Clinical and Molecular Epidemiology of Human Rhinovirus C in Children and Adults in Hong Kong Reveals a Possible Distinct Human Rhinovirus C Subgroup

Abstract BackgroundA novel human rhinovirus (HRV) species, HRV-C, was recently discovered, but its clinical features and epidemiology, compared with HRV-A and HRV-B, remains poorly understood, especially in adults MethodsOne thousand two hundred nasopharyngeal aspirate samples obtained from hospitalized children and adults during a 1-year period were subject to reverse-transcriptase polymerase chain reaction to detect HRV. The clinical and molecular epidemiology of the 3 HRV species was analyzed ResultsHRVs were detected in 178 (29.7%) of 600 nasopharyngeal aspirate samples from children and 42 (7%) of 600 nasopharyngeal aspirate samples from adults. HRV-A was most prevalent (n=111), followed by HRV-C (n=91) and HRV-B (n=18). Although upper respiratory tract infection was the most common presentation in children, 8 (62%) of the 13 adults with HRV-C infection had pneumonia, compared with 6 (27%) of the 22 adults with HRV-A infection (P<.05). Wheezing episodes were also more common among individuals with HRV-C (37%) and HRV-A (20%) infection than among those with HRV-B (0%) infection (P<.05). Clinical and molecular data analysis revealed HRV-C as a frequent cause of community and institutionalized outbreaks. A diverse set of HRV-C genotypes was circulating throughout the year, among which a potential distinct subgroup of strains was observed ConclusionHRV-C is associated with pneumonia in adults and outbreaks of respiratory infections requiring hospitalization. A potential novel HRV-C subgroup was identified

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Is it enough for COVID-19 screening test? Limitation of swab test and general characteristics of mild symptom patients

Science Progress ◽

10.1177/00368504211026152 ◽

2021 ◽

Vol 104 (2) ◽

pp. 003685042110261

Author(s):

Sungwoo Choi ◽

Hyo Jeong Choi ◽

Ho Jung Kim

Keyword(s):

Screening Test ◽

Community Treatment ◽

Upper Respiratory Tract ◽

Test Results ◽

Rt Pcr ◽

Pcr Assay ◽

Positive Rate ◽

Upper Respiratory ◽

Polymerase Chain ◽

Discharge Criteria

The most common method for SARS-CoV-2 testing is throat or nasal swabbing by real-time reverse transcription polymerase chain reaction (RT-PCR) assay. In South Korea, drive-through swab test is used for screening system and community treatment centers (CTCs), which admit and treat confirmed COVID-19 patients with mild symptoms, are being used. This retrospective study was conducted on patients admitted to a CTC on March 6, 2020. A total of 313 patients were admitted. The nasal and throat swabs were collected from the upper respiratory tract, and a sputum test was performed to obtain lower respiratory samples. The positive rate of the first set of test, sputum test was higher than that of the swab test ( p = 0.011). In the second set of test, 1 week after the first ones, the rate of positive swab tests was relatively high ( p = 0.026). In the first set of test, 66 of 152 (43.4%) patients showed 24-h consecutive negative swab test results, when the sputum test results were considered together, that number fell to 29 patients (19.1%) ( p < 0.001). Also, in the second set of test, 63 of 164 (38.4%) patients met the discharge criteria only when the swab test was considered; that number fell to 30 (18.3%) when the sputum test results were also considered ( p < 0.001). Using the swab test alone is insufficient for screening test and discharge decision. Patients who may have positive result in the sputum test can be missed.

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Anosmia as a Screening Tool for COVID-19 Infection: A Prospective Cohort Study

Dubai Medical Journal ◽

10.1159/000517483 ◽

2021 ◽

pp. 1-6

Author(s):

Esra AlHamadani ◽

Sania Zia ◽

Ali AlRahma ◽

Firas AlNajjar

Keyword(s):

