Numerous viruses can cause upper respiratory tract infections. They often precede serious lower respiratory tract infections. Each virus has a seasonal pattern, with peaks in activity in different ...seasons. We examined the effects of daily local meteorological data (temperature, relative humidity, "humidity-range" and dew point) from Edinburgh, Scotland on the seasonal variations in viral transmission. We identified the seasonality of rhinovirus, adenovirus, influenza A and B viruses, human parainfluenza viruses 1-3 (HPIV), respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) from the 52060 respiratory samples tested between 2009 and 2015 and then confirmed the same by a generalised linear model. We also investigated the relationship between meteorological factors and viral seasonality. Non-enveloped viruses were present throughout the year. Following logistic regression adenovirus, influenza viruses A, B, RSV and HMPV preferred low temperatures; RSV and influenza A virus preferred a narrow "humidity-range" and HPIV type 3 preferred the season with lower humidity. A change (i.e. increase or decrease) in specific meteorological factors is associated with an increase in activity of specific viruses at certain times of the year.
There are no antivirals to treat viral upper respiratory tract infection (URTI). Since numerous viruses cause URTI, antiviral therapy is impractical. As we have evidence of chloride-ion dependent ...innate antiviral response in epithelial cells, we conducted a pilot, non-blinded, randomised controlled trial of hypertonic saline nasal irrigation and gargling (HSNIG) vs standard care on healthy adults within 48 hours of URTI onset to assess recruitment (primary outcome). Acceptability, symptom duration and viral shedding were secondary outcomes. Participants maintained a symptom diary until well for two days or a maximum of 14 days and collected 5 sequential mid-turbinate swabs to measure viral shedding. The intervention arm prepared hypertonic saline and performed HSNIG. We recruited 68 participants (2.6 participants/week; November 2014-March 2015). A participant declined after randomisation. Another was on antibiotics and hence removed (Intervention:32, Control:34). Follow up data was available from 61 (Intervention:30, Control:31). 87% found HSNIG acceptable, 93% thought HSNIG made a difference to their symptoms. In the intervention arm, duration of illness was lower by 1.9 days (p = 0.01), over-the-counter medications (OTCM) use by 36% (p = 0.004), transmission within household contacts by 35% (p = 0.006) and viral shedding by ≥0.5 log
/day (p = 0.04). We hence need a larger trial to confirm our findings.
Post-hoc secondary analysis of data from our recent Edinburgh and Lothians Viral Intervention Study (ELVIS) pilot randomised controlled trial (RCT) indicates that hypertonic saline nasal irrigation ...and gargling (HSNIG) reduced the duration of coronavirus upper respiratory tract infection (URTI) by an average of two-and-a-half days. Epithelial cells have this innate antiviral immune mechanism to clear viral infections. Since bleach is effective against all virus types 4, we tested to see if a range of DNA, RNA, enveloped and non-enveloped viruses were inhibited in the presence of chloride ions supplied via salt (NaCl). Table 1 Number of days for self reported symptom improvement in the control and intervention arms infected by a coronavirus Variable label Treatment N Mean SD Difference in mean (intervention – control) (95% CI for difference) P-value Blocked nose Intervention 7 4.0 2.2 -3.1 (-6.0, -0.2) 0.0362 Blocked nose Control 8 7.1 2.9 Chest congestion Intervention 7 1.9 1.2 -0.8 (-2.7, 1.2) 0.4056 Chest congestion Control 8 2.6 2.1 Cough Intervention 7 2.7 1.3 -3.3 (-5.9, -0.7) 0.0179 Cough Control 8 6.0 3.0 Head congestion Intervention 7 3.4 1.9 -1.9 (-5.0, 1.1) 0.1931 Head congestion Control 8 5.4 3.3 Hoarseness Intervention 7 2.4 1.6 -2.9 (-5.6, -0.3) 0.0325 Hoarseness Control 8 5.4 2.9 Scratchy throat Intervention 7 2.6 1.0 -2.1 (-5.1, 1.0) 0.1712 Scratchy throat Control 8 4.6 3.6 Sneezing Intervention 7 3.9 1.7 -1.0 (-3.8, 1.8) 0.4469 Sneezing Control 8 4.9 3.0 Sore throat Intervention 7 3.6 1.9 -1.1 (-4.4, 2.3) 0.5139 Sore throat Control 8 4.6 3.7 Runny nose Intervention 7 4.4 1.3 -1.6 (-4.1, 0.9) 0.1999 Runny nose Control 8 6.0 2.8 Feeling tired Intervention 7 3.6 1.8 -2.1 (-5.1, 1.0) 0.1671 Feeling tired Control 8 5.6 3.3 SD – standard deviation, CI – confidence interval Figure 1 Response to global severity question and severity of symptoms.
