Last data update: Apr 22, 2024. (Total: 46599 publications since 2009)
Records 1-30 (of 38 Records) |
Query Trace: Fonseca S [original query] |
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Some patients with type 2 diabetes may benefit from intensive glycaemic and blood pressure control: A post-hoc machine learning analysis of ACCORD trial data
Jiao T , Kianmehr H , Lin Y , Li P , Singh Ospina N , Ghayee HK , Ruzieh M , Fonseca V , Shi L , Zhang P , Shao H . Diabetes Obes Metab 2024 AIM: The action to control cardiovascular risk in diabetes (ACCORD) trial showed a neutral average treatment effect of intensive blood glucose and blood pressure (BP) controls in preventing major adverse cardiovascular events (MACE) in individuals with type 2 diabetes. Yet, treatment effects across patient subgroups have not been well understood. We aimed to identify patient subgroups that might benefit from intensive glucose or BP controls for preventing MACE. MATERIALS AND METHODS: As a post-hoc analysis of the ACCORD trial, we included 10 251 individuals with type 2 diabetes. We applied causal forest and causal tree models to identify participant characteristics that modify the efficacy of intensive glucose or BP controls from 68 candidate variables (demographics, comorbidities, medications and biomarkers) at the baseline. The exposure was (a) intensive versus standard glucose control [glycated haemoglobin (HbA1c) <6.0% vs. 7.0%-7.9%], and (b) intensive versus standard BP control (systolic BP <120 vs. <140 mmHg). The primary outcome was MACE. RESULTS: Compared with standard glucose control, intensive one reduced MACE in those with baseline HbA1c <8.5% [relative risk (RR): 0.79, 95% confidence interval (CI): 0.67-0.93] and those with estimated glomerular filtration rate ≥106 ml/min/1.73 m(2) (RR: 0.74, 95% CI: 0.55-0.99). Intensive BP control reduced MACE in those with normal high-density lipoprotein levels (women >55 mg/dl, men >45 mg/dl; RR: 0.51, 95% CI: 0.34-0.74). Risk reductions were not significant in other patient subgroups. CONCLUSIONS: Our findings suggest heterogeneous treatment effects of intensive glucose and BP control and could provide biomarkers for future clinical trials to identify more precise HbA1c and BP treatment goals for individualized medicine. |
MaHPIC malaria systems biology data from Plasmodium cynomolgi sporozoite longitudinal infections in macaques.
DeBarry JD , Nural MV , Pakala SB , Nayak V , Warrenfeltz S , Humphrey J , Lapp SA , Cabrera-Mora M , Brito CFA , Jiang J , Saney CL , Hankus A , Stealey HM , DeBarry MB , Lackman N , Legall N , Lee K , Tang Y , Gupta A , Trippe ED , Bridger RR , Weatherly DB , Peterson MS , Jiang X , Tran V , Uppal K , Fonseca LL , Joyner CJ , Karpuzoglu E , Cordy RJ , Meyer EVS , Wells LL , Ory DS , Lee FE , Tirouvanziam R , Gutiérrez JB , Ibegbu C , Lamb TJ , Pohl J , Pruett ST , Jones DP , Styczynski MP , Voit EO , Moreno A , Galinski MR , Kissinger JC . Sci Data 2022 9 (1) 722 Plasmodium cynomolgi causes zoonotic malarial infections in Southeast Asia and this parasite species is important as a model for Plasmodium vivax and Plasmodium ovale. Each of these species produces hypnozoites in the liver, which can cause relapsing infections in the blood. Here we present methods and data generated from iterative longitudinal systems biology infection experiments designed and performed by the Malaria Host-Pathogen Interaction Center (MaHPIC) to delve deeper into the biology, pathogenesis, and immune responses of P. cynomolgi in the Macaca mulatta host. Infections were initiated by sporozoite inoculation. Blood and bone marrow samples were collected at defined timepoints for biological and computational experiments and integrative analyses revolving around primary illness, relapse illness, and subsequent disease and immune response patterns. Parasitological, clinical, haematological, immune response, and -omic datasets (transcriptomics, proteomics, metabolomics, and lipidomics) including metadata and computational results have been deposited in public repositories. The scope and depth of these datasets are unprecedented in studies of malaria, and they are projected to be a F.A.I.R., reliable data resource for decades. |
Lowering hemoglobin A1c level to less than 6.0% in people with type 2 diabetes may reduce major adverse cardiovascular events: a Bayesian's narrative
Shao H , Guo J , Laiteerapong N , Tang S , Fonseca V , Shi L , Zhang P . Curr Med Res Opin 2022 38 (11) 1-4 Whether lowering the hemoglobin A1c to <6.0% in patients with type 2 diabetes can reduce the risk of cardiovascular disease (CVD) remains under debate. The ACCORDION and the VADT studies both found reductions in the primary CVD composite associated with intensive glycemic control, though the difference is not statistically significant. However, the lack of significance is often overinterpreted as non-effective: a p-value >0.05 only implies that the study "failed to reject" the null hypothesis (i.e., lowering the A1c level to <6.0% results in no CVD benefit), which is different from concluding the null hypothesis being true. In this study, we used Bayesian analysis to reanalyze results from the ACCORDION and VADT-15 trials. Our results suggest achieving an A1c goal of <6.0% as compared to moderate control could result in a moderate risk reduction in MACE. |
Emergence of dengue virus serotype 2 cosmopolitan genotype, Brazil
Giovanetti M , Pereira LA , Santiago GA , Fonseca V , Mendoza MPG , de Oliveira C , de Moraes L , Xavier J , Tosta S , Fristch H , de Castro Barbosa E , Rodrigues ES , Figueroa-Romero D , Padilla-Rojas C , Cáceres-Rey O , Mendonça AF , de Bruycker Nogueira F , Venancio da Cunha R , de Filippis AMB , Freitas C , Peterka CRL , de Albuquerque CFC , Franco L , Méndez Rico JA , Muñoz-Jordán JL , Lemes da Silva V , Alcantara LCJ . Emerg Infect Dis 2022 28 (8) 1725-1727 We used nanopore sequencing and phylogenetic analyses to identify a cosmopolitan genotype of dengue virus serotype 2 that was isolated from a 56-year-old male patient from the state of Goiás in Brazil. The emergence of a cosmopolitan genotype in Brazil will require risk assessment and surveillance to reduce epidemic potential. |
Potential gains in life expectancy associated with achieving treatment goals in US adults with type 2 diabetes
