Cluster of Coronavirus Disease 2019 (COVID-19) in the French Alps, February 2020

Abstract Background On 7 February 2020, French Health authorities were informed of a confirmed case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an Englishman infected in Singapore who had recently stayed in a chalet in the French Alps. We conducted an investigation to identify secondary cases and interrupt transmission. Methods We defined as a confirmed case a person linked to the chalet with a positive reverse-transcription polymerase chain reaction sample for SARS-CoV-2. Results The index case stayed 4 days in the chalet with 10 English tourists and a family of 5 French residents; SARS-CoV-2 was detected in 5 individuals in France, 6 in England (including the index case), and 1 in Spain (overall attack rate in the chalet: 75%). One pediatric case, with picornavirus and influenza A coinfection, visited 3 different schools while symptomatic. One case was asymptomatic, with similar viral load as that of a symptomatic case. Seven days after the first cases were diagnosed, 1 tertiary case was detected in a symptomatic patient with from the chalet a positive endotracheal aspirate; all previous and concurrent nasopharyngeal specimens were negative. Additionally, 172 contacts were monitored; all contacts tested for SARS-CoV-2 (N = 73) were negative. Conclusions The occurrence in this cluster of 1 asymptomatic case with similar viral load as a symptomatic patient suggests transmission potential of asymptomatic individuals. The fact that an infected child did not transmit the disease despite close interactions within schools suggests potential different transmission dynamics in children. Finally, the dissociation between upper and lower respiratory tract results underscores the need for close monitoring of the clinical evolution of suspected cases of coronavirus disease 2019.

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Histopathological Features of Symptomatic and Asymptomatic Honeybees Naturally Infected by Deformed Wing Virus

Pathogens ◽

10.3390/pathogens10070874 ◽

2021 ◽

Vol 10 (7) ◽

pp. 874

Author(s):

Karen Power ◽

Manuela Martano ◽

Gennaro Altamura ◽

Nadia Piscopo ◽

Paola Maiolino

Keyword(s):

Viral Load ◽

Asymptomatic Group ◽

Deformed Wing Virus ◽

Stage Of Development ◽

Pathogenic Action ◽

Degenerative Alterations ◽

Flight Muscles ◽

Asymptomatic Individuals ◽

Histopathological Results

Deformed wing virus (DWV) is capable of infecting honeybees at every stage of development causing symptomatic and asymptomatic infections. To date, very little is known about the histopathological lesions caused by the virus. Therefore, 40 honeybee samples were randomly collected from a naturally DWV infected hive and subjected to anatomopathological examination to discriminate between symptomatic (29) and asymptomatic (11) honeybees. Subsequently, 15 honeybee samples were frozen at −80° and analyzed by PCR and RTqPCR to determinate the presence/absence of the virus and the relative viral load, while 25 honeybee samples were analyzed by histopathological techniques. Biomolecular results showed a fragment of the expected size (69bp) of DWV in all samples and the viral load was higher in symptomatic honeybees compared to the asymptomatic group. Histopathological results showed degenerative alterations of the hypopharyngeal glands (19/25) and flight muscles (6/25) in symptomatic samples while 4/25 asymptomatic samples showed an inflammatory response in the midgut and the hemocele. Results suggest a possible pathogenic action of DWV in both symptomatic and asymptomatic honeybees, and a role of the immune response in keeping under control the virus in asymptomatic individuals.

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A modified community viral load measure to support the evaluation of transmission potential of HIV in the population: a retrospective cohort study

The Lancet ◽

10.1016/s0140-6736(15)00628-5 ◽

2015 ◽

Vol 386 ◽

pp. S47

Author(s):

Ngai Sze Wong ◽

Owen T Y Tsang ◽

Ka Hing Wong ◽

Man Po Lee ◽

Denise P C Chan ◽

...

