Steep rise in norovirus cases and emergence of a new recombinant strain GII.P16-GII.2, Germany, winter 2016

Since early November 2016, the number of laboratory-confirmed norovirus infections reported in Germany has been increasing steeply. Here, we report the detection and genetic characterisation of an emerging norovirus recombinant, GII.P16-GII.2. This strain was frequently identified as the cause of sporadic cases as well as outbreaks in nine federal states of Germany. Our findings suggest that the emergence of GII.P16-GII.2 contributed to rising case numbers of norovirus gastroenteritis in Germany

Two Novel Parvoviruses in Frugivorous New and Old World Bats

Bats, a globally distributed group of mammals with high ecological importance, are increasingly recognized as natural reservoir hosts for viral agents of significance to human and animal health. In the present study, we evaluated pools of blood samples obtained from two phylogenetically distant bat families, in particular from flying foxes (Pteropodidae), Eidolon helvum in West Africa, and from two species of New World leaf-nosed fruit bats (Phyllostomidae), Artibeus jamaicensis and Artibeus lituratus in Central America. A sequence-independent virus discovery technique (VIDISCA) was used in combination with high throughput sequencing to detect two novel parvoviruses: a PARV4-like virus named Eh-BtPV-1 in Eidolon helvum from Ghana and the first member of a putative new genus in Artibeus jamaicensis from Panama (Aj-BtPV-1). Those viruses were circulating in the corresponding bat colony at rates of 7–8%. Aj-BtPV-1 was also found in Artibeus lituratus (5.5%). Both viruses were detected in the blood of infected animals at high concentrations: up to 10E8 and to 10E10 copies/ml for Aj-BtPV-1 and Eh-BtPV-1 respectively. Eh-BtPV-1 was additionally detected in all organs collected from bats (brain, lungs, liver, spleen, kidneys and intestine) and spleen and kidneys were identified as the most likely sites where viral replication takes place. Our study shows that bat parvoviruses share common ancestors with known parvoviruses of humans and livestock. We also provide evidence that a variety of Parvovirinae are able to cause active infection in bats and that they are widely distributed in these animals with different geographic origin, ecologies and climatic ranges

Similar virus spectra and seasonality in paediatric patients with acute respiratory disease, Ghana and Germany

Epidemiological differences between tropical and temperate regions regarding viruses causing acute respiratory infection are poorly understood. This is in part because methodological differences limit the comparability of data from these two regions. Using identical molecular detection methods, we tested 1174 Ghanaian and 539 German children with acute respiratory infections sampled over 12 months for the 15 most common respiratory viruses by PCR. A total 43.2% of the Ghanaian and 56.6% of the German children tested positive for at least one respiratory virus. The pneumoviruses respiratory syncytial virus and human metapneumovirus were most frequently detected, in 13.1% and 25.1% within the Ghanaian and German children, respectively. At both study sites, pneumoviruses were more often observed at younger ages (p < 0.001). In the Ghanaian rainy season, enveloped viruses were detected twice as often as non-enveloped viruses (prevalence rate ratio (PR) 2.0, 95% CI 1.7-2.4). In contrast, non-enveloped viruses were more frequent during the Ghanaian dry season (PR 0.6, 95% CI 0.4-0.8). In Germany, enveloped viruses were also more frequently detected during the relatively colder winter season (PR 1.6, 95% CI 1.2-2.1) and non-enveloped viruses during summer (PR 0.7, 95% CI 0.5-0.9). Despite a distance of about 5000 km and a difference of 44 degrees latitude separating Germany and Ghana, virus spectra, age associations and seasonal fluctuation showed similarities between sites. Neither respiratory viruses overall, nor environmentally stable (non-enveloped) viruses in particular were more frequent in tropical Ghana. The standardization of our sampling and laboratory testing revealed similarities in acute respiratory infection virus patterns in tropical and temperate climates. (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved

How successful is influenza vaccination in HIV infected patients? Results from an influenza A(H1N1)pdm09 vaccine study

Aim: To determine immune response after single vaccination with AS03-adjuvanted pandemic H1N1 vaccine in HIV-infected patients. Background: Individuals living with human immunodeficiency virus (HIV) are at risk with influenza due to hyporesponsiveness to influenza vaccine and a higher probability for developing severe disease. Especially, immunogenicity and tolerability of adjuvanted influenza vaccines in a pandemic setting are not well characterized in HIV infected individuals. Methods: Immune response following vaccination with a single dose of influenza A(H1N1)pdm09 AS03-adjuvanted vaccine (H1N1pdm09 vaccine) containing 3.75 mu g hemagglutinin was evaluated in HIV infected individuals by hemagglutination inhibition assay. Tolerability was assessed by questionnaires. Results: Three hundred eighty-nine patients from two German HIV clinics were evaluated. Seroprotection was found in as much as 191/389 (49%) of patients before vaccination. Following vaccination with H1N1pdm09 vaccine seroprotection rate increased to 66% (257/389). Due to high pre-vaccination seroprotection rates seroconversion was only found in a total of 27/389 (7%) of HIV patients. There was no association of seroprotection/seroconversion and current CD4(+) T-cell count, HIV-RNA load in plasma, antiretroviral treatment or demographic factors such as gender, age and ethnicity. The vaccine was overall well tolerated. Conclusions: In this large cohort of HIV infected patients with high baseline H1N1 seroprotective titers only a moderate antibody response to a single vaccination with H1N1pdm09 AS03-adjuvanted vaccine was detected. Emerging influenza pandemics warrant usage of booster vaccinations in order to achieve higher immunogenicity to protect a vulnerable patient population such as HIV positive individuals against influenza. (C) 2016 Polish AIDS Research Society. Published by Elsevier Sp. zo.o. All rights reserved

Low-threshold SARS-CoV-2 testing facility for hospital staff: Prevention of COVID-19 outbreaks?

