27 Aug 2014

#Coarse #particulate matter associated with increased #risk of #emergency #hospital admissions for #pneumonia in #HK (Thorax, abstract, edited)

[Source: Thorax, full page: (LINK). Abstract, edited.]

Thorax doi:10.1136/thoraxjnl-2014-205429

Respiratory epidemiology / Original article

Coarse particulate matter associated with increased risk of emergency hospital admissions for pneumonia in Hong Kong [      ]

Hong Qiu 1, Lin Wei Tian 1,2, Vivian C Pun 1, Kin-fai Ho 1,2, Tze Wai Wong 1, Ignatius T S Yu 1

Author Affiliations: 1The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, ShaTin, Hong Kong  2Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China

Correspondence to Professor Lin Wei Tian, 4/F, The Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin-NT, Hong Kong Special Administrative Region, ShaTin, Hong Kong; linweit@cuhk.edu.hk

Received 16 March 2014 - Revised 25 July 2014 - Accepted 7 August 2014  - Published Online First 27 August 2014




Epidemiological research on the effects of coarse particles (PMc, particulate matter between 2.5 and 10 μm in aerodynamic diameter) on respiratory morbidity is sparse and inconclusive. Pneumonia is an inflammatory condition of lung caused by infections, which may be triggered and exacerbated by PMc exposure.


To estimate the effect of PMc on emergency hospital admissions for pneumonia after controlling for PM2.5 and gaseous pollutants.


PMc concentrations were estimated by subtracting PM2.5 from PM10 measurements in each of the 10 air monitoring stations from January 2011 to December 2012 in Hong Kong and then citywide daily average concentrations of PMc were computed from the 10 stations. Generalised additive Poisson models were used to examine the relationship between PMc and daily emergency hospital admissions for pneumonia, adjusting for PM2.5 and gaseous pollutants (NO2, SO2 and O3). Subgroup analyses by gender and age were also performed to identify the most susceptible subpopulations.


PMc and PM2.5 were significantly associated with emergency pneumonia hospitalisations. Every 10 μg/m3 increment of PMc in the past 4 days (lag0–lag3) was associated with a 3.33% (95% CI 1.54% to 5.15%) increase in emergency hospitalisations for pneumonia. The effect estimates of PMc were robust to the adjustment of PM2.5, NO2 or SO2, but attenuated on the inclusion of O3 in the model. Women, children and older people might be more vulnerable to PMc exposure.


Short-term PMc exposure is associated with emergency hospitalisations for pneumonia in Hong Kong. Air quality regulation specifically for PMc might be considered.



#Hemagglutinin 222D/G Polymorphism Facilitates Fast Intra-Host #Evolution of #H1N1pdm09 #Influenza A Viruses (PLoS ONE, abstract, edited)

[Source: PLoS ONE, full page: (LINK). Abstract, edited.]

Hemagglutinin 222D/G Polymorphism Facilitates Fast Intra-Host Evolution of Pandemic (H1N1) 2009 Influenza A Viruses [      ]

by Nora Seidel, Andreas Sauerbrei, Peter Wutzler, Michaela Schmidtke



The amino acid substitution of aspartic acid to glycine in hemagglutinin (HA) in position 222 (HA-D222G) as well as HA-222D/G polymorphism of pandemic (H1N1) 2009 influenza viruses (A(H1N1)pdm09) were frequently reported in severe influenza in humans and mice. Their impact on viral pathogenicity and the course of influenza has been discussed controversially and the underlying mechanism remained unclarified. In the present study, BALB/c mice, infected with the once mouse lung- and cell-passaged A(H1N1)pdm09 isolate A/Jena/5258/09 (mpJena/5258), developed severe pneumonia. From day 2 to 3 or 4 post infection (p.i.) symptoms (body weight loss and clinical score) continuously worsened. After a short disease stagnation or even recovery phase in most mice, severity of disease further increased on days 6 and 7 p.i. Thereafter, surviving mice recovered. A 45 times higher virus titer maximum in the lung than in the trachea on day 2 p.i. and significantly higher tracheal virus titers compared to lung on day 6 p.i. indicated changes in the organ tropism during infection. Sequence analysis revealed an HA-222D/G polymorphism. HA-D222 and HA-G222 variants co-circulated in lung and trachea. Whereas, HA-D222 variant predominated in the lung, HA-G222 became the major variant in the trachea after day 4 p.i. This was accompanied by lower neutralizing antibody titers and broader receptor recognition including terminal sialic acid α-2,3-linked galactose, which is abundant on mouse trachea epithelial cells. Plaque-purified HA-G222-mpJena/5258 virus induced severe influenza with maximum symptom on day 6 p.i. These results demonstrated for the first time that HA-222D/G quasispecies of A(H1N1)pdm09 caused severe biphasic influenza because of fast viral intra-host evolution, which enabled partial antibody escape and minor changes in receptor binding.



#India, #Health Min tracking 821 #passengers for #Ebola (Deccan Herald, August 27 2014)

[Source: Deccan Herald, full page: (LINK).]