Kianmehr H , Zhang P , Luo J , Guo J , Pavkov ME , Bullard KM , Gregg EW , Ospina NS , Fonseca V , Shi L , Shao H . JAMA Netw Open 2022 5 (4) e227705 IMPORTANCE: Improvements in control of factors associated with diabetes risk in the US have stalled and remain suboptimal. The benefit of continually improving goal achievement has not been evaluated to date. OBJECTIVE: To quantify potential gains in life expectancy (LE) among people with type 2 diabetes (T2D) associated with lowering glycated hemoglobin (HbA1c), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and body mass index (BMI) toward optimal levels. DESIGN, SETTING, AND PARTICIPANTS: In this decision analytical model, the Building, Relating, Assessing, and Validating Outcomes (BRAVO) diabetes microsimulation model was calibrated to a nationally representative sample of adults with T2D from the National Health and Nutrition Examination Survey (2015-2016) using their linked short-term mortality data from the National Death Index. The model was then used to conduct the simulation experiment on the study population over a lifetime. Data were analyzed from January to October 2021. EXPOSURE: The study population was grouped into quartiles on the basis of levels of HbA1c, SBP, LDL-C, and BMI. LE gains associated with achieving better control were estimated by moving people with T2D from the current quartile of each biomarker to the lower quartiles. MAIN OUTCOMES AND MEASURES: Life expectancy. RESULTS: Among 421 individuals, 194 (46%) were women, and the mean (SD) age was 65.6 (8.9) years. Compared with a BMI of 41.4 (mean of the fourth quartile), lower BMIs of 24.3 (first), 28.6 (second), and 33.0 (third) were associated with 3.9, 2.9, and 2.0 additional life-years, respectively, in people with T2D. Compared with an SBP of 160.4 mm Hg (fourth), lower SBP levels of 114.1 mm Hg (first), 128.2 mm Hg (second), and 139.1 mm Hg (third) were associated with 1.9, 1.5, and 1.1 years gained in LE in people with T2D, respectively. A lower LDL-C level of 59 mg/dL (first), 84.0 mg/dL (second), and 107.0 mg/dL (third) were associated with 0.9, 0.7, and 0.5 years gain in LE, compared with LDL-C of 146.2 mg/dL (fourth). Reducing HbA1c from 9.9% (fourth) to 7.7% (third) was associated with 3.4 years gain in LE. However, a further reduction to 6.8% (second) was associated with only a mean of 0.5 years gain in LE, and from 6.8% to 5.9% (first) was not associated with LE benefit. Overall, reducing HbA1c from the fourth quartile to the first is associated with an LE gain of 3.8 years. CONCLUSIONS AND RELEVANCE: These findings can be used by clinicians to motivate patients in achieving the recommended treatment goals and to help prioritize interventions and programs to improve diabetes care in the US. |
Socioeconomic Factors Play a More Important Role than Clinical Needs in the Use of SGLT2 Inhibitors and GLP-1 Receptor Agonists in People With Type 2 Diabetes
Shao H , Li P , Guo J , Fonseca V , Shi L , Zhang P . Diabetes Care 2022 45 (2) e32-e33 Growing evidence from clinical trials and observational studies has demonstrated cardiac and renal benefits of two newer glucose-lowering drug classes, sodium–glucose cotransporter 2 inhibitors (SGLT2i) (including exenatide, liraglutide, dulaglutide, albiglutide, lixisenatide, and semaglutide) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) (including canagliflozin, empagliflozin, dapagliflozin, and ertugliflozin) (1). The American Diabetes Association recommends these two drug classes for people with type 2 diabetes (T2D) who are at increased risk for or who have established atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), and chronic kidney disease (CKD) (2). Our previous study documented a rapid increase in the use of the two classes in commercially insured populations between 2010 and 2018 (3). In contrast, a recent study suggested that use of the new drug classes remained low in other populations, such as Medicare beneficiaries (4). Medicare beneficiaries have higher risks of ASCVD, HF, and CKD than the commercially insured population due to their older age and longer diabetes duration and, thus, could benefit more from the new drug classes. However, the low utilization rate in the Medicare population suggests other factors play a more prominent role than clinical need. The objectives of this study were to examine factors associated with the use of the two new drug classes and estimate the contributions of these factors to use of the drugs |
Zika Virus Surveillance at the Human-Animal Interface in West-Central Brazil, 2017-2018.
Pauvolid-Correa A , Goncalves Dias H , Marina Siqueira Maia L , Porfirio G , Oliveira Morgado T , Sabino-Santos G , Helena Santa Rita P , Teixeira Gomes Barreto W , Carvalho de Macedo G , Marinho Torres J , Arruda Gimenes Nantes W , Martins Santos F , Oliveira de Assis W , Castro Rucco A , Mamoru Dos Santos Yui R , Bosco Vilela Campos J , Rodrigues Leandro ESilva R , da Silva Ferreira R , Aparecido da Silva Neves N , Charlles de Souza Costa M , Ramos Martins L , Marques de Souza E , Dos Santos Carvalho M , Goncalves Lima M , de Cassia Goncalves Alves F , Humberto Guimaraes Riquelme-Junior L , Luiz Batista Figueiro L , Fernandes Gomes de Santana M , Gustavo Rodrigues Oliveira Santos L , Serra Medeiros S , Lopes Seino L , Hime Miranda E , Henrique Rezende Linhares J , de Oliveira Santos V , Almeida da Silva S , Araujo Lucio K , Silva Gomes V , de Araujo Oliveira A , Dos Santos Silva J , de Almeida Marques W , Schafer Marques M , Junior Franca de Barros J , Campos L , Couto-Lima D , Coutinho Netto C , Strussmann C , Panella N , Hannon E , Cristina de Macedo B , Ramos de Almeida J , Ramos Ribeiro K , Carolina Barros de Castro M , Pratta Campos L , Paula Rosa Dos Santos A , Marino de Souza I , de Assis Bianchini M , Helena Ramiro Correa S , Ordones Baptista Luz R , Dos Santos Vieira A , Maria de Oliveira Pinto L , Azeredo E , Tadeu Moraes Figueiredo L , Augusto Fonseca Alencar J , Maria Barbosa de Lima S , Miraglia Herrera H , Dezengrini Shlessarenko R , Barreto Dos Santos F , Maria Bispo de Filippis A , Salyer S , Montgomery J , Komar N . Viruses 2019 11 (12) Zika virus (ZIKV) was first discovered in 1947 in Uganda but was not considered a public health threat until 2007 when it found to be the source of epidemic activity in Asia. Epidemic activity spread to Brazil in 2014 and continued to spread throughout the tropical and subtropical regions of the Americas. Despite ZIKV being zoonotic in origin, information about transmission, or even exposure of non-human vertebrates and mosquitoes to ZIKV in the Americas, is lacking. Accordingly, from February 2017 to March 2018, we sought evidence of sylvatic ZIKV transmission by sampling whole blood from approximately 2000 domestic and wild vertebrates of over 100 species in West-Central Brazil within the active human ZIKV transmission area. In addition, we collected over 24,300 mosquitoes of at least 17 genera and 62 species. We screened whole blood samples and mosquito pools for ZIKV RNA using pan-flavivirus primers in a real-time reverse-transcription polymerase chain reaction (RT-PCR) in a SYBR Green platform. Positives were confirmed using ZIKV-specific envelope gene real-time RT-PCR and nucleotide sequencing. Of the 2068 vertebrates tested, none were ZIKV positive. Of the 23,315 non-engorged mosquitoes consolidated into 1503 pools tested, 22 (1.5%) with full data available showed some degree of homology to insect-specific flaviviruses. To identify previous exposure to ZIKV, 1498 plasma samples representing 62 species of domestic and sylvatic vertebrates were tested for ZIKV-neutralizing antibodies by plaque reduction neutralization test (PRNT90). From these, 23 (1.5%) of seven species were seropositive for ZIKV and negative for dengue virus serotype 2, yellow fever virus, and West Nile virus, suggesting potential monotypic reaction for ZIKV. Results presented here suggest no active transmission of ZIKV in non-human vertebrate populations or in alternative vector candidates, but suggest that vertebrates around human populations have indeed been exposed to ZIKV in West-Central Brazil. |
