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Objective: To describe the clinical features, causal agent and transmission mode of a fever outbreak in a school in Shanghai. Methods: Field epidemiological approaches including case definition development, searching for contacts, distribution of diseases description, environmental sampling and laboratory testing. Results: A total of 16 influenza-like cases were included, all concentrated in the one class of grade two, including 15 students and 1 teacher. Among student cases, the incidence rate was 36.59%(15/41), the average age was 7.4 years, the incidence rate was 36.84%(7/19) for boys, 36.36%(8/22) for girls. The clinical course was 5-15 days, with the median of 9 days, and 18.75%(3/16) of the cases stayed studying while sick. The nasopharyngeal swab specimens in 16 cases all tested positive for influenza B, of which 11 tested positive for mycoplasma pneumoniae and 1 case also tested positive for coronavirus OC43. Body temperature, number of mononuclear cells, and treatment time of patients infected with Influenza B and mycoplasma pneumoniae were higher than those of patients infected with influenza B alone(P < 0.05). The outbreak lasted for 12 days, all sick students were treated and discharged from hospital, with no severe cases or death, and the outbreak was effectively controlled. Conclusion: This campus cluster outbreak caused by influenza B and mycoplasma pneumoniae. Patients with influenza B with mycoplasma pneumoniae have severe symptoms and a long course of illness, suggesting the importance of early management of the epidemic.
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Toxoplasmosis is a zoonotic illness that spreads from animals to people. Toxoplasma gondii, a protozoan parasite that infects warm-blooded mammals, causes the sickness. Toxoplasmosis is a parasitic infection that causes abortion and death in animals. Cats are the parasite's sole sexual hosts, thus they're the only ones who can get it. Because cats are frequent pets, they are highly likely to come into touch with humans. As a result, the disease poses a risk to human health. The potential danger is influenced by the frequency of oocyst secretion and the level of contamination in the environment. Toxoplasmosis has serious consequences for both animal and human health, hence preventative actions should be taken to reduce the dangers. COVID-19 is affected by such methods as well. Toxoplasmosis is thought to increase immunological and immunosuppressive factors, which increases the chance of SARS-CoV-2 infection and the severity of the resulting COVID-19. Research into Toxoplasma gondii intermediate hosts might help understand COVID-19's dynamics and determine if the virus can be transferred from animals to humans. We explore what we know about Toxoplasma gondii infection as a human parasitosis and how it may alter the course of SARS-CoV-2 infection in this review study.
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Viral pathogens in the lungs can cause severe outcomes, including acute lung injury and acute respiratory distress syndrome. Dangerous respiratory pathogens include some influenza A and B viruses, and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unfortunately, concurrent infections of influenza virus and SARS-CoV-2 increase severe outcome probabilities. Influenza viruses have eight cellular manipulations which can assist concurrent SARS-CoV-2 viral infections. The eight cellular manipulations include: (1) viral protein binding with cellular sensors to block antiviral transcription factors and cytokine expressions, (2) viral protein binding with cell proteins to impair cellular pre-messenger ribonucleic acid splicing, (3) increased ribonucleic acid virus replication through the phosphatidylinositol 3-kinase/Akt (protein kinase B) pathway, (4) regulatory ribonucleic acids to manipulate cellular sensors and pathways to suppress antiviral defenses, (5) exosomes to transmit influenza virus to uninfected cells to weaken cellular defenses before SARS-CoV-2 infection, (6) increased cellular cholesterol and lipids to improve virion synthesis stability, quality and virion infectivity, (7) increased cellular autophagy, benefiting influenza virus and SARS-CoV-2 replications and (8) adrenal gland stimulation to produce glucocorticoids, which suppress immune cells, including reduced synthesis of cytokines, chemokines and adhesion molecules. Concurrent infections by one of the influenza viruses and SARS-CoV-2 will increase the probability of severe outcomes, and with sufficient synergy potentially enable the recurrence of tragic pandemics.
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Coinfection caused by bacteria, parasites, or viruses complicates almost all feline panleukopenia virus (FPV) infections. Pathogens that colonize the gastrointestinal tract, Clostridium perfingens, Clostridium piliforme, Cryptosporidium spp, Giardia spp, Tritrichomonas fetus, canine parvovirus type 2,Salmonella sp., feline coronavirus, feline bocavirus, and feline astrovirus were isolated in the presence of FPV infection. Complex mechanisms between viruses, bacteria, protozoa, and hosts contribute to the pathogenesis and severity of coinfection. Prompt and accurate diagnosis, vaccination precautions, and appropriate treatment play important roles in reducing morbidity and mortality. This article outlines the etiology, pathogenesis, diagnosis, prevention, and treatment that can help veterinarians and pet owners improve their knowledge of managing the diseases.
