4 Mar 2015

4 years of the #humanitarian #tragedy in #Syria: who cares? (The Lancet, extract)

[Source: The Lancet, full page: (LINK). Extract.]


4 years of the humanitarian tragedy in Syria: who cares? [  SOC  ]

Humam Saltaji


© 2015 Elsevier Ltd. All rights reserved.


While the humanitarian crisis continues to worsen in Syria, the international community's support continues to weaken. Since December, 2013, at least 16 Syrian children and newborns have been reported to have frozen to death within the refugee camps bordering Syria and inside the country, including seven Syrian children and newborns who have frozen to death in the 2nd week of January, 2015 alone.




#Pregnancy Does Not Attenuate the #Antibody or Plasmablast #Response to Inactivated #Influenza #Vaccine (J Infect Dis., abstract, edited)

[Source: The Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

regnancy Does Not Attenuate the Antibody or Plasmablast Response to Inactivated Influenza Vaccine [      ]

Alexander W. Kay 1,*, Nicholas L. Bayless 2,*, Julia Fukuyama 3, Natali Aziz 4, Cornelia L. Dekker 1, Sally Mackey 1, Gary E. Swan 5, Mark M. Davis 2,6 and Catherine A. Blish 2,7

Author Affiliations: 1Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA 2Stanford Immunology, Stanford University School of Medicine, Stanford, CA, 94305, USA 3Department of Statistics, Stanford University, Stanford, CA, 94305, USA 4Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, 94305, USA 5Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA 6Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, CA, 94305, USA 7Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA

Corresponding author: Catherine A. Blish, M.D., Ph.D. Stanford University School of Medicine, 300 Pasteur Dr. Lane Building, L134, Stanford, CA 94305, Phone: 650-725-5132, Fax: 650-723-3474,

* Both authors contributed equally to this work.




Inactivated influenza vaccine (IIV) is recommended during pregnancy to prevent influenza infection and its complications in pregnant women and their infants. However, the extent to which pregnancy modifies the antibody response to vaccination remains unclear, and prior studies have focused primarily on hemagglutinin inhibition (HI) titers. A more comprehensive understanding of how pregnancy modifies the humoral immune response to influenza vaccination will aid in maximizing vaccine efficacy.


Healthy pregnant women and control women were studied prior to, 7 days after and 28 days after vaccination with IIV. HI titers, microneutralization (MN) titers and the frequency of circulating plasmablasts were evaluated in pregnant vs. control women.


Pregnant women and control women mount similarly robust serologic immune responses to IIV, with no significant differences for any influenza strain in post-vaccination geometric mean HI or MN titers. HI and MN titers correlate, though MN titers demonstrate more robust changes pre- vs. post-vaccination. The induction of circulating plasmablasts is increased in pregnant women vs. controls (median fold-change 2.60 vs. 1.49 [Interquartile Range 0.94-7.53 vs. 0.63-2.67]; p=0.03).


Pregnant women do not have impaired humoral immune responses to IIV and may have increased circulating plasmablast production compared to control women.

Received January 23, 2015. Revision received February 25, 2015. Accepted February 26, 2015.

© The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:



#Anhui Province reported a new #human case of #infection with #H7N9 #birdflu virus (Ifeng, March 4 2015, edited)

[Source: Ifeng, full page in Chinese: (LINK). Automatic translation, edited.]

#Anhui Province reported a new #human case of #infection with #H7N9 #birdflu virus [      ]

At 17:44 on March 4, 2015 / Source: People's Daily

Hefei March 4 - according to the Anhui Provincial Health and Family Planning Commission March 4 a new human case of H7N9 avian influenza virus infection has been confirmed.

The case is a male, 68 years old, backyard poultry farmers, resident in Chizhou east county, with exposure to live poultry before the onset of illness. On March 4 was diagnosed with H7N9 cases, the patient is now in a hospital in Anqing City for treatment.



#Egypt reported two new fatal #cases of #H5N1 #birdflu virus #infection (MoH, March 4 2015, edited)

[Source: Ministry of Health of Egypt, full page in Arabic: (LINK). Automatic translation, edited.]

#Egypt reported two new fatal #cases of #H5N1 #birdflu virus #infection [      ]

(March 4 2015)

The Ministry of Health and Population announced the recovery of an earlier reported case of H5N1 avian influenza virus infection: a child two years old child from the lake province.

