scholarly journals A rhesus macaque (Macaca mulatta) model of aerosol-exposure brucellosis (Brucella suis): pathology and diagnostic implications

2010 ◽  
Vol 59 (6) ◽  
pp. 724-730 ◽  
Author(s):  
Samuel L. Yingst ◽  
Louis M. Huzella ◽  
Lara Chuvala ◽  
Mark Wolcott
Keyword(s):  
Rhesus Macaques ◽  
Clinical Signs ◽  
Dna Amplification ◽  
Diagnostic Algorithm ◽  
Human Brucellosis ◽  
Aerosol Exposure ◽  
The Us ◽  
Brucella Suis ◽  
Control And Prevention ◽  
Aerosol Infection

The US Centers for Disease Control and Prevention lists Brucella as a potential bioterrorism threat requiring enhanced diagnostic capacity and surveillance (http://emergency.cdc.gov/bioterrorism/). Successful treatment and management of patients after exposure to biological threat agents depends on accurate and timely diagnosis, but many biothreat agents present with similar, vague clinical signs – commonly referred to as ‘flu-like illness’. Diagnosis of brucellosis is notoriously challenging, especially early in infection, and definitive diagnosis may require invasive methods, e.g. bone marrow biopsy. We studied the pathogenesis of Brucella suis aerosol infection in rhesus macaques in an effort to guide the diagnostic algorithm in case of possible intentional exposure of humans. Rhesus proved to be an excellent model for human brucellosis; the data showed that PCR DNA amplification testing of non-invasive diagnostic samples has the potential to definitively detect a point-source outbreak immediately and for several days after exposure.

scholarly journals Inhalational Botulism in Rhesus Macaques Exposed to Botulinum Neurotoxin Complex Serotypes A1 and B1

2010 ◽  
Vol 17 (9) ◽  
pp. 1293-1304 ◽  
Author(s):  
Daniel C. Sanford ◽  
Roy E. Barnewall ◽  
Michelle L. Vassar ◽  
Nancy Niemuth ◽  
Karen Metcalfe ◽  
...  
Keyword(s):  
Disease Progression ◽  
Dose Response ◽  
Botulinum Neurotoxin ◽  
Rhesus Macaques ◽  
Clinical Chemistry ◽  
Clinical Signs ◽  
Exposure Level ◽  
Clinical Observations ◽  
Aerosol Exposure ◽  
Serotype B

ABSTRACT A recombinant botulinum vaccine (rBV A/B) is being developed for protection against inhalational intoxication with botulinum neurotoxin (BoNT) complex serotype A, subtype A1 (BoNT/A1), and BoNT serotype B, subtype B1 (BoNT/B1). A critical component for evaluating rBV A/B efficacy will be the use of animal models in which the pathophysiology and dose-response relationships following aerosol exposure to well-characterized BoNT are thoroughly understood and documented. This study was designed to estimate inhaled 50% lethal doses (LD50) and to estimate 50% lethal exposure concentrations relative to time (LCt50) in rhesus macaques exposed to well-characterized BoNT/A1 and BoNT/B1. During the course of this study, clinical observations, body weights, clinical hematology results, clinical chemistry results, circulating neurotoxin levels, and telemetric parameters were documented to aid in the understanding of disease progression. The inhaled LD50 and LCt50 for BoNT/A1 and BoNT/B1 in rhesus macaques were determined using well-characterized challenge material. Clinical observations were consistent with the recognized pattern of botulism disease progression. A dose response was demonstrated with regard to the onset of these clinical signs for both BoNT/A1 and BoNT/B1. Dose-related changes in physiologic parameters measured by telemetry were also observed. In contrast, notable changes in body weight, hematology, and clinical chemistry parameters were not observed. Circulating levels of BoNT/B1 were detected in animals exposed to the highest levels of BoNT/B1; however, BoNT/A1 was not detected in the circulation at any aerosol exposure level. The rhesus macaque aerosol challenge model will be used for future evaluations of rBV A/B efficacy against inhalational BoNT/A1 and BoNT/B1 intoxication.

scholarly journals Natural History of Inhalation Melioidosis in Rhesus Macaques (Macaca mulatta) and African Green Monkeys (Chlorocebus aethiops)

