Exposure Characteristics of Hantavirus Pulmonary Syndrome Patients, United States, 1993-2015.
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ABSTRACT:
SUBMITTER: de St Maurice A
PROVIDER: S-EPMC5403056 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:We describe a case of hantavirus pulmonary syndrome in a patient exposed to Sin Nombre virus in a coastal county in California, USA, that had no previous record of human cases. Environmental evaluation coupled with genotypic analysis of virus isolates from the case-patient and locally trapped rodents identified the likely exposure location.
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Project description:BackgroundThe treatment, genotyping, and phenotyping of patients with World Health Organization Group 1 pulmonary arterial hypertension (PAH) have evolved dramatically in the last decade.Research questionThe United States Pulmonary Hypertension Scientific Registry was established as the first US PAH patient registry to investigate genetic information, reproductive histories, and environmental exposure data in a contemporary patient population.Study design and methodsInvestigators at 15 US centers enrolled consecutively screened adults diagnosed with Group 1 PAH who had enrolled in the National Biological Sample and Data Repository for PAH (PAH Biobank) within 5 years of a cardiac catheterization demonstrating qualifying hemodynamic criteria. Exposure and reproductive histories were collected by using a structured interview and questionnaire. The biobank provided genetic data.ResultsBetween 2015 and 2018, a total of 499 of 979 eligible patients with clinical diagnoses of idiopathic PAH (IPAH) or familial PAH (n = 240 [48%]), associated PAH (APAH; n = 256 [51%]), or pulmonary venoocclusive disease/pulmonary capillary hemangiomatosis (n = 3 [1%]) enrolled. The mean age was 55.8 years, average BMI was 29.2 kg/m2, and 79% were women. Mean duration between symptom onset and diagnostic catheterization was 1.9 years. Sixty-six percent of patients were treated with more than one PAH medication at enrollment. Past use of prescription weight loss drugs (16%), recreational drugs (27%), and oral contraceptive pills (77%) was common. Women often reported miscarriage (37%), although PAH was rarely diagnosed within 6 months of pregnancy (1.9%). Results of genetic testing identified pathogenic or suspected pathogenic variants in 13% of patients, reclassifying 18% of IPAH patients and 5% of APAH patients to heritable PAH.InterpretationPatients with Group 1 PAH remain predominately middle-aged women diagnosed with IPAH or APAH. Delays in diagnosis of PAH persist. Treatment with combinations of PAH-targeted medications is more common than in the past. Women often report pregnancy complications, as well as exposure to anorexigens, oral contraceptives, and/or recreational drugs. Results of genetic tests frequently identify unsuspected heritable PAH.
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Project description:Hantavirus pulmonary syndrome (HPS) is a human disease caused by a newly identified hantavirus, which we will refer to as Four Corners virus (FCV). FCV is related most closely to Puumala virus (PUU) and to Prospect Hill virus (PHV). Twenty-five acute HPS serum samples were tested for immunoglobulin G (IgG) and IgM antibody reactivities to FCV-encoded recombinant proteins in Western blot (immunoblot) assays. All HPS serum samples contained both IgG and IgM antibodies to the FCV nucleocapsid (N) protein. FCV N antibodies cross-reacted with PUU N and PHV N proteins. A dominant FCV N epitope was mapped to the segment between amino acids 17 and 59 (QLVTARQKLKDAERAVELDPDDVNKSTLQSRRAAVSALETKLG). All HPS serum samples contained IgG antibodies to the FCV glycoprotein-1 (G1) protein, and 21 of 25 serum samples contained FCV G1 IgM antibodies. The FCV G1 antibodies did not cross-react with PUU G1 and PHV G1 proteins. The FCV G1 type-specific antibody reactivity mapped to a segment between amino acids 59 and 89 (LKIESSCNFDLHVPATTTQKYNQVDWTKKSS). One hundred twenty-eight control serum samples were tested for IgG reactivities to the FCV N and G1 proteins. Nine (7.0%) contained FCV N reactivities, 3 (2.3%) contained FCV G1 reactivities, and one (0.8%) contained both FCV N and FCV G1 reactivities. The epitopes recognized by antibodies present in control serum samples were different from the epitopes recognized by HPS antibodies, suggesting that the control antibody reactivities were unrelated to FCV infections. These reagents constitute a type-specific assay for FCV antibodies.