The MoH also announced that  a 16 years old student from the eastern province and 33-years-old woman from Cairo Governorate passed away.

Currently, the total number of cases under treatment at MoH hospitals stands at 11.

Therefore the Ministry of Health reminded to citizens who deal with poultry immediately go to the nearest hospital for medical service in the case of the emergence of symptoms of influenza them where to receive the infected bird flu drug Tamiflu within the first 24 hours of the onset of symptoms increases the cure rates of disease and reduces death rates and advises the Ministry of Health of citizens who deal with poultry to exercise caution and prudence when dealing with birds, especially that shows the symptoms and the need to take preventive measures to prevent infection, such as covering the mouth and nose when dealing with poultry, wash your hands with soap and water after handling birds and not to take children to places of breeding birds or slaughter, as well as the need to separate the birds from the living quarters.

Source: Media Center



#HK, #Tourist with #fever tests negative for #MERS-CoV (CHP, March 4 2015)

[Source: Centre for Health Protection, Hong Kong PRC SAR, full page: (LINK).]

Tourist with fever tests negative for MERS-CoV [      ]

The Centre for Health Protection (CHP) of the Department of Health (DH) today (March 4) reported a suspected case of Middle East Respiratory Syndrome (MERS) which tested negative for MERS Coronavirus (MERS-CoV), and called on the public to stay alert and maintain good personal, food and environmental hygiene during travel.

The male patient, aged 43 with good past health, presented with fever and sore throat on February 28 during his stay in Dubai and sought medical attention from a local doctor. He travelled from Dubai to Hong Kong on March 2 and developed a high fever and cough with sputum after arriving in Hong Kong. He consulted a private doctor on the same day and attended the outpatient department of a private hospital the next day as his symptoms worsened. He was subsequently transferred to Pamela Youde Nethersole Eastern Hospital for isolation and treatment. He is currently in a stable condition.

The patient had no contact with camels or other animals while he was in Dubai. He claimed that some of his relatives in Dubai had influenza symptoms but have recovered. His travel collateral to Hong Kong remains asymptomatic.

His nasopharyngeal aspirate tested negative for MERS-CoV upon preliminary testing by the CHP's Public Health Laboratory Services Branch (PHLSB).


The public may visit the pages below for more information and health advice:

Tour leaders and tour guides operating overseas tours are advised to refer to the CHP's health advice on MERS (



3 Mar 2015

Estimating the #Life #Course of #Influenza A(#H3N2) #Antibody Responses from Cross-Sectional Data (PLoS Biology, abstract, edited)

[Source: PLoS Biology, full page: (LINK). Abstract, edited.]

Open Access / Peer-reviewed / Research Article

Estimating the Life Course of Influenza A(H3N2) Antibody Responses from Cross-Sectional Data [      ]

Adam J. Kucharski , Justin Lessler, Jonathan M. Read, Huachen Zhu, Chao Qiang Jiang, Yi Guan, Derek A. T. Cummings, Steven Riley

Published: March 3, 2015 / DOI: 10.1371/journal.pbio.1002082



The immunity of a host population against specific influenza A strains can influence a number of important biological processes, from the emergence of new virus strains to the effectiveness of vaccination programmes. However, the development of an individual’s long-lived antibody response to influenza A over the course of a lifetime remains poorly understood. Accurately describing this immunological process requires a fundamental understanding of how the mechanisms of boosting and cross-reactivity respond to repeated infections. Establishing the contribution of such mechanisms to antibody titres remains challenging because the aggregate effect of immune responses over a lifetime are rarely observed directly. To uncover the aggregate effect of multiple influenza infections, we developed a mechanistic model capturing both past infections and subsequent antibody responses. We estimated parameters of the model using cross-sectional antibody titres to nine different strains spanning 40 years of circulation of influenza A(H3N2) in southern China. We found that “antigenic seniority” and quickly decaying cross-reactivity were important components of the immune response, suggesting that the order in which individuals were infected with influenza strains shaped observed neutralisation titres to a particular virus. We also obtained estimates of the frequency and age distribution of influenza infection, which indicate that although infections became less frequent as individuals progressed through childhood and young adulthood, they occurred at similar rates for individuals above age 30 y. By establishing what are likely to be important mechanisms driving epochal trends in population immunity, we also identified key directions for future studies. In particular, our results highlight the need for longitudinal samples that are tested against multiple historical strains. This could lead to a better understanding of how, over the course of a lifetime, fast, transient antibody dynamics combine with the longer-term immune responses considered here.


