Posts Tagged ‘Emerging disease’

Pathogenesis and Emergence of Arboviruses

Friday, August 12th, 2011

Arboviruses A myriad of factors favor the emergence and re-emergence of arthropod-borne viruses (arboviruses), including migration, climate change, intensified livestock production, an increasing volume of international trade and transportation, and changes to ecosystems (e.g., deforestation and loss of biodiversity). Consequently, arboviruses are distributed worldwide and represent over 30% of all emerging infectious diseases identified in the past decade. Although some arboviral infections go undetected or are associated with mild, flu-like symptoms, many are important human and veterinary pathogens causing serious illnesses such as arthritis, gastroenteritis, encephalitis and hemorrhagic fever and devastating economic loss as a consequence of lost productivity and high mortality rates among livestock. One of the most consistent molecular features of emerging arboviruses, in addition to their near exclusive use of RNA genomes, is the inclusion of viral, non-structural proteins that act as interferon antagonists. In this review, we describe these interferon antagonists and common strategies that arboviruses use to counter the host innate immune response. In addition, we discuss the complex interplay between host factors and viral determinants that are associated with virus emergence and re-emergence, and identify potential targets for vaccine and anti-viral therapies.

 

The Role of Interferon Antagonist, Non-Structural Proteins in the Pathogenesis and Emergence of Arboviruses. (2011) Viruses 3(6): 629-658; doi:10.3390/v3060629

The virus is dead. Long live the virus!

Friday, July 8th, 2011

Microbiology Today How do we face up to the global challenge of emerging virus infections? With a solid grasp of the historical perspective and armed with the latest genomic toolkit, we can now evaluate the relative merits of eradication, vaccination and chemotherapy as Paul Duprex and Elke Mühlberger explain in this article in Microbiology Today (pdf):

Emerging and re-emerging viruses will be a continuing threat to human health because of their amazing potential to adapt to their current hosts, to switch to new hosts and to evolve strategies to escape antiviral measures. Moreover, global climate changes and destruction of habitats, in combination with extensive travel activity, may promote the spread of currently unknown pathogens. This threat comes not only from naturally occurring infections, but may also arise from bio- terrorism attacks involving deliberate release. Some emerging viruses, such as filoviruses, have attracted substantial scientific and popular attention despite the fact that less than 3,000 cases have been described since the first isolation of Marburg virus more than 40 years ago. Nevertheless, the deadly appearance of these viruses, with fatality rates of up to 90%, would most likely cause panic and social disruption in the case of an outbreak.

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Bacteriophage therapy of Pseudomonas aeruginosa in Cystic Fibrosis

Monday, April 18th, 2011

Pseudomonas aeruginosa Pseudomonas aeruginosa is the second most common pathogen responsible for hospital-acquired bacterial pneumonia as well as ventilator-associated pneumonia, and the first causative agent of morbidity and mortality in cystic fibrosis (CF) patients. Although antibiotics are still an effective means of treating bacterial lung infections, the alarming rise of multidrug-resistant bacteria in hospitals has highlighted the need for new therapies. Bacteriophages – viruses infecting bacteria – have been proposed to treat human bacterial infections since their discovery in the early 20th century. However, after a short period of development, the advent of antibiotics led to this therapeutic approach being abandoned, except in Eastern Europe where bacteriophages are still used today to treat patients. During the past 20 years, studies in animal models have demonstrated the potential of bacteriophages. Recently the first phase II clinical trial on bacteriophage treatments of chronic otitis was published, and demonstrated the interest of using bacteriophages on multidrug resistant infections.

The effects of bacteriophage therapy on lung infections has only very recently been addressed in animal models. On the one hand, a proof of concept with a bioluminescent strain of P. aeruginosa showed that bacteriophages administrated intranasally had a rapid efficacy with respect to preventing and curing deadly lung infections. On the other hand, a clinical strain of Burkholderia cenocepacia isolated from a CF patient was used to show that the intraperitoneal administration of bacteriophages was more effective than intranasal applications in a non-deadly infectious model. This paper reports an evaluation in an animal model of the efficacy of curative and preventive bacteriophage treatments of lung infections using a multidrug resistant mucoid P. aeruginosa strain isolated from a CF patient.

