalitis were 0.21 and 0.64 µM, respectively (Table 1). No toxicity was observed up to the highest concentrations tested (172 µM). Oral administration of AT-752 to Dengue-infected AG129 mice substantially improved survival, prevented weight loss and lowered viral loads by day 6, with virus being undetectable on day 8 and thereafter (Figure 1). Serum and spleen viral loads in control mice declined between days 4 and 8 but no control mice survived beyond day 8. In contrast, AT-752 treated mice survived up to day 19, eventually succumbing to model-induced CNS sequelae.Table 1. Antiviral Activity of AT-281 Against Various Flaviviruses in Huh-7 Cell Cultures Figure 1. Efficacy of AT-752 in the AG129 mouse model of Dengue infection. Panel a: health score: 1, healthy; 2, coat slightly ruffled; 3, coat ruffled/wet; 4, coat very ruffled, eyes slightly closed/inset; 5, coat very ruffled, eyes closed/inset; 6, coat very ruffled, eyes closed/inset, moribund requiring humane euthanasia; 7, found dead. Panel b: Kaplan-Meier survival plot. Panel c: percent weight loss. Panel d: serum viremia. Panel e: spleen viral load. ConclusionThe potent activity of AT-281 against Dengue virus in vitro and the efficacy of its salt form, AT-752, in the terminal AG129 mouse model warrant further clinical development of the drug. Preclinical safety studies are in progress and clinical trials will be initiated thereafter.DisclosuresSteven S. Good, MS, Atea Pharmaceuticals, Inc. (Employee) Adel Moussa, PhD, Atea Pharmaceuticals, Inc. (Employee) Xiao-Jian Zhou, PhD, Atea Pharmaceuticals, Inc. (Employee) Jean-Pierre Sommadossi, PhD, Atea Pharmaceuticals, Inc. (Board Member) Keith Pietropaolo, BA, Atea Pharmaceuticals, Inc. (Employee)

Prevalence of Human Immunodeficiency Virus Infection among Tuberculosis Patients at Infectious Disease Hospital, Kano State, Nigeria

The epidemic of Human Immunodeficiency Virus (HIV) and the emergence of drug resistant Mycobacterium tuberculosis strains have been recognized as the most important factors contributing to increasing resurgence of tuberculosis (TB). This study was conducted to determine the prevalence of HIV among tuberculosis patients and drug sensitivity pattern of some of the mycobacterial isolates. One hundred and sixty eight (168) sputum samples from tuberculosis patients attending Infectious Diseases Hospital, Kano were collected and processed for the presence of Mycobacteria. Blood samples of the patients were also screened for the presence of HIV. The drug susceptibility test (DST) was performed using the BACTEC Mycobacteria Growth Inhibitory Test (MGIT) M960 technique. Results revealed that out of the 168 patients studied 24 (14.29%) were TB and HIV co-infected and 135 (68.88%) were males while 61 (31.12%) were females (P = 0.001). Majority of the studied cases were of the age groups 15-24 years and 25-34 years (P = 0.001). Ten (58.82%) of the 17 isolates that were subjected to DST against the first-line anti-TB drugs (isoniazid, rifampicin, ethambutol, pyrazinamide) were found to be resistant against the various drugs to which they were tested; out of which 7 (41.17%) exhibited a primary drug resistance pattern, 3 (17.65%) exhibited acquired drug resistance pattern and 2 (11.74%) were multi-drug resistant TB. The highest drug resistance of 23.53% was recorded against isoniazid, followed by rifampicin, ethambutol and pyrazinamide each with a resistance of 17.65%. The study recommends screening of all TB patients for early diagnosis of HIV co-infection as well as conducting DST which will inform prompt management of the infected individuals and designing appropriate treatment schedule for effective TB/HV control as well as preventing transmission of drug resistant TB.

Work, Health, and COVID-19

Work, Health, and COVID-19

Prevalence and Association of Transfusion Transmitted Infections with ABO and Rh Blood Groups among Blood Donors at the National Blood Bank, Amman, Jordan.

