From #Hendra to #Wuhan: what has been learned in responding to emerging #zoonotic viruses (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

From Hendra to Wuhan: what has been learned in responding to emerging zoonotic viruses

Lin-Fa Wang, Danielle E Anderson, John S Mackenzie, Michael H Merson

Published: February 11, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30350-0

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As the world watches the rapid spread of the 2019 novel coronavirus (2019-nCoV) outbreak, it is important to reflect on the lessons that can be learned from this and previous emerging zoonotic viruses (EZV) in a comparative and analytic way. Although the source of 2019-nCoV is yet to be confirmed, early findings suggest a high possibility of a bat origin.1 There have been six major EZV outbreaks in the past 25 years caused by proven or suspected bat-borne viruses (table).2, 3, 4, 5,6,7 With these in mind, four major points are worth considering in the context of the 2019-nCoV outbreak.

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Keywords: COVID-19; Zoonoses; Emerging diseases; Henipavirus.

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A Qualitative Study of #Zoonotic #Risk Factors Among Rural Communities in Southern #China (Int Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Int Health  2020 Feb 10 [Online ahead of print]

A Qualitative Study of Zoonotic Risk Factors Among Rural Communities in Southern China

Hong-Ying Li 1, Guang-Jian Zhu 1, Yun-Zhi Zhang 2, Li-Biao Zhang 3, Emily A Hagan 1, Stephanie Martinez 1, Aleksei A Chmura 1, Leilani Francisco 4, Hina Tai 5, Maureen Miller 6, Peter Daszak 1

Affiliations: 1 EcoHealth Alliance, 460 West 34th Street, New York, NY 10001, USA. 2 Institute of Preventive Medicine, Dali University, Dali, 671000, China. 3 Guangdong Institute of Applied Biological Resources, Guangdong Academy of Sciences, #105 Xingang Road West, Guangzhou, 510260, China. 4 Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA. 5 School of Medicine, St. George’s University, Great River, NY 11739, USA. 6 Mailman School of Public Health, Columbia University, New York, NY 10032, USA.

PMID: 32040190 DOI: 10.1093/inthealth/ihaa001

 

Abstract

Background:

Strategies are urgently needed to mitigate the risk of zoonotic disease emergence in southern China, where pathogens with zoonotic potential are known to circulate in wild animal populations. However, the risk factors leading to emergence are poorly understood, which presents a challenge in developing appropriate mitigation strategies for local communities.

Methods:

Residents in rural communities of Yunnan, Guangxi and Guangdong provinces were recruited and enrolled in this study. Data were collected through ethnographic interviews and field observations, and thematically coded and analysed to identify both risk and protective factors for zoonotic disease emergence at the individual, community and policy levels.

Results:

Eighty-eight ethnographic interviews and 55 field observations were conducted at nine selected sites. Frequent human-animal interactions and low levels of environmental biosecurity in local communities were identified as risks for zoonotic disease emergence. Policies and programmes existing in the communities provide opportunities for zoonotic risk mitigation.

Conclusions:

This study explored the relationship among zoonotic risk and human behaviour, environment and policies in rural communities in southern China. It identifies key behavioural risk factors that can be targeted for development of tailored risk-mitigation strategies to reduce the threat of novel zoonoses.

Keywords: 2019-nCoV; SARS; Zoonotic Risk; coronavirus; ethnographic; qualitative; rural communities; southern China.

© The Author(s) 2020. Published by Oxford University Press.

Keywords: Zoonoses; Infectious Diseases; Emerging diseases; China.

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Recent #advances in the #detection of #respiratory virus #infection in #humans (J Med Virol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Med Virol. 2020 Jan 15. doi: 10.1002/jmv.25674. [Epub ahead of print]

Recent advances in the detection of respiratory virus infection in humans.

Zhang N1, Wang L2, Deng X3, Liang R3, Su M3, He C3, Hu L3, Su Y3, Ren J3, Yu F3, Du L4, Jiang S4,5.

Author information: 1 Department of Clinical Medicine, School of Medicine, Zhejiang University City College, Hangzhou, China. 2 State Key Laboratory of North China Crop Improvement and Regulation, Research Center of Chinese Jujube, Hebei Agricultural University, Baoding, China. 3 State Key Laboratory of North China Crop Improvement and Regulation, College of Life and Science, Hebei Agricultural University, Baoding, China. 4 Lindsley F. Kimball Research Institute, New York Blood Center, New York, USA. 5 Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China.

