Detection of Norovirus in Saliva Samples from Acute Gastroenteritis Cases and Asymptomatic Subjects: Association with Age and Higher Shedding in Stool

Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide and across all age groups, with two main genogroups (GI and GII) infecting humans. The aim of our study was to investigate the occurrence of norovirus in saliva samples from individuals involved in outbreaks of acute gastroenteritis in closed and semiclosed institutions, and its relationship with the virus strain, virus shedding in stool, the occurrence of symptoms, age, and the secretor status of the individual. Epidemiological and clinical information was gathered from norovirus outbreaks occurring in Catalonia, Spain during 2017–2018, and stool and saliva samples were collected from affected and exposed resident individuals and workers. A total of 347 saliva specimens from 25 outbreaks were analyzed. Further, 84% of individuals also provided a paired stool sample. For GII infections, norovirus was detected in 17.9% of saliva samples from symptomatic cases and 5.2% of asymptomatic individuals. Positivity in saliva occurred in both secretors and nonsecretors. None of the individuals infected by norovirus GI was positive for the virus in saliva. Saliva positivity did not correlate with any of the studied symptoms but did correlate with age ≥ 65 years old. Individuals who were positive in saliva showed higher levels of virus shedding in stool. Mean viral load in positive saliva was 3.16 ± 1.08 log10 genome copies/mL, and the predominance of encapsidated genomes was confirmed by propidium monoazide (PMA)xx-viability RTqPCR assay. The detection of norovirus in saliva raises the possibility of oral-to-oral norovirus transmission during the symptomatic phase and, although to a lesser extent, even in cases of asymptomatic infections.

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Human Astrovirus Outbreak in a Daycare Center and Propagation among Household Contacts

Viruses ◽

10.3390/v13061100 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1100

Author(s):

Ignacio Parrón ◽

Elsa Plasencia ◽

Thais Cornejo-Sánchez ◽

Mireia Jané ◽

Cristina Pérez ◽

...

Keyword(s):

Acute Gastroenteritis ◽

Age Groups ◽

Rt Pcr ◽

Daycare Center ◽

Infected People ◽

Conditioning Factors ◽

Household Contacts ◽

Human Astrovirus ◽

Asymptomatic Infections ◽

Clinical Cases

We investigated an outbreak of acute gastroenteritis due to human astrovirus in a daycare center, describing the transmission mechanism, the most affected age groups, conditioning factors and the extent of the outbreak among household contacts of the daycare center attenders. Data were collected from persons exposed at the daycare center and their home contacts. Fecal samples from affected and non-affected daycare center attenders were analyzed for viruses causing acute gastroenteritis by RT-PCR. The percentage of households affected and the attack rates (AR) were calculated. The attack rates were compared using the rate ratio (RR) with 95% confidence intervals. Information was obtained from 245 people (76 attenders and 169 contacts) of whom 49 were clinical cases. Five HAstV-4, two HAstV-8 and three non-typable HAstV cases were identified (six from clinical cases and four from asymptomatic infected people). The global AR was 20% (41.2% in children aged < 2 years). Data were obtained from 67 households: 20 households of affected attenders and 47 of non-affected attendees. Household contacts of affected attenders had a higher AR (74.3%) than that of non-affected attendees (2.4%). We found asymptomatic infections amongst daycare attendees. The transmission of HAstV during the outbreak was not limited to the daycare center but extended to household contacts of both affected and non-affected attenders.

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Shedding of norovirus in symptomatic and asymptomatic infections

Epidemiology and Infection ◽

10.1017/s095026881400274x ◽

2014 ◽

Vol 143 (8) ◽

pp. 1710-1717 ◽

Cited By ~ 108

Author(s):

P. F. M. TEUNIS ◽

F. H. A. SUKHRIE ◽

H. VENNEMA ◽

J. BOGERMAN ◽

M. F. C. BEERSMA ◽

...