Odds Ratio ◽

Screening Tool ◽

Index Finger ◽

Upper Respiratory Tract ◽

Chain Reaction ◽

The Public ◽

Single Center Study ◽

Upper Respiratory ◽

Polymerase Chain ◽

Low Sensitivity

Objectives: Several studies promoted anosmia as a possible isolated symptom for coronavirus disease 2019 (COVID-19). No studies used feasible methods of smell testing that the public would use to address the accuracy of these claims. Methods: This is a single-center study conducted between April 2020 and June 2020. The sense of smell was tested in vitally stable suspected COVID-19 patients with no/mild upper respiratory tract infection symptoms prior to nasopharyngeal swabbing for reverse-transcriptase polymerase chain reaction. Patients were instructed to close their eyes. Each nostril was tested separately while the other was blocked with the patient’s index finger. Patients inhaled from 2 concealed vials (coffee and strawberry essence) consecutively, kept within 30 cm of the nostril for 60 s. Patients who could not identify both odors with both nostrils were recorded as “anosmia.” Results: Out of 346 eligible subjects, 43 had anosmia of which 26 (60%) tested COVID-19 positive. χ2 test showed a p value <0.001. The test showed a sensitivity of 30% (95% confidence interval [CI] 21%, 41%) and specificity 94% (95% CI 90%, 96%). Logistic regression revealed an odds ratio of 5.9 (95% CI 3.0, 12) p value <0.001. Conclusion: Given the low sensitivity (30%) of this method in detecting COVID-19 infection, we conclude that this method is not a useful screening tool for COVID-19 infection. The moderate negative predictive value (80%) is nongeneralizable.

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Viral etiology and epidemiology of pediatric patients hospitalized for acute respiratory tract infections in Macao: a retrospective study from 2014 to 2017

BMC Infectious Diseases ◽

10.1186/s12879-021-05996-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Cheng Lei ◽

Lisong Yang ◽

Cheong Tat Lou ◽

Fan Yang ◽

Kin Ian SiTou ◽

...

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Pediatric Patients ◽

Respiratory Infections ◽

Upper Respiratory Tract ◽

Viral Etiology ◽

Upper Respiratory ◽

Syncytial Virus ◽

Tract Infections

Abstract Background Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. Methods A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. Results Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. Conclusions This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.

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Principles of Judicious Use of Antimicrobial Agents for Pediatric Upper Respiratory Tract Infections

PEDIATRICS ◽

10.1542/peds.101.s1.163 ◽

1998 ◽

Vol 101 (Supplement_1) ◽

pp. 163-165 ◽

Cited By ~ 11

Author(s):

Scott F. Dowell ◽

S. Michael Marcy ◽

William R. Phillips ◽

Michael A. Gerber ◽

Benjamin Schwartz

Keyword(s):

Respiratory Tract ◽

Antimicrobial Agents ◽

Respiratory Infections ◽

The United States ◽

Antimicrobial Treatment ◽

Antimicrobial Use ◽

Upper Respiratory Tract ◽

Oral Agents ◽

Upper Respiratory ◽

Tract Infections

This article introduces a set of principles to define judicious antimicrobial use for five conditions that account for the majority of outpatient antimicrobial use in the United States. Data from the National Center for Health Statistics indicate that in recent years, approximately three fourths of all outpatient antibiotics have been prescribed for otitis media, sinusitis, bronchitis, pharyngitis, or nonspecific upper respiratory tract infection.1Antimicrobial drug use rates are highest for children1; therefore, the pediatric age group represents the focus for the present guidelines. The evidence-based principles presented here are focused on situations in which antimicrobial therapy could be curtailed without compromising patient care. They are not formulated as comprehensive management strategies. For most upper respiratory infections that require antimicrobial treatment, there are several appropriate oral agents from which to choose. Although the general principles of selecting narrow-spectrum agents with the fewest side effects and lowest cost are important, the principles that follow include few specific antibiotic selection recommendations.

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Prescription Surveillance and Polymerase Chain Reaction Testing to Identify Pathogens during Outbreaks of Infection

BioMed Research International ◽

10.1155/2013/746053 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Hiroaki Sugiura ◽

Tsuguto Fujimoto ◽

Tamie Sugawara ◽

Nozomu Hanaoka ◽

Masami Konagaya ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Syndromic Surveillance ◽