Pulmonary Bacteriophage Therapy on Pseudomonas aeruginosa Cystic Fibrosis Strains: First Steps Towards Treatment and Prevention. (2011) PLoS ONE 6(2): e16963. doi:10.1371/journal.pone.0016963
Multidrug-resistant bacteria are the cause of an increasing number of deadly pulmonary infections. Because there is currently a paucity of novel antibiotics, phage therapy – the use of specific viruses that infect bacteria – is now more frequently being considered as a potential treatment for bacterial infections. Using a mouse lung-infection model caused by a multidrug resistant Pseudomonas aeruginosa mucoid strain isolated from a cystic fibrosis patient, we evaluated bacteriophage treatments. New bacteriophages were isolated from environmental samples and characterized. Bacteria and bacteriophages were applied intranasally to the immunocompetent mice. Survival was monitored and bronchoalveolar fluids were analysed. Quantification of bacteria, bacteriophages, pro-inflammatory and cytotoxicity markers, as well as histology and immunohistochemistry analyses were performed. A curative treatment (one single dose) administrated 2 h after the onset of the infection allowed over 95% survival. A four-day preventive treatment (one single dose) resulted in a 100% survival. All of the parameters measured correlated with the efficacy of both curative and preventive bacteriophage treatments. We also showed that in vitro optimization of a bacteriophage towards a clinical strain improved both its efficacy on in vivo treatments and its host range on a panel of 20 P. aeruginosa cystic fibrosis strains. This work provides an incentive to develop clinical studies on pulmonary bacteriophage therapy to combat multidrug-resistant lung infections.

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Vaccine Potential of Nipah Virus-Like Particles

Friday, April 15th, 2011

Nipah VLP Since it was first recognized in 1998, Nipah virus (NiV) has caused several outbreaks in humans of encephalitic disease associated with high lethality. In the first outbreak, which was in Malaysia and Singapore, 265 humans became sick and some 40% of them died. Epidemiological links pointed to human contact with sick pigs in commercial piggeries, and the outbreak was brought under control through culling of approximately 1.1 million pigs. Since then, the virus has re-emerged in Bangladesh and neighboring India, starting in 2001, and between then and now, has caused several smaller but even deadlier disease outbreaks with case fatality rates ranging between 60 and 90%. Unlike the Malaysian outbreak, the route of transmission in these outbreaks was considered to be bat-to-human via food contaminated with bat saliva. In some cases, nosocomial transmissibility and person-to-person spread was also noted. An additional concern is that NiV is also potentially an agent of agro-terror since the rate of transmission of this virus in the pig population is close to 100%. Effective vaccine and therapies are needed to combat the threats posed by NiV.

2011 Vaccine Potential of Nipah Virus-Like Particles. 2011 PLoS ONE 6(4): e18437. doi:10.1371/journal.pone.0018437
Nipah virus (NiV) was first recognized in 1998 in a zoonotic disease outbreak associated with highly lethal febrile encephalitis in humans and a predominantly respiratory disease in pigs. Periodic deadly outbreaks, documentation of person-to-person transmission, and the potential of this virus as an agent of agroterror reinforce the need for effective means of therapy and prevention. In this report, we describe the vaccine potential of NiV virus-like particles (NiV VLPs) composed of three NiV proteins G, F and M. Co-expression of these proteins under optimized conditions resulted in quantifiable amounts of VLPs with many virus-like/vaccine desirable properties including some not previously described for VLPs of any paramyxovirus: The particles were fusogenic, inducing syncytia formation; PCR array analysis showed NiV VLP-induced activation of innate immune defense pathways; the surface structure of NiV VLPs imaged by cryoelectron microscopy was dense, ordered, and repetitive, and consistent with similarly derived structure of paramyxovirus measles virus. The VLPs were composed of all the three viral proteins as designed, and their intracellular processing also appeared similar to NiV virions. The size, morphology and surface composition of the VLPs were consistent with the parental virus, and importantly, they retained their antigenic potential. Finally, these particles, formulated without adjuvant, were able to induce neutralizing antibody response in Balb/c mice. These findings indicate vaccine potential of these particles and will be the basis for undertaking future protective efficacy studies in animal models of NiV disease.

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Emerging fungal pathogens

Wednesday, April 6th, 2011

Microbiology Today As the number of immunocompromised individuals grows, fungal pathogens are becoming ever more important. In this article in Microbiology Today (pdf) Ken Haynes discusses how functional genomics technologies are helping to combat these less than well known eukaryotic adversaries:

The late 20th and early 21st centuries have seen the emergence (HIV), re-emergence (TB) and progression (malaria) of infectious disease around the world. The antibiotic age seemed to have rid us, the developed world at least, of the massive impact wrought by devastating infectious diseases. However, the war has not been won. Microbial pathogens have fought back, with extraordinary resourcefulness. Antibiotic resistance has given rise to populations of bacteria that are almost untreatable; vancomycin-resistant Staphylococcus aureus is a prime example. In addition, successful antibiotic therapies, combined paradoxically with advances in medical treatments, especially in the areas of transplantation and chemotherapy, have resulted in the emergence of a large group of immunocompromised patients that are now at serious risk of invasive, life-threatening disease from a group of fungi. These organisms are perhaps less well known than their bacterial and viral counterparts, but are nonetheless devastating for that.