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The article is devoted to the global problems of modern medicine - HIV infection and the COVID-19 pandemic. The review of the literature highlights current ideas about the pathogenesis and course of COVID-19 in patients with HIV infection, and also touches upon the problems of concomitant pathology and mental health of patients with HIV in the setting of the COVID-19 pandemic. It has been shown that HIV-positive patients are a risk group for the severe course of COVID-19, in particular, individuals with severe immunodeficiency (CD4+ T lymphocytes 200 cells/l) due to the development of synergetic lung damage by SARS-CoV-2 and secondary infectious agents such as cytomegalovirus and Pneumocystis carinii. It has been proven that one of the targets of the SARS-CoV-2 virus is CD4+ T cells, which in COVID-19 leads to a more rapid progression of immunodeficiency in patients with HIV infection and, thus, significantly increases the risk of secondary diseases and death. Particular attention should be paid to middle-aged and elderly people living with HIV, who, compared with HIV-negative patients, are more likely to have concomitant pathology - arterial hypertension, cardiomyopathy and diabetes mellitus, which are the risk factors for severe COVID-19. The results of studies on the effect of antiretroviral drugs on the course of COVID-19 showed that HIV-infected patients receiving tenofovir + emtricitabine have a lower risk of severe COVID-19 and associated hospitalization than patients receiving other HIV treatment regimens. Clinical and preclinical data support the potential use of tenofovir in the treatment of novel coronavirus infection.
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Objective: To understand the awareness level towards coronavirus disease 2019(COVID-19) prevention and the willingness to receive COVID-19 vaccine among people living with HIV/AIDS, and to discuss the related factors. Methods: A questionnaire survey was conducted among people living with HIV/AIDS who visited the HIV clinic in the PLA General Hospital from June to December 2021.A general descriptive analysis, univariate and binary logistic regression analysis were performed to analyze data. Results: A total of 169 questionnaires were analyzed. Among them, 93.5%(158/169) would like to know more about COVID-19 related knowledge, 88.2%(149/169) were reminded to inject vaccine, 98.8%(167/169) would be far away from medium and high risk areas, 97.0%(164/169) would persuade others to follow the disease preventive requirements, 14.2%(24/169) thought that the propaganda was exaggerated, 30.8%(52/169) were worried about the safety of the vaccine, 80.5%(136/169) thought that they would feel relieved after the vaccination, and 98.2%(166/169) agreed that vaccination was the most effective way to fight against COVID-19. However, only 60.4%(102/169) were willing to receive COVID-19 vaccine. The major factors affecting vaccination intention were age and feeling safe after vaccination. Conclusions: People living with HIV/AIDS are more cautious about COVID-19 vaccination, therefore the coverage rate is relatively low.It is necessary for health providers to understand the specific situation of people living with HIV, and to enhance the heath education on the safety of COVID-19 vaccine especially among people with HIV/AIDS in order to improve the willingness to receive COVID-19 vaccine.
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Background and purpose: There are limited studies on co-infection of COVID-19 and tuberculosis (TB). This study aimed to describe the clinical, radiological, laboratory characteristics, treatment and outcome of patients admitted with tuberculosis and COVID 19 co-infection. Materials and methods: In this retrospective study, we investigated all patients with either active TB or old TB and COVID-19 admitted to Qaemshahr Razi Teaching Hospital between 2020 and 2022. Results: A total of 9251 patients with COVID-19 were admitted to our hospital between February 2020 and May 2022. There were eight patients with pulmonary tuberculosis and COVID-19 co-infection, including five (62.5%) male patients. The mean age of these patients was 61.13..22.63 years old. The mean time of symptom onset to hospital admission was 15.13..30.56 days and 50% were diagnosed with active TB and other half had old TB. Four patients were admitted to the ICU, three of whom required ventilation. Finally, four (50%) patients deceased. In this study, among factors that influence patients' outcomes, only underlying diseases were significantly associated with death. Conclusion: Tuberculosis is assumed to cause a higher mortality risk in COVID-19 patients, especially in those with chronic underlying diseases.
