Long-term sequelae of sporadic cryptosporidiosis: a follow-up study

To determine the frequency of occurrence of sequelae following cryptosporidiosis. A follow-up study was performed during a case-control study for sporadic cryptosporidiosis in the Netherlands (2013-2016). Cryptosporidiosis cases were invited to complete a follow-up questionnaire 4 months after diagnosis. Using a case-crossover study design, we compared the frequencies of reported symptoms 4 months after the acute phase to those reported 4 months before the onset of illness and during illness. Frequencies of symptoms in the pre- to post-infection phases were also compared with those of a population control group. Cryptosporidium species-specific effects were also studied. Logistic regression was used to calculate adjusted odds ratios (aOR) for symptoms occurrence. Of the 731 available cases, 443 (60%) responded and 308 (42%) could be included in the follow-up study. The median age was 26 years (range 1-80); 58% were female; 30% were infected with C. hominis and 70% with C. parvum. Compared to before illness, cases were significantly more likely to report dizziness (OR = 2.25), headache (OR = 2.15), fatigue (OR = 2.04), weight loss (OR = 1.82), diarrhoea (OR = 1.50), abdominal pain (OR = 1.38) or joint pain (OR = 1.84). However, symptoms of joint pain and headache occurred among cases after illness at a rate that was not significantly different from that observed in the general population. There were no significant differences in post-infection symptom occurrence between C. hominis and C. parvum. The disease burden of cryptosporidiosis extends beyond the acute phase of the infection, with cases reporting both intestinal and extra-intestinal symptoms up to 4 months following infection

Long-term sequelae of sporadic cryptosporidiosis: a follow-up study.

To determine the frequency of occurrence of sequelae following cryptosporidiosis. A follow-up study was performed during a case-control study for sporadic cryptosporidiosis in the Netherlands (2013-2016). Cryptosporidiosis cases were invited to complete a follow-up questionnaire 4 months after diagnosis. Using a case-crossover study design, we compared the frequencies of reported symptoms 4 months after the acute phase to those reported 4 months before the onset of illness and during illness. Frequencies of symptoms in the pre- to post-infection phases were also compared with those of a population control group. Cryptosporidium species-specific effects were also studied. Logistic regression was used to calculate adjusted odds ratios (aOR) for symptoms occurrence. Of the 731 available cases, 443 (60%) responded and 308 (42%) could be included in the follow-up study. The median age was 26 years (range 1-80); 58% were female; 30% were infected with C. hominis and 70% with C. parvum. Compared to before illness, cases were significantly more likely to report dizziness (OR = 2.25), headache (OR = 2.15), fatigue (OR = 2.04), weight loss (OR = 1.82), diarrhoea (OR = 1.50), abdominal pain (OR = 1.38) or joint pain (OR = 1.84). However, symptoms of joint pain and headache occurred among cases after illness at a rate that was not significantly different from that observed in the general population. There were no significant differences in post-infection symptom occurrence between C. hominis and C. parvum. The disease burden of cryptosporidiosis extends beyond the acute phase of the infection, with cases reporting both intestinal and extra-intestinal symptoms up to 4 months following infection

Community-based SARS-CoV-2 testing in low-income neighbourhoods in Rotterdam: Results from a pilot study

Background: High incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and low testing uptake were reported in low-income neighbourhoods in Rotterdam. We aimed to improve willingness and access to testing by introducing community-based test facilities, and to evaluate the effectiveness of a rapid antigen detection test (RDT). Methods: Two to eleven test facilities operated consecutively in three low-income neighbourhoods in Rotterdam, offering the options of walk-in or appointments. Background characteristics were collected at intake and one nasopharyngeal swab was taken and processed using both RDT and reverse transcription polymerase chain reaction (RT-PCR). Visitors were asked to join a survey for evaluation purposes. Results: In total, 19 773 visitors were tested - 9662 (48.9%) without an appointment. Walk-in visitors were older, lived more often in the proximity of the test facilities, and reported coronavirus disease (COVID-19)-related symptoms less often than by-appointment visitors. For 67.7% of the visitors, this was the first time they got tested. A total of 1211 (6.1%) tested SARS-CoV-2-positive with RT-PCR, of whom 309 (25.5%) were asymptomatic. Test uptake increased among residents of the pilot neighbourhoods, especially in the older age groups, compared to people living in comparable neighbourhoods without community-based testing facilities. RDT detected asymptomatic individuals with 71.8% sensitivity, which was acceptable in this high prevalence setting. Visitors reported positive attitudes towards the test facilities and welcomed the easy access. Conclusions: Offering community-based SARS-CoV-2 testing seems a promising approach for increasing testing uptake among specific populations in low-income neighbourhoods

