Respiratory Syncytial Virus (RSV) Diseases

The respiratory syncytial virus (RSV) is an RNA virus that causes annual ARI outbreaks during winter with mild URTI in the general population, but with severe LRTI particularly among young children (bronchiolitis), patients with underlying diseases and people >65 years of age. RSV does not induce a long-lasting protective immunity and repeated infections throughout life are the norm. Basically, all children have been infected by 2 years of age and of those hospitalized, >50% are <3 months and 75% are <6 months of age. The overall CFR is 1/500. For adults ≥65 years, RSV hospitalization rates are 90–250/105. There is no specific therapy, general preventive measures include general hygiene and isolation/separation of patients. A monoclonal anti-F-protein antibody is available for passive immunization of selected high-risk children. It requires monthly injections, comes at a high cost and has limited efficacy (50% against RSV hospitalization). Active immunization failed in the past, probably as the post-fusion conformation of the F-protein was used. Long-acting monoclonal antibodies (for infants) as well as stabilized pre-fusion F-protein vaccines (for immunization of pregnant women, children, older adults) produced on various platforms are in late stages of clinical development.

Natural Patterns and Magnetic and Mental Processes of Coronavirus Activation and Neutralization

For twenty years, humanity has seen the third attempt at the transition of coronavirus to humans. The vaccine has been found, but coronavirus transitions will not stop even with the improvement of medicine. Nobel laureate in medicine Professor Luc Montagnier argues that vaccines may not live up to humanity's hopes of getting rid of COVID-19. Collective immunity for coronavirus has not been developed, repeated infections are more and more common, beds of seriously ill people are not empty, and mortality is running high, no one knows what will happen to all of us. In Israel, where vaccination has long been compulsory, and over 60% of the population, including underage children, have been vaccinated, the incidence is not just declining, but still breaking all records. So, the maximum number of cases here was revealed on September 1 - 16,629, which almost caught up with Russia (18,368 confirmed on the same September 1) with our percentage of vaccinated 26.1% of the number of citizens. At the end of September 2021, morbidity and mortality increase, because it is a system. Based on existing monthly pneumonia mortality statistics over the past 15 years, there are three waves each year. Since September 22, there has been a surge of pneumonia, ARI, and even non-communicable diseases. The second wave comes at the end of December - January, it is usually three times larger than the first. Then around March-April there is a third wave. These three waves exist steadily from year to year, their amplitudes can change, then one will be higher, then the other, they are not absolutely hard on schedule, but they are reproduced regularly in other countries. The first wave of the Spanish pandemic covered the world just at the end of September 1918. The coronavirus was the same. The first wave in America is September 2019, an unexplained surge of pneumonia with a rather high mortality rate, which was written off for smoking e-cigarettes and called "vape." Now they decided to watch the surviving tests of patients, and there - COVID-19. In Europe, it was the same.

Niemann-pick disease: Type A presenting as a case of protein energy malnutrition

We hereby report a rare case of a young child with Niemann-Pick disease who had multiple hospital admissions due to repeated gastrointestinal and respiratory tract infections. The disease is overall quite rare in our population however, our case highlights the fact that in any young child with repeated infections of unknown etiology, this condition should be considered and evaluated.

Th1/Th17 T cell Tissue-Resident Immunity Increases Protection, But Is Not Required in a Vaccine Strategy Against Genital Infection With Chlamydia trachomatis

The requirement for vaccine-induced tissue-resident immunity for protection against one or repeated infections with Chlamydia trachomatis (C.t.) is still not fully resolved. In this study, our aim was to investigate to which degree tissue-resident Th1/Th17 T cells in the genital tract (GT) could add to the protection mediated by circulating immunity. Out of several mucosal vaccine strategies, a strategy termed SIM (for simultaneous intrauterine and parenteral immunization with CAF01 adjuvanted CTH522), was superior in generating genital tract tissue-resident Th1/Th17 T cell immunity. This led to a faster and stronger local CD4 T cell response post infection, consisting of multifunctional IFNγ/TNFα-producing Th1 T cells and IFNγ/TNFα/IL-17-producing Th17 T cells, and a faster recruitment of innate immune cells. Post infection, SIM animals showed an additional significant reduction in bacterial levels compared to mice having received only a parenteral vaccine. Nevertheless, the parenteral strategy reduced bacterial levels by 75%, and interestingly, post infection, these mice generated their own vaccine-derived genital tract tissue-resident memory Th1/Th17 T cells, which upon a subsequent infection showed as fast an activation in the genital tract, as observed in SIM mice. Furthermore, in contrast to after the first infection, both groups of mice now showed a similar infection-induced boost in local vaginal IgA and IgG titers. Thus, vaccine-induced resident immunity, generated pre-infection, led to an advantage in the response against the first infection, but not the second infection, suggesting that a parenteral vaccine strategy is a suitable vaccine strategy against infections with Chlamydia trachomatis.