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Objective: To analyze the laboratory indexes of patients infected with malaria patients and COVID-19, so as to provide reliable evidence for the diagnosis of mixed infection of both. Methods The routine clinical laboratory items such as routine blood, biochemistry and lymphocyte subsets were tested in three cases of COVID-19 complicated with falciparum malaria who admitted to Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University from July to December 2020 were tested. Laboratory data were stage-wise analyzed in conjunction with changes in the course of disease. Results Three patients confirmed COVID-19 infection recruited all had malaria infection history. Fever, headache, and other symptoms emerged on the 4rd to 11th day after admission. Malaria parasite was detected by malaria parasite antigen testing and blood smear testing, and all three patients had re-ignition of malaria after being confirmed COVID-19 infection. In the early stage of malaria relapse, lymphocytes decreased, CRP and SAA increased, and gradually returned to normal level after antimalarial treatment. Interestingly, we only found one patient at the initial stage of malaria detection showed PLT decreased, no other unnormal changes in other routine blood results (WBC, ESO) and liver function results (ALT, AST, GGT, TBIL, DBIL, CG) were found from the beginning to end course of the disease. Conclusion COVID-19 infection may promote the resurgence of malaria, so the relapse of malaria should be monitored especially for the patient with malaria infection history who begin to develop fever and other symptoms a few days after the diagnosis of COVID-19. The inflammatory indicators would be worth able as an auxiliary judgment basis for the effective treatment of the two combined infection.
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Domestic and wild dogs of all ages and breeds are susceptible to Canine Coronavirus(CCoV) infections and be seen in T..rkiyeand amongst world. CCoV has recently been declared a zoonotic disease agent and the eighth pathogenic human coronavirus. This study was conducted on 143 naturally infected dogs with gastroenteritis which were not vaccinated against CCoV in T..rkiye in 2015-2020. The data of dogs were analyzed seroepidemiologically, clinicopathologically and statistically. CCOV antibodies in serum and CCOV antigens in stool were detected by ELISA and lateral immunochromatography. The rising CCoV IgG antibody titers were detected at all dogs and were as follows;<10 ng/L in 3 (2%), 10-20 ng/L in 18 (13%), 20-30 ng/L in 16 (11%), 30-40 ng/L in 14 (%10), 40-64 ng/L in 11 (8%) and >64 ng/L in 81 (81%) dogs. CCOV and Canine Parvovirus (CPV) antigen were detected together in the stool of the 41 (28.7%) dogs. As a result, it was concluded that the CCOV agent is in circulation among dogs living in T..rkiye. CCOV and CPV can cause co-infections and increased mortality. Although infection can be seen in dogs of all ages, it can be seen more frequently in dogs younger than 1 year of age, and especially in dogs younger than 6 months, and can cause enteritis, low hemoglobin, erythropenia, lymphopenia, leukopenia, thrombocytopenia, and hypoproteinemia.
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Introduction: Candida auris has been reported from various health care settings and has recently gained importance because of its intrinsic resistance to many classes of antifungal agents and to disinfection. The outbreak potential and high mortality associated with Candida auris infection reinforces the need for speciation. Routine conventional methods are cumbersome and automated systems are unable to confirm up to species level. Materials and Methods: Candida auris isolates from consecutive non-repetitive blood cultures over a 1-year period were speciated based on phenotypic, physiological and biochemical tests and VITEK. Molecular confirmation was done by PCR-RFLP and MALDI-TOF. Anti- fungal susceptibility test was performed according to CLSI guidelines (2021), using suitable controls. Virulence factors such as production of Hemolysin, Phospholipase, Esterase and Bio-film production were demonstrated. RT-PCR was used to screen the COVID-19 status using SD-Biosensor kit. Baseline data and clinical history were collected and analysed. Results: Of 3632 blood cultures (0.77%), 28 Candida sp. were isolated including 9 Candida auris, (9/28, 32.14%). Of these 8 were from COVID-19 positive patients (88.89%), while 1 was from COVID-19 negative patient (11.11%). Two patients survived, while the remaining 7 patients succumbed to the disease. Conclusion: The increasing incidence of Candidiasis especially during the COVID-19 pandemic has raised the concern for early speciation. Through multi-modal strategies such as quick and correct identification, active surveillance, guided reporting, stringent infection control measures and correct use of anti-fungals through proper susceptibility testing, we can prevent the occurrence and spread of new Candida auris cases in the future.
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This article discusses the global report on leishmaniasis surveillance, highlighting its significance as a major health problem in four eco-epidemiological regions of the world. The report provides an update on the GHO leishmaniasis indicators reported by 45 member states to WHO up to 2021 and describes specific indicators such as gender and age distribution, relapses, the AmBisomeR donation programme selected outbreaks, case fatality rates for visceral leishmaniasis, rates of co-infection with HIV and visceral leishmaniasis (VL), and the burden of post-kala-azar dermal leishmaniasis. It also discusses the impact of the COVID-19 pandemic on leishmaniasis surveillance efforts and the Kala-azar Elimination Programme in South-East Asia, as well as highlights adverse events after the administration of antileishmanial drugs and the need for continued surveillance efforts to control and eliminate leishmaniasis globally.