Author Summary

Host immunity against seasonal influenza viruses influences the emergence of new virus strains, the size and severity of “flu” epidemics, and the effectiveness of vaccination programmes. However, the specific factors that shape the immune response of a single human to a particular strain are little understood because individual infections and the development of immunity over a lifetime in that person are rarely observed directly. To determine the aggregate effect of a lifetime of influenza infections on host immunity, we developed a mathematical model that captures the specific strains with which an individual has been infected and for the corresponding antibody response, the relative contribution of boosting, cross-reactivity, and antigenic seniority to its neutralising ability. Combining the model with data from a survey in southern China that examined antibody levels against nine different influenza strains from 1968 to 2009, we revealed key components of the immune response to influenza virus infection, and obtained estimates of the frequency of influenza infection and the ages at which infection occurred. Our results suggest that “antigenic seniority”, whereby strains encountered earlier in life gain more “senior” positions in the immune response, and short-lived cross-reactivity between different strains are important components of the immune response and, therefore, could shape the evolution and emergence of influenza viruses.


Citation: Kucharski AJ, Lessler J, Read JM, Zhu H, Jiang CQ, et al. (2015) Estimating the Life Course of Influenza A(H3N2) Antibody Responses from Cross-Sectional Data. PLoS Biol 13(3): e1002082. doi:10.1371/journal.pbio.1002082

Academic Editor: Andrew Fraser Read, The Pennsylvania State University, UNITED STATES

Received: April 16, 2014; Accepted: January 16, 2015; Published: March 3, 2015

Copyright: © 2015 Kucharski et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Data Availability: Data on observed individual titres are available as Dataset S1 in DOI: 10.1371/journal.ppat.1002802. Model estimated titres are available in S1 Data.

Funding: This work is supported by the Medical Research Council (UK, Project MR/J008761/1); Wellcome Trust (UK, Project 093488/Z/10/Z); Fogarty International Centre (USA, R01 TW008246-01); Fogarty International Centre with the Science & Technology Directorate, Department of Homeland Security (USA, RAPIDD program); National Institute for General Medical Sciences (US, MIDAS U01 GM110721-01); and National Institute for Health Research (UK, for Health Protection Research Unit funding). JL's work was supported by a grant from NIAID (K22 AI092150-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations:: HA, haemagglutinin; HAI, haemagglutination inhibition; NA, neuraminidase



#Reassortant #Avian #Influenza A(#H9N2) Viruses in #Chickens in Retail #Poultry #Shops, #Pakistan, 2009–2010 (@CDC_EIDjournal, edited)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Edited.]

lume 21, Number 4—April 2015  / Dispatch

Reassortant Avian Influenza A(H9N2) Viruses in Chickens in Retail Poultry Shops, Pakistan, 2009–2010 [      ]

Mamoona Chaudhry, Angélique Angot, Hamad B. Rashid, Giovanni Cattoli, Manzoor Hussain, Giulia Trovò, Alessandra Drago, Viviana Valastro, Michael Thrusfield, Sue Welburn, Mark C. Eisler, and Ilaria Capua

Author affiliations: University of Veterinary and Animal Sciences, Lahore, Pakistan (M. Chaudhry, H.B. Rashid); University of Edinburgh, Edinburgh, Scotland, UK (M. Chaudhry, M. Thrusfield, S. Welburn); Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università, Legnaro, Padua, Italy (A. Angot, G. Cattoli, G. Trovò, A. Drago, V. Valastro, I. Capua); Food and Agriculture Organization of the United Nations, Islamabad, Pakistan (M. Hussain); University of Bristol, Bristol, UK (M.C. Eisler)



Phylogenetic analysis of influenza viruses collected during December 2009–February 2010 from chickens in live poultry retail shops in Lahore, Pakistan, showed influenza A(H9N2) lineage polymerase and nonstructural genes generate through inter- and intrasubtypic reassortments. Many amino acid signatures observed were characteristic of human isolates; hence, their circulation could enhance inter- or intrasubtypic reassortment.


The first outbreak of illness caused by avian influenza A(H9N2) virus in Pakistan was reported in 1998; isolates showed a close relationship to subtype H9N2 avian influenza viruses (AIVs) circulating in Hong Kong, China during 1997 that were grouped within the G1 lineage (1). In recent years, H9N2 genes have reassorted extensively, generating novel genotypes on the Indian subcontinent. Widespread co-circulation of H9N2 with other AIVs (e.g., highly pathogenic AIVs H5N1 and H7N3) could instigate the generation of novel variant and reassorted viruses, possibly with increased zoonotic potential (2).