Background and objectives: Blood screening is considered a compulsory procedure in health care services to reduce the occurrence of transfusion transmitted infections (TTIs). This study estimated the distribution rates of ABO and Rh blood group systems, prevalence rates of TTIs among blood donors and their association with the ABO blood group and Rh system. Materials and Methods: A retrospective study was conducted at the national blood bank, Amman, Jordan for a period of 6 years (from January 2013 to December 2018). For TTIs analysis, about 5 mL blood sample was collected from each volunteer. A total of 365,029 persons (346,048 (94.8%) males and 18,981 (5.2%) females) donated their blood at the national blood bank, Amman, Jordan from January 2013 to December 2018. Results: The results revealed that O and A were the most prevalent blood groups (37.44% and 36.82%, respectively), followed by B (18.62%) and AB (7.12%). The distribution of Rh + ve and Rh − ve among blood donors showed that Rh + ve donors were more prevalent (88.73%) compared with Rh − ve (11.27%). HBsAg was the most prevalent viral infection (0.38%) followed by HCV (0.13%), syphilis (0.02%), HIV (0.006%) and the male donors were highly infected when compared with female donors. The association between ABO/Rh blood groups and TTIs infections was nonsignificant. Conclusions: In conclusion, low frequency rates of TTIs among blood donors were detected in the current study, but improvements are still continuously required. Low percentages of female donors need to be managed via conducting health cultural education programs.

Seroprevalence of dengue infection: A hospital based study from Udaipur, Rajasthan

Dengue is one of the most important arthropod- borne viral infections, widely distributed throughout the tropics and subtropics. It is endemic to the Indian subcontinent and associated with explosive urban epidemics and has become a major public health problem in India. The present study was conducted to detect prevalence of Dengue virus infection in Udaipur, Rajasthan. Materials and Methods: Serum samples from 640 patients clinically suspected of having dengue infection visiting a tertiary care hospital during the period of August 2016 to February 2018 were screened for the presence of Dengue NS1 antigen and IgM and IgG antibodies using one-step immune-chromatographic assay (Dengue Rapid IgM/IgG test and NS1 test by SD BIOLINE). Result: Out of 640 samples 62 samples (9.68%) were positive for Dengue virus infection. Out of total positive Sample for dengue virus infection, 61% samples were of male patients and 39% samples were from female patients. Among them 28% positive samples were from paediatric age group (Age 1- 14 years) and rest were from Adult age group. Seasonal trend showed a gradual increase in Dengue positives starting from August with a peak in October. Most common presentation was fever (98%). Conclusion: Number of dengue cases is on increase in the region and continued surveillance is essential to determine epidemiological and seasonal trend.

Exploring the burden of Ntwetwe virus–A novel orthobunyavirus associated with CNS infections–in Ugandan children

Background: Ntwetwe virus is a novel orthobunyavirus which was recently discovered from the cerebrospinal fluid of a three-year-old Ugandan girl with a fatal CNS infection. Orthobunyaviruses are arthropod-borne viruses, are prevalent worldwide and can cause different types of disease, ranging from mild febrile illness to fatal CNS infections. It is expected that human exposure to Ntwetwe virus may be common because of its presumed vector (the Anopheles mosquito) and the high seroprevalence to its closest relative (Tataguine virus) in sub-Saharan Africa. Nonetheless, because of its recent discovery, attempts to further study this virus have not yet been performed. The objective of this study is to determine the prevalence of Ntwetwe virus infections in children in the region where the virus was first identified and describe the clinical characteristics of infected cases. Moreover, this study aims to determine whether and which mosquitoes transmit Ntwetwe virus. This information will provide us with the first insight into the burden of Ntwetwe virus infections which will be important for clinicians, policy makers and future research. Methods and materials: We conducted a human case-control study on children presenting with mild febrile and severe neurologic symptoms–each linked to a healthy control–to Kiboga hospital between August 2019 and January 2020. Infection by Ntwetwe virus was determined by a quantitative real-time polymerase chain reaction (RT-qPCR) of blood and cerebral spinal fluid samples in the Uganda Virus Research Institute. The prevalence of acute Ntwetwe virus infections for both case groups was compared to healthy controls. For Ntwetwe virus positive patients, clinical and anthropological risk factors for infection were determined by comparison to patients negative for Ntwetwe virus. Mosquitos were captured at two time points by field teams from the UVRI using CDC light traps over a period of 2 weeks in the area surrounding Kiboga hospital during the dry and rainy season. Results: Fifteen cases (14 mild and one severe) and five controls were included by mid October 2019. Further inclusion and testing is ongoing. Conclusion: Results of this study will–for the first time–be presented at the ICID.