 

Abstract

Respiratory tract viral infection caused by viruses or bacteria is one of the most common diseases in human worldwide, while those caused by emerging viruses, such as the novel coronavirus, 2019-nCoV that caused the pneumonia outbreak in Wuhan, China most recently, have posed great threats to global public health. Identification of the causative viral pathogens of respiratory tract viral infections is important to select an appropriate treatment, save people’s lives, stop the epidemics, and avoid unnecessary use of antibiotics. Conventional diagnostic tests, such as the assays for rapid detection of antiviral antibodies or viral antigens, are widely used in many clinical laboratories. With the development of modern technologies, new diagnostic strategies, including multiplex nucleic acid amplification and microarray-based assays, are emerging. This review summarizes currently available and novel emerging diagnostic methods for the detection of common respiratory viruses, such as influenza virus, human respiratory syncytial virus (RSV), coronavirus, human adenovirus (hAdV), and human rhinovirus (hRV). Multiplex assays for simultaneous detection of multiple respiratory viruses are also described. It is anticipated that such data will assist researchers and clinicians to develop appropriate diagnostic strategies for timely and effective detection of respiratory virus infections.

This article is protected by copyright. All rights reserved.

KEYWORDS: Respiratory viral infection; adenovirus; coronavirus; diagnostic methods; influenza virus; respiratory syncytial virus; rhinovirus

PMID: 31944312 DOI: 10.1002/jmv.25674

Keywords: Infectious Diseases; Diagnostic tests; 2019-nCoV.

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An observational prospective cohort study of the #epidemiology of hospitalized patients with acute #febrile #illness in #Indonesia (PLOS Negl Trop Dis., abstract)

[Source: PLOS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

An observational prospective cohort study of the epidemiology of hospitalized patients with acute febrile illness in Indonesia

Muhammad Hussein Gasem , Herman Kosasih , Emiliana Tjitra, Bachti Alisjahbana, Muhammad Karyana, Dewi Lokida, Aaron Neal, Jason Liang, Abu Tholib Aman, Mansyur Arif, Pratiwi Sudarmono, Suharto, Tuti Parwati Merati,  [ … ], for INA-RESPOND

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Published: January 10, 2020 / DOI: https://doi.org/10.1371/journal.pntd.0007927 / This is an uncorrected proof.

 

Abstract

Background

The epidemiology of acute febrile illness, a common cause of hospitalization in Indonesia, has not been systematically studied.

Methodology/Principal gindings

This prospective observational study enrolled febrile patients (temperature ≥38°C) aged ≥1 year from July 2013 until June 2016 at eight government referral teaching hospitals in seven provincial capitals in Indonesia. Patients were managed according to the hospital standard-of-care (SOC), and blood samples were drawn for molecular and serological assays. Clinical data, laboratory results, and specimens for additional tests were collected at enrollment, days 14–28, and at three months. Regular follow-up visits were then scheduled for every three months either until symptoms resolved or until one year. In total, this study included 1,486 adult and pediatric patients presenting with multi-organ (768, 51.7%), gastrointestinal (497, 33.0%), respiratory (114, 7.7%), constitutional (62, 4.2%), skin and soft-tissue (24, 1.6%), central nervous system (17, 1.1%), or genitourinary (4, 0.3%) manifestations. Microbiological diagnoses were found in 1,003/1,486 (67.5%) participants, of which 351/1,003 (35.0%) were not diagnosed during hospitalization using SOC diagnostic tests. Missed diagnoses included all cases caused by Rickettsia spp., chikungunya, influenza, and Seoul virus. The most common etiologic agents identified were dengue virus (467, 46.6%), Salmonella spp. (103, 10.3%), and Rickettsia spp. (103, 10.3%). The overall mortality was 89 (5.9%).

Conclusions/Significance

Febrile illness in Indonesia has various microbiologic etiologies and substantial overall mortality. Diagnostic limitations and lack of epidemiologic data resulted in potentially treatable, and at times fatal, diseases being missed.

 

Author summary

In tropical countries like Indonesia, fever due to infectious disease is the most common reason for hospitalization. However, diagnoses are mostly unconfirmed, as diagnostic tests are not available or are not performed due to budget constraints. Consequently, many patients are only treated based on clinical syndromes. To gain a better understanding of the epidemiology of acute fever in Indonesia, we conducted a study at eight hospitals in the seven largest cities from 2013–2016. We enrolled 1,486 subjects aged ≥1 year with acute fever ≥38°C. Blood cultures were mandatory for all subjects, while cultures of other biological specimens, microscopic examinations, and rapid tests for specific pathogens were based on clinical judgment and availability. Retrospectively, we performed molecular and serological testing for a panel of bacterial and viral pathogens for systemic, respiratory, and diarrheal diseases. We found six pathogens to be the most prevalent: dengue virus (47%), Salmonella Typhi/Paratyphi (10%), Rickettsia typhi (10%), influenza virus (7%), Leptospira spp. (5%), and chikungunya virus (4%). Rickettsia typhi, influenza, and chikungunya had not been considered in the differential diagnosis of any subject at the hospitals. Thus, multiple pathogens were associated with acute febrile illnesses, and a subset of treatable cases were missed. This may have resulted in increased overall mortality.