VAR2CSA serology to detect Plasmodium falciparum transmission patterns in pregnancy
Fonseca AM , Gonzalez R , Bardaji A , Jairoce C , Ruperez M , Jimenez A , Quinto L , Cistero P , Vala A , Sacoor C , Gupta H , Hegewisch-Taylor J , Brew J , Ndam NT , Kariuki S , Lopez M , Dobano C , Chitnis CE , Ouma P , Ramharter M , Abdulla S , Aponte JJ , Massougbodji A , Briand V , Mombo-Ngoma G , Desai M , Cot M , Nhacolo A , Sevene E , Macete E , Menendez C , Mayor A . Emerg Infect Dis 2019 25 (10) 1851-1860 Pregnant women constitute a promising sentinel group for continuous monitoring of malaria transmission. To identify antibody signatures of recent Plasmodium falciparum exposure during pregnancy, we dissected IgG responses against VAR2CSA, the parasite antigen that mediates placental sequestration. We used a multiplex peptide-based suspension array in 2,354 samples from pregnant women from Mozambique, Benin, Kenya, Gabon, Tanzania, and Spain. Two VAR2CSA peptides of limited polymorphism were immunogenic and targeted by IgG responses readily boosted during infection and with estimated half-lives of <2 years. Seroprevalence against these peptides reflected declines and rebounds of transmission in southern Mozambique during 2004-2012, reduced exposure associated with use of preventive measures during pregnancy, and local clusters of transmission that were missed by detection of P. falciparum infections. These data suggest that VAR2CSA serology can provide a useful adjunct for the fine-scale estimation of the malaria burden among pregnant women over time and space. |
Second WIN International Conference on "Integrated approaches and innovative tools for combating insecticide resistance in vectors of arboviruses", October 2018, Singapore
Corbel V , Durot C , Achee NL , Chandre F , Coulibaly MB , David JP , Devine GJ , Dusfour I , Fonseca DM , Griego J , Juntarajumnong W , Lenhart A , Kasai S , Martins AJ , Moyes C , Ng LC , Pinto J , Pompon JF , Muller P , Raghavendra K , Roiz D , Vatandoost H , Vontas J , Weetman D . Parasit Vectors 2019 12 (1) 331 The past 40 years have seen a dramatic emergence of epidemic arboviral diseases transmitted primarily by mosquitoes. The frequency and magnitude of the epidemics, especially those transmitted by urban Aedes species, have progressively increased over time, accelerating in the past 10 years. To reduce the burden and threat of vector-borne diseases, the World Health Organization (WHO) has recently adopted the Global Vector Control Response (GVCR) in order to support countries in implementing effective sustainable vector control. The evidence-base to support vector control is however limited for arboviral diseases which make prioritization difficult. Knowledge gaps in the distribution, mechanisms and impact of insecticide resistance on vector control impedes the implementation of locally tailored Aedes control measures. This report summarizes the main outputs of the second international conference of the Worldwide Insecticide resistance Network (WIN) on "Integrated approaches and innovative tools for combating insecticide resistance in arbovirus vectors" held in Singapore, 1-3 October 2018. The aims of the conference were to review progress and achievements made in insecticide resistance surveillance worldwide, and to discuss the potential of integrated vector management and innovative technologies for efficiently controlling arboviral diseases. The conference brought together 150 participants from 26 countries. |
A computational method for the identification of Dengue, Zika and Chikungunya virus species and genotypes.
Fonseca V , Libin PJK , Theys K , Faria NR , Nunes MRT , Restovic MI , Freire M , Giovanetti M , Cuypers L , Nowe A , Abecasis A , Deforche K , Santiago GA , Siqueira IC , San EJ , Machado KCB , Azevedo V , Filippis AMB , Cunha RVD , Pybus OG , Vandamme AM , Alcantara LCJ , de Oliveira T . PLoS Negl Trop Dis 2019 13 (5) e0007231 In recent years, an increasing number of outbreaks of Dengue, Chikungunya and Zika viruses have been reported in Asia and the Americas. Monitoring virus genotype diversity is crucial to understand the emergence and spread of outbreaks, both aspects that are vital to develop effective prevention and treatment strategies. Hence, we developed an efficient method to classify virus sequences with respect to their species and sub-species (i.e. serotype and/or genotype). This ArboTyping tool provides an easy-to-use software implementation of this new method and was validated on a large dataset assessing the classification performance with respect to whole-genome sequences and partial-genome sequences. Available online: http://krisp.ukzn.ac.za/app/. |
Notes from the Field: Multistate coccidioidomycosis outbreak in U.S. residents returning from community service trips to Baja California, Mexico - July-August 2018
Toda M , Gonzalez FJ , Fonseca-Ford M , Franklin P , Huntington-Frazier M , Gutelius B , Kawakami V , Lunquest K , McCracken S , Moser K , Oltean H , Ratner AJ , Raybern C , Signs K , Zaldivar A , Chiller TM , Jackson BR , McCotter O . MMWR Morb Mortal Wkly Rep 2019 68 (14) 332-333 On August 8, 2018, the New York City Department of Health and Mental Hygiene notified CDC about two high school students hospitalized for pneumonia of unknown etiology who had recently returned from community service trips constructing houses near Tijuana in Baja California, Mexico. Patients had developed fever 9 and 11 days after travel, followed by rash and lower respiratory symptoms. Symptoms did not improve with multiple courses of antibacterial medications, and the patients subsequently received diagnoses of coccidioidomycosis, a fungal disease commonly known as valley fever. |
Multistate Infestation with the Exotic Disease-Vector Tick Haemaphysalis longicornis - United States, August 2017-September 2018.