Keyword(s):

Cohort Study ◽

Viral Load ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Transmission Potential

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Higher Viral Load and Prolonged Viral Shedding Period is Associated with Impaired Th17 Cell Response in Patients with H1N1 Influenza A

Infection International ◽

10.1515/ii-2017-0021 ◽

2012 ◽

Vol 1 (3) ◽

pp. 137-145

Author(s):

Gui-lin Yang ◽

Ying-xia Liu ◽

Mu-tong Fang ◽

Wei-long Liu ◽

Xin-chun Chen ◽

...

Keyword(s):

T Cells ◽

Viral Load ◽

Cell Response ◽

Th17 Cell ◽

Influenza A ◽

H1n1 Influenza ◽

Cell Frequency ◽

Viral Loads ◽

Viral Shedding ◽

Ifn Γ

Abstract Objective To explore whether age, disease severity, cytokines and lymphocytes in H1N1 influenza A patients correlate with viral load and clearance. Methods Total of 70 mild and 16 severe patients infected with H1N1 influenza A virus were enrolled in this study. Results It was found that the patients under 14 years old and severe patients displayed significantly higher viral loads and prolonged viral shedding periods compared with the patients over 14 years old and mild patients, respectively (P < 0.05). Moreover, the patients under 14 years old and severe patients displayed significantly lower Th17 cell frequency than the patients over 14 years old and mild patients (P < 0.01). The viral shedding period inversely correlated with the frequency of IL-17+IFN-γ-CD4+ T cells. Additionally, the decreased concentration of serum TGF-β correlated with the decreased frequency of IL-17+IFN-γ-CD4+ T cells. Conclusions Both younger and severe patients are associated with higher viral loads and longer viral shedding periods, which may partially be attributed to the impaired Th17 cell response.

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STANDARDIZATION OF A HIGH-PERFORMANCE RT-qPCR FOR VIRAL LOAD ABSOLUTE QUANTIFICATION OF INFLUENZA A

Journal of Virological Methods ◽

10.1016/j.jviromet.2021.114439 ◽

2021 ◽

pp. 114439

Author(s):

L.A. Pereira ◽

B.A. Lapinscki ◽

M.C. Debur ◽

J.S. Santos ◽

R.R. Petterle ◽

...

Keyword(s):

Viral Load ◽

Influenza A ◽

High Performance ◽

Absolute Quantification

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Differential Kinetics of Cycle Threshold Values during Admission by Symptoms among Patients with Mild COVID-19: A Prospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158181 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8181

Author(s):

Teppei Sakano ◽

Mitsuyoshi Urashima ◽

Hiroyuki Takao ◽

Kohei Takeshita ◽

Hiroe Kobashi ◽

...

Keyword(s):

Cohort Study ◽

Viral Load ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Polymerase Chain Reaction Test ◽

Cycle Threshold ◽

Viral Loads ◽

Asymptomatic Patients ◽

Asymptomatic Individuals ◽

Chain Reaction Test

In the coronavirus disease 2019 (COVID-19) pandemic, more than half of the cases of transmission may occur via asymptomatic individuals, which makes it difficult to contain. However, whether viral load in the throat during admission is different between asymptomatic and symptomatic patients is not well known. By conducting a prospective cohort study of patients with asymptomatic or mild COVID-19, cycle threshold (Ct) values of the polymerase chain reaction test for COVID-19 were examined every other day during admission. The Ct values during admission increased more steadily in symptomatic patients and febrile patients than in asymptomatic patients, with significance (p = 0.01 and p = 0.004, respectively), although the Ct values as a whole were not significantly different between the two groups. Moreover, the Ct values as a whole were higher in patients with dysosmia/dysgeusia than in those without it (p = 0.02), whereas they were lower in patients with a headache than those without (p = 0.01). Patients who were IgG-positive at discharge maintained higher Ct values, e.g., more than 35, during admission than those with IgG-negative (p = 0.03). Assuming that viral load and Ct values are negatively associated, the viral loads as a whole and their changes by time may be different by symptoms and immune reaction, i.e., IgG-positive at discharge.