Keyword(s):

Individual Variation ◽

Time Course ◽

Large Population ◽

Oral Intake ◽

Virus Shedding ◽

Infectious Gastroenteritis ◽

Faecal Samples ◽

Asymptomatic Infections ◽

Asymptomatic Subjects ◽

Crowded Environments

SUMMARYNorovirus is the most frequent cause of acute infectious gastroenteritis and it is difficult to control in crowded environments like hospitals and nursing homes. Transmission depends on oral intake of virus deposited in the environment by infectious subjects. Data from volunteer studies indicate that virus concentrations in stool are highly variable, but systematic studies of the time-course of shedding and its individual variation are lacking. This paper quantifies norovirus shedding in a large population of 102 subjects, including asymptomatic shedders, and uses a longitudinal model to generalize shedding patterns. Enhanced surveillance for studies of transmission of norovirus in hospital outbreaks has yielded a considerable number of faecal samples from symptomatic and asymptomatic shedders, both from patients and staff. Norovirus concentrations were determined by real-time PCR. A quantitative dynamic model was fitted to the shedding data, in a multilevel Bayesian framework, to study the time-course of shedding and its variation. The results indicate that shedding in asymptomatic subjects is similar to that in symptomatic infections, both showing considerable variation in peak levels (average 105−109/g faeces) as well as duration of virus shedding (average 8–60 days). Patients appear to shed higher numbers of virus than staff, for slightly longer durations, but the differences are too small to be significant. Given equal shedding, the greater contribution of symptomatic cases to transmission must be caused by their higher efficiency in spreading these viruses. The results of this study will be helpful for risk studies that need to quantify the deposition of virus in the environment.

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Pervasiveness and Epidemiological Profile of SARS-CoV-2 Infection among the Population of Majha Region of Punjab,India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48749.15000 ◽

2021 ◽

Author(s):

Harsimrat Kaur ◽

Ravinder Singh ◽

Kanwardeep Singh ◽

Savjot Kaur ◽

Mohan Jairath ◽

...

Keyword(s):

Indian Subcontinent ◽

Age Groups ◽

Diagnostic Laboratory ◽

Medical College ◽

First Case ◽

Percent Positivity ◽

Positivity Ratio ◽

Asymptomatic Individuals ◽

Epidemiological Profile ◽

The Individual

Introduction: There are many types of coronaviruses that causes respiratory and intestinal infection in humans. Among these coronaviruses, is a group of Severe Acute Respiratory Syndrome (SARS)-like bat coronavirus, including both SARS-CoV and SARS-Cov-2 that comprise a unique clade under the subgenus Sarbecovirus. The SARS-CoV-2 strains in India are more closely related to bat-CoVRaTG13 (93% homology) than pangolin CoV (83.5% homology). India reported its first case of Coronavirus Disease 19 (COVID-19) on January 30, 2020. Punjab, a state in northwestern India comprises of 22 districts which are classified into three major distinct regions viz. Majha, Malwa and Doaba. Four districts of Majha region of Indian state of Punjab are Amritsar, Tarn Taran, Gurdaspur and Pathankot. Aim: The present study describes the SARS-CoV-2 epidemiology based on samples tested for this virus; received at Viral Research and Diagnostic Laboratory (VRDL), Government Medical College, Amritsar-Punjab, India. Materials and Methods: This epidemiological study was designed taking into consideration three main factors i.e. the gender, the age groups and the factor whether the individual has any symptoms or not. To study their context of applicability and its interpretation, a total of 3,47,418 samples from period of 01st April 2020 to 31st October 2020 were included in this study. Ribonucleic Acid amplification by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) of SARS-CoV-2 from nasopharyngeal/oropharyngeal swabs of all individuals revealed confirmation of 17,920 positive samples. Total 2,29,310 males and 1,18,108 females were tested for the COVID-19 infection. Social science statistics online tool (https://www.socscistatistics.com/tests/) was used for χ2 test to analyse different parameters. Results: Maximum number of COVID-19 positive patients was detected in 21 to 30 years age group (p<0.05). Highest positivity ratio of samples was observed in individuals exceeding the age of 50 years. Number of asymptomatic individuals was found to be quite higher than symptomatic individuals in total population. Overall percent positivity of asymptomatic individuals was 4.81% (p<0.00001), which accounts to 4.71% of total number of tested individuals in this study. Conclusion: COVID-19 is an evolving disease and data from this study elucidates the epidemiological profile of the SARS-CoV-2 infection among population of Majha region of Punjab state of Indian subcontinent.

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Validity of the Gender Dysphoria diagnosis and incidence trends in Sweden: a nationwide register study

Scientific Reports ◽

10.1038/s41598-021-95421-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Malin Indremo ◽

Richard White ◽

Thomas Frisell ◽

Sven Cnattingius ◽

Alkistis Skalkidou ◽

...