No information was available about the genetic makeup of AIVs circulating in live poultry retail shops (LPRSs) in Pakistan. This study was conducted to genetically characterize AIVs in LPRSs in Lahore District, Pakistan.


The Study



Thumbnail of Location of live poultry retail shops (X) in 5 towns in Lahore, Pakistan, where avian influenza A(H9N2) virus isolates were identified in chickens, 2009–2010. Inset shows location of Lahore in Punjab Province.


Figure. Location of live poultry retail shops (X) in 5 towns in Lahore, Pakistan, where avian influenza A(H9N2) virus isolates were identified in chickens, 2009–2010. Inset shows location of Lahore in Punjab...


We conducted a cross-sectional survey of LPRSs in Lahore (Figure), which is the capital of the Punjab Province in Pakistan. In each of 280 LPRSs, we collected tracheal swab samples from 5 randomly selected chickens and pooled them into 1 composite sample, totaling 280 pooled samples. The samples were characterized at the World Organisation for Animal Health/Food and Agriculture Organization of the United Nations National Reference Laboratory for Avian Influenza in Padua, Italy.

Of the 280 samples, 10 tested positive for H9N2 subtype by real-time reverse transcription PCR (rRT-PCR) (3) and virus isolation test (United Nations (Table 1( Results were negative for H5 and H7 subtypes. Two of the 280 samples were positive for Newcastle disease virus. Each of the 10 H9N2 isolates was characterized by sequencing for 6 gene segments (hemagglutinin [HA]: neuraminidase [NA], nonstructural [NS], matrix [M], and polymerase basic 1 and 2 [PB1, PB2]); 2 isolates (A/chicken/Pakistan/10RS3039-283-11/2010 and A/chicken/Pakistan/10RS3039-289-186/2010) were sequenced for all 8 gene segments (HA, NA, NS, M, PB1, PB2, polymerase [PA], and nucleoprotein [NP]), as described (4). Sequences for these viruses were deposited into GenBank (accession nos. KF975457–KF975503, and KP223678–KP223693). The NS gene sequence A/chicken/Pakistan/10RS3039-284-11/2010 could not be deposited due to poor data quality.

We generated neighbor-joining phylogenetic trees for all gene segments using the distance-based method in MEGA version 5.2.2 ( We calculated bootstrap values based on 1,000 replicates of alignment (5). HA and NA genes of viruses in this study tightly clustered within the G1 lineage along with H9N2 viruses from Pakistan, India, Iran, Israel, Saudi Arabia, and Bangladesh, suggesting derivation from a common ancestor: A/quail/Hong Kong/G1/97 (Technical Appendix[PDF - 688 KB - 7 pages]( Figure panels A, B). M and NP genes clustered within the G1 lineage (Technical Appendix[PDF - 688 KB - 7 pages]( Figure panels C, D) along with an influenza (H7N3) isolate from Pakistan (A/chicken/Karachi/NARC-100/2004; nucleotide identity >96% for M gene and 95% for NP gene). Two polymerase complex genes, PB1 and PA, and the NS gene did not cluster within G1 lineage or any other established Eurasian lineages: these gene sequences made a separate well-supported cluster with highly similar H9N2 viruses that circulated in Pakistan (2005–2008), Iran, India, and Bangladesh; these sequences had a high sequence identity (>95%) with A/chicken/Karachi/NARC-100/04 (H7N3) (2,6,7) (Technical Appendix[PDF - 688 KB - 7 pages]( Figure panels E, F, G). The PB2 segment clustered separately with H9N2 viruses from the subcontinent and Middle East (Technical Appendix[PDF - 688 KB - 7 pages]( Figure panel H), except A/chicken/Karachi/NARC-100/04. These results indicate a separate Indian subcontinental lineage of H9N2 viruses has emerged (2).