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Evaluation of Influenza Patients Admitted in 2019–2020 Flu Season

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0041-1741003 ◽

2022 ◽

Author(s):

Bahar Öztelcan Gündüz ◽

Erman Ataş ◽

Bülent Ünay ◽

Halit Halil

Keyword(s):

Physical Examination ◽

Chronic Diseases ◽

Influenza A ◽

Influenza Infection ◽

Febrile Seizures ◽

Influenza Viruses ◽

Influenza B ◽

Close Monitoring ◽

Group 2 ◽

Group 1

Abstract Objective Influenza viruses are among the most common respiratory pathogens for all age groups, and may cause seasonal outbreaks. The aim of our study was to describe the clinical characteristics of influenza cases in the 2019–2020 flu season and to study the risk factors for hospital admission and complications. Methods This was a retrospective study in 251 children (group 1: nonhospitalized; group 2: hospitalized) with influenza in the 2019–2020 flu season. Data on demographic features, influenza type, complaints, complications, and hospitalization length were collected and recorded. Results Influenza A was detected in 199 (79.3%) patients, and influenza B was detected in 52 (20.7%); 43.4% of patients were girls and 56.6% were boys. The mean age of the patients was 3.91 ± 3.3 years (16 days to 18 years). A total of 52 (20.7%) patients were hospitalized. The age of the patients in group 2 was lower than that in group 1 (3.1 vs. 4.2 years, p = 0.03). Group 2 patients were more likely to have creatine kinase (CK) elevation, febrile seizures, and physical examination abnormalities. Group 2 patients were also more likely to have influenza A. Patients with febrile seizures, chronic diseases, abnormal physical examination findings, developed complications, and additional drug use apart from oseltamivir in the treatment were also more likely to require hospitalization. Conclusion Infants and children with chronic diseases, history of febrile seizures, complications, and the use of drugs other than antiviral drugs should be carefully evaluated in case they need hospitalization. Increasing vaccination rates, initiation of antiviral treatment for selected patients, and close monitoring of patients in risk groups can decrease morbidity and mortality. Myalgias are a common complaint in patients with acute influenza infection. Previous studies suggest CK measurement be part of the work-up for the hospitalized patient with acute influenza infection.

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Human infection with pandemic Influenza (H1N1): A Review Article

Janapriya Journal of Interdisciplinary Studies ◽

10.3126/jjis.v8i0.27318 ◽

2019 ◽

Vol 8 ◽

pp. 191-199

Author(s):

Ranjita Karmacharya

Keyword(s):

Influenza A ◽

H1n1 Influenza ◽

Human Infection ◽

Transmission Risk ◽

Swine Flu ◽

Scientific Databases ◽

Health Authorities ◽

First Case ◽

Pandemic Influenza H1n1 ◽

Awareness Programs

Swine flu, also known as the H1N1 virus, is new strain of an influenza virus that causes symptoms similar to the regular flu. It originated in pigs, but is spread rapidly from person to person. Therefore, the objectives of this article are to highlight on H1N1 Influenza, its mode of transmission, risk factor, clinical spectrums and preventive ways. Studies published relevant to swine flu was searched through scientific databases like MEDLINE, Pubmed and online search engines like ‘Google Scholar’. Eligible studies involved at least one factor related to ‘influenza A virus’, ‘H1N1 subtype’, ‘epidemiology’, ‘transmission” and ‘preventive measures’ etc. Searches were limited to human only and also looked at the websites of the leading health authorities (e.g. WHO, CDC, HPA). Swine is a new flu virus that appears in human and spreads very quickly from person to person. In Nepal, the first case was detected on June 2009 after that the case is increasing day by day. In 2010 till May there were 172 confirmed positive cases, likewise on August 7, 2017 there were 10 death and 354 positive cases of swine flu in Nepal. Therefore, Government of Nepal has broadcasted awareness programs, organized seminars and meetings, to make people aware regarding H1N1 Influenza. But, it seems challenging to decrease its outbreak in Nepal because of low financial resources, low manpower, limited technology and political instability.