Keyword(s):

Gender Dysphoria ◽

Age Groups ◽

Medical Intervention ◽

Future Research ◽

Advantages And Disadvantages ◽

Incidence Trends ◽

Interaction Terms ◽

Definition Of ◽

The Individual ◽

Nationwide Register Study

AbstractThe aim of this study was to examine the validity of the Gender Dysphoria (GD) diagnoses in the Swedish National Patient Register (NPR), to discuss different register-based definitions of GD and to investigate incidence trends. We collected data on all individuals with registered GD diagnoses between 2001 and 2016 as well as data on the coverage in the NPR. We regarded gender confirming medical intervention (GCMI) as one proxy for a clinically valid diagnosis and calculated the positive predictive value (PPV) for receiving GCMI for increasing number of registered GD diagnoses. We assessed crude and coverage-adjusted time trends of GD during 2004–2015 with a Poisson regression, using assigned sex and age as interaction terms. The PPV for receiving GCMI was 68% for ≥ 1 and 79% for ≥ 4 GD-diagnoses. The incidence of GD was on average 35% higher with the definition of ≥ 1 compared to the definition of ≥ 4 diagnoses. The incidence of GD, defined as ≥ 4 diagnoses increased significantly during the study period and mostly in the age categories 10–17 and 18–30 years, even after adjusting for register coverage. We concluded that the validity of a single ICD code denoting clinical GD in the Swedish NPR can be questioned. For future research, we propose to carefully weight the advantages and disadvantages of different register-based definitions according to the individual study’s needs, the time periods involved and the age-groups under study.

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The trends of complementary alternative medicine use among cancer patients

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03338-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abdul Rahman Jazieh ◽

Khadega A. Abuelgasim ◽

Husam I. Ardah ◽

Mohammad Alkaiyat ◽

Omar B. Da’ar

Keyword(s):

Alternative Medicine ◽

Cancer Patients ◽

Clinical Information ◽

Cross Sectional Study ◽

Complementary Alternative Medicine ◽

Cultural Changes ◽

Cross Sectional ◽

Patients With Cancer ◽

Cam Use ◽

The Individual

Abstract Background The use of complementary and alternative medicine (CAM) is common among cancer patients and it may reflect the individual and societal beliefs on cancer therapy. Our study aimed to evaluate the trends of CAM use among patients with cancer between 2006 and 2018. Methods We included 2 Cohorts of patients with cancer who were recruited for Cohort 1 between 2006 and 2008 and for Cohort 2 between 2016 and 2018. The study is a cross-sectional study obtaining demographic and clinical information and inquiring about the types of CAM used, the reasons to use them and the perceived benefits. We compared the changes in the patterns of CAM use and other variables between the two cohorts. Results A total of 1416 patients were included in the study, with 464 patients in Cohort 1 and 952 patients in Cohort 2. Patients in Cohort 2 used less CAM (78.9%) than Cohort 1 (96.8%). Cohort 1 was more likely to use CAM to treat cancer compared to Cohort 2 (84.4% vs. 73%, respectively, p < 0.0001,); while Cohort 2 used CAM for symptom management such as pain control and improving appetite among others. Disclosure of CAM use did not change significantly over time and remains low (31.6% in Cohort 1 and 35.7% for Cohort 2). However, physicians were more likely to express an opposing opinion against CAM use in Cohort 2 compared to Cohort 1 (48.7% vs. 19.1%, p < 0.001, respectively). Conclusion There is a significant change in CAM use among cancer patients over the decade, which reflects major societal and cultural changes in this population. Further studies and interventions are needed to improve the disclosure to physicians and to improve other aspects of care to these patients.

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Zika RNA and Flavivirus-Like Antigens in the Sperm Cells of Symptomatic and Asymptomatic Subjects

Viruses ◽

10.3390/v13020152 ◽

2021 ◽

Vol 13 (2) ◽

pp. 152

Author(s):

Hernan Vanegas ◽

Fredman González ◽

Yaoska Reyes ◽

Edwing Centeno ◽

Jayrintzina Palacios ◽

...