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Project description:Phylogenetic analyses, based on partial medium- and large-segment sequences, support an ancient evolutionary origin of a genetically distinct hantavirus detected by reverse transcription-PCR in tissues of northern short-tailed shrews (Blarina brevicauda) captured in Minnesota in August 1998. To our knowledge, this is the first evidence of hantaviruses harbored by shrews in the Americas.
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Project description:Isoprene is the 2-methyl analog of 1,3-butadiene and is a possible human carcinogen (IARC Group 2B). We assessed isoprene exposure in the general US population by measuring its urinary metabolite, N-acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-l-cysteine (IPM3) in participants (≥3 year old) from the 2015-2016 National Health and Nutrition Examination Survey. Spot urine samples were analyzed for IPM3 using ultrahigh-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry. Exclusive tobacco smokers were distinguished from non-users using a combination of self-reporting and serum cotinine data. IPM3 was detected in 80.2% of samples. The median IPM3 level was higher for exclusive cigarette smokers (39.8 μg/g creatinine) than for non-users (3.05 μg/g creatinine). Sample weighted regression analysis, controlling for creatinine, sex, age, race, body mass index, and diet, showed that IPM3 was positively and significantly associated with serum cotinine. Smoking 1-10 cigarettes per day (CPD, 0.5 pack) was significantly associated with an IPM3 increase of 596% (p < .0001), and smoking >20 CPD (>1 pack) was significantly associated with an IPM3 increase of 1640% (p < .0001), controlling for confounding variables. Drinking beer/ale at median and 90th percentile levels (compared to zero consumption) was associated (p < 0.05) with 0 and 2.9% increase in IPM3 in non-users, respectively. We conclude that tobacco smoke is a major source of isoprene exposure in the US population. This study provides important public health biomonitoring data on isoprene exposure in the general US population.
| S-EPMC7931248 | biostudies-literature
Project description:To confirm circulation of Anajatuba virus in Maranhao, Brazil, we conducted a serologic survey (immunoglobulin G ELISA) and phylogenetic studies (nucleocapsid gene sequences) of hantaviruses from wild rodents and persons with hantavirus pulmonary syndrome. This virus is transmitted by Oligoryzomys fornesi rodents and is responsible for hantavirus pulmonary syndrome in this region.
| S-EPMC3294554 | biostudies-literature
Project description:ImportanceAcute traumatic spinal cord injury results in disability and use of health care resources, yet data on contemporary national trends of traumatic spinal cord injury incidence and etiology are limited.ObjectiveTo assess trends in acute traumatic spinal cord injury incidence, etiology, mortality, and associated surgical procedures in the United States from 1993 to 2012.Design, setting, and participantsAnalysis of survey data from the US Nationwide Inpatient Sample databases for 1993-2012, including a total of 63,109 patients with acute traumatic spinal cord injury.Main outcomes and measuresAge- and sex-stratified incidence of acute traumatic spinal cord injury; trends in etiology and in-hospital mortality of acute traumatic spinal cord injury.ResultsIn 1993, the estimated incidence of acute spinal cord injury was 53 cases (95% CI, 52-54 cases) per 1 million persons based on 2659 actual cases. In 2012, the estimated incidence was 54 cases (95% CI, 53-55 cases) per 1 million population based on 3393 cases (average annual percentage change, 0.2%; 95% CI, -0.5% to 0.9%). Incidence rates among the younger male population declined from 1993 to 2012: for age 16 to 24 years, from 144 cases/million (2405 cases) to 87 cases/million (1770 cases) (average annual percentage change, -2.5%; 95% CI, -3.3% to -1.8%); for age 25 to 44 years, from 96 cases/million (3959 cases) to 71 cases/million persons (2930 cases), (average annual percentage change, -1.2%; 95% CI, -2.1% to -0.3%). A high