Xiaoyan Lu

Publications of Xiaoyan Lu

• Outbreak of lower respiratory tract illness associated with human enterovirus 68 among American Indian children.

  Authors: Lara M Jacobson, John T Redd, Eileen Schneider, Xiaoyan Lu, Shur-Wern W Chern, M Steven Oberste, Dean D Erdman, Gayle E Fischer, Gregory L Armstrong, Maja Kodani, Jennifer Montoya, Julie M Magri, James E Cheek

  The Pediatric infectious disease journal. 03/2012; 31(3):309-12.

  Human enterovirus 68 (EV68) infections are rarely reported. We describe a respiratory outbreak associated with EV68 among 18 children admitted to a remote Indian Health Service facility during AugustHuman enterovirus 68 (EV68) infections are rarely reported. We describe a respiratory outbreak associated with EV68 among 18 children admitted to a remote Indian Health Service facility during August 11, 2010 through September 14, 2010. Clinical illness was characterized by pneumonia and wheezing. EV68 should be considered as an etiology in outbreaks of lower respiratory tract illness.

• Human rhinovirus species associated with hospitalizations for acute respiratory illness in young US children.

  Authors: Marika K Iwane, Mila M Prill, Xiaoyan Lu, E Kathryn Miller, Kathryn M Edwards, Caroline B Hall, Marie R Griffin, Mary A Staat, Larry J Anderson, John V Williams, Geoffrey A Weinberg, Asad Ali, Peter G Szilagyi, Yuwei Zhu, Dean D Erdman

  The Journal of infectious diseases. 12/2011; 204(11):1702-10.

  The contribution of human rhinovirus (HRV) to severe acute respiratory illness (ARI) is unclear. To assess the association between HRV species detection and ARI hospitalizations. Children <5 yearsThe contribution of human rhinovirus (HRV) to severe acute respiratory illness (ARI) is unclear. To assess the association between HRV species detection and ARI hospitalizations. Children <5 years old hospitalized for ARI were prospectively enrolled between December 2003 and April 2005 in 3 US counties. Asymptomatic controls were enrolled between December 2003 and March 2004 and between October 2004 and April 2005 in clinics. Nasal and throat swab samples were tested for HRV and other viruses (ie, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, and influenza virus) by reverse-transcription-polymerase chain reaction, and genetic sequencing identified HRV species and types. HRV species detection was compared between controls and patients hospitalized during months in which controls were enrolled. A total of 1867 children with 1947 ARI hospitalizations and 784 controls with 790 clinic visits were enrolled and tested for HRV. The HRV-A detection rate among participants ≥24 months old was 8.1% in the hospitalized group and 2.2% in the control group (P = .009), and the HRV-C detection rates among those ≥6 months old were 8.2% and 3.9%, respectively (P = .002); among younger children, the detection rates for both species were similar between groups. The HRV-B detection rate was ≤1%. A broad diversity of HRV types was observed in both groups. Clinical presentations were similar among HRV species. Compared with children infected with other viruses, children with HRV detected were similar for severe hospital outcomes and more commonly had histories or diagnoses of asthma or wheezing. HRV-A and HRV-C were associated with ARI hospitalization and serious illness outcomes.

• Deaths associated with human adenovirus-14p1 infections, Europe, 2009-2010.

  Authors: Michael J Carr, Adriana E Kajon, Xiaoyan Lu, Linda Dunford, Paul O'Reilly, Paul Holder, Cillian F De Gascun, Suzie Coughlan, Jeff Connell, Dean D Erdman, William W Hall

  Emerging infectious diseases. 08/2011; 17(8):1402-8.

  Human adenovirus (HAdV) serotype 14 is rarely identified. However, an emerging variant, termed HAdV-14p1, recently has been described in the United States in association with outbreaks of acuteHuman adenovirus (HAdV) serotype 14 is rarely identified. However, an emerging variant, termed HAdV-14p1, recently has been described in the United States in association with outbreaks of acute respiratory disease with high rates of illness and death. We retrospectively analyzed specimens confirmed positive for HAdV by immunofluorescence, virus culture, or real-time PCR during July 1, 2009-July 31, 2010, and describe 9 cases of HAdV-14p1 infection with characteristic mutations in the fiber and E1A genes that are phylogenetically indistinguishable from the viruses previously detected in the United States. Three patients died; 2 were immunocompromised, and 1 was an immunocompetent adult. We propose that surveillance should be increased for HAdV-14p1 and recommend that this virus be considered in the differential diagnosis of sudden-onset acute respiratory disease, particularly fatal infections, for which an etiology is not clear.