Keyword(s):

Clinical Symptoms ◽

Time Frame ◽

Sperm Cells ◽

Human Semen ◽

Zikv Infection ◽

Virus Shedding ◽

One Year ◽

Asymptomatic Subjects ◽

A Prospective Study ◽

Male Subjects

Zika virus (ZIKV) RNA has been found to remain in human semen for up to one year after infection, but the presence of Flavivirus antigens in the different compartments of semen has been largely unexplored. Following the introduction of ZIKV in Nicaragua (2016), a prospective study of patients with clinical symptoms consistent with ZIKV was conducted in León to investigate virus shedding in different fluids. ZIKV infection was confirmed in 16 male subjects (≥18 years of age) by RT-qPCR in either blood, saliva or urine. Of these, three provided semen samples at 7, 14, 21, 28, 60 and 180 days postsymptom onset (DPSO) for Flavivirus antigens and RNA studies. These cases were compared with 19 asymptomatic controls. Flavivirus antigens were examined by immunofluorescence (IF) using the 4G2 Mabs, and confocal microscopy was used to explore fluorescence patterns. The three (100%) symptomatic subjects and 3 (16%) of the 19 asymptomatic subjects had Flavivirus antigens and viral RNA in the spermatozoa fraction. The percentage of IF Flavivirus-positive spermatozoa cells ranged from 1.9% to 25% in specimens from symptomatic subjects, as compared with 0.8% to 3.8% in specimens from asymptomatic controls. A marked IF-pattern in the cytoplasmic droplets and tail of the spermatozoa was observed. The sperm concentrations (45 × 106/mL vs. 63.5 × 106/mL, p = 0.041) and the total motility percentage (54% vs. 75%, p = 0.009) were significantly lower in specimens from ZIKV-positive than in those of ZIKV-negative. In conclusion, this study demonstrated the presence of Flavivirus antigens and RNA within a time frame of 28 DPSO in sperm cells of symptomatic and asymptomatic subjects during the ZIKV epidemic. These findings have implications for public health, in terms of nonarthropod-born, silent transmission facilitated by sperm cells and potential transmission from asymptomatic males to pregnant women, with consequences to the fetus.

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Distribution and titres of rotavirus antibodies in different age groups

Journal of Hygiene ◽

10.1017/s0022172400053201 ◽

1977 ◽

Vol 79 (3) ◽

pp. 365-372 ◽

Cited By ~ 32

Author(s):

M. M. Elias

Keyword(s):

Indirect Immunofluorescence ◽

Acute Gastroenteritis ◽

Neutralizing Antibodies ◽

Complement Fixation ◽

Age Groups ◽

Newborn Infants ◽

Older Age ◽

Human Rotavirus ◽

Hospital Patients

SUMMARYThree hundred and fifty-seven sera selected at random from hospital patients of all ages were examined for rotavirus antibodies using indirect immunofluorescence (FA) and complement fixation tests (CFT). Three hundred and fourteen of these were also tested for neutralizing antibodies to human rotavirus. Sera from patients admitted with a diagnosis of acute gastroenteritis were excluded from this survey.FA antibodies were found in newborn infants but fell to undetectable titres at 3 months. The highest titres were found in children between the ages of one and three years. In older age groups, the modal titre fell gradually with increasing age until, in sera from those above 70 years of age, FA antibodies were almost undetectable. The same pattern was observed with neutralizing antibodies. A high modal titre of CF antibodies was only found in sera from those aged one to three years.

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Evaluation of the sensitivity of faecal sampling for detection of monophasic Salmonella Typhimurium and other Salmonella in cattle and pigs

Epidemiology and Infection ◽

10.1017/s0950268814002453 ◽

2014 ◽

Vol 143 (8) ◽

pp. 1681-1691 ◽

Cited By ~ 3

Author(s):

M. E. ARNOLD ◽

R. J. GOSLING ◽

F. MARTELLI ◽

D. MUELLER-DOBLIES ◽

R. H. DAVIES

Keyword(s):