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Viral Kinetics and Resistance Development in Children Treated with Neuraminidase Inhibitors: The Influenza Resistance Information Study (IRIS)

Clinical Infectious Diseases ◽

10.1093/cid/ciz939 ◽

2019 ◽

Vol 71 (5) ◽

pp. 1186-1194 ◽

Cited By ~ 3

Author(s):

Rueshandra Roosenhoff ◽

Vaughan Reed ◽

Andy Kenwright ◽

Martin Schutten ◽

Charles A Boucher ◽

...

Keyword(s):

Viral Load ◽

Influenza A ◽

Antiviral Treatment ◽

Vaccination Status ◽

Viral Clearance ◽

Viral Rna ◽

Baseline Viral Load ◽

Influenza B ◽

Resistance Mutations ◽

Viral Burden

Abstract Background We studied the effect of age, baseline viral load, vaccination status, antiviral therapy, and emergence of drug resistance on viral shedding in children infected with influenza A or B virus. Methods Samples from children (aged ≤13 years) enrolled during the 7 years of the prospective Influenza Resistance Information Study were analyzed using polymerase chain reaction to determine the influenza virus (sub-)type, viral load, and resistance mutations. Disease severity was assessed; clinical symptoms were recorded. The association of age with viral load and viral clearance was examined by determining the area under the curve for viral RNA shedding using logistic regression and Kaplan-Meier analyses. Results A total of 2131 children infected with influenza (683, A/H1N1pdm09; 825, A/H3N2; 623, influenza B) were investigated. Age did not affect the mean baseline viral load. Children aged 1−5 years had prolonged viral RNA shedding (±1–2 days) compared with older children and up to 1.2-fold higher total viral burden. Besides, in older age (odds ratio [OR], 1.08; confidence interval [CI], 1.05–1.12), prior vaccination status (OR, 1.72; CI, 1.22–2.43) and antiviral treatment (OR, 1.74; CI, 1.43–2.12) increased the rate of viral clearance. Resistance mutations were detected in 49 children infected with influenza A virus (34, A/H1N1pdm09; 15, A/H3N2) treated with oseltamivir, most of whom were aged <5 years (n = 39). Conclusions Children aged 1−5 years had a higher total viral burden with prolonged virus shedding and had an increased risk of acquiring resistance mutations following antiviral treatment. Clinical Trials Registration NCT00884117.

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Development of Myocardial Infarction in a 12-Year-Old Female after the Use of Inhaled Salbutamol

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1709151 ◽

2020 ◽

Vol 09 (04) ◽

pp. 295-298

Author(s):

Can Yilmaz Yozgat ◽

Selcuk Uzuner ◽

Hafize Otcu Temur ◽

Serap Nur Ergor ◽

Aynur Guliyeva ◽

...

Keyword(s):

Myocardial Infarction ◽

Myocardial Ischemia ◽

Pediatric Patients ◽

Clinical Manifestations ◽

Symptomatic Patient ◽

Clinical Findings ◽

Close Monitoring ◽

Myocardial Ischemia And Infarction ◽

Sporadic Cases ◽

Tomography Scan

AbstractAnomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) accounts for 0.023% of all cases reported in pediatric patients. According to literature, only a handful of ALCAPA patients are able to reach adulthood. Clinical manifestations of ALCAPA range from fatigue during exercise to sudden death in adulthood. Herein, we described a 12-year-old symptomatic patient with ALCAPA who had severe chest pain after using salbutamol treatment for presumed asthma. ALCAPA is one of the curable versions of myocardial ischemia and infarction in childhood. Due to clinical findings in conjunction with electrocardiogram and echocardiography, a computed tomography scan with coronary angiography was performed and the diagnosis of ALCAPA was confirmed. We presented this case because ALCAPA-related myocardial ischemia and infarction in children are rare with only sporadic cases reported. This case illustrated the need for close monitoring and surgery as the best treatment for ALCAPA associated with myocardial infarction.

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