Beard CB , Occi J , Bonilla DL , Egizi AM , Fonseca DM , Mertins JW , Backenson BP , Bajwa WI , Barbarin AM , Bertone MA , Brown J , Connally NP , Connell ND , Eisen RJ , Falco RC , James AM , Krell RK , Lahmers K , Lewis N , Little SE , Neault M , Perez de Leon AA , Randall AR , Ruder MG , Saleh MN , Schappach BL , Schroeder BA , Seraphin LL , Wehtje M , Wormser GP , Yabsley MJ , Halperin W . MMWR Morb Mortal Wkly Rep 2018 67 (47) 1310-1313 Haemaphysalis longicornis is a tick indigenous to eastern Asia and an important vector of human and animal disease agents, resulting in such outcomes as human hemorrhagic fever and reduction of production in dairy cattle by 25%. H. longicornis was discovered on a sheep in New Jersey in August 2017 (1). This was the first detection in the United States outside of quarantine. In the spring of 2018, the tick was again detected at the index site, and later, in other counties in New Jersey, in seven other states in the eastern United States, and in Arkansas. The hosts included six species of domestic animals, six species of wildlife, and humans. To forestall adverse consequences in humans, pets, livestock, and wildlife, several critical actions are indicated, including expanded surveillance to determine the evolving distribution of H. longicornis, detection of pathogens that H. longicornis currently harbors, determination of the capacity of H. longicornis to serve as a vector for a range of potential pathogens, and evaluation of effective agents and methods for the control of H. longicornis. |
Analysis of erythrocyte dynamics in Rhesus macaque monkeys during infection with Plasmodium cynomolgi
Fonseca LL , Joyner CJ , Saney CL , Moreno A , Barnwell JW , Galinski MR , Voit EO . Malar J 2018 17 (1) 410 BACKGROUND: Malaria is a major mosquito transmitted, blood-borne parasitic disease that afflicts humans. The disease causes anaemia and other clinical complications, which can lead to death. Plasmodium vivax is known for its reticulocyte host cell specificity, but many gaps in disease details remain. Much less is known about the closely related species, Plasmodium cynomolgi, although it is naturally acquired and causes zoonotic malaria. Here, a computational model is developed based on longitudinal analyses of P. cynomolgi infections in nonhuman primates to investigate the erythrocyte dynamics that is pertinent to understanding both P. cynomolgi and P. vivax malaria in humans. METHODS: A cohort of five P. cynomolgi infected Rhesus macaques (Macaca mulatta) is studied, with individuals exhibiting a plethora of clinical outcomes, including varying levels of anaemia. A discrete recursive model with age structure is developed to replicate the dynamics of P. cynomolgi blood-stage infections. The model allows for parasitic reticulocyte preference and assumes an age preference among the mature RBCs. RBC senescence is modelled using a hazard function, according to which RBCs have a mean lifespan of 98 +/- 21 days. RESULTS: Based on in vivo data from three cohorts of macaques, the computational model is used to characterize the reticulocyte lifespan in circulation as 24 +/- 5 h (n = 15) and the rate of RBC production as 2727 +/- 209 cells/h/microL (n = 15). Analysis of the host responses reveals a pre-patency increase in the number of reticulocytes. It also allows the quantification of RBC removal through the bystander effect. CONCLUSIONS: The evident pre-patency increase in reticulocytes is due to a shift towards the release of younger reticulocytes, which could result from a parasite-induced factor meant to increase reticulocyte availability and satisfy the parasite's tropism, which has an average value of 32:1 in this cohort. The number of RBCs lost due to the bystander effect relative to infection-induced RBC losses is 62% for P. cynomolgi infections, which is substantially lower than the value of 95% previously determined for another simian species, Plasmodium coatneyi. |
Duration of Infectious Zika Virus in Semen and Serum.
Medina FA , Torres G , Acevedo J , Fonseca S , Casiano L , De Leon-Rodriguez CM , Santiago GA , Doyle K , Sharp TM , Alvarado LI , Paz-Bailey G , Munoz-Jordan JL . J Infect Dis 2018 219 (1) 31-40 Zika virus (ZIKV) has recently caused a large epidemic in the Americas associated with birth defects. Although ZIKV is primarily transmitted by Aedes spp. mosquitoes, ZIKV RNA is detectable in blood and semen of infected individuals for weeks or months, during which time sexual and other modes of transmission are possible. However, viral RNA is usually detectable for longer than infectious virus is present. We determined the frequency of isolation of infectious virus from semen and serum samples prospectively obtained from a cohort of patients in Puerto Rico. We confirmed positive isolation by tissue culture cytopathic effect, increase in virus genome copy equivalents (GCE), immunofluorescence, and quantitation of infected cells by flow cytometry. These criteria confirmed infectious virus in semen from 8 of 97 patients for up to 38 days after initial detection when virus loads are higher than 1.4x106 GCE/mL. Two serum isolates were obtained from 296 patients. These findings can help guide important prevention guidelines for persons that may potentially be infectious and transmit ZIKV sexually. |
Collection of data on race, ethnicity, language, and nativity by US Public Health Surveillance and Monitoring Systems: Gaps and opportunities