Faecal Sample ◽

Management Practices ◽

Age Groups ◽

Farm Animals ◽

Infection Prevalence ◽

Sample Type ◽

Sample Data ◽

Using Data ◽

The Individual ◽

Positive Groups

SUMMARYThere has been a rapid rise in the prevalence of cases of monophasic Salmonella Typhimurium (mST) in both humans and farm animals, and it has been found in pigs, cattle and poultry. It is therefore vital to have a good understanding of how to efficiently detect infected farms. The objective of this project was to determine sample type sensitivity in the detection of Salmonella to detect infected groups of animals on both pig (breeder, grower and finisher sites) and cattle (beef and dairy) farms, using data collected from a study investigating farms that were positive for mST, and to explore any variation between different age groups and management practices. A Bayesian approach in the absence of a gold standard was adopted to analyse the individual and pooled faecal sample data collected from each epidemiological group on each of the farms. The sensitivity of pooled sampling depended on the prevalence of infection in the group being sampled, with a higher prevalence leading to higher sensitivity. Pooled sampling was found to be more efficient at detecting positive groups of animals than individual sampling, with the probability of a random sample from a group of animals with 5% prevalence testing positive being equal to 15·5% for immature pigs (3·6% for an individual faecal sample, taking into account the sensitivity and infection prevalence), 7·1% for adult pigs (1·2% for individual sampling), 30% for outdoor cattle (2% for individual sampling) and 34% for indoor cattle (1% for individual sampling). The mean prevalence of each epidemiological group was higher in outdoor farms than indoor for both pigs and cattle (mean within-farm prevalence of 29·4% and 38·7% for outdoor pigs and cattle, respectively, compared to 19·8% and 22·1% for indoor pigs and cattle)

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Molecular epidemiology of norovirus from patients with acute gastroenteritis in northwestern Spain

Epidemiology and Infection ◽

10.1017/s0950268814000740 ◽

2014 ◽

Vol 143 (2) ◽

pp. 316-324 ◽

Cited By ~ 7

Author(s):

C. F. MANSO ◽

J. L. ROMALDE

Keyword(s):

Phylogenetic Analysis ◽

Molecular Epidemiology ◽

Genetic Drift ◽

Acute Gastroenteritis ◽

Age Groups ◽

Capsid Gene ◽

High Prevalence ◽

High Incidence ◽

Northwestern Spain

SUMMARYThe high incidence of norovirus (NoV) infections seems to be related to the emergence of new variants that evolved by genetic drift of the capsid gene. In this work, that represents a first effort to describe the molecular epidemiology of NoV in the northwest of Spain, a total of eight different NoV genotypes (GII.1, GII.3, GII.4, GII.6, GII.7, GII.12, GII.13, GII.14) were detected. The major genotypes observed were GII.4 (45·42%) and GII.14 (34·9%), being detected in all age groups. In addition, and although most of GII.4 sequences belonged to 2006b (7·2%) and 2010 (50·35%) variants, the presence of new NoV variants was observed. Phylogenetic analysis revealed that a high number of GII.4 sequences (35·24%) could be assigned to the newly emerging Sydney 2012 variant, even during late 2010. The high prevalence of NoV GII.14 observed in this study may indicate the emergence of this genotype in Spain.

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Inequality in active ageing: evidence from a new individual-level index for European countries

Ageing and Society ◽

10.1017/s0144686x17001052 ◽

2017 ◽

Vol 39 (3) ◽

pp. 541-567 ◽

Cited By ~ 8

Author(s):

MIKKEL BARSLUND ◽

MARTEN VON WERDER ◽

ASGHAR ZAIDI

Keyword(s):

Age Groups ◽

Positive Association ◽

European Countries ◽

Active Ageing ◽

Unequal Distribution ◽

Individual Level ◽

Country Level ◽

Challenges And Opportunities ◽

Share Data ◽

The Individual

ABSTRACTIn the context of emerging challenges and opportunities associated with population ageing, the study of inequality in active-ageing outcomes is critical to the design of appropriate and effective social policies. While there is much discussion about active ageing at the aggregate country level, little is known about inequality in active-ageing experiences within countries. Based on the existing literature on active ageing, this paper proposes an individual-level composite active ageing index based on Survey of Health, Ageing and Retirement in Europe (SHARE) data. The individual-level nature of the index allows us to analyse inequality in experiences of active ageing within selected European countries. One important motivation behind measuring active ageing at the individual level is that it allows for a better understanding of unequal experiences of ageing, which may otherwise be masked in aggregate-level measures of active ageing. Results show large differences in the distribution of individual-level active ageing across the 13 European countries covered and across age groups. Furthermore, there is a positive association between the country-level active ageing index and the equality of its distribution within a country. Hence, countries with the lowest average active ageing index tend to have the most unequal distribution in active-ageing experiences. For nine European countries, where temporal data are also available, we find that inequality in active-ageing outcomes decreased in the period 2004 to 2013.

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