2012 ◽  
Vol 80 (9) ◽  
pp. 3332-3340 ◽  
Author(s):  
John J. Yeager ◽  
Paul Facemire ◽  
Paul A. Dabisch ◽  
Camenzind G. Robinson ◽  
David Nyakiti ◽  
...  
Keyword(s):  
Rhesus Macaques ◽  
Clinical Signs ◽  
Necrosis Factor Alpha ◽  
Content Type ◽  
Chlorocebus Aethiops ◽  
Tnf Α ◽  
Control And Prevention ◽  
History Of ◽  
Medical Countermeasures ◽  
Green Monkeys

ABSTRACTBurkholderia pseudomallei, the causative agent of melioidosis, is recognized as a serious health threat due to its involvement in septic and pulmonary infections in areas of endemicity and is recognized by the Centers for Disease Control and Prevention as a category B biothreat agent. An animal model is desirable to evaluate the pathogenesis of melioidosis and medical countermeasures. A model system that represents human melioidosis infections is essential in this process. A group of 10 rhesus macaques (RMs) and 10 African green monkeys (AGMs) was exposed to aerosolizedB. pseudomallei1026b. The first clinical signs were fever developing 24 to 40 h postexposure followed by leukocytosis resulting from a high percentage of neutrophils. Dyspnea manifested 2 to 4 days postexposure. In the AGMs, an increase in interleukin 1β (IL-1β), IL-6, IL-8, gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α) was observed. In the RMs, IL-1β, IL-6, and TNF-α increased. All the RMs and AGMs had various degrees of bronchopneumonia, with inflammation consisting of numerous neutrophils and a moderate number of macrophages. Both the RMs and the AGMs appear to develop a melioidosis infection that closely resembles that seen in acute human melioidosis. However, for an evaluation of medical countermeasures, AGMs appear to be a more appropriate model.

scholarly journals West Nile Virus Seroprevalence in an Outdoor Nonhuman Primate Breeding Colony in South Florida

2021 ◽  
Author(s):  
Stara N Robertson ◽  
Angus I Cameron ◽  
Pablo R Morales ◽  
Wesley M Burnside
Keyword(s):  
West Nile Virus ◽  
Rhesus Macaques ◽  
Clinical Signs ◽  
South Florida ◽  
Subtropical Climate ◽  
West Nile ◽  
Hamadryas Baboons ◽  
Vector Borne Diseases ◽  
Control And Prevention ◽  
Experimental Use

West Nile virus (WNV) was first detected in Florida in July 2001, with 404 human cases reported to the Centers for Disease Control and Prevention as of February 2020. The subtropical climate of Florida is ideal for the mosquitoes that transmit WNV. We investigated the WNV seroprevalence in 3 NHP species housed outdoors at The Mannheimer Foundation in South Florida. From January to December 2016, 520 3 to 30 y old NHP were sampled at our 2 closed sites in Homestead and LaBelle:200 rhesus macaques (Macaca mulatta), 212 cynomolgus macaques (Macaca fascicularis), and 108 hamadryas baboons (Papiohamadryas hamadryas). The presence of WNV IgG antibodies in these animals was determined by serum neutralizationassays, which found a total seroprevalence of 14%. Seroprevalence was significantly higher in the baboons (29%) than the rhesus (11%) and cynomolgus (9%) macaques. The probability of seropositivity significantly increased with age, but sex and site did not significantly affect seroprevalence. The frequency of WNV seropositivity detected in these outdoor-housed NHP suggests that screening for WNV and other vector-borne diseases may be necessary prior to experimental use, particularlyfor infectious disease studies in which viremia or viral antibodies could confound results, and especially for populations housed outdoors in warm, wet climates. As no seropositive subjects demonstrated clinical signs of WNV and WNV exposure did not appear to significantly impact colony health, routine testing is likely unnecessary for most NHP colonies. However,WNV infection should still be considered as a differential diagnosis for any NHP presenting with nonspecific neurologic signs. Mosquito abatement plans and vigilant sanitation practices to further decrease mosquito and avian interaction withresearch NHP should also be considered.

