scholarly journals Human Coronavirus-HKU1 Infection Among Adults in Cleveland, Ohio

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Anubhav Kanwar ◽  
Suresh Selvaraju ◽  
Frank Esper
Keyword(s):  
Respiratory Tract ◽  
Influenza A ◽  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
The United States ◽  
Supplemental Oxygen ◽  
Respiratory Pathogen ◽  
Disease Spectrum

Abstract Background Human coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness. Coronavirus-HKU1 has been described predominantly among children less than 5 years of age in the United States with few studies characterizing the disease spectrum among adults. Methods Nasopharyngeal specimens of patients with respiratory symptoms were analyzed for CoV-HKU1 by NxTAG Respiratory Pathogen Panel multiplex assay from February 7, 2016 to April 30, 2016. Epidemiologic, clinical, and laboratory data were collected on adults (patients >18 years) whose samples screened positive. Results Of 832 adult respiratory specimens screened, 13 (1.6%) cases of CoV-HKU1 were identified. Adults age ranged between 23 and 75 years and 6 (46%) were males. All of whom had 1 or more respiratory symptoms, and 5 (38%) also reported 1 or more gastrointestinal symptoms. Eleven (85%) reported history of smoking and 5 (38%) used inhaled steroids. Seven (54%) required hospitalization, 5 (71%) of these needed supplemental oxygen, and 2 (29%) were admitted to intensive care. Median length of hospitalization was 5 days. Eight (62%) received antibiotics despite identification of CoV-HKU1. Infectious work-up in 1 patient who died did not reveal any other pathogen. In 2 (15%) CoV-HKU1-positive adults, the only viral coinfection detected was influenza A. Conclusions Coronavirus-HKU1 accounted for 1.6% of adult respiratory infections and should be considered in differential diagnosis of severe respiratory illnesses among adults.

scholarly journals Human Coronavirus (HCoV) Infection Among Adults in Cleveland, Ohio: An Increasingly Recognized Respiratory Pathogen

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S312-S312 ◽  
Author(s):  
Anubhav Kanwar ◽  
Suresh Selvaraju ◽  
Frank Esper
Keyword(s):  
Respiratory Tract ◽  
Clinical Characteristics ◽  
Gastrointestinal Symptoms ◽  
Respiratory Illness ◽  
The United States ◽  
Respiratory Pathogen ◽  
Presenting Symptoms ◽  
Respiratory Tract Illness ◽  
Coronavirus Infection ◽  
Cleveland Ohio

Abstract Background Human Coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness, yet there are few recent studies characterizing disease among adults in the United States. Here, we describe CoV infections and clinical characteristics among adults (>18 years) presenting with respiratory illness in Cleveland, Ohio. Methods Between February 1, 2016 and April 30, 2017, 2949 nasopharyngeal swab specimens were analyzed by NxTAG Respiratory Pathogen Panel in adults presenting with respiratory illness at MetroHealth Medical Center. Clinical data were collected on adults whose samples screened positive for CoV-HKU1, CoV-OC43, CoV-229E or CoV-NL63. Results Coronaviruses were detected in 192 (6.5%) adults including 105 (3.5%) OC43, 67 (2.3%) 229E, 13 (0.4%) HKU1 and 7 (0.2%) NL63. The majority of adults with coronavirus infection were females (66.2%) with a median age of 53 years. Common comorbidities included smoking (40.0%), asthma (38.0%), COPD (35.4%), and inhaled corticosteroid use (28.6%). Eighty-five (46.4%) required admission to the hospital. Common presenting symptoms included shortness of breath (42.7%) and cough (31.0%) whereas fever was uncommon (12.5%). Gastrointestinal symptoms were more common in HKU1 and NL63 infected adults. Seventy-three percent of coronavirus disease occurred between the months of January and March. Despite the recognition of coronavirus infection, 70 (36.5%) received antibiotics for their disease. Conclusion This study provides needed insight into clinical characteristics and severity associated with coronavirus infection in adults. Coronavirus infection should be considered in differential diagnosis of respiratory tract illness in adults including those that require hospitalization, have a history of smoking and have pulmonary comorbidities. Disclosures All authors: No reported disclosures.