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Citation: Gasem MH, Kosasih H, Tjitra E, Alisjahbana B, Karyana M, Lokida D, et al. (2020) An observational prospective cohort study of the epidemiology of hospitalized patients with acute febrile illness in Indonesia. PLoS Negl Trop Dis 14(1): e0007927. https://doi.org/10.1371/journal.pntd.0007927

Editor: Florian Marks, International Vaccine Institute, REPUBLIC OF KOREA

Received: December 5, 2018; Accepted: November 14, 2019; Published: January 10, 2020

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: This project has been funded in whole or in part with Federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, under contract Nos. HHSN261200800001E and HHSN261201500003I. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Infectious Diseases; Indonesia.

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#Global #warming threatens #human #thermoregulation and #survival (J Clin Invest., summary)

[Source: Journal of Clinical Investigation, full page: (LINK). Summary, edited.]

Global warming threatens human thermoregulation and survival

Rexford S. Ahima

First published January 6, 2020

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There is overwhelming evidence showing that human activities have contributed to global warming over the past century. Global warming has a severe impact on food and water supplies, housing and other infrastructure, health, and economic activities. The human body has thermoregulatory mechanisms that adapt to ambient temperature and maintain normal core body temperature for physiological functions. This JCI Viewpoint article discusses how extreme temperatures driven by global warming disrupt normal thermoregulation and imperil human health and survival.

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Keywords: Climate change; Global Warming; Infectious diseases.

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#Climatechange brings the #specter of new #infectious diseases (J Clin Invest., summary)

[Source: Journal of Clinical Investigation, full page: (LINK). Summary, edited.]

Climate change brings the specter of new infectious diseases

Arturo Casadevall

First published January 6, 2020

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Climate change will bring major changes to the epidemiology of infectious diseases through changes in microbial and vector geographic range. Human defenses against microbial diseases rely on advanced immunity that includes innate and adaptive arms and endothermy, which creates a thermal restriction zone for many microbes. Given that microbes can adapt to higher temperatures, there is concern that global warming will select for microbes with higher heat tolerance that can defeat our endothermy defenses and bring new infectious disease.

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Keywords: Climate Change; Global Warming; Infectious Diseases.

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Uncrewed #aircraft #systems versus #motorcycles to deliver laboratory #samples in west #Africa: a comparative economic study (Lancet Glob Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Lancet Glob Health. 2020 Jan;8(1):e143-e151. doi: 10.1016/S2214-109X(19)30464-4.

Uncrewed aircraft systems versus motorcycles to deliver laboratory samples in west Africa: a comparative economic study.

Ochieng WO1, Ye T2, Scheel C2, Lor A2, Saindon J3, Yee SL2, Meltzer MI4, Kapil V2, Karem K2.

Author information: 1 Karna LLC, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: ocu9@cdc.gov. 2 Office of the Director, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. 3 Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4 Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

 

Abstract

BACKGROUND:

Transportation of laboratory samples in low-income and middle-income countries is often constrained by poor road conditions, difficult geographical terrain, and insecurity. These constraints can lead to long turnaround times for laboratory diagnostic tests and hamper epidemic control or patient treatment efforts. Although uncrewed aircraft systems (UAS)-ie, drones-can mitigate some of these transportation constraints, their cost-effectiveness compared with land-based transportation systems is unclear.

METHODS:

We did a comparative economic study of the costs and cost-effectiveness of UAS versus motorcycles in Liberia (west Africa) for transportation of laboratory samples under simulated routine conditions and public health emergency conditions (based on the 2013-16 west African Ebola virus disease epidemic). We modelled three UAS with operational ranges of 30 km, 65 km, and 100 km (UAS30, UAS65, and UAS100) and lifespans of 1000 to 10 000 h, and compared the costs and number of samples transported with an established motorcycle transportation programme (most commonly used by the Liberian Ministry of Health and the charity Riders for Health). Data for UAS were obtained from Skyfire (a UAS consultancy), Vayu (a UAS manufacturer), and Sandia National Laboratories (a private company with UAS research experience). Motorcycle operational data were obtained from Riders for Health. In our model, we included costs for personnel, equipment, maintenance, and training, and did univariate and probabilistic sensitivity analyses for UAS lifespans, range, and accident or failures.

FINDINGS:

Under the routine scenario, the per sample transport costs were US$0·65 (95% CI 0·01-2·85) and $0·82 (0·56-5·05) for motorcycles and UAS65, respectively. Per-sample transport costs under the emergency scenario were $24·06 (95% CI 21·14-28·20) for motorcycles, $27·42 (95% CI 19·25-136·75) for an unadjusted UAS model with insufficient geographical coverage, and $34·09 (95% CI 26·70-127·40) for an adjusted UAS model with complementary motorcycles. Motorcycles were more cost-effective than short-range UAS (ie, UAS30). However, with increasing range and operational lifespans, UAS became increasingly more cost-effective.

INTERPRETATION:

Given the current level of technology, purchase prices, equipment lifespans, and operational flying ranges, UAS are not a viable option for routine transport of laboratory samples in west Africa. Field studies are required to generate evidence about UAS lifespan, failure rates, and performance under different weather conditions and payloads.

FUNDING:

None.

Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

PMID: 31839129 DOI: 10.1016/S2214-109X(19)30464-4

Keywords: West Africa; Infectious diseases; Society.

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