Prevalence and Genetic Analysis of Porcine Circovirus 3 in China From 2019 to 2020

Porcine circovirus type 3 (PCV3), a virus belonging to the Circoviridae family, is considered to be associated with respiratory and neurological signs, cardiac and multisystemic inflammation, reproductive failure, and porcine dermatitis and nephropathy syndrome-like disease in pigs (Sus scrofa). In this study, epidemiological and serological investigations of PCV3 in clinically healthy pigs from different regions of China were performed. Overall, 42.87% (1,101/2,568) of pigs were positive for PCV3 Cap antibody via indirect enzyme-linked immunosorbent assay, with a higher prevalence of PCV3 in multiparous sows (62.22%, 881/1,416) and fattening pigs (28.96%, 159/549) than in suckling piglets (8.96%, 32/357) and nursery pigs (11.79%, 29/246). Of the 2,568 samples, 255 were further tested for PCV3 DNA using real-time polymerase chain reaction, and 63.14% of these were positive, with nearly half having &lt;10 virus copies. The PCV3 DNA and antibody positivity rates were high in the pig serum samples; however, the virus titers and antibody levels were both low, indicating that the humoral immune response of PCV3-infected pigs was weak or lagging, and persistent or repeated infections could occur. Additionally, the complete genomes of 23 PCV3 strains were sequenced and analyzed, which showed nucleotide identities of 98.5~100.0%, 98.6~100.0%, and 99.2~100.0% in the complete genome, open reading frame (ORF)2, and ORF1 sequences, respectively, and amino acid identities of 96.7~100.0% and 99.3~100.0% in the capsid and replicase proteins, respectively. Phylogenetic analysis based on ORF2 nucleotide sequences indicated that the PCV3 strains obtained in the present study could be classified into three sub-clades, with most strains clustered into clade 3c, indicating that PCV3c is the dominant subtype in the regions of China investigated. In general, the present study revealed a high prevalence and high genetic divergence of PCV3 among Chinese pig herds, and indicated that the potential effect of PCV3 on the pig industry may be a concern.

Novel HLA-B7-restricted human metapneumovirus epitopes enhance viral clearance in mice and are recognized by human CD8+ T cells

Human metapneumovirus (HMPV) is a leading cause of acute lower respiratory tract illness in children and adults. Repeated infections are common and can be severe in young, elderly, and immunocompromised persons due to short-lived protective humoral immunity. In turn, few protective T cell epitopes have been identified in humans. Thus, we infected transgenic mice expressing the common human HLA MHC-I allele B*07:02 (HLA-B7) with HMPV and screened a robust library of overlapping and computationally predicted HLA-B7 binding peptides. Six HLA-B7-restricted CD8+ T cell epitopes were identified using ELISPOT screening in the F, M, and N proteins, with M195–203 (M195) eliciting the strongest responses. MHC-tetramer flow cytometric staining confirmed HLA-B7 epitope-specific CD8+ T cells migrated to lungs and spleen of HMPV-immune mice. Immunization with pooled HLA-B7-restricted peptides reduced viral titer and protected mice from virulent infection. Finally, we confirmed that CD8+ T cells from HLA-B7 positive humans also recognize the identified epitopes. These results enable identification of HMPV-specific CD8+ T cells in humans and help to inform future HMPV vaccine design.

Strategies for Persistent Intracranial Infection Associated With Subcutaneous Effusion in the Posterior Fossa

Objective: Due to the particularity of anatomy, there are many subcutaneous effusions after posterior fossa surgery. This paper discusses the characteristics and treatment strategies of persistent infection related to subcutaneous effusions in the posterior fossa. Methods: Seventeen patients with persistent intracranial infection after neurosurgical posterior fossa surgery from March 2015 to July 2020 were retrospectively analyzed. According to different stages of infection, the treatment process of intracranial infection was divided into the acute infection stage, clinical response stage and infection cure stage, and the measures taken in the different stages were summarized.Results: Compared with the acute infection stage, the indices of body temperature, blood and cerebrospinal fluid in the clinical response stage were improved, but there was no significant difference. There was a significant difference in each index between the acute infection stage and the infection cure stage. After the infection was cured, 17 patients were significantly relieved or cured of subcutaneous effusions by various methods.Conclusion: It is necessary to be alert to the existence of subcutaneous effusions in cases of poor effects or repeated infections after routine treatment. Multiple replacements and flushing of subcutaneous effusions are an important means of treating this kind of infection.