Background: The ongoing global SARS-CoV-2 pandemic has caused over 4.7 million infections greatly challenging healthcare workers (HCW) and medical institutions worldwide. The SARS-CoV-2 pandemic has shown to significantly impact mental and physical health of HCW. Thus, implementation of testing facilities supporting HCW are urgently needed. Methods: A low-threshold SARS-CoV-2 testing facility was introduced at the University Hospital Bonn, Germany, in March 2020. Irrespective of clinical symptoms employees were offered a voluntary and free SARS-CoV-2 test. Furthermore, employees returning from SARS-CoV-2 risk regions and employees after risk contact with SARSCoV-2 infected patients or employees were tested for SARS-CoV-2 infection. Pharyngeal swabs were taken and reverse transcription polymerase chain reaction for detection of SARS-CoV-2 was performed, test results being available within 24 h. Profession, symptoms and reason for SARS-CoV-2 testing of employees were recorded. Results: Between 9th March and April 30, 2020, a total of 1510 employees were tested for SARS-CoV-2 infection. 1185 employees took advantage of the low-threshold testing facility. One percent (n = 11) were tested positive for SARS-CoV-2 infection, 18% being asymptomatic, 36% showing mild and 36% moderate/severe symptoms (missing 10%). Furthermore, of 56 employees returning from SARS-CoV-2 risk regions, 18% (10/56) were tested SARS-CoV-2 positive. After risk contact tracking by the hospital hygiene 6 patient-to-employee transmissions were identified in 163 employees with contact to 55 SARS-CoV-2 positive patients. Conclusion: In the absence of easily accessible public SARS-CoV-2 testing facilities low-threshold SARS-CoV-2 testing facilities in hospitals with rapid testing resources help to identify SARS-CoV-2 infected employees with absent or mild symptoms, thus stopping the spread of infection in vulnerable hospital environments. High levels of professional infection prevention training and implementation of specialized wards as well as a perfectly working hospital hygiene network identifying and tracking risk contacts are of great importance in a pandemic setting

Measles, mumps, rubella and VZV: importance of serological testing of vaccine-preventable diseases in young adults living with HIV in Germany

Measles, mumps, rubella (MMR) and varicella zoster virus (VZV) infection can cause serious diseases and complications in the HIV-positive population. Due to successful vaccination programmes measles, mumps and congenital rubella syndrome has become neglected in Germany. However, recent outbreaks of measles have occurred from import-associated cases. In this cross-sectional study the serostatus for MMR and VZV in 2013 HIV-positive adults from three different university outpatient clinics in Bonn (n = 544), Cologne (n = 995) and Munich (n = 474) was analysed. Sera were tested for MMR- and VZV-specific immunglobulin G antibodies using commercial immunoassays. Seronegativity was found in 3% for measles, 26% for mumps, 11% for rubella and 2% for VZV. Regarding MMR, 35% of patients lacked seropositivity against at least one infectious agent. In multivariable analysis younger age was strongly associated with seronegativity against all four viruses, measles, mumps, rubella (P < 0.001, P < 0.001 and P = 0.001, respectively) and VZV (P = 0.001). In conclusion, there is high need for MMR and VZV vaccination in people living with HIV in Germany born in 1970 or later. Thus, systematic MMR and VZV antibody screening and vaccination should be implemented in the HIV-positive population to prevent serious disease and complications of vaccine-preventable diseases

Detection of Eh-BtPV-1 in different body compartments of 7 <i>Eidolon helvum</i> bats.^a

a<p>Viral concentrations are indicated as copies/ml in serum and copies/g of tissue obtained from different organs; NEG = negative; NA = not available. The boldface viral concentrations indicate organs with a concentration at least 10 fold higher than serum.</p

Identity ranges (%) of the 3 ORFs both at amino acid (bold) and nucleotide level between species in the PARV4-like viruses^a.

a<p>Eh-BtPV-1 (<i>Eidolon helvum Bat Parvovirus</i> 1), PARV4-g1/3 (<i>Human Parvovirus 4</i> genotypes 1, NC_007018, 2, DQ873391, 3, EU874248), ChimpPTV (<i>Chimpanzee PARV4</i>, HQ113143), PHoV (<i>Porcine Hokovirus</i>, EU200673), BHoV (<i>Bovine Hokovirus</i>, EU200670).</p

Three types of Aj-BtPV-1.

<p>The phylogenetic tree was based on a 740 nt fragment (nucleotides 3820–4561) of Aj-BtPV identified in <i>Artibeus jamaicensis</i> and <i>Artibeus lituratus</i> (#174) bats from Panama, showing the 3 different viral types (panel A). Identity values (in percentage) within and between the 3 types are shown in panel B.</p

Primers used in this study for screening, sequencing and quantifying Eh-BtPV-1 and Aj-BtPV-1.

<p>Primers used in this study for screening, sequencing and quantifying Eh-BtPV-1 and Aj-BtPV-1.</p