IntroductionEdinburgh and Lothians’ Viral Intervention Study Kids is a parallel, open-label, randomised controlled trial of hypertonic saline (HS) nose drops (~2.6% sodium chloride) vs standard care ...in children <7 years of age with symptoms of an upper respiratory tract infection (URTI).Methods and analysisChildren are recruited prior to URTI or within 48 hours of developing URTI symptoms by advertising in areas such as local schools/nurseries, health centres/hospitals, recreational facilities, public events, workplaces, local/social media. Willing parents/guardians, of children <7 years of age will be asked to contact the research team at their local site. Children will be randomised to either a control arm (standard symptomatic care), or intervention arm (three drops/nostril of HS, at least four times a day, until 24 hours after asymptomatic or a maximum of 28 days). All participants are requested to provide a nasal swab at the start of the study (intervention arm: before HS drops) and then daily for four more days. Parent/guardian complete a validated daily diary, an end of illness diary, a satisfaction questionnaire and a wheeze questionnaire (day 28). The parent/guardian of a child in the intervention arm is taught to prepare HS nose drops. Parent/guardian of children asymptomatic at recruitment are requested to inform the research team within 48 hours of their child developing an URTI and follow the instructions already provided. The day 28 questionnaire determines if the child experienced a wheeze following illness. Participation in the study ends on day 28.Ethics and disseminationThe study has been approved by the West of Scotland Research Ethics Service (18/WS/0080). It is cosponsored by Academic and Clinical Central Office for Research and Development—a partnership between the University of Edinburgh and National Health Service Lothian Health Board. The findings will be disseminated through peer-reviewed publications, conference presentations and via the study website.Trial registration numberNCT03463694.
Rash and arthralgia caused by hepatitis E Al-Shukri, Intisar, MD; Davidson, Emma, MRCGP; Tan, Adrian, MRCP ...
The Lancet (British edition),
11/2013, Letnik:
382, Številka:
9907
Journal Article
Recenzirano
The general practitioner requested baseline blood tests including full blood count, liver and renal function tests, rheumatoid factor, auto-antibodies and complements, prescribed analgesia, and ...referred the patient to a rheumatologist. Acute hepatitis E presenting as polyarthritis with longlasting viraemia (up to 7 months) has been reported in an individual who travelled to Egypt during the incubation period.3 By contrast, viraemia was short lived in our case. ...recently, HEV infection in developed countries was thought to be travel-associated.
We detected 2 hepatitis E virus (HEV) strains in an acutely infected immunocompetent patient. Two populations of genotype 3 virus were observed in the hypervariable regions and open reading frames 2 ...and 3, indicating multiple infection with hepatitis E virus. Persons with mixed infections may provide the opportunity for virus recombination.
Can Robots Improve Testing Capacity for SARS-CoV-2? Cresswell, Kathrin; Ramalingam, Sandeep; Sheikh, Aziz
JMIR. Journal of medical internet research/Journal of medical internet research,
08/2020, Letnik:
22, Številka:
8
Journal Article
Recenzirano
Odprti dostop
There is currently increasing interest internationally in deploying robotic applications for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, as these can help to reduce the risk ...of transmission of the virus to health care staff and patients. We provide an overview of key recent developments in this area. We argue that, although there is some potential for deploying robots to help with SARS-CoV-2 testing, the potential of patient-facing applications is likely to be limited. This is due to the high costs associated with patient-facing functionality, and risks of potentially adverse impacts on health care staff work practices and patient interactions. In contrast, back-end laboratory-based robots dealing with sample extraction and amplification, that effectively integrate with established processes, software, and interfaces to process samples, are much more likely to result in safety and efficiency gains. Consideration should therefore be given to deploying these at scale.
Phagocytes destroy ingested microbes by producing hypochlorous acid (HOCl) from chloride ions (Cl
) and hydrogen peroxide within phagolysosomes, using the enzyme myeloperoxidase. HOCl, the active ...ingredient in bleach, has antibacterial/antiviral properties. As myeloperoxidase is needed for HOCl production, non-myeloid cells are considered incapable of producing HOCl. Here, we show that epithelial, fibroblast and hepatic cells have enhanced antiviral activity in the presence of increasing concentrations of sodium chloride (NaCl). Replication of enveloped/non-enveloped, DNA (herpes simplex virus-1, murine gammaherpesvirus 68) and RNA (respiratory syncytial virus, influenza A virus, human coronavirus 229E, coxsackievirus B3) viruses are inhibited in a dose-dependent manner. Whilst treatment with sodium channel inhibitors did not prevent NaCl-mediated virus inhibition, a chloride channel inhibitor reversed inhibition by NaCl, suggesting intracellular chloride is required for antiviral activity. Inhibition is also reversed in the presence of 4-aminobenzoic hydrazide, a myeloperoxidase inhibitor, suggesting epithelial cells have a peroxidase to convert Cl
to HOCl. A significant increase in intracellular HOCl production is seen early in infection. These data suggest that non-myeloid cells possess an innate antiviral mechanism dependent on the availability of Cl
to produce HOCl. Antiviral activity against a broad range of viral infections can be augmented by increasing availability of NaCl.
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