Management of giant condyloma acuminatum on HIVAIDS patients with limited healthcare facilities

AbstractGiant Condyloma Acuminatum (GCA) or Buschke-Lowenstein Tumour (BLT) is a unique variant of condyloma acuminatum. The incidence of this disease tends to increase due to the increasing prevalence of Human Immunodeficiency Virus (HIV) infection. Until now, there is no therapeutic guideline for GCA, and many therapeutic options are not available for one in limited healthcare facilities. We present one case of GCA in HIV-positive women treated in health centers with limited facilities in a rural area. We treat the patient by doing a sitz bath with povidone-iodine 1%, simple excision with electrocautery for the tumour, adequate analgetics, regular wound care, and zinc supplementation acts as immunotherapy. Complications of wound infection by candida caused the lengthy hospitalization of the patient. After discharge, the patient came for control every week; no other lump arises again, and the wound was getting better. A combination of conservative and surgical treatment followed by regular wound care can lead to a good result in the GCA case, even with minimal healthcare facilities.

Mucin-Inspired, High Molecular Weight Virus Binding Inhibitors Show Biphasic Binding Behavior to Influenza A Viruses.

Multivalent binding inhibitors are a promising new class of antivirals that prevent virus infections by inhibiting virus binding to cell membranes. The design of these inhibitors is challenging as many properties, for example, inhibitor size and functionalization with virus attachment factors, strongly influence the inhibition efficiency. Here, virus binding inhibitors are synthesized, the size and functionalization of which are inspired by mucins, which are naturally occurring glycosylated proteins with high molecular weight (MDa range) and interact efficiently with various viruses. Hyperbranched polyglycerols (hPGs) with molecular weights ranging between 10 and 2600kDa are synthesized, thereby hitting the size of mucins and allowing for determining the impact of inhibitor size on the inhibition efficiency. The hPGs are functionalized with sialic acids and sulfates, as suggested from the structure of mucins, and their inhibition efficiency is determined by probing the inhibition of influenza A virus (IAV) binding to membranes using various methods. The largest, mucin-sized inhibitor shows potent inhibition at pm concentrations, while the inhibition efficiency decreases with decreasing the molecular weight. Interestingly, the concentration-dependent IAV inhibition shows a biphasic behavior, which is attributed to differences in the binding affinity of the inhibitors to the two IAV envelope proteins, neuraminidase, and hemagglutinin.

Predominance of ON1 and BA9 genotypes of respiratory syncytial virus (RSV) in Bulgaria, 2016-2018.

The objectives of this study were to investigate the prevalence of respiratory syncytial virus (RSV) infections in Bulgaria, to characterize the genetic diversity of the RSV strains, and to perform amino acid sequence analysis of the RSV G protein. Clinical, epidemiological data and nasopharyngeal swabs were prospectively collected from children aged less than 5 years presenting with acute respiratory infections from October 2016 to September 2018. Real-time polymerase chain reaction for 12 respiratory viruses, and sequencing, phylogenetic, and amino acid analyses of the RSV G gene/protein were performed. Of the 875 children examined, 645 (73.7%) were positive for at least one viral respiratory pathogen. RSV was the most commonly detected virus (26.2%), followed by rhinoviruses (15%), influenza A (H3N2) (9.7%), adenoviruses (9%), bocaviruses (7.2%), human metapneumovirus (6.1%), parainfluenza viruses 1/2/3 (5.8%), influenza type B (5.5%), and A(H1N1)pdm09 (3.4%). The detection rate for RSV varied across two winter seasons (36.7% vs 20.3%). RSV-B cases outnumbered those of the RSV-A throughout the study period. RSV was the most common virus detected in patients with bronchiolitis (45.1%) and pneumonia (24%). Phylogenetic analysis indicated that all the sequenced RSV-A strains belonged to the ON1 genotype and the RSV-B strains were classified as BA9 genotype. Amino acid substitutions at 15 and 22 positions of the HVR-2 were identified compared with the ON1 and BA prototype strains,respectively. This study revealed the leading role of RSV as a causative agent of serious respiratory illnesses in early childhood, year-on-year fluctuations in RSV incidence, the dominance of RSV-B, and relatively low genetic diversity in the circulating RSV strains.