Comparison of symptoms of influenza A with abacavir-associated hypersensitivity reaction

2003 ◽  
Vol 14 (7) ◽  
pp. 478-481 ◽  
Author(s):  
Philip Keiser ◽  
Naiel Nassar ◽  
Daniel Skiest ◽  
Charla Andrews ◽  
Beena Yazdani ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Hypersensitivity Reaction ◽  
Odds Ratio ◽  
Influenza A ◽  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Gastrointestinal Symptoms ◽  
Gi Symptoms ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

Differentiation between abacavir hypersensitivity and viral respiratory infections is problematic. Fifteen cases of abacavir hypersensitivity were matched to 30 controls with culture proven influenza A with no abacavir exposure. Rash was associated with hypersensitivity (odds ratio [OR] = 13.1, P = 0.02) as was the presence of nausea (OR = 30, P < 0.001), vomiting (OR = 17.1, P = 0.001) or diarrhoea (OR = 22, P < 0.001). The number of gastrointestinal symptoms was also predictive of hypersensitivity reaction ( P < 0.001). Respiratory symptoms (cough, sore throat, or dyspnoea) were not associated with abacavir hypersensitivity (OR = 0.08, P = 0.001). Multivariate analysis confirmed the following associations for abacavir hypersensitivity: the number of gastrointestinal symptoms (OR = 8.6, P = 0.0032), cough (OR = 0.039, P = 0.02) and rash (OR = 16.9, P = 0.07). Abacavir hypersensitivity is strongly associated with gastrointestinal (GI) symptoms. Cough without GI symptoms is associated with influenza.

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

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 163-165 ◽  
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.

Bacterial Infections of the Adult Upper Respiratory Tract

2019 ◽  
Author(s):  
Laura K Certain ◽  
Miriam B Barshak
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Group A Streptococcus ◽  
The United States ◽  
Controlled Study ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Upper respiratory tract infections are the most common maladies experienced by humankind.1 The majority are caused by respiratory viruses. A Dutch case-controlled study of primary care patients with acute respiratory tract infections found that viruses accounted for 58% of cases; rhinovirus was the most common (24%), followed by influenza virus type A (11%) and corona­viruses (7%). Group A streptococcus (GAS) was responsible for 11%, and 3% of patients had mixed infections. Potential pathogens were detected in 30% of control patients who were free of acute respiratory symptoms; rhinovirus was the most common.2 Given the increasing problem of antibiotic resistance and the increasing awareness of the importance of a healthy microbiome, antibiotic use for upper respiratory infections should be reserved for those patients with clear indications for treatment. A recent study of adult outpatient visits in the United States found that respiratory complaints accounted for 150 antibiotic prescriptions per 1,000 population annually, yet the expected “appropriate” rate would be 45.3 In other words, most antibiotic prescriptions for these complaints are unnecessary. Similarly, a study in the United Kingdom found that general practitioners prescribed antibiotics to about half of all patients presenting with an upper respiratory infection, even though most of these infections are viral.4 This review contains 5 figures, 16 tables, and 82 references. Keywords: infection, airway, sinusitis, otitis media, otitis externa, pharyngitis, epiglottitis, abscess

scholarly journals Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S360-S360
Author(s):  
Ryan Maves ◽  
Derek Larson ◽  
Michael Dempsey ◽  
Benjamin Connors ◽  
James Baldwin ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Influenza A ◽  
Respiratory Infections ◽  
Salt Lake ◽  
The United States ◽  
Cold Chain ◽  
Medical Laboratory ◽  
Influenza A Viruses ◽  
Laboratory Staff ◽  
Viral Respiratory

