The Journal of Infectious Diseases
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Published By Oxford University Press

1537-6613, 0022-1899
Updated Monday, 18 October 2021

Roger Y Dodd ◽  
Edward P Notari ◽  
Jaye P Brodsky ◽  
Gregory A Foster ◽  
Meng Xu ◽  

Abstract From December 2020 to June 2021, 1,654,487 blood donors were tested for antibodies to SARS-CoV-2 S1 protein and 1,028,547 (62.17%) were reactive. A rapid increase in prevalence was due to vaccination. Among a subset of 1,567,446 donors, 729,771 (46.56%) reported SARS-CoV-2 vaccination, of whom 633,769 (86.84%) were S1-antibody reactive only, in response to vaccination and 68,269 (9.35%) were reactive to both S1 and nucleocapsid, in response to prior infection; the remainder were not reactive to either antibody. Among the 837,675 (53.44%) donors who did not report vaccination, 210,022 (25.07%) had reactivity to both antibodies and 29,446 (3.52%) to S1 only.

Alexander G Shaw ◽  
Laura V Cooper ◽  
Nicksy Gumede ◽  
Ananda S Bandyopadhyay ◽  
Nicholas C Grassly ◽  

Abstract Background Detection of poliovirus outbreaks relies on a complex laboratory algorithm of cell-culture, PCR and sequencing to distinguish wild-type and vaccine-derived polioviruses (VDPV) from Sabin-like strains. We investigated the potential for direct molecular detection and nanopore sequencing (DDNS) to accelerate poliovirus detection. Methods We analysed laboratory data for time required to analyse and sequence serotype-2 VDPV (VDPV2) in stool collected from children with acute flaccid paralysis in Africa (May 2016-February 2020). Impact of delayed detection on VDPV2 outbreak size was assessed through negative binomial regression. Results VDPV2 confirmation in 525 stools required a median of 49 days from paralysis onset (10th-90th percentile: 29-74), comprising collection and transport (median: 16 days), cell-culture (7 days), intratypic differentiation RT-qPCR (3 days) and sequencing (including shipping if required) (15 days). New VDPV2 outbreaks were confirmed a median of 35 days (27-60) after paralysis onset, which we estimate could be reduced to 16 days by DDNS (9-37). Because longer delays in confirmation and response were positively associated with more cases (p<0.001), we estimate that DDNS could reduce the number of VDPV2 cases before a response by 28% (95% CrI 12-42%). Conclusions DDNS could accelerate poliovirus outbreak response, reducing their size and the cost of eradication.

Colin J Forsyth ◽  
Jennifer Manne-Goehler ◽  
Caryn Bern ◽  
Jeffrey Whitman ◽  
Natasha S Hochberg ◽  

Abstract Background Chagas disease affects an estimated 326,000-347,000 people in the United States and is severely underdiagnosed. Lack of awareness and clarity regarding screening and diagnosis is a key barrier. Objective This document provides straightforward recommendations, with the goal of simplifying identification and testing of people at risk for U.S. healthcare providers. Methods A multidisciplinary working group of clinicians and researchers with expertise in Chagas disease agreed on six main questions, and developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, after reviewing the relevant literature on Chagas disease in the United States. Results Individuals who were born or resided for prolonged time periods in endemic countries of Mexico, Central and South America should be tested for T. cruzi infection, and family members of people who test positive should be screened. Women of childbearing age with risk factors and infants born to seropositive mothers deserve special consideration due to the risk of vertical transmission. Diagnostic testing for chronic T. cruzi infection should be conducted using two distinct assays. Conclusions Increasing provider-directed screening for T. cruzi infection is key to addressing this neglected public health challenge in the United States.

Stephane Carryn ◽  
Brigitte Cheuvart ◽  
Michael Povey ◽  
Alemnew F Dagnew ◽  
Rafael Harpaz ◽  

Abstract Background Universal varicella vaccination might reduce opportunities for varicella-zoster virus (VZV) exposure and protective immunological boosting, thus increasing herpes zoster incidence in latently infected adults. Here, we assessed humoral and cell-mediated immunity (CMI), as markers of VZV exposure, from adults aged ≥50 years. Methods We repurposed data from placebo recipients in a large multinational clinical trial (ZOE-50, NCT01165177). Countries were clustered based on their varicella vaccination programme characteristics, as having high, moderate or low VZV circulation. Anti-VZV antibody geometric mean concentrations, median frequencies of VZV-specific CD4 T cells and percentages of individuals with increases in VZV-specific CD4 T cell frequencies were compared across countries and clusters. Sensitivity analyses using a variable number of timepoints and different thresholds were also performed for CMI data. Results VZV-specific humoral immunity from 17 countries (12 high, two moderate, three low circulation) varied significantly between countries (p<0·0001) but not by VZV circulation. No significant differences were identified in VZV-specific CMI between participants from two high versus one low circulation countries. In 3/5 sensitivity analyses, increases in CMI were more frequent in high VZV circulation countries (0.03≤p<0.05). Conclusions We found no consistent evidence of reduced VZV exposure among older adults in countries with universal varicella vaccination.