Prevalence and Molecular Epidemiology of Human T-Lymphotropic Virus (HTLV) Infection in People Living With HIV/AIDS in the Pará State, Amazon Region of Brazil.

The human T-lymphotropic virus (HTLV) is part of the group of retroviruses that share similar routes of transmission to the human immunodeficiency virus (HIV). Coinfection of these viruses can affect the clinical course of both infections, and reports have shown a quicker progression to AIDS and the development of HIV-related opportunistic infections. The current study investigated the demographic characteristics, prevalence, and the subtypes of HTLV among people living with HIV/AIDS (PLWHA) in the State of Pará, Northern Brazil. Blood samples were obtained from patients who were attending a reference unit that provides medical assistance to HIV-infected individuals in the State of Pará, Brazil, during the period of May 2016 to June 2017. Plasma samples were screened by ELISA tests to detect antibodies anti-HTLV-1/2. DNA and viral types were identified by real-time polymerase chain reaction (qPCR). All samples with viral DNA were submitted to nested PCR and nucleotide sequencing. The overall coinfection rate was 1.4% (5/368), and all samples were from subtype HTLV-1a. No cases of HTLV-2 infection were detected. The prevalence of HTLV-1 was higher in females (80%), individuals between 31 and 50 years of age, heterosexual, unmarried, with low monthly income, with secondary educational level or higher, sporadic condom usage, limited number of sexual partners, and no history of sexually transmitted infections. All samples from HTLV-1-infected patients were identified as strains belonging to the subtype 1a (Cosmopolitan), subgroup A (Transcontinental). This study identified that the prevalence of HIV/HTLV coinfection has dropped from 8 to 1.3% in the current investigation. There was a shift of HTLV subtype from a predominance of HTLV-2 infection in the past to an actual exclusively HTLV-1a. There was no significant association between economic, sociodemographic, and behavioral characteristics in HIV/HTLV coinfection.

Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies.

There is an increasing prevalence of human immunodeficiency virus (HIV) infection in older adults in China, but the findings across prevalence studies have been mixed. This is the first meta-analysis of the prevalence of HIV infection and its moderating factors in older adults in China. Two investigators systematically and independently searched both international (PubMed, PsycINFO, Web of Sciences and EMBASE) and Chinese (WanFang, CNKI, and CQVIP) databases. HIV infection rates in older adults were analyzed using the random-effects model. Altogether 46 studies were included in the analysis. The pooled prevalence of HIV infection in older adults was 2.1% (95% CI [1.9%–2.3%], I2 = 99.4%). Subgroup analyses revealed that men who have sex with men (MSM), hospital population samples, publications after 2014, studies conducted in the western region of China, and higher study quality were significantly associated with higher HIV infection rate. This meta-analysis found that the HIV infection prevalence in older adults is significantly higher than the general population in China. Attention should be given to this urgent public health issue, and effective HIV/AIDS preventive, screening and treatment measures are warranted in this population. PROSPERO: CRD42019124286.