Penyuluhan Kesehatan Berpengaruh Terhadap Pengetahuan Keluarga Tentang Stunting

Stunting is one of the national health problems caused by multidimensional factors. Stunting children have an increased risk of suffering from repeated infections that can lead to death such as diarrhea, pneumonia, smallpox, and an increased risk of chronic heart disease in childhood. The purpose of the activity was to increase the knowledge or behavior of the community about stunting in Betteng village, Pamboang sub-district. The target of the activity was the community in the working area of ​​the Pamboang Public Health Center. This counseling emphasized more on the method of delivering information about stunting, especially in the causes, prevention, and control which were carried out in the form of explanations for families who have stunting children. In conclusion, health education affects changes in knowledge about stunting. Therefore, it is recommended to carry out health education activities if public knowledge is to be increased. ABSTRAK Kejadian Stunting merupakan salah satu permasalah kesehatan secara nasional yang diakibatkan oleh faktor multidimensi. Anak stunting meningkat resiko untuk menderita infeksi berulang yang dapat mengakibatkan kematian seperti diare, pneumonia dan cacar serta meningkatkan resiko mengalami penyakit jantung kronik di usia anak. Tujuan kegiatan pengabdian masyarakat untuk mengetahui pengaruh penyuluhan kesehatan terhadap stunting. Untuk itu perlu diperlukan pengetahuan yang baik oleh semua pihak. Metode kegiatan pengabdian kepada masyarakat Metode kuantitatif dengan pre-eksperimental dengan menggunakan suatu rancangan One Group Pre test and Post test design dengan memberikan penyuluhan kepada para petugas kesehatan tentang stunting terkait penyebab dan upaya penanggulangannya. Hasil pengukurannya menunjukkan bahwa pada pengukuran sebelum dengan pengukuran setelah intervensi memiliki nilai p = 0,084. Dengan nilai α ( 0,05 ) > nilai p value ( 0,084 ) sehingga ada perbedaan pengetahuan sebelum dan sesudah intervensi atau ada pengaruh intervensi penyuluhan penguatan keluarga dalam pengendalian stunting. Kesimpulannya bahwa penyuluhan kesehatan berpengaruh terhadap perubahan pengetahuan tetang stunting. Sehingga direkomendasikan melakukan kegiatan penyuluhan kesehatan jika ingin meningkatkan pengetahuan masyarakat.

Empowering Maasai women behind the camera: Photovoice as a tool for trachoma control

Background Photovoice is a method used to help engage community members to understand local realities and promote social change. Photovoice uses cameras in the hands of participants as a tool to visually document a specified topic. Photos taken by participants allow for reflection and stimulate dialog on an issue to ideally lead to social change. Trachoma, hyperendemic in Maasai communities in Northern Tanzania, is the commonest infectious cause of blindness worldwide, caused by chlamydia trachomatis. The bacterial infection commonly occurs in childhood and over many years repeated infections leads to inflammation and scarring of the eyelid. Often as adults this leads to the upper eyelid turning inward and eyelashes scratching the eye, resulting in pain and eventually blindness. We used photovoice as a tool for Maasai women to share their lived experiences of educating peers on trachoma and ultimately empowering women in this society. Methods This public engagement intervention was conducted September thru October 2017. We held a workshop on trachoma control for 20 Maasai women including use of photovoice method. Women were asked to disseminate information from the trachoma control workshop to their community and to capture their experiences using disposable cameras. Five weeks post-workshop we facilitated a discussion and women displayed photos of the successes and challenges they encountered as advocates for trachoma control in their community. Intervention Outcomes It was observed throughout the process and at the photo discussion meeting, that women articulated empowerment by this experience; as educators, agents of change and a source of valued information. Conclusion Photovoice should be considered for future interventions as a communication tool on health issues and to empower women to be ambassadors for health promotion.