Rodriguez-Lainz A , McDonald M , Fonseca-Ford M , Penman-Aguilar A , Waterman SH , Truman BI , Cetron MS , Richards CL . Public Health Rep 2017 133 (1) 33354917745503 OBJECTIVE: Despite increasing diversity in the US population, substantial gaps in collecting data on race, ethnicity, primary language, and nativity indicators persist in public health surveillance and monitoring systems. In addition, few systems provide questionnaires in foreign languages for inclusion of non-English speakers. We assessed (1) the extent of data collected on race, ethnicity, primary language, and nativity indicators (ie, place of birth, immigration status, and years in the United States) and (2) the use of data-collection instruments in non-English languages among Centers for Disease Control and Prevention (CDC)-supported public health surveillance and monitoring systems in the United States. METHODS: We identified CDC-supported surveillance and health monitoring systems in place from 2010 through 2013 by searching CDC websites and other federal websites. For each system, we assessed its website, documentation, and publications for evidence of the variables of interest and use of data-collection instruments in non-English languages. We requested missing information from CDC program officials, as needed. RESULTS: Of 125 data systems, 100 (80%) collected data on race and ethnicity, 2 more collected data on ethnicity but not race, 26 (21%) collected data on racial/ethnic subcategories, 40 (32%) collected data on place of birth, 21 (17%) collected data on years in the United States, 14 (11%) collected data on immigration status, 13 (10%) collected data on primary language, and 29 (23%) used non-English data-collection instruments. Population-based surveys and disease registries more often collected data on detailed variables than did case-based, administrative, and multiple-source systems. CONCLUSIONS: More complete and accurate data on race, ethnicity, primary language, and nativity can improve the quality, representativeness, and usefulness of public health surveillance and monitoring systems to plan and evaluate targeted public health interventions to eliminate health disparities. |
Resisting and tolerating P. falciparum in pregnancy under different malaria transmission intensities
Ndam NT , Mbuba E , Gonzalez R , Cistero P , Kariuki S , Sevene E , Ruperez M , Fonseca AM , Vala A , Maculuve S , Jimenez A , Quinto L , Ouma P , Ramharter M , Aponte JJ , Nhacolo A , Massougbodji A , Briand V , Kremsner PG , Mombo-Ngoma G , Desai M , Macete E , Cot M , Menendez C , Mayor A . BMC Med 2017 15 (1) 130 BACKGROUND: Resistance and tolerance to Plasmodium falciparum can determine the progression of malaria disease. However, quantitative evidence of tolerance is still limited. We investigated variations in the adverse impact of P. falciparum infections among African pregnant women under different intensities of malaria transmission. METHODS: P. falciparum at delivery was assessed by microscopy, quantitative PCR (qPCR) and placental histology in 946 HIV-uninfected and 768 HIV-infected pregnant women from Benin, Gabon, Kenya and Mozambique. Resistance was defined by the proportion of submicroscopic infections and the levels of anti-parasite antibodies quantified by Luminex, and tolerance by the relationship of pregnancy outcomes with parasite densities at delivery. RESULTS: P. falciparum prevalence by qPCR in peripheral and/or placental blood of HIV-uninfected Mozambican, Gabonese and Beninese women at delivery was 6% (21/340), 11% (28/257) and 41% (143/349), respectively. The proportion of peripheral submicroscopic infections was higher in Benin (83%) than in Mozambique (60%) and Gabon (55%; P = 0.033). Past or chronic placental P. falciparum infection was associated with an increased risk of preterm birth in Mozambican newborns (OR = 7.05, 95% CI 1.79 to 27.82). Microscopic infections were associated with reductions in haemoglobin levels at delivery among Mozambican women (-1.17 g/dL, 95% CI -2.09 to -0.24) as well as with larger drops in haemoglobin levels from recruitment to delivery in Mozambican (-1.66 g/dL, 95% CI -2.68 to -0.64) and Gabonese (-0.91 g/dL, 95% CI -1.79 to -0.02) women. Doubling qPCR-peripheral parasite densities in Mozambican women were associated with decreases in haemoglobin levels at delivery (-0.16 g/dL, 95% CI -0.29 to -0.02) and increases in the drop of haemoglobin levels (-0.29 g/dL, 95% CI -0.44 to -0.14). Beninese women had higher anti-parasite IgGs than Mozambican women (P < 0.001). No difference was found in the proportion of submicroscopic infections nor in the adverse impact of P. falciparum infections in HIV-infected women from Kenya (P. falciparum prevalence by qPCR: 9%, 32/351) and Mozambique (4%, 15/417). CONCLUSIONS: The lowest levels of resistance and tolerance in pregnant women from areas of low malaria transmission were accompanied by the largest adverse impact of P. falciparum infections. Exposure-dependent mechanisms developed by pregnant women to resist the infection and minimise pathology can reduce malaria-related adverse outcomes. Distinguishing both types of defences is important to understand how reductions in transmission can affect malaria disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT00811421 . Registered 18 December 2008. |
International workshop on insecticide resistance in vectors of arboviruses, December 2016, Rio de Janeiro, Brazil
Corbel V , Fonseca DM , Weetman D , Pinto J , Achee NL , Chandre F , Coulibaly MB , Dusfour I , Grieco J , Juntarajumnong W , Lenhart A , Martins AJ , Moyes C , Ng LC , Raghavendra K , Vatandoost H , Vontas J , Muller P , Kasai S , Fouque F , Velayudhan R , Durot C , David JP . Parasit Vectors 2017 10 (1) 278 Vector-borne diseases transmitted by insect vectors such as mosquitoes occur in over 100 countries and affect almost half of the world's population. Dengue is currently the most prevalent arboviral disease but chikungunya, Zika and yellow fever show increasing prevalence and severity. Vector control, mainly by the use of insecticides, play a key role in disease prevention but the use of the same chemicals for more than 40 years, together with the dissemination of mosquitoes by trade and environmental changes, resulted in the global spread of insecticide resistance. In this context, innovative tools and strategies for vector control, including the management of resistance, are urgently needed. This report summarizes the main outputs of the first international workshop on Insecticide resistance in vectors of arboviruses held in Rio de Janeiro, Brazil, 5-8 December 2016. The primary aims of this workshop were to identify strategies for the development and implementation of standardized insecticide resistance management, also to allow comparisons across nations and across time, and to define research priorities for control of vectors of arboviruses. The workshop brought together 163 participants from 28 nationalities and was accessible, live, through the web (> 70,000 web-accesses over 3 days). |
Serro 2 Virus Highlights the Fundamental Genomic and Biological Features of a Natural Vaccinia Virus Infecting Humans.