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Candida auris, a multidrug-resistant yeast, can cause primary or secondary infections in a wide range of patients, including those diagnosed with the new coronavirus to even healthy individuals. The fungus has been reported in less than a decade on all six continents and in more than 45 countries. Ease of distribution, long shelf life, and resistance to several antifungal drugs have raised concerns about the prevention and management of patients with C. auris infection. Recent reports indicate serious challenges in identifying, understanding the mechanism of drug resistance, and preventing mortality from the infection with this microorganism. Given the prevalence of COVID-19 infection, it is important to identify patients colonized with C. auris correctly and at the early stages, to control and prevent a possible outbreak. In this article, the widespread occurrence of infections due to C. auris in the world and Iran, its clinical manifestations, risk factors, pathogenic mechanisms, diagnostic enhancements and challenges, drug resistance, treatment options, prevention, and control as well as concomitant C. auris infections in patients with COVID-19 virus, are reviewed.
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Both coronavirus disease 2019(COVID-19) and acquired immune deficiency syndrome(AIDS) are known as category B infectious diseases, which were caused respectively by SARS-CoV-2 and human immunodeficiency virus(HIV). Although HIV infection is not a risk factor for COVID-19, latest clinical studies have shown that HIV-positive COVID-19 patients experience longer disease course and are more likely to have severe COVID-19 compared with HIV-negative COVID-19 patients, especially those with low CD4+ T cells count or with no antiretroviral therapy(ART).In this review, we aim to compare the etiological and pathogenetic differences between COVID-19 and AIDS, and to elucidate the immunological and virologic characteristics of HIV-positive COVID-19 patients, which helps for a better understanding of SARS-CoV-2 and HIV co-infections.
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During second wave of COVID-19 pandemic, increase in incidence of typhoid was observed in different cities of Pakistan. Rapid diagnostic tests for COVID-19 and typhoid are less sensitive and confirmatory tests are required to diagnose the infection. Moreover, COVID-19 IgM mimic Salmonella typhi IgM and have same clinical presentations as typhoid. Muzaffargarh is a district of province Punjab. Being a hotspot for COVID-19, it also has high prevalence of Typhoid. Therefore, in this study we aim to evaluate the cross antigenicity of COVID-19 IgM with Salmonella typhi IgM. 593 patients were enrolled in study with informed consent. Blood samples were collected from patients and laboratory biomarkers were analyzed. Data was recorded and statistical analysis was done. Among study participants, 64% were males while 36% were females. All the laboratory biomarkers were elevated in all the patients. Different age groups didn't exhibit difference in all laboratory biomarkers except ferritin. Significant difference was observed in creatinine, LDH and ferritin levels in male and female patients. It can be concluded that all age groups are under same risk. However, disease severity is higher in male population.
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These proceedings contain lectures and presentations that discuss invasive fungal infections in severe COVID-19 patients and ongoing battle against gram-positive bacteria.
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The COVID-19 pandemic has caused resource depletion and a shift in priorities in the public health system, impacting the control of other communicable diseases of public interest. Hepatitis A virus is a notifiable disease transmitted through faeco-oral transmission. We conducted a retrospective analysis of patients with a clinical diagnosis of hepatitis whose specimens were submitted to the Virology Laboratory of the National Hospital, Kandy, from January 2019 to December 2021. During pre-pandemic time 28 (4.4%) were positive for hepatitis A, while it was 86 (10.2%) during the pandemic. There was a statistically significant difference in incidence between the two cohorts (p < 0.0001). The majority of patients in 2021 (25 patients;64.1%) resided in Badulla. Our data shows an increased incidence of hepatitis A cases during the pandemic, and residents in Badulla were predominantly affected in 2021. Strategies should therefore be undertaken to prevent further cases in the central part of the country.