Health Min tracking 821 passengers for Ebola [      ]

The Health Ministry today said 821 passengers were being tracked for Ebola in the country with most of them belonging to states of Maharashtra, Kerala and Tamil Nadu.




RD #Congo : les Nations unies se mobilisent pour financer la #lutte contre #Ebola (Radio Okapi, August 27 2014)

[Source: Radio Okapi, full page: (LINK).]

RDC : les Nations unies se mobilisent pour financer la lutte contre Ebola [      ]

Le Pooled Fund, un mécanisme de financement géré par Ocha pour répondre aux besoins humanitaires en RDC, a déjà déboursé 1,5 millions USD.




Largest-Ever #Outbreak of #Ebola Virus Disease Thrusts Experimental #Therapies, #Vaccines Into Spotlight (JAMA, extract)

[Source: The Journal of the American Medical Association, full page: (LINK). Extract.]

Medical News & Perspectives | August 27, 2014

Largest-Ever Outbreak of Ebola Virus Disease Thrusts Experimental Therapies, Vaccines Into Spotlight [      ]


Tracy Hampton, PhD

JAMA. Published online August 27, 2014. doi:10.1001/jama.2014.11170 - Published online


As efforts to successfully contain the largest outbreak of Ebola virus disease in history prove elusive, the mounting number of cases and deaths has brought research to develop much-needed treatments and protective vaccines into the spotlight. Although the approval process for drugs and vaccines is typically slow and deliberate, the latest outbreak, declared by the World Health Organization (WHO) on August 8 as an international health emergency, has galvanized regulatory officials to consider proposals for providing as-yet unproven treatments under special emergency New Drug Applications.




Severe #respiratory #disease associated with #MERS-CoV, 11th #update, 21 August 2014 (@ECDC_EU, August 27 2014, edited)

#Ebola virus disease – Democratic Republic of #Congo (@WHO, August 27 2014)

[Source: World Health Organization, full page: (LINK). Edited.]

Ebola virus disease – Democratic Republic of Congo [      ]

Disease outbreak news / 27 August 2014


Epidemiology and surveillance

On 26 August 2014, the Ministry of Health, Democratic Republic of Congo (DRC) notified the World Health Organization (WHO) of an outbreak of Ebola virus disease (EVD) in Equateur Province.

The index case was a pregnant woman from Ikanamongo Village who butchered a bush animal that had been killed and given to her by her husband. She became ill with symptoms of EVD and reported to a private clinic in Isaka Village. On 11 August 2014, she died of a then-unidentified haemorrhagic fever.

Local customs and rituals associated with death meant that several health-care workers were exposed and presented with similar symptoms in the following week.

Between 28 July and 18 August 2014, a total of 24 suspected cases of haemorrhagic fever, including 13 deaths, have been identified.

Human-to-human transmission has been established and includes the health-care personnel who were exposed to the deceased pregnant woman during surgery (one doctor and two nurses) in addition to the hygienist and a ward boy, all of whom developed symptoms and died.

Other deaths have been recorded among the relatives who attended the index case, individuals who were in contact with the clinic staff, and those who handled the bodies of the deceased during funerals.

The other 11 cases are currently being treated in isolation centres.

Samples have been sent to laboratories in Kinshasa and in Gabon for confirmation of EVD and to identify the strain.

The index case and the 80 contacts have no history of travel to the EVD-affected countries in West Africa (Guinea, Liberia, Nigeria, or Sierra Leone) or history of contact with individuals from the affected areas.

At this time, it is believed that the outbreak in DRC is unrelated to the ongoing outbreak in west Africa.


Health sector response

The Ministry of Health of DRC has dispatched field teams to the area to monitor and evaluate the situation. Contact tracing has begun and 80 individuals are currently being followed-up. Treatment of patients is ongoing and infection prevention and control measures are in place and are being supported by WHO with the delivery of personal protective equipment to the area.

WHO is currently monitoring the situation with the Government of DRC and awaiting confirmation of the disease strain from the laboratories. A rapid response team is poised to deploy and assist DRC, if needed. This is the seventh outbreak of EVD in the former Zaire / present DRC since 1976.

WHO does not recommend any travel or trade restrictions be applied except in cases where individuals have been confirmed or are suspected of being infected with EVD or where individuals have had contact with cases of EVD. (Contacts do not include properly-protected health-care workers and laboratory staff.)

Temporary recommendations from the Emergency Committee with regard to actions to be taken by countries can be found at: IHR Emergency Committee on Ebola outbreak in west Africa



#Antiviral #therapy for human #rabies. (Antivir Ther., abstract, edited)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Antivir Ther. 2014 Aug 26. doi: 10.3851/IMP2851. [Epub ahead of print]

Antiviral therapy for human rabies. [      ]

Appolinario CM1, Jackson AC.

Author information: 1Department of Veterinary Hygiene and Public Health, UNESP - School of Veterinary Medicine and Animal Science, Botucatu, Sao Paulo, Brazil.