Human respiratory viruses, including SARS-CoV-2, circulating in the winter season 2019–2020 in Parma, Northern Italy

ObjectivesThe aim of this study was to determine the prevalence of respiratory virus infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during the winter period December 2019 to March 2020, via a tertiary care hospital-based survey in Parma, Northern Italy. MethodsA total of 906 biological samples from the respiratory tract were analysed by both conventional assays (including culture) and molecular assays targeting nucleic acids of SARS-CoV-2 and other respiratory viruses. ResultsOverall, 474 samples (52.3%) were positive for at least one virus, with a total of 583 viruses detected. Single infections were detected in 380 (80.2%) samples and mixed infections were detected in 94 (19.8%). Respiratory syncytial virus (138/583, 23.7%) and rhinovirus (130/583, 22.3%) were the most commonly identified viruses, followed by SARS-CoV-2 (82/583, 14.1%). Respiratory syncytial virus predominated until February, with 129 detections; it then decreased drastically in March to only nine detections. SARS-CoV-2 was absent in the study area until February 26, 2020 and then reached 82 detections in just over a month. SARS-CoV-2 was found in mixed infections in only three cases, all observed in children younger than 1 year old. ConclusionsThis study showed a completely different trend between SARS-CoV-2 and the ‘common’ respiratory viruses: the common viruses mostly affected children, without any distinction according to sex, while SARS-CoV-2 mostly affected adult males.

Prevalence of Influenza Virus Type and Subtype at Siriraj Hospital, Bangkok, Thailand During 2013 - 2017

Background: Influenza A (pandemic and seasonal H1/H3) and influenza B viruses were the predominant circulating seasonal influenza strains. Following its massive outbreak in 2009 globally, including Thailand, influenza A (H1N1) pdm09 viruses have replaced the previous seasonal H1 strain and become one of the circulating strains ever since. Both influenza A and B viruses are highly contagious and potentially cause respiratory illness ranging from mild to severe.
 Objective: To determine the prevalence of types and subtypes of circulating influenza virus strains in Bangkok, Thailand during 2013 - 2017.
 Methods: The 4385 nasopharyngeal wash specimens were collected from patients presented with influenza-like illness from January 2013 to December 2017 at Siriraj Hospital, Bangkok, Thailand. Influenza virus types and subtypes were determined using real-time RT-PCR technique. Clinical characteristics of patients infected with influenza A viruses and influenza B virus were compared and analyzed.
 Results: Of 4385 nasopharyngeal wash specimens, the prevalence of influenza virus infection during 2013 - 2017 was 18.22% (n = 799). Of 799 influenza-positive samples, 608 (76.09%) and 191 (23.90%) samples were positive for influenza A and influenza B viruses, respectively. Most patients were presented with fever, cough, and runny nose; however, patients infected with influenza A virus generally had higher severity than those with influenza B virus infection (P < .05).
 Conclusions: The findings provided the characteristics of influenza virus types and subtypes at Siriraj Hospital, Bangkok, Thailand during 2013 - 2017. Sporadic cases of influenza occurred all year round, but the incidence peaked in March 2014 and August 2017. The outcomes of this study are potentially useful for prevention, treatment, and disease monitoring.

Enterovirus Neutralizing Antibodies, Monocyte Toll Like Receptors Expression and Interleukin Profiles Are Similar Between Non-affected and Affected Siblings From Long-Term Discordant Type 1 Diabetes Multiplex-Sib Families: The Importance of HLA Background

Enteroviruses are main candidates among environmental agents in the development of type 1 diabetes (T1D). However, the relationship between virus and the immune system response during T1D pathogenesis is heterogeneous. This is an interesting paradigm and the search for answers would help to highlight the role of viral infection in the etiology of T1D. The current data is a cross-sectional study of affected and non-affected siblings from T1D multiplex-sib families to analyze associations among T1D, genetic, islet autoantibodies and markers of innate immunity. We evaluated the prevalence of anti-virus antibodies (Coxsackie B and Echo) and its relationships with human leukocyte antigen (HLA) class II alleles, TLR expression (monocytes), serum cytokine profile and islet β cell autoantibodies in 51 individuals (40 T1D and 11 non-affected siblings) from 20 T1D multiplex-sib families and 54 healthy control subjects. The viral antibody profiles were similar among all groups, except for antibodies against CVB2, which were more prevalent in the non-affected siblings. TLR4 expression was higher in the T1D multiplex-sib family's members than in the control subjects. TLR4 expression showed a positive correlation with CBV2 antibody prevalence (rS: 0.45; P = 0.03), CXCL8 (rS: 0.65, P = 0.002) and TNF-α (rS: 0.5, P = 0.01) serum levels in both groups of T1D multiplex-sib family. Furthermore, within these families, there was a positive correlation between HLA class II alleles associated with high risk for T1D and insulinoma-associated protein 2 autoantibody (IA-2A) positivity (odds ratio: 38.8; P = 0.021). However, the HLA protective haplotypes against T1D prevalence was higher in the non-affected than the affected siblings. This study shows that although the prevalence of viral infection is similar among healthy individuals and members from the T1D multiplex-sib families, the innate immune response is higher in the affected and in the non-affected siblings from these families than in the healthy controls. However, autoimmunity against β-islet cells and an absence of protective HLA alleles were only observed in the T1D multiplex-sib members with clinical disease, supporting the importance of the genetic background in the development of T1D and heterogeneity of the interaction between environmental factors and disease pathogenesis despite the high genetic diversity of the Brazilian population.

