Environmental persistence of Human Rotavirus causing a large outbreak in Western Mindanao, Philippines, 2016

Abstract

Purpose: Pneumocystis jivoreci is an opportunistic pathogen which can lead to life threatening respiratory failure. It has a documented mortality of between 5-20%. Historically it was almost exclusive to HIV patients however; an increase in immunosuppressive therapies has led to a reciprocal increase in the prevalence of Pneumocystis pneumonia (PJP) in this non-HIV population.Despite clear guidelines for PJP prophylaxis in HIV, there is a haphazard approach in other immunosuppressed populations.A growing body of evidence suggests that immunosuppressed patients are at an increased risk of PJP, but to what extent, or to whom that risk is greatest is not certain.Given this uncertainty we felt it prudent to review regional rates of PJP to develop a clearer understanding of the potential at risk population.Methods & Materials: We audited a random cohort of 103 patients with Pneumocystis pneumonia over a 5 year period in a region in the United Kingdom. We collated information on potential risk factors, morbidity and mortality.Results: The highest proportion of patients were cancer patients, however the most at risk population were rheumatology patients, with a 73% mortality rate in those who tested positive for PCP.Admission to ICU was 38% and mortality was 32%. Mortality was highest when prescribed three modalities of immunosuppression in combination; however prednisolone alone carries a mortality rate of 62%. Conclusion:We feel that prophylaxis guidelines should be considered in these identified high risk groups, but much more study is required on the absolute risk, and on how prophylaxis should be approached.

Bottleneck Size-Dependent Changes in the Genetic Diversity and Specific Growth Rate of a Rotavirus A Strain

“…Rotavirus, a doublestranded RNA (dsRNA) virus with 11 genome segments, exists as quasispecies (15) and is transmitted via the fecal-oral route and causes severe diarrhea among children under five years old. Despite recommendations to vaccinate and improve hygiene (10), rotavirus outbreaks have occurred sporadically both in developed and developing countries (11)(12)(13)(14). Assuming a human-to-human transmission, RRV was serially passaged under weaker or stronger bottleneck events (multiplicity of infection (MOI) of 0.1 or 0.001, respectively) without any positive selections.…”

Bottleneck Size-Dependent Changes in the Genetic Diversity and Specific Growth Rate of a Rotavirus A Strain

“…Rotavirus is a double-stranded RNA (dsRNA) virus with 11 genome segments that is transmitted via the fe-cal-oral route and causes severe diarrhea among children under five years old. Despite recommendations to vaccinate and improve hygiene (10), rotavirus outbreaks have occurred sporadically both in developed and developing countries (11–14). Assuming a human-to-human transmission, RRV was serially passaged under weaker or stronger bottleneck events (multiplicity of infection (MOI) of 0.1 or 0.001, respectively) without any positive selections.…”