Influenza viremia and the potential for blood‐borne transmission

Likos, Anna; Kelvin, David J.; Cameron, Cheryl M.; Rowe, Thomas; Kuehnert, Matthew J.; Norris, Philip J.

doi:10.1111/j.1537-2995.2007.01264.x

Cited by 73 publications

(48 citation statements)

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“…However, viremia from human influenza virus infection appears to be rare after onset of symptoms and, if it occurs, is not sustained for long periods. 78 Proof of replication of human influenza virus in extrarespiratory tissues comes from direct immunofluorescence, immunohistochemistry, or in situ hybridization in the tissue concerned. However, such reports are rare, and further confirmation of the ability of human influenza virus to replicate in extrarespiratory human tissues in vivo is badly needed.…”

Section: Human Influenza Virusesmentioning

confidence: 99%

“…The isolation of HPAI H5N1 virus from the blood of 2 patients and the detection of viral RNA by reverse transcriptase polymerase chain reaction in the blood of 9 of 16 patients suggest that viremia can occur at reasonably high levels and for prolonged periods in people with symptoms of HPAI H5N1 virus infection. 78 Another HPAI H5N1 virus that has been reported to cause fatal disease in humans is HPAI H7N7 virus. In 2003, infection with this virus caused an outbreak in poultry in the Netherlands, and the virus was detected in 86 people who had handled affected poultry, as well as 3 of their family members.…”

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confidence: 99%

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Comparative Pathology of Select Agent Influenza A Virus Infections

et al. 2010

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Influenza A virus infections may spread rapidly in human populations and cause variable mortality. Two of these influenza viruses have been designated as select agents: 1918 H1N1 virus and highly pathogenic avian influenza (HPAI) virus. Knowledge of the pathology of these virus infections in humans, other naturally infected species, and experimental animals is important to understand the pathogenesis of influenza, to design appropriate models for evaluation of medical countermeasures, and to make correct diagnoses. The most important complication of influenza in humans is viral pneumonia, which often occurs with or is followed by bacterial pneumonia. Viremia and extrarespiratory disease are uncommon. HPAI viruses, including HPAI H5N1 virus, cause severe systemic disease in galliform species as well as in anseriform species and bird species of other orders. HPAI H5N1 virus infection also causes severe disease in humans and several species of carnivores. Experimental animals are used to model different aspects of influenza in humans, including uncomplicated influenza, pneumonia, and virus transmission. The most commonly used experimental animal species are laboratory mouse, domestic ferret, and cynomolgus macaque. Experimental influenza virus infections are performed in various other species, including domestic pig, guinea pig, and domestic cat. Each of these species has advantages and disadvantages that need to be assessed before choosing the most appropriate model to reach a particular goal. Such animal models may be applied for the development of more effective antiviral drugs and vaccines to protect humans from the threat of these virus infections.

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Section: Human Influenza Virusesmentioning

confidence: 99%

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confidence: 99%

Comparative Pathology of Select Agent Influenza A Virus Infections

et al. 2010

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“…Many investigators have reported influenza viremia, the potential for blood-borne influenza transmission, and the need for blood screening for influenza. 6,7 It is likely that IAV is present in the blood during human infection and promotes DC differentiation from blood monocytes. In line with this possibility, it would be interesting to examine the potential increase in blood DCs during human infection, with the caveat that DCs may rapidly exit the blood and thereby avoid detection.…”

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confidence: 99%

Viral infection triggers rapid differentiation of human blood monocytes into dendritic cells

Hou

Gibbs

et al. 2012

Blood

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IntroductionPBMCs in healthy individuals consist of roughly 70% T cells, 10% B cells, 10% monocytes, and 1% each of natural killer (NK) cells and dendritic cells (DCs). Three distinct blood monocyte subsets can be identified on the basis of CD14 and CD16 expression: ϳ 90% CD14 ϩϩ CD16 Ϫ , 10% CD14 ϩ CD16 ϩϩ , and a minor population of CD14 ϩϩ CD16 ϩ . 1 DCs are potent APCs with a nearly unique capacity to prime naive T lymphocytes. 1 Because of their paucity in blood, DCs are typically generated by culturing monocytes ex vivo with cytokines. 2,3 Little is known about the interaction of PBMCs with viruses that principally replicate in nonimmune cells. Here, we investigate the effect of infecting PBMCs with 3 representative nonhemotropic viruses that are highly lytic to their normal host cells. Methods PBMC infectionFresh buffy coat preparations were obtained from healthy anoymous donors at the National Institutes of Health (NIH) blood bank who provided informed consent. We also obtained whole blood from healthy donors with informed consent in accordance with the Declaration of Helsinki approved by University of California at Los Angeles Institutional Review Board. PBMCs or purified monocytes were incubated with virus for 1 hour at room temperature in balanced salt solution with 0.1% BSA and then resuspended at 1 ϫ 10 6 cells per well in complete RPMI 1640. Six or 18 hours after infection, cells were stained with mAbs including PerCP-eFluor 710-conjugated anti-CD3, -CD14, -CD19, and -CD56 or a combination of these "lineage marker" mAbs (all eBioscience); eFluor 450-conjugated anti-HLA-DR, AlexaFluor700 anti-CD11c, and PE-Cy7-conjugated anti-CD123 (all eBioscience); AlexaFluor488 anti-hemagglutinin (Bennink-Yewdell Lab, National Institute of Allergy and Infectious Diseases); PE-Cy7-conjugated anti-TNF, eFluor605NC anti-CD16, and PE anti-CD83 (all eBioscience); PE anti-CD1c (Miltenyi Biotec); PE anti-CD141 (BD Biosciences); FITC anti-CLEC4C (Miltenyi Biotec); and APC anti-CLEC9A (R&D Systems). Real-time PCRAfter 6 hours' infection, total RNA purified from influenza A virus (IAV)-infected monocytes primed with random hexamers was PCR analyzed with Profiler PCR arrays for DC APC and IFN/IFN receptor gene expression (SABiosciences PAHS-406 and PAHS-064), with expression normalized to 5 internal housekeeping genes. A custom array was obtained from SABiosciences for the detection of the human genes CCR7, CD1C,, and LAMP3 (DC-LAMP). Results and discussionWe chose 3 representative viruses: IAV, vesicular stomatitis (VSV), and vaccinia virus (VV). For VV and VSV, we measured infection by expression of enhanced green fluorescent protein inserted into the viral genome. For IAV, infection was monitored by cell surface expression of hemagglutinin. After infecting PBMCs for 6 or 18 hours, cells were characterized by standard flow cytometry phenotypic markers ( Figure 1A).For each of the 3 viruses tested, T cells (CD3 ϩ ), B cells (CD19 ϩ ), and NK cells (CD56 ϩ ) expressed negligible or undetectable levels of viral proteins over...

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“…Thereafter, many groups reported that influenza virus could be detected in the blood of infected patients (Lehmann and Gust 1971;Roberts and Roberts 1976). The recent isolation of H5N1 virus from the plasma of a patient from Thailand (Chutinimitkul et al 2006) confirmed the occurrence of H5N1 viremia and highlighted the high potential of the H5N1 virus to disseminate systemically and become transmissible as a blood-borne pathogen (Likos et al 2007). Therefore, a fast, simple, and reliable test that allows clinicians to rapidly evaluate patients and to implement screening measures for H5N1 viremia is urgently needed.…”

Section: Introduction Avian Influenza Virus (Aiv) Is a Member Of The mentioning

confidence: 90%