• A naturally occurring human adenovirus type 7 variant with a 1743 bp deletion in the E3 cassette.

  Authors: Juliana C Marinheiro, Tatiana G Dos Santos, Joselma Siqueira-Silva, Xiaoyan Lu, Daniela Carvalho, Ataíde A da Camara, Eurico Arruda, Karla Arruda, Dean D Erdman, Charlotte M Hársi

  The Journal of general virology. 06/2011; 92(Pt 10):2399-404.

  Human adenovirus type 7 (HAdV-7) is an important cause of acute respiratory disease (ARD). Different genomic variants of HAdV-7 have been described, designated 7a-7l. In a previous study toHuman adenovirus type 7 (HAdV-7) is an important cause of acute respiratory disease (ARD). Different genomic variants of HAdV-7 have been described, designated 7a-7l. In a previous study to investigate risk factors for ARD and wheezing, nasopharyngeal samples were collected from 90 ill children seeking medical attention in Ribeirão Preto, São Paulo, Brazil. HAdVs were identified in 31 samples and were characterized by serum neutralization and genome restriction analysis. Eleven HAdVs were identified as being HAdV-7, five of which were classified as being of genome type 7p (Gomen). Six other HAdV-7 isolates gave new restriction profiles with all enzymes used and were classified as being a new genomic variant, 7m. These isolates were further characterized by sequencing. The hexon and fiber genes of the 7m variant were nearly identical to the prototype, 7p. However, nucleotide sequences from the E3 cassette revealed a 1743 bp deletion affecting the 16.1K, 19K, 20.1K and 20.5K ORFs.

• Human rhinovirus infections in rural Thailand: epidemiological evidence for rhinovirus as both pathogen and bystander.

  Authors: Alicia M Fry, Xiaoyan Lu, Sonja J Olsen, Malinee Chittaganpitch, Pongpun Sawatwong, Somrak Chantra, Henry C Baggett, Dean Erdman

  PloS one. 01/2011; 6(3):e17780.

  We describe human rhinovirus (HRV) detections in SaKaeo province, Thailand. From September 1, 2003-August 31, 2005, we tested hospitalized patients with acute lower respiratory illness and outpatientWe describe human rhinovirus (HRV) detections in SaKaeo province, Thailand. From September 1, 2003-August 31, 2005, we tested hospitalized patients with acute lower respiratory illness and outpatient controls without fever or respiratory symptoms for HRVs with polymerase chain reaction and molecularly-typed select HRVs. We compared HRV detection among hospitalized patients and controls and estimated enrollment adjusted incidence. HRVs were detected in 315 (16%) of 1919 hospitalized patients and 27 (9.6%) of 280 controls. Children had the highest frequency of HRV detections (hospitalized: <1 year: 29%, 1-4 year: 29%, ≥ 65 years: 9%; controls: <1 year: 24%, 1-4 year: 14%, ≥ 65 years: 2.8%). Enrollment adjusted hospitalized HRV detection rates were highest among persons aged <1 year (1038/100,000 persons/year), 1-4 years (457), and ≥ 65 years (71). All three HRV species were identified, HRV-A was the most common species in most age groups including children aged <1 year (61%) and all adult age groups. HRV-C was the most common species in the 1-4 year (51%) and 5-19 year age groups (54%). Compared to controls, hospitalized adults (≥ 19 years) and children were more likely to have HRV detections (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.5, 15.8; OR: 2.0, CI: 1.2, 3.3, respectively) and hospitalized children were more likely to have HRV-A (OR 1.7, CI: 0.8, 3.5) or HVR-C (OR 2.7, CI: 1.2, 5.9) detection. HRV rates were high among hospitalized children and the elderly but asymptomatic children also had substantial HRV detection. HRV (all species), and HRV-A and HRV-C detections were epidemiologically-associated with hospitalized illness. Treatment or prevention modalities effective against HRV could reduce hospitalizations due to HRV in Thailand.

• Outbreak of pneumonia associated with emergent human adenovirus serotype 14--Southeast Alaska, 2008.

  Authors: Douglas H Esposito, Tracie J Gardner, Eileen Schneider, Lauren J Stockman, Jacqueline E Tate, Catherine A Panozzo, Cheryl L Robbins, Sue A Jenkerson, Lorita Thomas, Colleen M Watson [......] Dean D Erdman, Xiaoyan Lu, Theresa Cromeans, Mary Westcott, Catherine Humphries, Jayme Ballantyne, Gayle E Fischer, Joseph B McLaughlin, Gregory Armstrong, Larry J Anderson

  The Journal of infectious diseases. 07/2010; 202(2):214-22.