Respiratory Infections ◽

Emerging Infectious Diseases ◽

Upper Respiratory Tract ◽

Chain Reaction ◽

Specific Pathogen ◽

Polymerase Chain ◽

Syncytial Virus ◽

Tract Infections

Syndromic surveillance, including prescription surveillance, offers a rapid method for the early detection of agents of bioterrorism and emerging infectious diseases. However, it has the disadvantage of not considering definitive diagnoses. Here, we attempted to definitively diagnose pathogens using polymerase chain reaction (PCR) immediately after the prescription surveillance system detected an outbreak. Specimens were collected from 50 patients with respiratory infections. PCR was used to identify the pathogens, which included 14 types of common respiratory viruses andMycoplasma pneumoniae. Infectious agents includingM. pneumoniae, respiratory syncytial virus (RSV), rhinovirus, enterovirus, and parainfluenza virus were detected in 54% of patients. For the rapid RSV diagnosis kit, sensitivity was 80% and specificity was 85%. For the rapid adenovirus diagnosis kit, no positive results were obtained; therefore, sensitivity could not be calculated and specificity was 100%. Many patients were found to be treated for upper respiratory tract infections without the diagnosis of a specific pathogen. In Japan, an outbreak ofM. pneumoniaeinfection began in 2011, and our results suggested that this outbreak may have included false-positive cases. By combining syndromic surveillance and PCR, we were able to rapidly and accurately identify causative pathogens during a recent respiratory infection outbreak.

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Medical Consultations After Typhoon Haiyan in a Field Hospital in the Philippines

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2019.99 ◽

2019 ◽

Vol 14 (1) ◽

pp. 34-38

Author(s):

Julita Gil Cuesta ◽

Joris Adriaan Frank van Loenhout ◽

Maria Lourdes de Lara Banquesio ◽

Masniza Mustaffa ◽

Debarati Guha-Sapir

Keyword(s):

Respiratory Tract Infections ◽

Respiratory Infections ◽

District Hospital ◽

The Philippines ◽

Upper Respiratory Tract ◽

Field Hospital ◽

Adult Men ◽

Medical Consultations ◽

Upper Respiratory ◽

Tract Infections

ABSTRACTIntroduction and Objectives:Typhoon Haiyan partially destroyed the Ormoc District Hospital in the Philippines. A field hospital was established to replace its outpatient department for 5 weeks. We investigated the reasons for medical consultation in the field hospital.Methods:We described the consultations by sex, age, week, and diagnosis according to the Surveillance in Post-Extreme Emergencies and Disasters system. We compared the number and proportion of upper respiratory tract infections (URTIs) with a control season in 2014.Results:We included 6785 consultations, 55.9% from women. The majority of consultations were communicable diseases (88.2%) followed by noncommunicable (7.1%) and injuries (5.6%). Males suffered more often from injuries than women (66.0% vs 34.0%). Consultations due to injuries decreased from 10.0% in the first to 2.9% in the last week. The most frequent diagnosis over the study period was acute respiratory infections (ARIs) (73.1%), of which 83.0% were children. The number of daily URTIs was higher than in a similar 2014 period.Conclusions:ARI was the most prevalent diagnosis. We recommend ARI treatments being fully accessible after such a disaster. During the first week, injury prevention should focus on adult men. Studies after natural disasters should include control periods to better understand disease distribution, ultimately improving the prioritization in disasters.

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An outbreak of SARS-CoV-2 with high mortality in mink (Neovison vison) on multiple Utah farms

10.1101/2021.06.09.447754 ◽

2021 ◽

Author(s):

Chrissy Eckstrand ◽

Tom Baldwin ◽

Mia Kim Torchetti ◽

Mary Lea Killian ◽

Kerry A Rood ◽

...

Keyword(s):

Respiratory Tract ◽

Clinical Signs ◽

Viral Transmission ◽

Viral Rna ◽

Upper Respiratory Tract ◽

Tracheobronchial Lymph Node ◽

Multiple Organs ◽

Upper Respiratory ◽

Polymerase Chain

The breadth of animal hosts that are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may serve as reservoirs for continued viral transmission are not known entirely. In August 2020, an outbreak of SARS-CoV-2 occurred in multiple mink farms in Utah and was associated with high mink mortality and rapid viral transmission between animals. The outbreak's epidemiology, pathology, molecular characterization, and tissue distribution of virus within infected mink is provided. Infection of mink was likely by reverse zoonosis. Once established, infection spread rapidly between independently housed animals and farms, and caused severe respiratory disease and death. Clinical signs were most notably sudden death, anorexia, and increased respiratory effort. Gross pathology examination revealed severe pulmonary congestion and edema. Microscopically there was pulmonary edema with moderate vasculitis, perivasculitis, and fibrinous interstitial pneumonia. Reverse transcriptase polymerase chain reaction (RT-PCR) of tissues collected at necropsy demonstrated the presence of SARS-CoV-2 viral RNA in multiple organs including nasal turbinates, lung, tracheobronchial lymph node, epithelial surfaces, and others. Whole genome sequencing from multiple mink was consistent with published SARS-CoV-2 genomes with few polymorphisms. The Utah mink SARS-CoV-2 strain fell into Clade GH, which is unique among mink and other animal strains sequenced to date and did not share other spike RBD mutations Y453F and F486L found in mink. Localization of viral RNA by in situ hybridization revealed a more localized infection, particularly of the upper respiratory tract. Mink in the outbreak reported herein had high levels of virus in the upper respiratory tract associated with mink-to-mink transmission in a confined housing environment and were particularly susceptible to disease and death due to SARS-CoV-2 infection.