Pathological findings and diagnostic implications of a rhesus macaque (Macaca mulatta) model of aerosol-exposure melioidosis (Burkholderia pseudomallei)

2014 ◽  
Vol 63 (1) ◽  
pp. 118-128 ◽  
Author(s):  
Samuel L. Yingst ◽  
Paul Facemire ◽  
Lara Chuvala ◽  
David Norwood ◽  
Mark Wolcott ◽  
...  
Keyword(s):  
Rhesus Macaque ◽  
Burkholderia Pseudomallei ◽  
Rhesus Macaques ◽  
Severe Pneumonia ◽  
Diagnostic Algorithm ◽  
Diagnostic Methods ◽  
Pcr Analysis ◽  
Non Invasive ◽  
Aerosol Exposure ◽  
Bronchial Lymph Node

Aerosolized Burkholderia pseudomallei, the causative agent of melioidosis, can infect many species of mammals (including humans), causing rapid, severe pneumonia with high mortality. Diagnosis in humans is challenging, as few organisms can be detected in blood or other non-invasive samples. Although it cannot be said that the model is established, studies to date indicate that rhesus macaques may represent a good model of human melioidosis. This is supported by the results of this study. The early progression of meliodosis in the rhesus macaque was studied in an effort to better understand the disease and the application of rapid diagnostic methods. Results indicate that a PCR analysis of key diagnostic samples such as nasal swabs, throat swabs, tracheo bronchial lymph node aspirates and broncho-alveolar lavage may be a useful component of a rapid diagnostic algorithm in case of aerosol exposure.

scholarly journals Stethoscope hygiene: A call to action. Recommendations to update the CDC guidelines

2021 ◽  
pp. 1-3
Author(s):  
Sarathi Kalra ◽  
Alpesh Amin ◽  
Nancy Albert ◽  
Cindy Cadwell ◽  
Cole Edmonson ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Acoustic Properties ◽  
Patient Encounter ◽  
Call To Action ◽  
The Us ◽  
Cdc Guidelines ◽  
Control And Prevention ◽  
Healthcare Acquired Infections ◽  
Current Guidance ◽  
Tremendous Challenge

Abstract Healthcare-acquired infections are a tremendous challenge to the US medical system. Stethoscopes touch many patients, but current guidance from the Centers for Disease Control and Prevention does not support disinfection between each patient. Stethoscopes are rarely disinfected between patients by healthcare providers. When cultured, even after disinfection, stethoscopes have high rates of pathogen contamination, identical to that of unwashed hands. The consequence of these practices may bode poorly in the coronavirus 2019 disease (COVID-19) pandemic. Alternatively, the CDC recommends the use of disposable stethoscopes. However, these instruments have poor acoustic properties, and misdiagnoses have been documented. They may also serve as pathogen vectors among staff sharing them. Disposable aseptic stethoscope diaphragm barriers can provide increased safety without sacrificing stethoscope function. We recommend that the CDC consider the research regarding stethoscope hygiene and effective solutions to contemporize this guidance and elevate stethoscope hygiene to that of the hands, by requiring stethoscope disinfection or change of disposable barrier between every patient encounter.

scholarly journals Covid-19 Preparedness and Response Capability: A Case Study of the Hanoi Primary Healthcare System

2021 ◽  
Vol 14 ◽  
pp. 117863292110192
Author(s):  
Minh Van Hoang ◽  
Anh Tuan Tran ◽  
Trang Thu Vu ◽  
Tuan Kim Duong
Keyword(s):  
Public Information ◽  
Enabling Factors ◽  
Cross Sectional ◽  
Emergency Operations ◽  
The Us ◽  
Local Stakeholders ◽  
Control And Prevention ◽  
Issue Public ◽  
Analytical Frameworks

This study examined the coronavirus disease 2019 (COVID-19) preparedness and response of the health system (HS) in Hanoi, Vietnam, and identified enabling factors and barriers. This cross-sectional, mixed-methods study was conducted in 4 urban and peri-urban districts that included some wards with COVID-19-positive cases and some without. The US Centers for Disease Control and Prevention (CDC) analytical frameworks were used. Overall, 10% of health facilities (HFs) failed to fully implement COVID-19 risk determination; 8.8% failed to fully implement stronger community partnerships with local stakeholders to support public health (PH) preparedness; 35% and 2.5% incompletely implemented and did not implement evaluation of PH emergency operations, respectively; 10% did not identify communication channels to issue public information, alerts, warnings, and notifications; 25% incompletely implemented identification, development of guidance, and standards for information; 72.5% had good preventive and treatment collaboration; and 10% did not fully implement procedures for laboratory testing and reporting results. Enablers included sufficient infrastructure and equipment, strong leadership, and good cross-public-sector collaboration with police and military forces. Barriers included workforce constraints, overburdened and inconsistent reporting systems, inappropriate financial mechanisms, ambiguous health governance, and lack of private-sector engagement. Nonetheless, the HS preparedness and response were satisfactory, although further coordinated efforts in evaluation, coordination, communication, and volunteering remain necessary.