  In September 2008, an outbreak of pneumonia associated with an emerging human adenovirus (human adenovirus serotype 14 [HAdV-14]) occurred on a rural Southeast Alaska island. Nine patients requiredIn September 2008, an outbreak of pneumonia associated with an emerging human adenovirus (human adenovirus serotype 14 [HAdV-14]) occurred on a rural Southeast Alaska island. Nine patients required hospitalization, and 1 patient died. To investigate the outbreak, pneumonia case patients were matched to control participants on the basis of age, sex, and community of residence. Participants in the investigation and their household contacts were interviewed, and serum samples and respiratory tract specimens were collected. Risk factors were evaluated by means of conditional logistic regression. Among 32 pneumonia case patients, 21 (65%) had confirmed or probable HAdV-14 infection. None of 32 matched control participants had evidence of HAdV-14 infection (P<.001 for the difference). Factors independently associated with pneumonia included contact with a known HAdV-14-infected case patient (odds ratio [OR], 18.3 [95% confidence interval {CI}, >or=2.0]), current smoking (OR, 6.7 [95% CI, >or=0.9]), and having neither traveled off the island nor attended a large public gathering (OR, 14.7 [95% CI, >or=2.0]). Fourteen (67%) of 21 HAdV-14-positive case patients belonged to a single network of people who socialized and often smoked together and infrequently traveled off the island. HAdV-14 infection occurred in 43% of case-patient household contacts, compared with 5% of control-participant household contacts (P = .005). During a community outbreak in Alaska, HAdV-14 appeared to have spread mostly among close contacts and not widely in the community. Demographic characteristics and illness patterns among the case patients were similar to those observed in other recent outbreaks of HAdV-14 infection in the United States.

• Outbreak of adenovirus type 4 infection in a long-term care facility for the elderly.

  Authors: Ruth Kandel, Arjun Srinivasan, Erika M C D'Agata, Xiaoyan Lu, Dean Erdman, Michael Jhung

  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. 07/2010; 31(7):755-7.

  An outbreak of acute respiratory disease due to human adenovirus and a resulting increase in mortality occurred in a long-term care facility for the elderly. By use of viral culture and polymeraseAn outbreak of acute respiratory disease due to human adenovirus and a resulting increase in mortality occurred in a long-term care facility for the elderly. By use of viral culture and polymerase chain reaction, not a rapid antigen test, the virus was detected. Human adenovirus infection can occur in elderly individuals, but detection by rapid antigen testing may be limited.

• Molecular epidemiology and brief history of emerging adenovirus 14-associated respiratory disease in the United States.

  Authors: Adriana E Kajon, Xiaoyan Lu, Dean D Erdman, Janice Louie, David Schnurr, Kirsten St George, Marion P Koopmans, Taslim Allibhai, David Metzgar

  The Journal of infectious diseases. 07/2010; 202(1):93-103.

  First isolated in the Netherlands in 1955 during an outbreak of acute respiratory disease (ARD) among military recruits, human adenovirus 14 (HAdV-14) has historically been considered rare. With noFirst isolated in the Netherlands in 1955 during an outbreak of acute respiratory disease (ARD) among military recruits, human adenovirus 14 (HAdV-14) has historically been considered rare. With no precedent of circulation in North America, HAdV-14 has been isolated from military and civilian cases of ARD of variable severity since 2003 in the United States. Ninety-nine isolates from military and civilian cases from different geographic locations and circulation periods were characterized by restriction enzyme analysis of viral DNA and select gene sequencing. All examined viruses were found to be identical and to belong to a new genome type designated "HAdV-14p1" (formerly known as "14a"). Comparative alignments of E1A, hexon, and fiber gene sequences with other subspecies B2 HAdVs suggest that HAdV-14p1, like the closely related HAdV-11a, arose from recombination among similar HAdV-11 and HAdV-14 ancestral strains. A deletion of 2 amino acids in the knob region of the fiber protein is the only identified unique characteristic of HAdV-14p1. The current geographic distribution of HAdV-14p1 involves at least 15 states in the Unites States. The role of the fiber mutations in the recent emergence of HAdV-14p1 ARD in North America warrants further study.

• Human bocavirus species 2 and 3 in Brazil.

  Authors: Norma Santos, Teresa C T Peret, Charles D Humphrey, Maria Carolina M Albuquerque, Raquel Cirlene Silva, Fabrício José Benati, Xiaoyan Lu, Dean D Erdman

  Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 04/2010; 48(2):127-30.

