Seroprevalence and risk factor analysis for exposure to equine encephalosis virus in Israel, Palestine and Jordan

Equine encephalosis virus (EEV) is an orbivirus transmitted by Culicoides species. Most infected horses show mild clinical signs and mortality is usually very low. EEV is closely related and similarly transmitted to other, more pathogenic and economically important, orbiviruses such as African horse sickness virus (AHSV), bluetongue virus (BTV) and epizootic haemorrhagic disease viruses (EHDV), and may serve as an indicator for possible transmission of the latter. Israel has been reported to be endemic for EEV since 2001. This study was initiated to re-evaluate the current seroprevalence and risk factors for EEV exposure in Israel, and to assess, for the first time, the seroprevalence of EEV in Palestine and Jordan. Three hundred and sixteen serum samples were collected from apparently healthy horses at 21 farms in Israel, 66 horses at nine farms in Palestine and 100 horses at three farms in Jordan. The presence of EEV antibodies was detected by a serum neutralization assay. Seroprevalence of EEV was 58.2% (184/316 horses) in Israel, 48.5% (32/66 horses) in Palestine and 2% (2/100 horses) in Jordan. Seroprevalence in Jordan was significantly lower than in Israel and Palestine (P < 0.001). The farm (P < 0.001) and horse age (P = 0.003) were found as significant risk factors for EEV exposure in Israel in multivariable statistical analysis. The results of this study further demonstrate that EEV is no longer limited to South Africa and is endemic in both Israel and Palestine and horses in Jordan were also exposed to this virus emphasizing the potential of pathogens to invade new ecological niches

Observational cohort study of IP-10's potential as a biomarker to aid in inflammation regulation within a clinical decision support protocol for patients with severe COVID-19.

BackgroundTreatment of severely ill COVID-19 patients requires simultaneous management of oxygenation and inflammation without compromising viral clearance. While multiple tools are available to aid oxygenation, data supporting immune biomarkers for monitoring the host-pathogen interaction across disease stages and for titrating immunomodulatory therapy is lacking.MethodsIn this single-center cohort study, we used an immunoassay platform that enables rapid and quantitative measurement of interferon γ-induced protein 10 (IP-10), a host protein involved in lung injury from virus-induced hyperinflammation. A dynamic clinical decision support protocol was followed to manage patients infected with severe acute respiratory syndrome coronavirus 2 and examine the potential utility of timely and serial measurements of IP-10 as tool in regulating inflammation.ResultsOverall, 502 IP-10 measurements were performed on 52 patients between 7 April and 10 May 2020, with 12 patients admitted to the intensive care unit. IP-10 levels correlated with COVID-19 severity scores and admission to the intensive care unit. Among patients in the intensive care unit, the number of days with IP-10 levels exceeding 1,000 pg/mL was associated with mortality. Administration of corticosteroid immunomodulatory therapy decreased IP-10 levels significantly. Only two patients presented with subsequent IP-10 flare-ups exceeding 1,000 pg/mL and died of COVID-19-related complications.ConclusionsSerial and readily available IP-10 measurements potentially represent an actionable aid in managing inflammation in COVID-19 patients and therapeutic decision-making.Trial registrationClinicaltrials.gov, NCT04389645, retrospectively registered on May 15, 2020