Abstract Background Viral respiratory infections are a significant threat to deployed military units. Pathogen-based surveillance may be hampered by limitations in trained personnel in theater, difficulty with specimen shipment, and technical issues with equipment maintenance. In this project, we evaluated the performance of the FilmArray respiratory panel at military clinics in Afghanistan and compare results to testing performed in the United States. Methods Participants were recruited after presenting at military clinics at Bagram Airfield (BAF), Afghanistan, in 2013–2014 with fever (≥38° C) and respiratory symptoms (cough, dyspnea, chest pain, and/or sore throat). General medical laboratory staff at BAF were trained to operate the FilmArray; nasopharyngeal swabs were obtained and tested in-theater using the FilmArray respiratory panel (Biofire Diagnostics, Salt Lake City, UT). Samples were then shipped to the USAFSAM Applied Technology Center in 50% RNALater (Qiagen, Valencia, CA) without dry ice and then retested using the same panel. Selected influenza isolates then underwent sequencing to evaluate for potential novel circulating strains. Results 29 specimens underwent testing. A virus was identified on FilmArray in 22/29 specimens at BAF and 24/29 specimens at USAFSAM, of whom 17/29 had influenza A. Positive results between BAF and USAFSAM were concordant in all cases; 2 of the negative results at BAF were identified as having influenza A and rhinovirus, respectively. Among those with influenza A, all but one had undergone seasonal influenza vaccination. 5 influenza isolates then underwent sequencing; 2 were A(H1N1pdm09) consistent with the predominant 2012–2013 strain, while 3 were A(H3N2) viruses with HA mutations that differed from those in the 2013–2014 vaccine strain. No resistance-associated neuraminidase mutations were identified. Conclusion Surveillance using the FilmArray system is effective and feasible in theater by general laboratory staff. H1N1 and H3N2 influenza A viruses predominated in this sample of acute respiratory infections in a deployed military setting despite high vaccination rates. The use of the RNALater preservative is an effective method for specimen transport without requiring a cold chain and may facilitate biosurveillance in remote settings. Disclosures All authors: No reported disclosures.

scholarly journals Prevalence of gastroenteritis among 4-year-old children in South Australia

2003 ◽  
Vol 130 (3) ◽  
pp. 443-451 ◽  
Author(s):  
J. S. HEYWORTH ◽  
P. BAGHURST ◽  
K. A. McCAUL
Keyword(s):  
Risk Factors ◽  
Respiratory Symptoms ◽  
School Health ◽  
Respiratory Infections ◽  
Gastrointestinal Symptoms ◽  
South Australia ◽  
Antibiotic Use ◽  
Medical Attention ◽  
Cross Sectional Survey ◽  
Cross Sectional

The aim of this study was to determine the prevalence of gastroenteritis among children aged 4 years in South Australia. A cross-sectional survey of 9543 South Australian children aged 4 years was undertaken. Parents completed a questionnaire on behalf of their child who had attended a pre-school health check in 1998. The questionnaire covered gastrointestinal and respiratory symptoms experienced by the child in the previous 2 weeks and other risk factors for gastroenteritis. The 2-week prevalence of gastroenteritis among 4-year-old children was 14·2%. The major risk factors for gastroenteritis were presence of persons who had gastroenteritis inside the home, contact with persons who had gastroenteritis outside the home, antibiotic use and sore throat. Medical attention was sought for 20% of children who had gastroenteritis. Gastroenteritis is a significant cause of morbidity among young children and presents a considerable burden on the community. A substantial proportion of these occurrences of highly credible gastrointestinal symptoms may be manifestations of respiratory infections.

scholarly journals The prevalence of enteroviruses that cause respiratory infections in patients with influenzavirus A/H1N1 hospitalized in the Lublin province

2014 ◽  
Vol 27 (3) ◽  
pp. 199-201
Author(s):  
Adrian Jarzynski ◽  
Agata Dubas ◽  
Malgorzata Polz-Dacewicz
Keyword(s):  
Respiratory Tract ◽  
Influenza A ◽  
Respiratory Tract Infections ◽  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Genetic Material ◽  
Respiratory Viruses ◽  
Influenza A H1n1 ◽  
Tract Infections ◽  
Viral Respiratory