Mycobacterium chimaera infections among cardiothoracic surgery patients associated with heater-cooler devices—Kansas and California, 2019

2021 ◽  
pp. 1-6
Author(s):  
Kerui Xu ◽  
Lauren E. Finn ◽  
Robert L. Geist ◽  
Christopher Prestel ◽  
Heather Moulton-Meissner ◽  
...  
Keyword(s):  
Operating Room ◽  
Environmental Samples ◽  
Chart Review ◽  
Whole Genome ◽  
Environmental Isolates ◽  
Outbreak Strain ◽  
Medical Chart Review ◽  
The Us ◽  
Control And Prevention ◽  
Cleaning And Disinfection

Abstract Background: In 2015, an international outbreak of Mycobacterium chimaera infections among patients undergoing cardiothoracic surgeries was associated with exposure to contaminated LivaNova 3T heater-cooler devices (HCDs). From June 2017 to October 2020, the Centers for Disease Control and Prevention was notified of 18 patients with M. chimaera infections who had undergone cardiothoracic surgeries at 2 hospitals in Kansas (14 patients) and California (4 patients); 17 had exposure to 3T HCDs. Whole-genome sequencing of the clinical and environmental isolates matched the global outbreak strain identified in 2015. Methods: Investigations were conducted at each hospital to determine the cause of ongoing infections. Investigative methods included query of microbiologic records to identify additional cases, medical chart review, observations of operating room setup, HCD use and maintenance practices, and collection of HCD and environmental samples. Results: Onsite observations identified deviations in the positioning and maintenance of the 3T HCDs from the US Food and Drug Administration (FDA) recommendations and the manufacturer’s updated cleaning and disinfection protocols. Additionally, most 3T HCDs had not undergone the recommended vacuum and sealing upgrades by the manufacturer to decrease the dispersal of M. chimaera–containing aerosols into the operating room, despite hospital requests to the manufacturer. Conclusions: These findings highlight the need for continued awareness of the risk of M. chimaera infections associated with 3T HCDs, even if the devices are newly manufactured. Hospitals should maintain vigilance in adhering to FDA recommendations and the manufacturer’s protocols and in identifying patients with potential M. chimaera infections with exposure to these devices.

Some skin conditions in pigs: types, control and prevention

Livestock ◽  
2021 ◽  
Vol 26 (6) ◽  
pp. 300-308
Author(s):  
John Carr ◽  
Mark Howells ◽  
William Hersey
Keyword(s):  
Treatment Plan ◽  
Clinical Signs ◽  
African Swine Fever ◽  
Skin Lesions ◽  
Veterinary Surgeons ◽  
Careful Clinical Examination ◽  
Welfare Problem ◽  
Control And Prevention ◽  
Veterinary Surgeon ◽  
Skin Conditions

Skin conditions in pigs are common problems presented to the veterinary surgeon. A careful clinical examination, especially considering the age of the pig and the distribution of the lesions, all aids making an accurate diagnosis and treatment plan. Pain management is essential in clinical management. Sarcoptic mange is a condition that can be eliminated from pigs and should be considered a welfare problem. Ear necrosis and trauma injuries can be particularly problematic and must be treated aggressively. African swine fever (ASF) presents with a range of clinical signs including skin lesions, and all veterinary surgeons must be able to put ASF as a differential where appropriate.

Should Blood Lead Screening Recommendations Be Revised?

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 201-204
Author(s):  
Birt Harvey
Keyword(s):  
Universal Screening ◽  
Human Services ◽  
Blood Lead ◽  
Consensus Conference ◽  
National Institutes Of Health ◽  
Department Of Health ◽  
Area Of Interest ◽  
The Us ◽  
Control And Prevention ◽  
Blood Lead Screening

In October 1991, the Centers for Disease Control and Prevention (CDC) recommended blood lead (BPb) screening for virtually all 1-year-old children and, preferably, for all 2-year-old children as well.1 In April 1993, the US Department of Health and Human Services distributed guidelines recommending that all newborns, regardless of race or ethnicity, be screened for sickle cell anemia.2 In June 1993, the National Institutes of Health issued a consensus conference recommendation that all infants be tested for hearing impairment within the first 3 months of life, preferably before newborns leave the hospital.3 In each instance, these screening recommendations were developed because a group of experts, after identifying a child health problem within its area of interest, believed that universal screening was indicated.

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