 

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New Virus Identified in China Kills 30% of Victims

Thursday, March 17th, 2011

A previously unrecognized severe febrile illness in China has been traced to a novel bunyavirus, possibly transmitted by ticks. Characterized by severe fever and thrombocytopenia, the illness had an initial case fatality rate of 30%. Since June 2009, investigators have documented the presence of the virus in 171 patients from six regions in central and northeastern China, and the infection proved fatal in 12% of cases. The virus invaded multiple cells, but primarily thrombocytes and leukocytes. Multi-organ failure developed rapidly, as reflected by elevated liver enzymes, creatine kinase, and lactate dehydrogenase. A causal relationship between the virus and the illness has yet to be established. However, epidemiologic, clinical, and laboratory data strongly implicate the virus in the febrile illness, the researchers reported online in the New England Journal of Medicine.

via Medical News: New Viral Illness in China Linked to Ticks

Source:

Fever with Thrombocytopenia Associated with a Novel Bunyavirus in China. NEJM March 16 2011 doi: 10.1056/NEJMoa1010095

Present and future arbovirus threats

Monday, February 28th, 2011

Arthropod-borne viruses (arboviruses) are transmitted biologically among vertebrate hosts by hematophagous (blood feeding) arthropod vectors such as mosquitoes and other biting flies, and ticks. Being, by definition, biologically transmitted, arboviruses must replicate in the arthropod vector prior to transmission, as opposed to being mechanically transmitted, without replication in the vector, through contaminated mouthparts. Biological transmission can be vertical, involving the passage of the virus from an infected female vector to both male and female offspring. Horizontal transmission can be venereal, from a vertically infected male directly to a female vector, as well as oral from a female vector to a vertebrate host via the saliva during blood feeding. The latter horizontal mode of transmission is most common for the majority of arboviruses and involves infection of the vector alimentary tract following a viremic bloodmeal, dissemination of the virus in the vector, and eventual virus replication in the salivary glands, followed by the injection of infectious saliva during blood feeding.

The march of West Nile virus

The arboviruses include a wide variety of RNA virus taxa including the alphaviruses (genus Alphavirus, one of two genera in the family Togaviridae); the flaviviruses (genus Flavivirus, one of three genera in the family Flaviviridae); the bunyaviruses (Bunyaviridae: Bunyavirus), nairoviruses (Bunyaviridae: Nairovirus) and phleboviruses (Bunyaviridae: Phlebovirus); the orbiviruses (one of nine genera in the family Reoviridae); the vesiculoviruses (one of six genera in the family Rhabdoviridae) and the thogotoviruses (one of four genera in the family Orthomyxoviridae). These groups of RNA viruses have a variety of types of RNA genomes and replication strategies, suggesting that the arthropod-borne transmission strategy has arisen many times during the evolution of RNA viruses. The only known DNA arbovirus is African swine fever virus (Asfarviridae: Asfarvirus), and the paucity of DNA arboviruses suggests that the greater genetic plasticity and higher mutation rates exhibited by RNA viruses allow them to accommodate a cycle of alternating replication in disparate vertebrate and invertebrate hosts.

Arboviruses circulate among wild animals, and cause disease after spillover transmission to humans and/or domestic animals that are incidental or dead-end hosts. Viruses such as dengue (DENV) and chikungunya (CHIKV) that have lost the requirement for enzootic amplification now produce extensive epidemics. Many arboviruses that have evolved and diversified in the tropics have produced virulent and invasive strains that have caused major outbreaks at temperate latitudes. The ability of these viruses to cause human disease depends on factors ranging from epidemiology to viral genetics. Herein, we review how some of these factors have led to arboviral emergences and resulted in human disease, by using several examples of viruses with a known epidemic history as well as some that have a poorly recognized epidemic potential.