On the basis of these analyses, we could conclude that internal genes PB1, PA, and NS of these viruses originated by intersubtypic (between different HA subtypes) reassortment events from local H7N3 viruses circulating in Pakistan (nucleotide identity >95%). This suggests that intersubtypic reassortment events continuously result from mixing of AIV subtypes in domestic poultry and wild birds in Pakistan (8), and that PB2, M, and NP genes were acquired by intrasubtypic reassortment between H9N2 viruses of G1 lineage circulating within Pakistan. These results support speculation that the currently circulating H9N2 lineage is a reassortment of G1 lineage from Hong Kong and the highly pathogenic H7N3 virus that circulated in Pakistan and can be assigned to genetic group B (8).

We aligned amino acid sequences of current viruses and compared them to representative H9N2 lineages. When compared to the prototype G1 viruses, H9N2 viruses isolated from LPRSs showed that they have evolved to acquire mammalian host-specific mutations throughout the genome (Technical Appendix[PDF - 688 KB - 7 pages]( Table 1). Of these mutations, certain amino acid substitutions throughout the viral genome have become fixed (9). All LPRS isolates possessed the K-S-S-R motif at the cleavage site. The presence of lysine at position 4 was observed in H9 isolates from the Indian subcontinent (2,9), but it is uncommon elsewhere. Amino acid signature changes of human influenza viruses were also observed in internal gene segments (Table 2(

Each of the 10 isolates had the Q226L substitution (H3 numbering) in the receptor-binding site of HA, correlating to a shift in affinity from avian-type sialic acid receptor to human-type (10). We identified 3 representative substitutions: E/T190 A in 9 viruses and E/T190V in 1 virus, and Q227I in all 10 viruses (H3 numbering). The outcomes of these substitutions have not been investigated; further study is needed (2). Glycosylation sites at positions 551, 218, and 206 were absent in the study viruses, suggesting a frequent alteration in sequences from this region (2,6,9) and possibly signifying the selected adaptation of H9N2 to poultry (10). We did not find an R292K substitution, which is associated with resistance to the sialidase inhibitors oseltamivir and zanamivir, in the NA proteins of any of the 10 LPRS virus isolates. HB sites were also well conserved with few substitutions (K367E in 5 viruses, K367G in 1 virus, and S372A and W403R in all 10 viruses). An additional glycosylation site was present at position 44, which is believed to enhance virulence caused by altered antigenicity or sialidase activity (11) (Technical Appendix[PDF - 688 KB - 7 pages]( Table 1).

Many residues in nucleoprotein and polymerase are considered determinants of the host range of AIVs and increase virulence or replication in the mammalian host (2,10,12). The analyses of internal genes showed that these viruses also contained mammalian host-specific markers (2,8) that have become permanent in M protein (M1, V15I, T37A; M2, E16G, L55F); in PB1 protein (L13P); and in NS1 protein (V149A) of all LPRS isolates and in NP (E372D) of the 2 isolates we sequenced (Technical Appendix[PDF - 688 KB - 7 pages]( Table 2). In M2 protein, no substitutions linked to resistant amantadine were seen. All viruses contained an uncommon K-S-E-I sequence as a PDZ ligand motif in the NS protein. Residue isoleucine at the C-terminus of PDZ ligand motif has been reported as a rare substitution (12). NS also harbored E227K mutation in the C-terminal, which has been demonstrated to modulate pathogenicity of AIVs (13) and appeared to be a rare amino acid signature, although in this study it was observed in all 10 virus isolates from chickens in LPRSs.



Our analysis confirmed that continuous gene reassortment has occurred among influenza A(H9N2) viruses since their emergence in poultry in Pakistan. Because H9N2 viruses infect multiple species, they may donate genes to emerging human pathogens; it has been observed that H7N9 acquired internal genes from the avian H9N2 virus (14). In wet markets, availability of freshly slaughtered poultry, live poultry transportation, and mixed trading of domestic animals provide a favorable environment for gene reassortment, mutation, and interspecies transmission of AIVs (15). Continuous circulation of these viruses in LPRSs increases the chances of their evolution into new genotypes. Close contact of humans and poultry in LPRSs with no biosecurity barriers increases the risk for emergence of novel influenza viruses with zoonotic or human pandemic potential. Continued surveillance in LPRSs is essential to better understand the public health risk posed by H9N2 AIVs.


Dr. Chaudhry is an academician in the Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore. Her research interests include epidemiology of infectious diseases of public health concern.



We thank the staff members of the live poultry retail shops in which the study subjects were housed for data and sample collection.