Human rabies is virtually always fatal despite numerous attempts at aggressive therapy. Most survivors received one or more doses of rabies vaccine prior to the onset of the disease. The Milwaukee Protocol has proved to be an ineffective for rabies and should no longer be used. New approaches are needed and an improved understanding of basic mechanisms responsible for the clinical disease in rabies may prove to be useful for the development of novel therapeutic approaches. Antiviral therapy is thought to be an important component of combination therapy for the management of human rabies, and immunotherapy and neuroprotective therapy should also be strongly considered. There are many important issues for consideration for drug delivery to the central nervous system in rabies, which are in part related to the presence of the blood-brain barrier and also the blood-spinal cord barrier. Ribavirin and interferon-α have proved to be disappointing agents for the therapy of rabies. There is insufficient evidence to support the continued use of ketamine or amantadine for the therapy of rabies. Minocycline or corticosteroids should not be used because of concerns about aggravating the disease. A variety of new antiviral agents are under development and evaluation, including favipavir, RNA interference (e.g., siRNAs), and novel targeted approaches, including interference with viral capsid assembly and viral egress.

PMID: 25156675 [PubMed - as supplied by publisher]



Elucidation of the #Ebola virus VP24 cellular interactome and disruption of virus #biology through targeted inhibition of host cell protein function (J Proteome Res., abstract, edited)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Proteome Res. 2014 Aug 26. [Epub ahead of print]

Elucidation of the Ebola virus VP24 cellular interactome and disruption of virus biology through targeted inhibition of host cell protein function. [      ]

García-Dorival I, Wu W, Dowall S, Armstrong S, Touzelet O, Wastling J, Barr JN, Matthews D, Carroll M, Hewson R, Hiscox JA.



Viral pathogenesis in the infected cell is a balance between anti-viral responses and subversion of host cell processes. Many viral proteins specifically interact with host cell proteins in order to promote virus biology. Understanding these interactions can lead to knowledge gains about infection and provide potential targets for anti-viral therapy. One such virus is Ebola that has profound consequences for human health, and causes viral haemorrhagic fever where case fatality rates can approach 90%. The Ebola virus VP24 protein plays a critical role in the evasion of the host immune response, and is likely to interact with multiple cellular proteins. To map these interactions and better understand the potential functions of VP24, label free quantitative proteomics was used to identify cellular proteins that had a high probability of forming the VP24 cellular interactome. Several known interactions were confirmed thus placing confidence in the technique but new interactions were also discovered including one with ATP1A1, which is involved in osmoregulation and cell signalling. Disrupting the activity of ATP1A1 in Ebola virus infected cells with a small molecule inhibitor resulted in a decrease in progeny virus, thus illustrating how quantitative proteomics can be used to identify potential therapeutic targets.

PMID: 25158218 [PubMed - as supplied by publisher]



Circulation of Reassortant #Influenza A(#H7N9) Viruses in #Poultry and #Humans, #Guangdong Province, #China, 2013 (@CDC_EIDjournal, abstract, edited)

[Source: Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 20, Number 12—December 2014  / Research

Circulation of Reassortant Influenza A(H7N9) Viruses in Poultry and Humans, Guangdong Province, China, 2013 [      ][      ]

Changwen Ke, Jing Lu, Jie Wu, Dawei Guan, Lirong Zou, Tie Song, Lina Yi, Xianqiao Zeng, Lijun Liang, Hanzhong Ni, Min Kang, Xin Zhang, Haojie Zhong, Jianfeng He, Jinyan Lin, Derek Smith, David Burke, Ron A.M. Fouchier, Marion Koopmans, and Yonghui Zhang

Author affiliations: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (C. Ke, J. Lu, J. Wu, D. Guan, L. Zou, T. Song, L. Yi, X. Zeng, L. Liang, H. Ni, M. Kang, X. Zhang, H. Zhong, J. He, J. Lin, Y. Zhang); University of Cambridge, Cambridge, UK (D. Smith, D. Burke); Erasmus MC, Rotterdam, the Netherlands (R.A.M. Fouchier, M. Koopmans); National Institute of Public Health and the Environment, Bilthoven, the Netherlands (M. Koopmans)



Influenza A(H7N9) virus emerged in eastern China in February 2013 and continues to circulate in this region, but its ecology is poorly understood. In April 2013, the Guangdong Provincial Center for Disease Control and Prevention (CDC) implemented environmental and human syndromic surveillance for the virus. Environmental samples from poultry markets in 21 city CDCs (n = 8,942) and respiratory samples from persons with influenza-like illness or pneumonia (n = 32,342) were tested; viruses isolated from 6 environmental samples and 16 patients were sequenced. Sequence analysis showed co-circulation of 4 influenza A(H7N9) virus strains that evolved by reassortment with avian influenza A(H9N2) viruses circulating in this region. In addition, an increase in human cases starting in late 2013 coincided with an increase in influenza A H7 virus isolates detected by environmental surveillance. Co-circulation of multiple avian influenza viruses that can infect humans highlights the need for increased surveillance of poultry and potential environmental sources.