Trindade GS , Emerson GL , Sammons S , Frace M , Govil D , Fernandes Mota BE , Abrahao JS , de Assis FL , Olsen-Rasmussen M , Goldsmith CS , Li Y , Carroll D , Guimaraes da Fonseca F , Kroon E , Damon IK . Viruses 2016 8 (12) Vaccinia virus (VACV) has been implicated in infections of dairy cattle and humans, and outbreaks have substantially impacted local economies and public health in Brazil. During a 2005 outbreak, a VACV strain designated Serro 2 virus (S2V) was collected from a 30-year old male milker. Our aim was to phenotypically and genetically characterize this VACV Brazilian isolate. S2V produced small round plaques without associated comets when grown in BSC40 cells. Furthermore, S2V was less virulent than the prototype strain VACV-Western Reserve (WR) in a murine model of intradermal infection, producing a tiny lesion with virtually no surrounding inflammation. The genome of S2V was sequenced by primer walking. The coding region spans 184,572 bp and contains 211 predicted genes. Mutations in envelope genes specifically associated with small plaque phenotypes were not found in S2V; however, other alterations in amino acid sequences within these genes were identified. In addition, some immunomodulatory genes were truncated in S2V. Phylogenetic analysis using immune regulatory-related genes, besides the hemagglutinin gene, segregated the Brazilian viruses into two clusters, grouping the S2V into Brazilian VACV group 1. S2V is the first naturally-circulating human-associated VACV, with a low passage history, to be extensively genetically and phenotypically characterized. |
Tracking insecticide resistance in mosquito vectors of arboviruses: the Worldwide Insecticide resistance Network (WIN)
Corbel V , Achee NL , Chandre F , Coulibaly MB , Dusfour I , Fonseca DM , Grieco J , Juntarajumnong W , Lenhart A , Martins AJ , Moyes C , Ng LC , Pinto J , Raghavendra K , Vatandoost H , Vontas J , Weetman D , Fouque F , Velayudhan R , David JP . PLoS Negl Trop Dis 2016 10 (12) e0005054 The transmission of the arboviral agents of dengue, yellow fever, Chikungunya, and Zika by Aedes mosquitoes represents expanding threats to global health. At the 69th World Health Assembly [1], the WHO Director-General Margaret Chan declared that the spread of the Zika virus was "the result of the abandon of mosquito control" by governments since the 1970s and urged Member States to mobilize more efforts and resources to prevent further spread of the diseases. The recent rise of microcephaly cases and other neurological disorders reported in Brazil prompted WHO to declare Zika as a Public Health Emergency of International Concern [2]. After limited early outbreaks in the Pacific in 2007 and 2013, the Zika virus has spread to more than 30 countries in the Americas and the Caribbean, affecting over 1.5 million people [3]. With growing evidence supporting the link between microcephaly and Zika [4, 5] and preliminary evidence confirming Aedes aegypti as the primary vector in the Brazilian outbreak [6], the mandate for control is clear and urgent. | Although progress is being made on vaccine development (for example, Sanofi Pasteur’s recently licensed dengue vaccine Dengvaxia [7]), vector control by removing larval habitats and using biological and chemical insecticides still remain the first line of defence against arboviruses [8]. Unfortunately, decades of efforts failed to consistently control Aedes mosquito populations and/or to curtail the cycle of epidemics. Control of adult mosquitoes using space spray applications of pyrethroids and organophospates in plural is fraught with complications, including high cost, slow operational response, low community buy-in, ineffective timing of application, and rather low efficacy and/or residual effect [9–11]. Furthermore, some countries have a lack of capacity in monitoring the use of public health insecticides for the control of arbovirus vectors [12] that is essential for guiding pesticide management systems on appropriate use and reduction of risks to human health and environment. |
Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians
Moore CA , Staples JE , Dobyns WB , Pessoa A , Ventura CV , Fonseca EB , Ribeiro EM , Ventura LO , Neto NN , Arena JF , Rasmussen SA . JAMA Pediatr 2016 171 (3) 288-295 Importance: Zika virus infection can be prenatally passed from a pregnant woman to her fetus. There is sufficient evidence to conclude that intrauterine Zika virus infection is a cause of microcephaly and serious brain anomalies, but the full spectrum of anomalies has not been delineated. To inform pediatric clinicians who may be called on to evaluate and treat affected infants and children, we review the most recent evidence to better characterize congenital Zika syndrome. Observations: We reviewed published reports of congenital anomalies occurring in fetuses or infants with presumed or laboratory-confirmed intrauterine Zika virus infection. We conducted a comprehensive search of the English literature using Medline and EMBASE for Zika from inception through September 30, 2016. Congenital anomalies were considered in the context of the presumed pathogenetic mechanism related to the neurotropic properties of the virus. We conclude that congenital Zika syndrome is a recognizable pattern of structural anomalies and functional disabilities secondary to central and, perhaps, peripheral nervous system damage. Although many of the components of this syndrome, such as cognitive, sensory, and motor disabilities, are shared by other congenital infections, there are 5 features that are rarely seen with other congenital infections or are unique to congenital Zika virus infection: (1) severe microcephaly with partially collapsed skull; (2) thin cerebral cortices with subcortical calcifications; (3) macular scarring and focal pigmentary retinal mottling; (4) congenital contractures; and (5) marked early hypertonia and symptoms of extrapyramidal involvement. Conclusions and Relevance: Although the full spectrum of adverse reproductive outcomes caused by Zika virus infection is not yet determined, a distinctive phenotype-the congenital Zika syndrome-has emerged. Recognition of this phenotype by clinicians for infants and children can help ensure appropriate etiologic evaluation and comprehensive clinical investigation to define the range of anomalies in an affected infant as well as determine essential follow-up and ongoing care. |
Quantifying the removal of red blood cells in Macaca mulatta during a Plasmodium coatneyi infection.
Fonseca LL , Alezi HS , Moreno A , Barnwell JW , Galinski MR , Voit EO . Malar J 2016 15 (1) 410 BACKGROUND: Malaria is the most deadly parasitic disease in humans globally, and the long-time coexistence with malaria has left indelible marks in the human genome that are the causes of a variety of genetic disorders. Although anaemia is a common clinical complication of malaria, the root causes and mechanisms involved in the pathogenesis of malarial anaemia are unclear and difficult to study in humans. Non-human primate (NHP) model systems enable the mechanistic study and quantification of underlying causative factors of malarial anaemia, and particularly the onset of severe anaemia. METHODS: Data were obtained in the course of Plasmodium coatneyi infections of malaria-naive and semi-immune rhesus macaques (Macaca mulatta), whose red blood cells (RBCs) were labelled in situ with biotin at the time the infections were initiated. The data were used for a survival analysis that permitted, for the first time, an accurate estimation of the lifespan of erythrocytes in macaques. The data furthermore formed the basis for the development and parameterization of a recursive dynamic model of erythrocyte turnover, which was used for the quantification of RBC production and removal in each macaque. RESULTS: The computational analysis demonstrated that the lifespan of erythrocytes in macaques is 98 +/- 21 days. The model also unambiguously showed that death due to senescence and parasitaemia is not sufficient to account for the extent of infection-induced anaemia. Specifically, the model permits, for the first time, the quantification of the different causes of RBC death, namely, normal senescence, age-independent random loss, parasitization, and bystander effects in uninfected cells. Such a dissection of the overall RBC removal process is hardly possible with experimental means alone. In the infected malaria-naive macaques, death of erythrocytes by normal physiological senescence processes accounts for 20 % and parasitization for only 4 %, whereas bystander effects are associated with an astonishing 76 % of total RBC losses. Model-based comparisons of alternative mechanisms involved in the bystander effect revealed that most of the losses are likely due to a process of removing uninfected RBCs of all age classes and only minimally due to an increased rate of senescence of the uninfected RBCs. CONCLUSIONS: A new malaria blood-stage model was developed for the analysis of data characterizing P. coatneyi infections of M. mulatta. The model used a discrete and recursive framework with age-structure that allowed the quantification of the most significant pathophysiological processes of RBC removal. The computational results revealed that the malarial anaemia caused by this parasite is mostly due to a loss of uninfected RBCs by an age-independent process. The biological identity and complete mechanism of this process is not fully understood and requires further investigation. |
The US Culture Collection Network lays the foundation for progress in preservation of valuable microbial resources.