ABSTRACT Viruses that cause respiratory tract infections are the most common agents of infectious diseases in humans throughout the world. A virus that infects the respiratory system, may induce various clinical symptoms. What is more, the same symptoms may be caused by different viruses. The aim of the study was to analyze the prevalence of enteroviruses that cause respiratory infections in patients with influenzavirus A/H1N1 hospitalized in the Lublin province. The experimental material was throat and nose swabs taken from patients hospitalized in Lublin and Tomaszow Lubelski. In the group of 44 patients (20 women and 24 men) infected with influenza A/H1N1, the genetic material of enteroviruses was detected in 13 patients (29.5%). Respiratory viruses co-infections are very common in hospitalized patients. Studies show that co-infection with influenza virus and enterovirus are more common in children than in adults. Moreover, viral respiratory tract infections are independent from the patients’ gender.

scholarly journals National and Regional Assessment of Antimicrobial Resistance among Community-Acquired Respiratory Tract Pathogens Identified in a 2005-2006 U.S. Faropenem Surveillance Study

2007 ◽  
Vol 51 (12) ◽  
pp. 4382-4389 ◽  
Author(s):  
Ian A. Critchley ◽  
Steven D. Brown ◽  
Maria M. Traczewski ◽  
Glenn S. Tillotson ◽  
Nebojsa Janjic
Keyword(s):  
United States ◽  
Respiratory Tract ◽  
Respiratory Infections ◽  
Empirical Therapy ◽  
The United States ◽  
Respiratory Pathogens ◽  
Study Objective ◽  
Tract Infections ◽  
Resistance Rates

ABSTRACT Surveillance studies conducted in the United States over the last decade have revealed increasing resistance among community-acquired respiratory pathogens, especially Streptococcus pneumoniae, that may limit future options for empirical therapy. The objective of this study was to assess the scope and magnitude of the problem at the national and regional levels during the 2005-2006 respiratory season (the season when community-acquired respiratory pathogens are prevalent) in the United States. Also, since faropenem is an oral penem being developed for the treatment of community-acquired respiratory tract infections, another study objective was to provide baseline data to benchmark changes in the susceptibility of U.S. respiratory pathogens to the drug in the future. The in vitro activities of faropenem and other agents were determined against 1,543 S. pneumoniae isolates, 978 Haemophilus influenzae isolates, and 489 Moraxella catarrhalis isolates collected from 104 U.S. laboratories across six geographic regions during the 2005-2006 respiratory season. Among S. pneumoniae isolates, the rates of resistance to penicillin, amoxicillin-clavulanate, and cefdinir were 16, 6.4, and 19.2%, respectively. The least effective agents were trimethoprim-sulfamethoxazole (SXT) and azithromycin, with resistance rates of 23.5 and 34%, respectively. Penicillin resistance rates for S. pneumoniae varied by region (from 8.7 to 22.5%), as did multidrug resistance rates for S. pneumoniae (from 8.8 to 24.9%). Resistance to β-lactams, azithromycin, and SXT was higher among S. pneumoniae isolates from children than those from adults. β-Lactamase production rates among H. influenzae and M. catarrhalis isolates were 27.4 and 91.6%, respectively. Faropenem MICs at which 90% of isolates are inhibited were 0.5 μg/ml for S. pneumoniae, 1 μg/ml for H. influenzae, and 0.5 μg/ml for M. catarrhalis, suggesting that faropenem shows promise as a treatment option for respiratory infections caused by contemporary resistant phenotypes.

scholarly journals Ozonated Air Therapy for the Treatment of Upper and Lower Respiratory Tract Infections as a Potential Therapy for Prevention and Treatment of Covid 19 Infection

2020 ◽  
pp. 39-45
Author(s):  
Sagar A. Jawale
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Influenza A ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Inhalation Therapy ◽  
Lower Respiratory Tract Infections ◽  
Influenza A H1n1 ◽  
Novel Coronavirus ◽  
Tract Infections