Controlling a human parainfluenza virus-3 outbreak in a haematology ward in a tertiary hospital:the importance of screening strategy and molecular diagnostics in relation to clinical symptoms

BACKGROUND: Human parainfluenza 3 (HPIV-3) outbreak at the haemato-oncology ward of the Maastricht University Medical Center in the summer of 2016. AIM: To describe an effective strategy to control the largest reported HPIV-3 outbreak at an adult haematology-oncology ward in the Netherlands by implementing infection control measures and molecular epidemiology investigation. METHODS: Clinical, patient and diagnostic data were both pro- and retrospectively collected. HPIV-3 real-time-PCR (HPIV-3 RT-PCR) was validated using oropharyngeal rinse samples. Screening of all new and admitted patients was implemented to identify asymptomatic infection or prolonged shedding of HPIV-3 allowing cohort isolation. FINDINGS: The HPIV-3 outbreak occurred between 9 July and 28 September 2016 and affected 53 patients. HPIV-3 RT-PCR on oropharyngeal rinse samples demonstrated an up to tenfold higher sensitivity compared to pharyngeal swabs. Monitoring showed that at first positive PCR, 20 patients (38%) were asymptomatic (of which 11 remained asymptomatic) and the average duration of shedding was 14 days (range 1-58). Asymptomatic patients had lower viral load, shorter period of viral shedding (≤14 days) and were mostly immune competent oncology patients. The outbreak was under control 5 weeks after implementation of screening of asymptomatic patients. CONCLUSION: Implementation of a sensitive screening method identified both symptomatic and asymptomatic patients which had lower viral load and allowed early cohort isolation. This is especially important in a ward that combines patients with varying immune status, since both immunocompromised and immune competent patients are likely to spread the HPIV-3 virus, either through prolonged shedding or through asymptomatic course of disease

Expression, purification and activities of the entire family of intact membrane sensor kinases from Enterococcus faecalis

Two-component signal transduction systems are the main mechanism by which bacteria sense and respond to their environment, and their membrane-located histidine protein kinases generally constitute the sensory components of these systems. Relatively little is known about their fundamental mechanisms and precise nature of the molecular signals sensed, because of the technical challenges of producing sufficient quantities of these hydrophobic membrane proteins. This study evaluated the heterologous production, purification and activities of the 16 intact membrane sensor kinases of Enterococcus faecalis. Following the cloning of the genes into expression plasmid pTTQ18His, all but one kinase was expressed successfully in Escherichia coli inner membranes. Purification of the hexa-histidine 'tagged' recombinant proteins was achieved for 13, and all but one were verified as intact. Thirteen intact kinases possessed autophosphorylation activity with no added signal when assayed in membrane vesicles or as purified proteins. Signal testing of two functionally-characterized kinases, FsrC and VicK, was successful examplifying the potential use of in vitro activity assays of intact proteins for systematic signal identification. Intact FsrC exhibited an approximately 10-fold increase in activity in response to a two-fold molar excess of synthetic GBAP pheromone, whilst glutathione, and possibly redox potential, were identified for the first time as direct modulators of VicK activity in vitro. The impact of DTT on VicK phosphorylation resulted in increased levels of phosphorylated VicR, the downstream response regulator, thereby confirming the potential of this in vitro approach for investigations of modulator effects on the entire signal transduction process of two-component systems