McCluskey K , Alvarez A , Bennett AR , Bokati D , Boundy-Mills K , Brown D , Bull CT , Coffey M , Dreaden T , Duke C , Dye G , Ehmke E , Eversole K , Fenstermacher K , Geiser DM , Glaeser J , Greene S , Gribble L , Griffith MP , Hanser K , Humber R , Johnson BW , Kermode A , Krichevsky M , Lauden M , Leach J , Leslie JF , May M , Melcher U , Nobles DR , Risso Fonseca N , Robinson S , Ryan M , Scott J , Silflow C , Vidaver A , Webb K , Wertz J , Yentsch S , Zehr S . Phytopathology 2016 106 (6) 532-40 The United States Culture Collection Network was formed in 2012 by a group of culture collection scientists and stakeholders in order to continue the progress established previously through efforts of an ad hoc group. The network is supported by a Research Coordination Network grant from the US National Science Foundation (NSF) and has the goals of promoting interaction among collections, encouraging the adoption of best practices, and protecting endangered or orphaned collections. After prior meetings to discuss best practices, shared data, and synergy with genome programs, the network held a meeting at the US Department of Agriculture (USDA) Agricultural Research Service (ARS) National Center for Genetic Resources Preservation (NCGRP) in Fort Collins, Colorado in October 2015 specifically to discuss collections that are vulnerable because of changes in funding programs, or are at risk of loss because of retirement or lack of funding. The meeting allowed collection curators who had already backed up their resources at the USDA NCGRP to visit the site, and brought collection owners, managers, and stakeholders together. Eight formal collections have established off-site backups with the USDA-ARS, ensuring that key material will be preserved for future research. All of the collections with backup at the NCGRP are public distributing collections including US NSF-supported genetic stock centers, USDA ARS collections, and university supported collections. Facing the retirement of several pioneering researchers, the community discussed the value of preserving personal research collections and agreed that a mechanism to preserve these valuable collections was essential to any future national culture collection system. Additional input from curators of plant and animal collections emphasized that collections of every kind face similar challenges in developing long-range plans for sustainability. |
Genome of Rhodnius prolixus, an insect vector of Chagas disease, reveals unique adaptations to hematophagy and parasite infection.
Mesquita RD , Vionette-Amaral RJ , Lowenberger C , Rivera-Pomar R , Monteiro FA , Minx P , Spieth J , Carvalho AB , Panzera F , Lawson D , Torres AQ , Ribeiro JM , Sorgine MH , Waterhouse RM , Montague MJ , Abad-Franch F , Alves-Bezerra M , Amaral LR , Araujo HM , Araujo RN , Aravind L , Atella GC , Azambuja P , Berni M , Bittencourt-Cunha PR , Braz GR , Calderon-Fernandez G , Carareto CM , Christensen MB , Costa IR , Costa SG , Dansa M , Daumas-Filho CR , De-Paula IF , Dias FA , Dimopoulos G , Emrich SJ , Esponda-Behrens N , Fampa P , Fernandez-Medina RD , da Fonseca RN , Fontenele M , Fronick C , Fulton LA , Gandara AC , Garcia ES , Genta FA , Giraldo-Calderon GI , Gomes B , Gondim KC , Granzotto A , Guarneri AA , Guigo R , Harry M , Hughes DS , Jablonka W , Jacquin-Joly E , Juarez MP , Koerich LB , Latorre-Estivalis JM , Lavore A , Lawrence GG , Lazoski C , Lazzari CR , Lopes RR , Lorenzo MG , Lugon MD , Majerowicz D , Marcet PL , Mariotti M , Masuda H , Megy K , Melo AC , Missirlis F , Mota T , Noriega FG , Nouzova M , Nunes RD , Oliveira RL , Oliveira-Silveira G , Ons S , Pagola L , Paiva-Silva GO , Pascual A , Pavan MG , Pedrini N , Peixoto AA , Pereira MH , Pike A , Polycarpo C , Prosdocimi F , Ribeiro-Rodrigues R , Robertson HM , Salerno AP , Salmon D , Santesmasses D , Schama R , Seabra-Junior ES , Silva-Cardoso L , Silva-Neto MA , Souza-Gomes M , Sterkel M , Taracena ML , Tojo M , Tu ZJ , Tubio JM , Ursic-Bedoya R , Venancio TM , Walter-Nuno AB , Wilson D , Warren WC , Wilson RK , Huebner E , Dotson EM , Oliveira PL . Proc Natl Acad Sci U S A 2015 112 (48) 14936-14941 Rhodnius prolixus not only has served as a model organism for the study of insect physiology, but also is a major vector of Chagas disease, an illness that affects approximately seven million people worldwide. We sequenced the genome of R. prolixus, generated assembled sequences covering 95% of the genome ( approximately 702 Mb), including 15,456 putative protein-coding genes, and completed comprehensive genomic analyses of this obligate blood-feeding insect. Although immune-deficiency (IMD)-mediated immune responses were observed, R. prolixus putatively lacks key components of the IMD pathway, suggesting a reorganization of the canonical immune signaling network. Although both Toll and IMD effectors controlled intestinal microbiota, neither affected Trypanosoma cruzi, the causal agent of Chagas disease, implying the existence of evasion or tolerance mechanisms. R. prolixus has experienced an extensive loss of selenoprotein genes, with its repertoire reduced to only two proteins, one of which is a selenocysteine-based glutathione peroxidase, the first found in insects. The genome contained actively transcribed, horizontally transferred genes from Wolbachia sp., which showed evidence of codon use evolution toward the insect use pattern. Comparative protein analyses revealed many lineage-specific expansions and putative gene absences in R. prolixus, including tandem expansions of genes related to chemoreception, feeding, and digestion that possibly contributed to the evolution of a blood-feeding lifestyle. The genome assembly and these associated analyses provide critical information on the physiology and evolution of this important vector species and should be instrumental for the development of innovative disease control methods. |
Multinational disease surveillance programs: promoting global information exchange for infectious diseases
Varan AK , Bruniera-Oliveira R , Peter CR , Fonseca-Ford M , Waterman SH . Am J Trop Med Hyg 2015 93 (3) 668-71 Cross-border surveillance for emerging diseases such as Ebola and other infectious diseases requires effective international collaboration. We surveyed representatives from 12 multinational disease surveillance programs between January 2013 and April 2014. Our survey identified programmatic similarities despite variation in health priorities, geography, and socioeconomic context, providing a contemporary perspective on infectious disease surveillance networks. |
Rabies death attributed to exposure in Central America with symptom onset in a U.S. Detention facility - Texas, 2013
Wallace RM , Bhavnani D , Russell J , Zaki S , Muehlenbachs A , Hayden-Pinneri K , Aplicano RM , Peruski L , Vora NM , Balter S , Elson D , Lederman E , Leeson B , McLaughlin T , Waterman S , Fonseca-Ford M , Blanton J , Franka R , Velasco-Villa A , Niezgoda M , Orciari L , Recuenco S , Damon I , Hanlon C , Jackson F , Dyer J , Wadhwa A , Robinson L . MMWR Morb Mortal Wkly Rep 2014 63 (20) 446-9 On June 7, 2013, a man was diagnosed in a Texas hospital with rabies. He had been detained in a U.S. detention facility during his infectious period. To identify persons exposed to rabies who might require rabies postexposure prophylaxis (PEP), CDC and the Texas Department of State Health Services (DSHS) conducted investigations at four detention facilities, one medical clinic, and two hospitals. In all, 25 of 742 persons assessed for rabies exposure were advised to receive PEP. Early diagnosis of rabies is essential for implementation of appropriate hospital infection control measures and for rapid assessment of potential contacts for PEP recommendations. |
Full-genome analysis of avian influenza A(H5N1) virus from a human, North America, 2013.