No small matter: a perspective on nanotechnology-enabled solutions to fight COVID-19.

There is an urgent need for safe and effective approaches to combat COVID-19. Here, we asked whether lessons learned from nanotoxicology and nanomedicine could shed light on the current pandemic. SARS-CoV-2, the causative agent, may trigger a mild, self-limiting disease with respiratory symptoms, but patients may also succumb to a life-threatening systemic disease. The host response to the virus is equally complex and studies are now beginning to unravel the immunological correlates of COVID-19. Nanotechnology can be applied for the delivery of antiviral drugs or other repurposed drugs. Moreover, recent work has shown that synthetic nanoparticles wrapped with host-derived cellular membranes may prevent virus infection. We posit that nanoparticles decorated with ACE2, the receptor for SARS-CoV-2, could be exploited as decoys to intercept the virus before it infects cells in the respiratory tract. However, close attention should be paid to biocompatibility before such nano-decoys are deployed in the clinic.

Physical, Psychological, and Social Challenges in Patients with Hepatitis B Infection

Context: Hepatitis B is the most prevalent chronic viral infection in humans, which imposes limitations on patients and has many physical, psychological, and social consequences due to its chronic nature. The purpose of this study was to evaluate the physical, psychological, and social challenges of patients with hepatitis B virus (HBV). Evidence Acquisition: First, a set of keywords, including hepatitis B, challenge, physical, psychological, and social, were searched in databases, such as Google Scholar, PubMed, SID, Magiran, and IranMedex. Then, the articles published between 2009 and 2019 were reviewed according to the inclusion and exclusion criteria in two stages – the title and the abstract in the first stage and the whole paper in the second stage. Finally, 34 articles were selected out of 1426 articles. Results: The articles used in this study were as follows: descriptive and cross-sectional studies (10 articles), review studies (9 articles), qualitative studies (9 articles), cohort studies (3 articles), randomized controlled trials, mixed-methods studies, and field studies (one article each). Most studies had considered patients with hepatitis B with an emphasis on physical issues (10 articles), social stigma (7 articles), psychological reactions (5 articles), the discovery of patients’ experiences (3 articles), and discrimination (2 articles). In 25 studies, the samples were patients with HBV. Conclusions: It is necessary to understand and support the patients to treat them properly and help them live with minimum challenges and limitations. Therefore, it is necessary to consider educational and counseling programs to identify different aspects of this disease.

ALL-045: Community-Acquired Viral Infections in Hospitalized Egyptian Children with Malignancy