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An investigation of coronavirus (CoV) and hepatitis E virus (HEV) in rodents was performed to understand CoV and HEV infection of rodents in Dali City, Yunnan Province. Rodent samples were obtained in the four towns of Dali city through traps from August 2020 to August 2021. A total of 76 rodents belonging to six species and five genera were captured: Rattus tanezumi, Rattus norvegicus, Apodemus chevrieri, Eothenomys miletus, Niviventer fulvescens, and Mus Pahari. Detection of CoV and HEV was performed by nested-PCR. The infection rate of CoV was 40.74% (11/27) and 2.38% (1/42) in R. norvegicus and R. tanezumi, respectively. The infection rate of HEV was 14.81% (4/27) and 2.38% (1/42) in R. norvegicus and R. tanezumi, respectively. Co-infection with CoV and HEV was detected in two R. norvegicus, with a co-infection rate of 7.41% (2/27). A Basic Local Alignment Search Tool (BLAST) search was performed on partial RNA-dependent RNA polymerase (RdRp) sequences of CoV and HEV. Eleven strains from R. norvegicus were a-CoV, and matched best to strain KY370050 from Rattus losea (Fujian, China), with 99.73% to 99.74% nucleotide (nt) sequency identity. One strain was ss-CoV from R. tanezumi, which displayed 98.21% nt sequence identity with strain MT820632 from Bandicota indica (Yunnan, China). Five strains from R. norvegicus were all HEV-C, and showed 95.87% to 96.21% sequence similarity to strain MN450853 from a patient in Hong Kong, China. In conclusion, CoV and HEV infections are present in rodents in Dali City. Because the host animals of the two viruses are closely related to humans, surveillance and investigations of related viruses should be strengthened.
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The epidemiological situation of tuberculosis (TB) in most countries with a low TB incidence is characterized by low transmission rates in the general population and occasional outbreaks. At the time of the COVID-19 pandemic, we should expect it to increase in the post-pandemic period. Most cases of active TB are caused by the reactivation of latent tuberculosis. High concentrations of the disease are recorded in certain risk groups (poor people, homeless people, migrants, prisoners, ethnic minorities and people living with HIV infection or other diseases, excessive drinkers, drug addicts and other marginalized groups). At a time of increasing migration, TB will not be permanently eliminated in any country unless it is eradicated worldwide.
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The pandemic of the new coronavirus infection caused by the SARS-CoV-2 virus is a challenge to the health system around the world. At the moment, we have more information about this disease, which is manifested mainly by symptoms of a respiratory infection, from mild manifestations of ARVI to severe lung damage. Also, coronavirus infection often manifests itself as symptoms of a gastrointestinal disease, in the form of vomiting, diarrhea and abdominal pain. In addition, over a year of observation, starting from the very beginning of the pandemic in China, liver dysfunctions of various origins have been described in patients with coronavirus infection. Possible reasons include the direct cytopathic effect of the virus capable of binding to ACE2beta receptors of the hepato-biliary system, immune-mediated damage to hepatocytes, including during a "cytokine storm" and hepatotoxicity of drugs used in coronavirus infection. In addition to these mechanisms of liver damage, there is also a reactivation of chronic persistent infections. In particular, we are talking about the reactivation of chronic hepatitis B. In addition to the burden of infection in the manifest period, there are no less severe consequences for convalescents or those who have suffered a mild illness, which we must remember in order to take the necessary measures in the near and distant period of recovery after COVID -19. In this article, we present our own observations of the reactivation of chronic hepatitis in 4 patients who underwent manifest COVID-19.
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This study aimed to evaluate the etiological and clinical characteristics of acute upper respiratory tract infections in children from GuangZhou, China. A total of 2 665 nose swabs specimen collected from children with acute upper respiratory tract infections from Zhujiang Hospital, Southern Medical University, Guangzhou, China during November 2009 to September 2015 were enrolled in this study. There were 1 566 virus positive responses were detected in samples from 2665 child patients with acute upper respiratory infections, with the positive rate of 58.8%. The positive rates were 22.5% for respiratory sycytial virus (RSV), 13.0% for rhinovirus (HRV), 9.0% for influenza virus (FLU), 7.6% for parainfluenza virus (PIV), 6.1% for adenovirus (AdV), 4.0% for human metapneumovirus (HMPV), 3.7% for human coronavirus (HCOV), 3.5% for human Bocavirus (HBOV). There was statistical significant in the detection rates of 8 respiratory viruses in different seasons, with the highest in spring, followed by summer and winter, and lowest in autumn. The respiratory virus infection rate of children gradually decreased with age, with a positive detection rate of 67.0% between children aged 0-3 years. And the respiratory virus detection rate of boys was significantly higher than that of girls. The co-infection rates were higher in child patients aged 0-3 years, and were higher during spring and summer than that of autumn and winter. Cough is the main clinical symptom of acute upper respiratory virus infection, followed by sputum and runny nose. The clinical symptoms are different in children between 8 respiratory virus infections. This study increases our knowledge of the etiological and clinical characteristics of these 8 common respiratory viruses among children with respiratory tract infections. Which might also provide relevant data to guide clinical treatment and prevention.