Update on avian influenza A (H5N1) virus infection in humans

Avian influenza A (H5N1) viruses are entrenched among poultry in parts of Asia and Africa and continue to cause disease with high mortality in humans. This update summarizes recent information including research on the transmission and pathogenesis of the infection and on the current strategies for treatment and prevention. Copyright © 2008 Massachusetts Medical Society. All rights reserved.published_or_final_versio

CONSISE statement on the reporting of Seroepidemiologic Studies for influenza (ROSES-I statement): an extension of the STROBE statement

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Modes of Transmission of Influenza B Virus in Households

Introduction:While influenza A and B viruses can be transmitted via respiratory droplets, the importance of small droplet nuclei "aerosols'' in transmission is controversial. Methods and Findings: In Hong Kong and Bangkok, in 2008-11, subjects were recruited from outpatient clinics if they had recent onset of acute respiratory illness and none of their household contacts were ill. Following a positive rapid influenza diagnostic test result, subjects were randomly allocated to one of three household-based interventions: hand hygiene, hand hygiene plus face masks, and a control group. Index cases plus their household contacts were followed for 7-10 days to identify secondary infections by reverse transcription polymerase chain reaction (RT-PCR) testing of respiratory specimens. Index cases with RT-PCR-confirmed influenza B were included in the present analyses. We used a mathematical model to make inferences on the modes of transmission, facilitated by apparent differences in clinical presentation of secondary infections resulting from aerosol transmission. We estimated that approximately 37% and 26% of influenza B virus transmission was via the aerosol mode in households in Hong Kong and Bangkok, respectively. In the fitted model, influenza B virus infections were associated with a 56%-72% risk of fever plus cough if infected via aerosol route, and a 23%-31% risk of fever plus cough if infected via the other two modes of transmission. Conclusions: Aerosol transmission may be an important mode of spread of influenza B virus. The point estimates of aerosol transmission were slightly lower for influenza B virus compared to previously published estimates for influenza A virus in both Hong Kong and Bangkok. Caution should be taken in interpreting these findings because of the multiple assumptions inherent in the model, including that there is limited biological evidence to date supporting a difference in the clinical features of influenza B virus infection by different modes.published_or_final_versio

Active Ebola Virus Replication and Heterogeneous Evolutionary Rates in EVD Survivors

Summary: Following cessation of continuous Ebola virus (EBOV) transmission within Western Africa, sporadic EBOV disease (EVD) cases continued to re-emerge beyond the viral incubation period. Epidemiological and genomic evidence strongly suggests that this represented transmission from EVD survivors. To investigate whether persistent infections are characterized by ongoing viral replication, we sequenced EBOV from the semen of nine EVD survivors and a subset of corresponding acute specimens. EBOV evolutionary rates during persistence were either similar to or reduced relative to acute infection rates. Active EBOV replication/transcription continued during convalescence, but decreased over time, consistent with viral persistence rather than viral latency. Patterns of genetic divergence suggest a moderate relaxation of selective constraints within the sGP carboxy-terminal tail during persistent infections, but do not support widespread diversifying selection. Altogether, our data illustrate that EBOV persistence in semen, urine, and aqueous humor is not a quiescent or latent infection. : Whitmer et al. find that Ebola virus continues replication/transcription within the eye and male genital tract of Ebola virus disease survivors. They describe viral replication, evolutionary rates, and selective pressures experienced during acute and persistent infection. Keywords: Ebola virus, EVD survivors, persistent viral infection, evolutionary pressure, evolutionary rates, RNA hyper-editin

Techno-economic assessment of an industrial project towards carbon neutrality

This paper describes the application of the system simulation platform Modelon Impact for techno-economical assessment of energy projects towards carbon neutrality. The control co-design approach applied in the work allows for rapid assessment of various technology options without the need for deriving complex control laws for the considered assets. The approach is here applied on an industrial use case where the goal is to identify the technology options that minimize the total cost of ownership while achieving carbon neutrality

Contributo para a validação portuguesa do Remarriage Belief Inventory (RMBI): escala de avaliação de crenças face ao recasamento