Present and future arboviral threats. Antiviral Res. 2010 85(2): 328-345
Arthropod-borne viruses (arboviruses) are important causes of human disease nearly worldwide. All arboviruses circulate among wild animals, and many cause disease after spillover transmission to humans and agriculturally important domestic animals that are incidental or dead-end hosts. Viruses such as dengue (DENV) and chikungunya (CHIKV) that have lost the requirement for enzootic amplification now produce extensive epidemics in tropical urban centers. Many arboviruses recently have increased in importance as human and veterinary pathogens using a variety of mechanisms. Beginning in 1999, West Nile virus (WNV) underwent a dramatic geographic expansion into the Americas. High amplification associated with avian virulence coupled with adaptation for replication at higher temperatures in mosquito vectors, has caused the largest epidemic of arboviral encephalitis ever reported in the Americas. Japanese encephalitis virus (JEV), the most frequent arboviral cause of encephalitis worldwide, has spread throughout most of Asia and as far south as Australia from its putative origin in Indonesia and Malaysia. JEV has caused major epidemics as it invaded new areas, often enabled by rice culture and amplification in domesticated swine. Rift Valley fever virus (RVFV), another arbovirus that infects humans after amplification in domesticated animals, undergoes epizootic transmission during wet years following droughts. Warming of the Indian Ocean, linked to the El Niño-Southern Oscillation in the Pacific, leads to heavy rainfall in east Africa inundating surface pools and vertically infected mosquito eggs laid during previous seasons. Like WNV, JEV and RVFV could become epizootic and epidemic in the Americas if introduced unintentionally via commerce or intentionally for nefarious purposes. Climate warming also could facilitate the expansion of the distributions of many arboviruses, as documented for bluetongue viruses (BTV), major pathogens of ruminants. BTV, especially BTV-8, invaded Europe after climate warming and enabled the major midge vector to expand is distribution northward into southern Europe, extending the transmission season and vectorial capacity of local midge species. Perhaps the greatest health risk of arboviral emergence comes from extensive tropical urbanization and the colonization of this expanding habitat by the highly anthropophilic (attracted to humans) mosquito, Aedes aegypti. These factors led to the emergence of permanent endemic cycles of urban DENV and CHIKV, as well as seasonal interhuman transmission of yellow fever virus. The recent invasion into the Americas, Europe and Africa by Aedes albopictus, an important CHIKV and secondary DENV vector, could enhance urban transmission of these viruses in tropical as well as temperate regions. The minimal requirements for sustained endemic arbovirus transmission, adequate human viremia and vector competence of Ae. aegypti and/or Ae. albopictus, may be met by two other viruses with the potential to become major human pathogens: Venezuelan equine encephalitis virus, already an important cause of neurological disease in humans and equids throughout the Americas, and Mayaro virus, a close relative of CHIKV that produces a comparably debilitating arthralgic disease in South America. Further research is needed to understand the potential of these and other arboviruses to emerge in the future, invade new geographic areas, and become important public and veterinary health problems.

Alternative Lifestyles of Species in the Fungal Genus Pneumocystis

Wednesday, February 23rd, 2011

Pneumocystis Pneumocystis species are ascomycetous fungi that obligatorily dwell with no apparent ill effect in the lungs of normal mammals, but they become pathogenic when host defenses are compromised. Identified more than 100 years ago, these atypical fungi manifest characteristics that are unique within the Fungi, such as the lack of ergosterol, genetic complexity of surface antigens, and antigenic variation. Thought to be confined to the severely immunocompromised host, Pneumocystis spp. are being associated with new population niches owing to the advent of immunomodulatory therapies and increased numbers of patients suffering from chronic diseases. The inability to grow Pneumocystis spp. outside the mammalian lung has thwarted progress toward understanding their basic biology, but via the use of new genetic tools and other strategies, researchers are beginning to uncover their biological and genetic characteristics including a biphasic life cycle, significant metabolic capacities, and modulation of lifestyles. This review describes the alternative lifestyles indulged in by these organisms.

Stealth and opportunism: alternative lifestyles of species in the fungal genus Pneumocystis. Annu Rev Microbiol. 2010 64: 431-452

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Patterns and predictions for the arrival, establishment and spread of exotic diseases

Tuesday, January 18th, 2011

The march of West Nile virus Emerging infectious diseases arise by a range of distinct phenomena, such as the resurgence or upsurge of pre-existing endemic infections, the arrival of exotic microorganisms and the appearance of genetically new microorganisms. The evolutionary emergence of new human pathogens is driven by changes in the biological barriers that determine host-pathogen interactions and therefore the transmission competence of any new partnership. True evolutionary emergence is rare. Among emerging infectious diseases other than infection by drug-resistant bacteria, there is a high percentage of zoonoses. This review focuses on infectious diseases that have emerged recently in new areas, where selection may favour microbial genetic novelties. Among these, vector-borne pathogens are particularly common.

The arrival, establishment and spread of exotic diseases: patterns and predictions. Nature Rev Microbiol. 2010 8(5): 361-371 doi: 10.1038/nrmicro2336
The impact of human activities on the principles and processes governing the arrival, establishment and spread of exotic pathogens is illustrated by vector-borne diseases such as malaria, dengue, chikungunya, West Nile, bluetongue and Crimean-Congo haemorrhagic fevers. Competent vectors, which are commonly already present in the areas, provide opportunities for infection by exotic pathogens that are introduced by travel and trade. At the same time, the correct combination of environmental conditions (both abiotic and biotic) makes many far-flung parts of the world latently and predictably, but differentially, permissive to persistent transmission cycles. Socioeconomic factors and nutritional status determine human exposure to disease and resistance to infection, respectively, so that disease incidence can vary independently of biological cycles.

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