rate of increase was observed in men aged 65 to 74 years (from 84 cases/million in 1993 [695 cases] to 131 cases/million [1465 cases]; average annual percentage change, 2.7%; 95% CI, 2.0%-3.5%). The percentage of spinal cord injury associated with falls increased significantly from 28% (95% CI, 26%-30%) in 1997-2000 to 66% (95% CI, 64%-68%) in 2010-2012 in those aged 65 years or older (P < .001). Although overall in-hospital mortality increased from 6.6% (95% CI, 6.1%-7.0%) in 1993-1996 to 7.5% (95% CI, 7.0%-8.0%) in 2010-2012 (P < .001), mortality decreased significantly from 24.2% (95% CI, 19.7%-28.7%) in 1993-1996 to 20.1% (95% CI, 17.0%-23.2%) in 2010-2012 (P = .003) among persons aged 85 years or older.Conclusions and relevanceBetween 1993 and 2012, the incidence rate of acute traumatic spinal cord injury remained relatively stable but, reflecting an increasing population, the total number of cases increased. The largest increase in incidence was observed in older patients, largely associated with an increase in falls, and in-hospital mortality remained high, especially among elderly persons.
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Project description:BackgroundPrevalence of self-reported methamphetamine use has remained relatively stable over the past decade; however, deaths and seizures involving methamphetamine have been increasing. Research is needed to determine if select subgroups in the US are at increased risk for use.MethodsWe examined data from individuals ages ≥12 from the 2015-2018 National Survey on Drug Use and Health (n = 226,632), an annual nationally representative cross-sectional survey of non-institutionalized individuals in the US. Log-linear trends in past-year methamphetamine use were examined, stratified by demographic and drug use characteristics.ResultsMethamphetamine use increased in the US from 2015 to 2018, including among those reporting past-year use of ecstasy/MDMA (6.1 % to 10.8 % [p = .018], a 78.2 % increase), cocaine (8.4 % to 11.8 % [p = .013], a 40.1 % increase), and among those reporting past-year prescription opioid misuse (5.4 % to 8.0 % [p = .019], a 49.2 % increase). Increases were particularly pronounced among those reporting past-year use of heroin (22.5 % to 37.4 % [p = .032], a 66.2 % increase) and LSD (5.1 %-= to 10.3 % [p = .002], a 100.4 % increase). Small increases were also detected among heterosexuals (0.6 % to 0.7 % [p = .044], a 16.2 % increase), those with a high school diploma or less (1.0 % to 1.2 % [p = .020], a 22.0 % increase), and among those receiving government assistance (1.4 % to 1.8 % [p = .046], a 26.2 % increase).ConclusionsMethamphetamine use is increasing among people who use other drugs with sharp increases among people who use heroin or LSD in particular, and this could have serious public health consequences. Results may signal that methamphetamine use may continue to increase in the general population.
| S-EPMC7371537 | biostudies-literature
Project description:Heartland virus (HRTV) is a North American phlebovirus suspected to be transmitted by the lone star tick Amblyomma americanum. White-tailed deer (WTD) have been shown to develop HRTV-neutralizing antibodies following experimental infection. To further define the geographic distribution of HRTV through retrospective sampling of WTD, sera from the WTD herd health serum archive at the Southeastern Cooperative Wildlife Disease Study between 2001 and 2015 were analyzed using serum neutralization. Of 783 serum samples tested, 57 (7.3%) were positive for HRTV-neutralizing antibodies. Deer with moderate to heavy tick burdens were more likely seropositive. Seropositive samples were obtained from deer originating from states with documented human cases of HRTV-associated disease. Seropositive samples were identified from years before the recognition of the first human case in 2009. Overall, this study indicates that WTD in the southeastern United States have been exposed to HRTV as early as 2001 and that the presence of seropositive animals corresponds roughly with reported human HRTV-associated disease.
| S-EPMC6221220 | biostudies-literature