Severe Respiratory Illness Associated with Human Metapneumovirus in Nursing Home, New Mexico, USA.

Human metapneumovirus is an emerging pathogen that causes upper and lower respiratory illness. Nursing home outbreaks of infection with this virus can cause severe illness and lead to poor patient outcomes. We report an outbreak investigation in a nursing home during 2018 and infection control guidelines to assist in disease control.

Human bocavirus species 2 and 3 in Brazil.

BACKGROUND: The newly described human bocavirus (HBoV) species 2 and 3 have been repeatedly detected in stool strengthening the possibility that these viruses might present a tropism for the gastrointestinal tract and may be etiological agents of diarrhea. OBJECTIVE: In this study we assessed the presence of HBoV2 and HBoV3 in stool specimens from Brazilians with acute gastroenteritis. STUDY DESIGN: Stool samples from Brazilian patients with acute diarrhea were analyzed for HBoV2 and HBoV3 by PCR assay. Full or partial genome sequences were obtained for selected isolates. Electron microscopy analysis was used to investigate virus morphology. RESULTS: Electron microscopy confirmed the presence of virus-like particles in HBoV PCR-positive specimens, with morphology similar to other members of the Parvoviridae family. Five samples out of 807 (0.6%) were positive for HBoV3. Three of the HBoV3-positive patients were HIV/AIDS positive. A selected group of 144 samples was also tested for HBoV2 and 30 samples (20.8%) were positive, 11 of which were HIV/AIDS positive. CONCLUSION: This study reports the detection and genetic characterization of HBoV3 and HBoV2 in the stool of Brazilian patients with acute diarrhea. This is the first description of HBoV3 outside Australia, suggesting a wide global distribution of this virus. Further studies are needed to better understand the role of HBoV in gastrointestinal infections, particularly among patients with HIV/AIDS.

Positive selection results in frequent reversible amino acid replacements in the G protein gene of human respiratory syncytial virus.

Human respiratory syncytial virus (HRSV) is the major cause of lower respiratory tract infections in children under 5 years of age and the elderly, causing annual disease outbreaks during the fall and winter. Multiple lineages of the HRSVA and HRSVB serotypes co-circulate within a single outbreak and display a strongly temporal pattern of genetic variation, with a replacement of dominant genotypes occurring during consecutive years. In the present study we utilized phylogenetic methods to detect and map sites subject to adaptive evolution in the G protein of HRSVA and HRSVB. A total of 29 and 23 amino acid sites were found to be putatively positively selected in HRSVA and HRSVB, respectively. Several of these sites defined genotypes and lineages within genotypes in both groups, and correlated well with epitopes previously described in group A. Remarkably, 18 of these positively selected tended to revert in time to a previous codon state, producing a "flip-flop" phylogenetic pattern. Such frequent evolutionary reversals in HRSV are indicative of a combination of frequent positive selection, reflecting the changing immune status of the human population, and a limited repertoire of functionally viable amino acids at specific amino acid sites.

Positive selection results in frequent reversible amino acid replacements in the G protein gene of human respiratory syncytial virus

Human respiratory syncytial virus (HRSV) is the major cause of lower respiratory tract infections in children under 5 years of age and the elderly, causing annual disease outbreaks during the fall and winter. Multiple lineages of the HRSVA and HRSVB serotypes co-circulate within a single outbreak and display a strongly temporal pattern of genetic variation, with a replacement of dominant genotypes occurring during consecutive years. In the present study we utilized phylogenetic methods to detect and map sites subject to adaptive evolution in the G protein of HRSVA and HRSVB. A total of 29 and 23 amino acid sites were found to be putatively positively selected in HRSVA and HRSVB, respectively. Several of these sites defined genotypes and lineages within genotypes in both groups, and correlated well with epitopes previously described in group A. Remarkably, 18 of these positively selected tended to revert in time to a previous codon state, producing a "flipflop" phylogenetic pattern. Such frequent evolutionary reversals in HRSV are indicative of a combination of frequent positive selection, reflecting the changing immune status of the human population, and a limited repertoire of functionally viable amino acids at specific amino acid sites.

Padrões de circulação temporal em vírus sincicial respiratório humano dos grupos A e B / Standards of temporal circulatory in human respiratory syncytial virus in groups A e B

O vírus respiratório síncicial humano é classificado em dois grupos principais, A e B. Ambos os grupos contêm múltiplas variantes, reconhecidas por anticorpos monoclonais e técnicas genéticas, notadamente sequenciamento. Com o intuito de caracterizar a epidemiologia molecular de cepas de vírus respiratório sincicial humano, foi realizado o sequenciamento de uma região variável do gene que codifica a proteína responsável pela ligação do respectivo vírus à célula em amostras colhidas durante 5 anos consecutivos em uma comunidade. A análise filogenética realizada identificou clades distintas (genotipos), subsequentemente divididos em subtipos, com base em similiaridade > 96 por cento a nível de nucleotídeo. Foram identificados cinco genotipos e 22 subtipos entre os 123 isolados de vírus respiratório sincicial humano do grupo A e quatro genotipos e seis subtipos entre os 81 isolados do grupo B. Um ou dois genotipos e subtipos representaram no mínimo 50 por cento dos isolados identificados em cada ano. Foi verificada uma altemância no genotipo e subtipo predominantes, circulantes em cada ano, sendo que nenhum genotipo ou subtipo predominou por mais de um ano nos cinco anos do estudo. A consistência na substituição das cepas predominantes sugere que um "shift", mesmo entre as cepas de um mesmo grupo, representaria uma vantagem evolutiva para o vírus. Postulamos que a "nova" cepa circulante em um determinado ano teria maior capacidade de evadir a imunidade previamente induzida a nível da população e consequentemente circular mais eficientemente. A altemância anual apresentada pelas cepas de vírus respiratório sincicial humano pode contribuir para a melhor capacidade do vírus em causar surtos anuais de doença respiratória. Nossos resultados também sugerem que a caracterização de vírus respiratório sincicial humano a nível de grupo e genotipo pode ser necessária para compreender melhor o papel da imunidade protetora, após a infecção natural pelo vírus, bem como para a avaliação dos estudos envolvendo a eficácia de vacinas contra o vírus

Caminho percorrido na construçäo do sistema de saúde em Campina Grande-PB / Steps to implantation to Campina Grande-PB Health System

Este trabalho, busca de forma sucinta registrar a memória institucional de etapas ligadas à construçäo do Sistema de Saúde na cidade de Campina Grande, esperando, com isso, abrir mais um canal para a democratizaçäo destas informaçöes. Para isso, nos propomos a realizar um estudo retrospectivo, isento de análise conjuntural, dando ênfase ao processo de Municipalizaçäo. Os registros aqui contidos säo frutos de dados primários obtidos através de conversas informais com pessoas que, direta ou indiretamente participaram desse processo e de dados secundários contidos nos documentos formais. Certamente, possíveis lacunas seräo identificadas, resultantes da ausência de registro da maioria desses fatos juntos aos órgäos competentes