Acute Respiratory Disease at a Chinese Military Recruitment Training Center: Three-Year Consecutive Investigation

Background Military recruits are at a higher risk of acute respiratory disease(ARD) and the causative agents might change over time, which needs to be investigated. Methods The nasopharyngeal swabs and blood samples were consecutively collected from conscripts for three years in a military training center. The real-time fluorescent quantitative PCR assays were conducted for 15 species of common respiratory pathogens; the serum anti-Legionella pneumophila antibodies were detected by indirect immunofluorescence(IIF) assay, and serum anti-Microplasma pneumoniae antibodies, serum anti-influenza B virus and anti-influenza A virus-Ig M and Ig G were detected by ELISA. Results The prevalences of ARD were 59.3%(108/182) in 2008, 23.3%(50/215) in 2009,and 19.6%(40/204) in 2010. Among the patients with ARD from 2008 to 2010, the influenza B virus infection accounted for 45.4%, 30.0% and 55.0%, and seasonal influenza A virus infection for 8.3%, 8.0% and 5.0%, respectively; the positive rates of serum anti-Legionella pneumophila and anti-Microplasma pneumoniae antibodies in recruits was lower than 10% each year respectively in the three years without diagnostic significance. Conclusion The early appropriate diagnosis and treatment of ARD in military personnel will ensure the power strength of armed forces.

Temperature Inversions,Meteorological Variables and Air Pollutants and Their Influence on Acute Respiratory Disease in the Guadalajara Metropolitan Zone,Jalisco,Mexico

The presence of temperature inversions (TI), concentration of air pollutants (AP) and meteorological variables (MV) affect the welfare of the population, creating public health problems (acute respiratory diseases ARDs, among others). The Guadalajara Metropolitan Zone (GMZ) experiences high levels of air pollution, which associated with the presence of temperature inversions and meteorological variations is conducive to the incidence of ARDs in children. The aim of this work is to evaluate the TI, MV, AP and their influence on the ARDs in children under five years in the GMZ from 2003 to 2007. In this period, the moderate and strong TI are the most frequent presenting from November to May. The AP shows a variable behavior during the year and between years, with the highest concentration of particles less than 10 microns (PM10), followed by ozone (O3), nitrogen dioxide (NO2), nitrogen oxides (NOX), carbon monoxide (CO) and sulfur dioxide (SO2), the most affected areas are the southeast of the GMZ. Annual arithmetic mean is 213,510 ± 41,209 ARDs consultations. The most important diseases are acute respiratory infections (98.0%), followed by pneumonia and bronchopneumonia (1.1%), asthma and status asthmaticus (0.5%) and streptococcal pharyngitis and tonsillitis (0.4%). Months with most inquiries were from October to March, mainly in the southeast, south and center of the city, coinciding with high levels of AP. Statistical analysis shows that the TI have significant correlation with ARDs in three years, temperature (Temp) in two, relative humidity (RH) in two, wind speed (WS) in three, wind direction (WD) in two, while that air pollutants NOX and NO2 showed significant correlation with ARDs throughout the period. CO and SO2 showed significance in two years, while the PM10 and O3 in one.

Simultaneous detection of enterovirus-D68 and vaccine-related poliovirus 3 in the stool samples of a 5-month hospitalized child with acute respiratory disease:A case report

Human enterovirus(EV)infections can lead to various manifestations,with variable correlations between genotypes and symptoms.Human enterovirus D68(EV-D68)was considered to be associated with acute respiratory disease and acute flaccid myelitis.In this short report,both EV-D68 and poliovirus 3 were detected in the stool of a hospitalized 5-month child who presented with acute respiratory symptoms and who was recently vaccinated with oral polio vaccine(OPV),using a metatranscriptomic high-throughput sequencing method.The nearly full-length genome sequences with complete open reading frames of EV-D68 and poliovirus 3 were assembled.One previously-reported neurovirulence-related amino acid substitution(T860N)in the EV-D68 VP1 region was observed,but the patient showed no neurological symptoms.More attention should be paid to EV-D68,and continuous multiple syndrome-based surveillance on non-polio enterovirus is called for.

Early stage nonclinical pulmonary disorder in COVID-19 may present asymptomatic and fuel the contagion

Evidence shows that pulmonary problems in coronavirus disease 2019(COVID-19)may set off from vascular injury that progresses to physiological disturbances through a compromised gas exchange,following an infection with the severe acute respiratory syndrome coronavirus 2.In this process,inefficient gas exchange in the alveolar could precipitate silent nonclinical hypoxemia.Unfortunately,patients with“silent hypoxemia”do not necessarily experience any breathing difficulty(dyspnea)at the early stage of COVID-19 while the disease progresses.As a result,several asymptomatic,presymptomatic and patients with mild symptoms may escape quarantine measure and thus continue to spread the virus through contacts.Therefore,early diagnosis of“silent hypoxemia“,which attracts no clinical warnings,could be an important diagnostic measure to prevent acute respiratory distress syndrome from the risk of pulmonary failure among the presymptomatic and as a screening tool in the asymptomatic who are hitherto potential spreaders of the virus.

Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses:a retrospective study

Human adenoviruses(HAdVs)can cause acute hepatitis in immunocompromised patients.However,it is unclear whether HAdVs are contributors to hepatitis in immunocompetent children.In this study,the liver function test(LFT)results were retrospectively analyzed among children hospitalized(age<14 years)between January 2016 and October 2019 for acute respiratory infection caused by adenoviruses.Alanine transaminase(ALT)and aspartate aminotransferase(AST)levels were elevated in 7.74%and 46.89%of patients,respectively.All patients with>2 folds of the upper limit of ALT or AST levels were infected with HAdV-7 or HAdV-55.Significantly higher levels of ALT,AST,γ-glutamyl transpeptidase(γ-GT),and lower albumin levels were observed in the HAdV-7 infection group than in the HAdV-3 infection group.HAdV-55 infection led to significantly higherγ-GT,total bilirubin,and direct bilirubin levels than the other infection types.The records of four patients with serial monitoring of the LFT results were further analyzed.Multiple indicators remained abnormal during the entire hospitalization in these patients.These results indicate that HAdV infection is often accompanied by abnormal liver function,and HAdV-7 and HAdV-55 might be under-recognized contributors to hepatitis among children.

Seroprevalence of Neutralizing Antibodies against Six Human Adenovirus Types Indicates the Low Level of Herd Immunity in Young Children from Guangzhou, China

Human adenoviruses(HAdVs) commonly cause many diseases such as respiratory diseases, gastroenteritis, cystitis worldwide. HAdV-3,-7,-4 and emergent HAdV-55 and HAdV-14 are the most important types causing severe respiratory diseases. There is no effective drug available for clinical treatment, and no vaccine available for the general population.Therefore, it is important to investigate the seroprevalence against HAdV for developing novel vaccines and vectors. In this study, we investigated the seroprevalence and titer levels of neutralizing antibodies(NAb) against HAdV-3,-4,-7,-14,-55,and-11 in total 278 healthy populations between 0 months and 49 years of age(228 children and 50 adults) from Guangzhou. In children under the age of 18 years, the seropositive rates were significantly increased against HAdV-3 at12.07%, 33.96%, and 64.29% and against HAdV-7 at 0%, 18.87%, and 19.05% in age groups of 1–2, 3–5, and 6–17 years,respectively. The seroprevalence was very low(0% - 8.1%) for all other four types. In adults aged between 18 and49 years, HAdV-3,-4, and-7(> 50.00%) were the most common types, followed by HAdV-14(38.00%),-55(34.00%),and-11(24.00%). Adults tended to have high NAb titers against HAdV-4 and-55. HAdV-55-seropositive donors tended to be HAdV-11-and HAdV-14-seropositive. These results indicated the low level of herd immunity against all six HAdV types in young children, and HAdV-14,-55,-11 in adults from Guangzhou City. Our findings demonstrate the importance of monitoring HAdV types and developing vaccines against HAdV for children and adults.

Molecular targets for COVID-19 drug development:Enlightening Nigerians about the pandemic and future treatment

There is little or no research initiated on enlightening Nigerians about the pathogenesis,targets for drug development and repositioning for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Coronavirus disease 2019(COVID-19)is a viral infection causing symptoms like dry cough,sore throat,nasal congestion,tiredness,fever,loss of taste,and smell etc.The disease was first reported in Wuhan,China,in December 2019.The infection is caused by SARS-CoV-2,which is the third introduction of a highly pathogenic coronavirus into the human population.Coronaviruses are viruses with a positive RNA envelope assigned toα,β,γ,andδgenera.Moreover,SARS-CoV-2 belongs to theβgenus.The four structural proteins ofβcoronavirus are membrane(M),envelope(E),spike(S),and nucleocapsid(N)protein,mediation of coronavirus host infection is established by spike(S)protein.Therefore,the search for drug development targets and repositioning of existing therapeutics is essential for fighting the present pandemic.It was reviewed that therapeutics targeting SARS-CoV-2 binding to ACE2 receptor,viral RNA synthesis and replication,3CLpro,RdRp,and helicase will play a crucial role in the development of treatment for SARS-CoV-2 infection.Furthermore,the RdRp and spike protein of SARS-CoV-2 are the most promising targets for drug development and repositioning and vaccine development.Remdesivir combination with chloroquine/hydroxychloroquine are promising drug repositioning for the treatment of COVID-19,and mRNA-1273 targeting spike protein is the promising vaccine.However,as patient management and drug repositioning are taking place,it is imperative to identify other promising targets used by SARS-CoV-2 to establish infection,to develop novel therapeutics.