Detection of Acute HIV Infection in Two Evaluations of a New HIV Diagnostic Testing Algorithm — United States, 2011–2013

The highly infectious phase of acute human immunodeficiency virus (HIV) infection, defined as the interval between the appearance of HIV RNA in plasma and the detection of HIV-1-specific antibodies, contributes disproportionately to HIV transmission. The current HIV diagnostic algorithm consists of a repeatedly reactive immunoassay (IA), followed by a supplemental test, such as the Western blot (WB) or indirect immunofluorescence assay (IFA). Because current laboratory IAs detect HIV infection earlier than supplemental tests, reactive IA results and negative supplemental test results very early in the course of HIV infection have been erroneously interpreted as negative. To address this problem, CDC has been evaluating a new HIV diagnostic algorithm. This report describes two evaluations of this algorithm. An HIV screening program at a Phoenix, Arizona emergency department (ED) identified 37 undiagnosed HIV infections during July 2011-February 2013. Of these, 12 (32.4%) were acute HIV infections. An ongoing HIV testing study in three sites identified 99 cases with reactive IA and negative supplemental test results; 55 (55.6%) had acute HIV infection. CDC and many health departments recognize that confirmatory supplemental tests can give false-negative results early in the course of HIV infection. This problem can be resolved by testing for HIV RNA after a reactive IA result and negative supplemental test result

SARS-CoV-2 Infects Human Engineered Heart Tissues and Models COVID-19 Myocarditis.

There is ongoing debate as to whether cardiac complications of coronavirus disease-2019 (COVID-19) result from myocardial viral infection or are secondary to systemic inflammation and/or thrombosis. We provide evidence that cardiomyocytes are infected in patients with COVID-19 myocarditis and are susceptible to severe acute respiratory syndrome coronavirus 2. We establish an engineered heart tissue model of COVID-19 myocardial pathology, define mechanisms of viral pathogenesis, and demonstrate that cardiomyocyte severe acute respiratory syndrome coronavirus 2 infection results in contractile deficits, cytokine production, sarcomere disassembly, and cell death. These findings implicate direct infection of cardiomyocytes in the pathogenesis of COVID-19 myocardial pathology and provides a model system to study this emerging disease

The Emergence of Zoonotic Onchocerca lupi Infection in the United States--A Case-Series.

This case-series describes the 6 human infections with Onchocerca lupi, a parasite known to infect cats and dogs, that have been identified in the United States since 2013. Unlike cases reported outside the country, the American patients have not had subconjunctival nodules but have manifested more invasive disease (eg, spinal, orbital, and subdermal nodules). Diagnosis remains challenging in the absence of a serologic test. Treatment should be guided by what is done for Onchocerca volvulus as there are no data for O. lupi. Available evidence suggests that there may be transmission in southwestern United States, but the risk of transmission to humans is not known. Research is needed to better define the burden of disease in the United States and develop appropriately-targeted prevention strategies

Climate and socio- economic factors explain differences between observed and expected naturalization patterns of European plants around the world

The number of naturalized (i.e. established) alien species has increased rapidly over recent centuries. Given the differences in environmental tolerances among species, little is known about what factors determine the extent to which the observed size of the naturalized range of a species and hence the extent to which the observed richness of naturalized species of a region approach their full potential. Here, we asked which region- and species-specific characteristics explain differences between observed and expected naturalizations. Location: Global. Time period: Present. Major taxa studied: Vascular plants. Methods: We determined the observed naturalized distribution outside Europe for 1,485 species endemic to Europe using the Global Naturalized Alien Flora (GloNAF) database and their expected distributions outside Europe using species distribution models. First, we investigated which of seven socio-economic factors related to introduction pathways, anthropogenic pressures and inventory effort best explained the differences between observed and expected naturalized European floras. Second, we examined whether distributional features, economic use and functional traits explain the extent to which species have filled their expected ranges outside Europe. Results: In terms of suitable area, more than 95% of expected naturalizations of European plants were not yet observed. Species were naturalized in only 4.2% of their suitable regions outside of Europe (range filling) and in 0.4% of their unsuitable regions (range expansion). Anthropogenic habitat disturbance primarily explained the difference between observed and expected naturalized European floras, as did the number of treaties relevant to invasive species. Species of ornamental and economic value and with large specific leaf area performed better at filling and expanding beyond their expected range. Main conclusions: The naturalization of alien plant species is explained by climate matching but also by the regional level of human development, the introduction pressure associated with the ornamental and economic values of the species and their adaptation to disturbed environments