The European Union project Training and technology transfer of avian influenza diagnostics and disease management skills (FLUTRAIN) provided financial support for training of MC at IZSVe, Italy. The Higher Education Commission of Pakistan provided a PhD scholarship to MC through the Overseas Scholarship Scheme (10%- Batch-2).

We acknowledge the memory of Isabel Minguez Tudela (1955–2011), of the European Commission, who supported this collaboration as a contribution to improving veterinary public health.



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Figure. Location of live poultry retail shops (X) in 5 towns in Lahore, Pakistan, where avian influenza A(H9N2) virus isolates were identified in chickens, 2009–2010. Inset shows location of Lahore in...(


Technical Appendix

Comparisons of structure and pathogenicity determinants of avian influenza isolates and phylogenetic distribution of 10 sequenced viruses from samples from chickens in live poultry retail shops in Lahore, Pakistan, 2009–2010.... 688 KB(


Suggested citation for this article: Chaudhry M, Angot A, Rashid HB, Cattoli G, Hussain M, Trovò G, et al. Reassortant avian influenza A(H9N2) viruses in chickens in retail poultry shops, Pakistan, 2009–2010. Emerg Infect Dis. 2015 April [date cited].

DOI: 10.3201/eid2104.141570



#Pregnant #women infected with pandemic influenza #H1N1pdm09 virus showed differential #immune #response correlated with disease severity (J Clin Virol., abstract, edited)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Clin Virol. 2015 Mar;64:52-8. doi: 10.1016/j.jcv.2015.01.009. Epub 2015 Jan 13.

Pregnant women infected with pandemic influenza A(H1N1)pdm09 virus showed differential immune response correlated with disease severity. [      ]

Periolo N1, Avaro M2, Czech A2, Russo M2, Benedetti E2, Pontoriero A2, Campos A2, Peralta LM3, Baumeister E2.

Author information: 1National Influenza Centre PAHO/WHO, Laboratorio Nacional de Referencia de Influenza y Virus Respiratorios, Servicio Virosis Respiratorias, Departamento Virología, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Carlos G. Malbrán", Buenos Aires, Argentina. Electronic address: 2National Influenza Centre PAHO/WHO, Laboratorio Nacional de Referencia de Influenza y Virus Respiratorios, Servicio Virosis Respiratorias, Departamento Virología, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Carlos G. Malbrán", Buenos Aires, Argentina. 3Instituto de Microbiología y Parasitología Médica, Universidad de Buenos Aires-Consejo Nacional de Investigaciones Científicas y Tecnológicas (IMPaM, UBA CONICET), Argentina.




During pregnancy, immunological and hormonal alterations place women at increased risk for influenza-related severe illnesses including hospitalization and death. Although A(H1N1) pdm09 infection resulted in increased disease severity in pregnant women, the precise mechanisms responsible for this risk have yet to be established.


The present study was aimed to investigate the role of host chemokines and cytokine profiles in A(H1N1) pdm09 infection regarding disease severity in pregnant women.


This retrospective survey examined 41 pregnant women with confirmed A(H1N1) pdm09 infection. Of them, 12 died (D), 29 survived (S), and 17 remained uninfected and served as controls (C). Antiviral response was evaluated for IFN-β expression and gene expression profiles of cytokines (TNF-α, IL-6, IL-12, TGF-β) and chemokines (IL-8, RANTES, MCP-1, IP-10), and the viral Matrix (M1) gene was quantified and normalized using the housekeeping gene product β-actin mRNA.


Higher IL-8 and TNF-α mRNA expression were found in D and S compared with C, while IL-6 showed higher expression in D. Interestingly, these results were associated with a decrease in the anti-inflammatory response of TGF-β mRNA and IFN-β. These alterations would lead to an imbalance in the immune response of those patients.


Pregnancy-related reductions in IFN-β and TGF-β expression levels and elevated levels of pro-inflammatory cytokines could explain the increased severity of infection and death of pregnant women. These findings may help improve the understanding of the high susceptibility and disease severity to influenza virus infection during pregnancy.

Copyright © 2015 Elsevier B.V. All rights reserved.

KEYWORDS: A(H1N1)pdm09; Chemokines; Cytokines; Influenza virus; Pregnant women

PMID: 25728079 [PubMed - in process]



Meet #Cuban #Ebola #Fighters: #Interview with Félix Báez and Jorge Pérez. A MEDICC Review Exclusive (MEDICC Rev., abstract, edited)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

MEDICC Rev. 2015 Jan;17(1):6-10.