Os fenómenos recasamento e famílias recasadas são uma tendência crescente nopanorama global, cuja investigação atual tem vindo a dedicar maior atenção. Apesar dasdiferentes trajetórias, as pessoas continuam a querer casar e formar (nova) família, ondePortugal não é exceção, seguindo essa tendência. Paradoxalmente, esta prática demonstra termaior expressão no âmbito geral do divórcio do que no casamento, sugerindo que as famíliasrecasadas apresentam maior risco de separação, nomeadamente, as segundas uniões parecemterminar mais rapidamente que as primeiras. Uma das principais razões prende-se com o fatodos indivíduos reforçarem seus padrões irrealistas como equivalentes à funcionalidade dasua família, como aconteceria no primeiro casamento/união. Assim, existem crençasdisfuncionais e pouco realistas que levam consigo para as novas relações, impactandonegativamente a interação do casal, a adaptação e a qualidade da relação.Consequentemente, torna-se imprescindível aprofundar nosso conhecimento e compreensãosobre estes processos, com a finalidade de enriquecer a investigação e intervenção juntodesta população-alvo.Consideramos que uma forma de atingir esse fim é recorrendo a instrumentosdevidamente elaborados e testados, como é o caso do Remarriage Beliefs Inventory -RMBIde Higginbotham & Adler-Baeder (2005), concebido para avaliar as crenças que influenciamas relações das famílias recasadas. Este trabalho tem como objectivo central proceder à suaadaptação e validação para população portuguesa. As propriedades psicométricas da versãoportuguesa revelaram resultados mistos, no entanto a análise fatorial confirmatória (AFC)revelou boa qualidade de ajustamento do modelo, cujos valores se assemelham aos da versãooriginal

Rapid-Test Based Identification of Influenza as an Etiology of Acute Febrile Illness in Cambodia

Influenza can be manifested as an acute febrile illness, with symptoms similar to many pathogens endemic to Cambodia. The objective of this study was to evaluate the Quickvue influenza A+B rapid test to identify the etiology of acute febrile illness in Cambodia. During December 2006–May 2008, patients enrolled in a study to identify the etiology of acute febrile illnesses were tested for influenza by real-time reverse transcriptase PCR (RT-PCR) and Quickvue influenza A+B rapid test. The prevalence of influenza was 19.7% by RT-PCR. Compared with RT-PCR, the sensitivity and specificity of the rapid test were 52.1% and 92.5%, respectively. The influenza rapid test identified the etiology in 10.2% of enrollees and ≥ 35% during peak times of influenza activity. This study suggests that rapid influenza tests may be useful during peak times of influenza activity in an area where several different etiologies can present as an acute febrile illness

Detecting Human-to-Human Transmission of Avian Influenza A (H5N1)

Effective surveillance, containment response, and field evaluation are essential to contain potential pandemic strain

Infection Rates and Risk Factors for Infection Among Health Workers During Ebola and Marburg Virus Outbreaks:A Systematic Review

Background: Infection in health workers (HWs) has characterized outbreaks of Ebola virus disease (EVD) and Marburg virus disease (MVD). We conducted a systematic review to investigate infection and mortality rates and common exposure risks in HWs in EVD and MVD outbreaks.Methods: We searched the EMBASE and PubMed databases to identify articles posted before 27 December 2017, with no language restrictions. Data on the number, frequency, and mortality of HW infection and exposure risks were extracted.Results: Ninety-four articles related to 22 outbreaks were included. HW infections composed 2%-100% of cases in EVD and 5%-50% of cases in MVD outbreaks. Among exposed HWs, 0.6%-92% developed EVD, and 1%-10% developed MVD. HW infection rates were consistent through outbreaks. The most common exposure risk situations were inadequate personal protective equipment and exposure to patients with unrecognized EVD/MVD. Similar risks were reported in past EVD/MVD outbreaks and in the recent outbreak in West Africa.Conclusions: Many outbreaks reported high proportions of infected HWs. Similar HW infection rates and exposure risk factors in both past and recent EVD and MVD outbreaks emphasize the need to improve the implementation of appropriate infection control measures consistently across all healthcare settings.</p

Gaps in the clinical management of influenza a century since the 1918 pandemic

This year marks the centennial of the devastating 1918 influenza A(H1N1) pandemic, which killed an estimated 50 million people worldwide. Prevention and control activities were limited in 1918 because global surveillance did not exist, influenza viruses were not yet discovered, and no influenza vaccines had been developed. Diagnostic tests for influenza were unavailable prior to isolation of influenza viruses in the 1930s, so spread of the pandemic virus was tracked by news reports of increased respiratory disease and related deaths. Establishment of the World Health Organization’s Global Influenza Surveillance Network in 1952 has contributed substantially to coordinated surveillance, vaccine development, and influenza vaccine strain selection