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Human Rhinovirus Molecular Epidemiology and Genotyping in Iranian Military Trainees with Acute Respiratory Symptoms

Journal of Archives in Military Medicine ◽

10.5812/jamm.111224 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

Fahimeh Safarnezhad Tameshkel ◽

Ali Salimi Jeda ◽

Ahmad Tavakoli ◽

Mohammad Hadi Karbalaie Niya ◽

Morteza Izadi ◽

...

Keyword(s):

Molecular Epidemiology ◽

Clinical Symptoms ◽

Respiratory Infections ◽

Direct Sequencing ◽

Human Rhinovirus ◽

P Value ◽

Rt Pcr ◽

Respiratory Problems ◽

Pcr Products ◽

Tract Infections

Background: Human rhinovirus (HRV) is still the most prevalent viral infection in humans and a significant cause of acute respiratory tract infections (ARTIs) in many communities, including military personnel undergoing basic training. Objectives: In this research, we assessed the molecular epidemiology, genotyping, and phylogenetic classification of HRVs in Iranian military trainees with respiratory infections (RI). Methods: For HRV identification and genotyping, respiratory specimens were obtained, and RT-PCR was conducted for genotyping and phylogenetic analysis of HRV utilizing primers for the 5-UTR region. Results: Among 400 Iranian military trainees (average age of 21 ± 4 years, the range of 18 - 57 years) with respiratory infections, HRV was detected in 29 patients (7%) using RT-PCR. The direct sequencing of PCR products from 10 specimens showed that the incidence of type A (n = 5, 50%) was higher than that of type B (n = 4, 40%) and type C (n = 1, 10%). There were no significant associations between HRV and respiratory and clinical symptoms, blood group, and indoor or outdoor conditions (P-value > 0.05). Conclusions: This research was the first to record HRV as a significant cause of respiratory problems among military trainees in Iran, with a frequency of 7%. The most prevalent genotype was HRV-A, which may be applicable in epidemiological and clinical studies, as well as vaccination plans.

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Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19

10.2310/nephro.1422 ◽

2020 ◽

Author(s):

Michael G. Ison

Keyword(s):

Middle East ◽

Middle East Respiratory Syndrome ◽

World Health ◽

Upper Respiratory Tract ◽

Viral Pathogens ◽

Control And Prevention ◽

The Common ◽

Upper Respiratory ◽

Polymerase Chain ◽

Health Organization

Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review. This review contains 12 tables, 3 figure and 48 references. Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction

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Diseases Due to Chlamydiaceae

10.2310/im.1136 ◽

2013 ◽

Author(s):

Walter E Stamm

Keyword(s):

Sexually Transmitted Diseases ◽

Respiratory Infections ◽

Close Contact ◽

Mammalian Species ◽

Perinatal Transmission ◽

Upper Respiratory Tract ◽

Sexually Transmitted ◽

Obligate Intracellular ◽

Upper Respiratory ◽

Obligate Intracellular Bacteria

The Chlamydiaceae are obligate intracellular bacteria that produce a wide variety of infections in many mammalian and avian species. Three species belonging to two genera of Chlamydiaceae infect humans: Chlamydia trachomatis, Chlamydophila psittaci, and Chlamydophila pneumoniae. C. trachomatis is exclusively a human pathogen and is transmitted from person to person via sexual contact, perinatal transmission, or close contact in households. C. psittaci, in contrast, is more widely distributed in nature, producing genital, conjunctival, intestinal, or respiratory infections in many avian and mammalian species. C. pneumoniae is a fastidious organism that produces upper respiratory tract infection and pneumonitis in both children and adults. This chapter details the epidemiology, pathogenesis, diagnosis, and treatment of chlamydial diseases. Sexually transmitted diseases, perinatal infections, adult inclusion conjunctivitis, trachoma, and psittacosis are covered. The chapter also includes tables outlining comparative features of the three species and treatment of sexually transmitted diseases caused by C. trachomatis, as well as a figure illustrating the life cycle of Chlamydiaceae. This review contains 1 highly rendered figure, 2 tables, and 87 references.

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