Meet Cuban Ebola Fighters: Interview with Félix Báez and Jorge Pérez. A MEDICC Review Exclusive. [      ]

Reed G.



Tramping through the Himalayan snows to treat patients after the 2005 Pakistan earthquake, internist Félix Báez could never have imagined he would be on the front lines of Ebola in Sierra Leone nine years later….much less that he would contract the deadly virus, live to tell the story and also to return to his team in Africa to continue the fight. At his side in the Geneva University Hospital, where he was airlifted, was Dr Jorge Pérez, today director of Cuba's Pedro Kourí Tropical Medicine Institute (IPK), but best known as "Cuba's AIDS doctor." Times have changed for both physicians, and Ebola is first on their minds as it rages on. At this writing, while there is cautious optimism in Liberia, the epidemic is not yet under control. Ebola has already infected nearly 22,000 people, taken over 8600 lives; Sierra Leone is one of the countries hardest hit. Among the sick and dying have been too many local health workers: 103 of the 138 infected, at last count. The first to sound the global alarm was Doctors Without Borders, which, like Cuba, already had health professionals on the ground in Africa; they were joined by many more, and Cuba was the country that offered the most assistance once WHO called for nations to step up with funds and, most importantly, human resources. Cuba sent 256 volunteers, all with significant international emergency experience: 38 to Guinea, 53 to Liberia and 165 to Sierra Leone. And more wait in the wings, specially-trained disaster medical workers who have already received their first round of Ebola courses at IPK. These Cuban and other international volunteers are bringing patients back from the brink of death, assisting national health workers and community educators. And people like Jorge Pérez are working to get to the bottom of Ebola to help prevent its spread throughout Africa and to other parts of the world. But to keep an epidemic like this from happening again, it will take more, much more. Not only could the global community have done a better job this time around. But as Jim Kim, President of the World Bank admonished, Ebola didn't start with disease, but rather with historic inequalities, the virus festering within health systems barely able to function. A lesson for us all. Hours before Dr Báez's return to Sierra Leone-where he is now-MEDICC Review interviewed him and Dr Pérez at IPK in Havana.

PMID: 25725761 [PubMed - in process]



#Disinfecting personal protective #equipment with pulsed #xenon ultraviolet as a #risk mitigation #strategy for health care #workers (Am J Infect Control., abstract, edited)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Am J Infect Control. 2015 Feb 25. pii: S0196-6553(15)00031-0. doi: 10.1016/j.ajic.2015.01.013. [Epub ahead of print]

Disinfecting personal protective equipment with pulsed xenon ultraviolet as a risk mitigation strategy for health care workers. [      ]

Jinadatha C1, Simmons S2, Dale C3, Ganachari-Mallappa N4, Villamaria FC4, Goulding N5, Tanner B5, Stachowiak J3, Stibich M3.

Author information: 1Department of Medicine, Central Texas Veterans Healthcare System, Temple, TX; Department of Medicine, College of Medicine, Texas A&M Health Science Center, Bryan, TX. 2Xenex Disinfection Services LLC, San Antonio, TX. Electronic address: 3Xenex Disinfection Services LLC, San Antonio, TX. 4Department of Medicine, Central Texas Veterans Healthcare System, Temple, TX. 5Antimicrobial Test Laboratories, Round Rock, TX.



The doffing of personal protective equipment (PPE) after contamination with pathogens such as Ebola poses a risk to health care workers. Pulsed xenon ultraviolet (PX-UV) disinfection has been used to disinfect surfaces in hospital settings. This study examined the impact of PX-UV disinfection on an Ebola surrogate virus on glass carriers and PPE material to examine the potential benefits of using PX-UV to decontaminate PPE while worn, thereby reducing the pathogen load prior to doffing. Ultraviolet (UV) safety and coverage tests were also conducted. PX-UV exposure resulted in a significant reduction in viral load on glass carriers and PPE materials. Occupational Safety and Health Administration-defined UV exposure limits were not exceeded during PPE disinfection. Predoffing disinfection with PX-UV has potential as an additive measure to the doffing practice guidelines. The PX-UV disinfection should not be considered sterilization; all PPE should still be considered contaminated and doffed and disposed of according to established protocols.

Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

KEYWORDS: Doffing process; Ebola; Environmental disinfection; Outbreak control; Personal protective equipment; Ultraviolet

PMID: 25726129 [PubMed - as supplied by publisher]