Pabbaraju K , Tellier R , Wong S , Li Y , Bastien N , Tang JW , Drews SJ , Jang Y , Davis CT , Fonseca K , Tipples GA . Emerg Infect Dis 2014 20 (5) 887-91 Full-genome analysis was conducted on the first isolate of a highly pathogenic avian influenza A(H5N1) virus from a human in North America. The virus has a hemagglutinin gene of clade 2.3.2.1c and is a reassortant with an H9N2 subtype lineage polymerase basic 2 gene. No mutations conferring resistance to adamantanes or neuraminidase inhibitors were found. |
Surveillance for yellow fever virus in non-human primates in southern Brazil, 2001-2011: a tool for prioritizing human populations for vaccination
Almeida MA , Cardoso Jda C , Dos Santos E , da Fonseca DF , Cruz LL , Faraco FJ , Bercini MA , Vettorello KC , Porto MA , Mohrdieck R , Ranieri TM , Schermann MT , Sperb AF , Paz FZ , Nunes ZM , Romano AP , Costa ZG , Gomes SL , Flannery B . PLoS Negl Trop Dis 2014 8 (3) e2741 In Brazil, epizootics among New World monkey species may indicate circulation of yellow fever (YF) virus and provide early warning of risk to humans. Between 1999 and 2001, the southern Brazilian state of Rio Grande do Sul initiated surveillance for epizootics of YF in non-human primates to inform vaccination of human populations. Following a YF outbreak, we analyzed epizootic surveillance data and assessed YF vaccine coverage, timeliness of implementation of vaccination in unvaccinated human populations. From October 2008 through June 2009, circulation of YF virus was confirmed in 67 municipalities in Rio Grande do Sul State; vaccination was recommended in 23 (34%) prior to the outbreak and in 16 (24%) within two weeks of first epizootic report. In 28 (42%) municipalities, vaccination began more than two weeks after first epizootic report. Eleven (52%) of 21 laboratory-confirmed human YF cases occurred in two municipalities with delayed vaccination. By 2010, municipalities with confirmed YF epizootics reported higher vaccine coverage than other municipalities that began vaccination. In unvaccinated human populations timely response to epizootic events is critical to prevent human yellow fever cases. |
Full-length genome characterization and genetic relatedness analysis of hepatitis A virus outbreak strains associated with acute liver failure among children.
Vaughan G , Forbi JC , Xia GL , Fonseca-Ford M , Vazquez R , Khudyakov YE , Montiel S , Waterman S , Alpuche C , Goncalves Rossi LM , Luna N . J Med Virol 2014 86 (2) 202-8 Clinical infection by hepatitis A virus (HAV) is generally self-limited but in some cases can progress to liver failure. Here, an HAV outbreak investigation among children with acute liver failure in a highly endemic country is presented. In addition, a sensitive method for HAV whole genome amplification and sequencing suitable for analysis of clinical samples is described. In this setting, two fatal cases attributed to acute liver failure and two asymptomatic cases living in the same household were identified. In a second household, one HAV case was observed with jaundice which resolved spontaneously. Partial molecular characterization showed that both households were infected by HAV subtype IA; however, the infecting strains in the two households were different. The HAV outbreak strains recovered from all cases grouped together within cluster IA1, which contains closely related HAV strains from the United States commonly associated with international travelers. Full-genome HAV sequences obtained from the household with the acute liver failure cases were related (genetic distances ranging from 0.01% to 0.04%), indicating a common-source infection. Interestingly, the strain recovered from the asymptomatic household contact was nearly identical to the strain causing acute liver failure. The whole genome sequence from the case in the second household was distinctly different from the strains associated with acute liver failure. Thus, infection with almost identical HAV strains resulted in drastically different clinical outcomes. |
Rapid hepatitis C virus divergence among chronically infected individuals.
Cruz-Rivera M , Carpio-Pedroza JC , Escobar-Gutierrez A , Lozano D , Vergara-Castaneda A , Rivera-Osorio P , Martinez-Guarneros A , Chacon CA , Fonseca-Coronado S , Vaughan G . J Clin Microbiol 2013 51 (2) 629-32 Here, we analyze the viral divergence among hepatitis C virus (HCV) chronic cases infected with genotype 1. The intrahost viral evolution was assessed by deep sequencing using the 454 Genome Sequencer platform. The results showed a rapid nucleotide sequence divergence. This notorious short-term viral evolution is of the utmost importance for the study of HCV transmission, because direct links between related samples were virtually lost. Thus, rapid divergence of HCV significantly affects genetic relatedness studies and outbreak investigations. |
Acute viral hepatitis in the United States-Mexico border region: data from the Border Infectious Disease Surveillance (BIDS) project, 2000-2009
Spradling PR , Xing J , Phippard A , Fonseca-Ford M , Montiel S , Guzman NL , Campuzano RV , Vaughan G , Xia GL , Drobeniuc J , Kamili S , Cortes-Alcala R , Waterman SH . J Immigr Minor Health 2012 15 (2) 390-7 Little is known about the characteristics of acute viral hepatitis cases in the United States (US)-Mexico border region. We analyzed characteristics of acute viral hepatitis cases collected from the Border Infectious Disease Surveillance Project from January 2000-December 2009. Over the study period, 1,437 acute hepatitis A, 311 acute hepatitis B, and 362 acute hepatitis C cases were reported from 5 Mexico and 2 US sites. Mexican hepatitis A cases most frequently reported close personal contact with a known case, whereas, US cases most often reported cross-border travel. Injection drug use was common among Mexican and US acute hepatitis B and C cases. Cross-border travel during the incubation period was common among acute viral hepatitis cases in both countries. Assiduous adherence to vaccination and prevention guidelines in the US is needed and strategic implementation of hepatitis vaccination and prevention programs south of the border should be considered. |
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