Kentaro Akata ◽  
Janice M Leung ◽  
Kei Yamasaki ◽  
Fernando S Leitao Filho ◽  
Julia Yang ◽  

Abstract Background People with HIV (PWH) have an increased risk of developing Chronic Obstructive Pulmonary Disease (COPD). Methods We phenotyped lung macrophages in four subgroups: M1 (CD40+CD163-), M2 (CD40-CD163+), Double Positives (CD40+CD163+), Double Negatives (CD40-CD163-) and determined their phagocytic capacity in PWH with and without COPD. Results PWH with COPD have more double negative macrophages (84.1%) vs PWH without (54.3%) vs controls (23.9%) (p=0.004) and reduced phagocytosis (p=0.012). Double negative macrophages had the worst phagocytic capacity (p<0.001). Conclusions PWH with COPD have an abundance of non-polarized macrophages which have poor phagocytic capacity therefore predispose them to increased risk of disease progression.

Aleksandra Kovacevic ◽  
Rosalind M Eggo ◽  
Marc Baguelin ◽  
Matthieu Domenech de Cellès ◽  
Lulla Opatowski

Abstract Background Circulation of seasonal non-SARS-CoV-2 respiratory viruses with syndromic overlap during the COVID-19 pandemic may alter quality of COVID-19 surveillance, with possible consequences for real-time analysis and delay in implementation of control measures. Methods Using a multi-pathogen Susceptible-Exposed-Infectious-Recovered (SEIR) transmission model formalizing co-circulation of SARS-CoV-2 and another respiratory virus, we assess how an outbreak of secondary virus may affect two COVID-19 surveillance indicators: testing demand and positivity. Using simulation, we assess to what extent the use of multiplex PCR tests on a subsample of symptomatic individuals can help correct of the observed SARS-CoV-2 percent positivity and improve surveillance quality. Results We find that a non-SARS-CoV-2 epidemic strongly increases SARS-CoV-2 daily testing demand and artificially reduces the observed SARS-CoV-2 percent positivity for the duration of the outbreak. We estimate that performing one multiplex test for every 1,000 COVID-19 tests on symptomatic individuals could be sufficient to maintain surveillance of other respiratory viruses in the population and correct the observed SARS-CoV-2 percent positivity. Conclusions This study highlights that co-circulating respiratory viruses can distort SARS-CoV-2 surveillance. Correction of the positivity rate can be achieved by using multiplex PCR tests, and a low number of samples is sufficient to avoid bias in SARS-CoV-2 surveillance.

Joao Toledo ◽  
Michelle M Haby ◽  
Ludovic Reveiz ◽  
Leopoldo Sosa Leon ◽  
Rodrigo Angerami ◽  

Abstract Background Hantavirus is known to be transmitted from rodents to humans. However, some reports from Argentina and Chile have claimed that the hantavirus strain – Andes virus (ANDV) – can cause human-to-human transmission of the disease. The aim of this systematic review was to assess the evidence for human-to-human transmission of hantavirus. Methods We searched PubMed (inception to 28 February 2021), Cochrane CENTRAL, Embase, LILACS and SciELO (inception to 3 July 2020) and other sources. We included studies that assessed whether interpersonal contact with a person with laboratory-confirmed hantavirus infection led to human-to-human transmission. Two reviewers conducted screening, selection, data extraction, and risk of bias (RoB) assessment. Results Twenty-two studies met the inclusion criteria. Meta-analysis was not possible due to heterogeneity. With the exception of one prospective cohort study of ANDV in Chile with serious RoB, evidence from comparative studies (strongest level of evidence available) does not support human-to-human transmission of hantavirus infection. Non-comparative studies with a critical RoB suggest that human-to-human transmission of ANDV may be possible. Conclusions The balance of the evidence does not support the claim of human-to-human transmission of ANDV. Well-designed cohort and case-control studies that control for co-exposure to rodents are needed to inform public health recommendations.

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