Introduction: In India and worldwide, there are millions of cases of acute respiratory infections annually killing hundreds of thousand people. It also has billions of dollars of losses worldwide. There are frequent outbreaks of deadly infections such as severe acute respiratory syndrome (SARS) in 2003, caused by a novel coronavirus (SARS-CoV), the novel swine-origin influenza A (H1N1) virus in Mexico in March 2009, Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 and the current pandemic with Novel CoronaVirus -Covid19. I did my research to find a common effective, safe, and cheap therapynamed as Ozonated air inhalation therapy (OAIT) for respiratory infections. Materials and methods: In the last one year, I treated 21 patients (group A) with upper and lower respiratory tract infections (URTI and LRTI) with 0.1 ppm Ozonated air inhalation therapy (OAIT). OAIT was given as a monotherapy. In the same time period, 36 patients (group B) were given conventional treatment in the form of antibiotics, anti-histaminic and analgesics kept as control.

scholarly journals Pathogenesis and Transmission of Genetically Diverse Swine-Origin H3N2 Variant Influenza A Viruses from Multiple Lineages Isolated in the United States, 2011–2016

2018 ◽  
Vol 92 (16) ◽  
Author(s):  
Xiangjie Sun ◽  
Joanna A. Pulit-Penaloza ◽  
Jessica A. Belser ◽  
Claudia Pappas ◽  
Melissa B. Pearce ◽  
...  
Keyword(s):  
United States ◽  
Respiratory Tract ◽  
Influenza A ◽  
Seasonal Influenza ◽  
The United States ◽  
Influenza Viruses ◽  
Upper Respiratory Tract ◽  
Pandemic Preparedness

ABSTRACTWhile several swine-origin influenza A H3N2 variant (H3N2v) viruses isolated from humans prior to 2011 have been previously characterized for their virulence and transmissibility in ferrets, the recent genetic and antigenic divergence of H3N2v viruses warrants an updated assessment of their pandemic potential. Here, four contemporary H3N2v viruses isolated during 2011 to 2016 were evaluated for their replicative ability in bothin vitroandin vivoin mammalian models as well as their transmissibility among ferrets. We found that all four H3N2v viruses possessed similar or enhanced replication capacities in a human bronchial epithelium cell line (Calu-3) compared to a human seasonal influenza virus, suggestive of strong fitness in human respiratory tract cells. The majority of H3N2v viruses examined in our study were mildly virulent in mice and capable of replicating in mouse lungs with different degrees of efficiency. In ferrets, all four H3N2v viruses caused moderate morbidity and exhibited comparable titers in the upper respiratory tract, but only 2 of the 4 viruses replicated in the lower respiratory tract in this model. Furthermore, despite efficient transmission among cohoused ferrets, recently isolated H3N2v viruses displayed considerable variance in their ability to transmit by respiratory droplets. The lack of a full understanding of the molecular correlates of virulence and transmission underscores the need for close genotypic and phenotypic monitoring of H3N2v viruses and the importance of continued surveillance to improve pandemic preparedness.IMPORTANCESwine-origin influenza viruses of the H3N2 subtype, with the hemagglutinin (HA) and neuraminidase (NA) derived from historic human seasonal influenza viruses, continue to cross species barriers and cause human infections, posing an indelible threat to public health. To help us better understand the potential risk associated with swine-origin H3N2v viruses that emerged in the United States during the 2011-2016 influenza seasons, we use bothin vitroandin vivomodels to characterize the abilities of these viruses to replicate, cause disease, and transmit in mammalian hosts. The efficient respiratory droplet transmission exhibited by some of the H3N2v viruses in the ferret model combined with the existing evidence of low immunity against such viruses in young children and older adults highlight their pandemic potential. Extensive surveillance and risk assessment of H3N2v viruses should continue to be an essential component of our pandemic preparedness strategy.

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