Context Children with cancer comprise an important immunocompromised population who are more vulnerable and at high-risk to a variety of infectious pathogens, including respiratory viruses that are widespread in the community. Objective Studying the role of these viruses is important especially in countries with high population density, increasing chances of community-acquired infections. This prospective study aimed to assess the annual prevalence of community-acquired respiratory viral infections among children with cancer presenting with clinical picture suggestive of lower respiratory tract infections (LRTIs), and evaluate its risk factors and prognosis. Design Patients who presented either to the out-patient clinic or to the emergency department, had clinical evidence and/or radiological criteria suggestive of LRTIs, and were fulfilling the criteria of community-acquired infection were recruited, subjected to clinical assessment, investigated through hematology panel, blood culture, chest X-ray, CT chest, and PCR for influenza A and B, parainfluenza (PIV) types 1 and 3 viruses, and respiratory syncytial virus (RSV), and prospectively followed up for the clinical outcome. Results Over a year, 90 eligible children were recruited; 48 patients had ALL, 9 had AML, and 33 had solid tumors; 54.4% of them were in the induction phase. Annual prevalence of viral infections was 37.7%, with a seasonal peak from April to May. The most frequently detected virus was influenza virus [type A (47%), type B (12%)] followed by parainfluenza virus [PIV1 (26%), PIV3 (15%)], and none had RSV. Bacteria were identified in 26 patients, fungi in four, mixed infections (bacterial/viral and bacterial/fungal) in 13, and 36 cases had unidentified etiology. The majority of patients with influenza and parainfluenza infections had haematological malignancy, presented with fever, and had mild self-limited respiratory illness. Five patients with mixed viral and bacterial infection had severe symptoms, necessitating ICU admission. Six patients died from infection-related sequelae; two had mixed PIV and staphylococcal infections. Conclusions Community-acquired influenza and parainfluenza infections are common in pediatrics children with malignancy, either as isolated or mixed viral/bacterial infections. Clinical suspicion is essential as radiological manifestations are non-specific and mandate rapid diagnosis and management to improve patients' outcome.

Prevalence of Human Immunodeficiency Virus and Opportunistic Infections Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Database Study.

We performed a cross-sectional analysis of the prevalence of HIV and opportunistic infections among transgender patients in clinical care. Of 10,160 transgender patients identified, 3.9% had a diagnosis of HIV, compared to 0.32% in the non-transgender cohort (p<0.0001). Transgender patients experience the burden of all opportunistic infection compared to non-transgender patients in this analysis, although prevalence of pneumocystis pneumonia was not significant. This cohort-based, all-payer electronic health record study of HIV patients connected to care revealed that transgender patients have a higher prevalence of HIV infection and opportunistic infections compared to the non-transgender cohort.

Serological Evidence of Foot-and-Mouth Disease Infection in Goats in Lao PDR

Foot and Mouth Disease (FMD) causes significant economic loss in Lao PDR (Laos) and perpetuates the cycle of smallholder poverty mainly through large ruminant productivity losses, increased costs of production and potential limitations to market access for trade in livestock and their products. Goats are emerging as an important livestock species in Laos, and there is an increasing trend in the number of households with goats, often farmed alongside cattle and buffalo. Although an FMD susceptible species, very little is known about the role of goats in the epidemiology of the disease in Laos. A cross-sectional seroprevalence study was conducted by detecting antibodies to the non-structural proteins (NSP), an indication of a previous infection, and serotype-specific structural proteins (SP) that could be due to vaccination or infection. The study commenced in late 2017 and sera were collected from 591 goats in 26 villages of northern, central and southern Laos. For a subset of sera samples, paired oral swab samples were also collected by a simple random sampling method to detect the prevalence of FMD virus infection at the time of collection. The NSP seroprevalence in the provinces of Borkeo and Xayabouli in the north was 42 and 8%, respectively and in Khammoune in the center, it was 20%. In the other five provinces, Luang Namtha and Luang Prabang (northern Laos), Xieng Khouang and Savannaket (central Laos), and Champasak (southern Laos), the seroprevalence was close to zero. The multivariable analysis indicated that age (p < 0.001) was positively associated with animal-level seropositivity and males were less likely to be seropositive than females (OR: 0.29; 95%CI: 0.10–0.83; p = 0.017). Continued sero-surveillance for FMD in goats is recommended to improve our understanding of their role in the epidemiology of FMD in the region and to extend support to FMD control decisions, particularly regarding vaccination.

Prevention and control of coronavirus disease 2019 in Grade-III Class-A hospitals outside of Wuhan.

Prevention and control of coronavirus disease 2019 in Grade-III Class-A hospitals outside of Wuhan.