  The newly described human bocavirus (HBoV) species 2 and 3 have been repeatedly detected in stool strengthening the possibility that these viruses might present a tropism for the gastrointestinalThe newly described human bocavirus (HBoV) species 2 and 3 have been repeatedly detected in stool strengthening the possibility that these viruses might present a tropism for the gastrointestinal tract and may be etiological agents of diarrhea. In this study we assessed the presence of HBoV2 and HBoV3 in stool specimens from Brazilians with acute gastroenteritis. Stool samples from Brazilian patients with acute diarrhea were analyzed for HBoV2 and HBoV3 by PCR assay. Full or partial genome sequences were obtained for selected isolates. Electron microscopy analysis was used to investigate virus morphology. Electron microscopy confirmed the presence of virus-like particles in HBoV PCR-positive specimens, with morphology similar to other members of the Parvoviridae family. Five samples out of 807 (0.6%) were positive for HBoV3. Three of the HBoV3-positive patients were HIV/AIDS positive. A selected group of 144 samples was also tested for HBoV2 and 30 samples (20.8%) were positive, 11 of which were HIV/AIDS positive. This study reports the detection and genetic characterization of HBoV3 and HBoV2 in the stool of Brazilian patients with acute diarrhea. This is the first description of HBoV3 outside Australia, suggesting a wide global distribution of this virus. Further studies are needed to better understand the role of HBoV in gastrointestinal infections, particularly among patients with HIV/AIDS.

• Frequent detection of human adenovirus from the lower gastrointestinal tract in men who have sex with men.

  Authors: Marcel E Curlin, Meei-Li Huang, Xiaoyan Lu, Connie L Celum, Jorge Sanchez, Stacy Selke, Jared M Baeten, Richard A Zuckerman, Dean D Erdman, Lawrence Corey

  PloS one. 01/2010; 5(6):e11321.

  The association between baseline seropositivity to human adenovirus (HAdV) type 5 and increased HIV acquisition in the Step HIV Vaccine Study has raised questions concerning frequency of acquiredThe association between baseline seropositivity to human adenovirus (HAdV) type 5 and increased HIV acquisition in the Step HIV Vaccine Study has raised questions concerning frequency of acquired and/or persistent Adenovirus infections among adults at high risk of HIV-1 infection. To evaluate the frequency and pattern of HAdV shedding from the lower GI tract, we retrospectively tested rectal swabs for HAdVs in a cohort of 20 HSV-2 positive HIV-positive Peruvian men who have sex with men (MSM) undergoing rectal swabbing three times/week for 18 consecutive weeks, in a prospective study of HSV-2 suppression in HIV infection. Viral DNA was extracted and amplified using a sensitive multiplex PCR assay that detects all currently recognized HAdV types. Molecular typing of viruses was performed on selected samples by hexon gene sequencing. Baseline neutralizing antibody titers to HAdVs -5, -26, -35 and -48 were also assessed. 15/20 individuals had HAdV detected during follow up. The median frequency of HAdV detection was 30% of samples (range 2.0% to 64.7%). HAdV shedding typically occurred on consecutive days in clustered episodes lasting a median of 4 days (range 1 to 9 days) separated by periods without shedding, suggesting frequent new infections or reactivation of latent infections over time. 8 of the 15 shedders had more than one type detected in follow-up. 20 HAdV types from species B, C, and D were identified, including HAdV-5, -26 and -48, HAdV types under development as potential vaccine candidates. 14/20 subjects were seropositive for HAdV-5; 15/20 for HAdV-26; 3/20 for HAdV-35; and 2/20 for HAdV-48. HAdV shedding did not correlate with CD4 count, plasma HIV-1 viral load, or titers to HAdV-5 or HAdV-35. The sole individual with HAdV-5 shedding was HAdV-5 seropositive. HAdV shedding was highly prevalent and diverse, including types presently under consideration as HIV vaccine vectors. Subclinical HAdV infection of the GI tract is common among MSM in Peru; the prevalence of HAdV in the enteric tract should be evaluated in other populations. The association between ongoing recent enteric HAdV and the immune response to recombinant HAdV vaccines should be evaluated.

• Health care transmission of a newly emergent adenovirus serotype in health care personnel at a military hospital in Texas, 2007.

  Authors: Fernanda C Lessa, Philip L Gould, Neil Pascoe, Dean D Erdman, Xiaoyan Lu, Michel L Bunning, Vincent C Marconi, Lisa Lott, Marc-Alain Widdowson, Larry J Anderson, Arjun Srinivasan

  The Journal of infectious diseases. 12/2009; 200(11):1759-65.

  BACKGROUND: Adenoviruses can cause outbreaks of febrile respiratory illness in military trainees, but until 2007, adenovirus serotype 14 (Ad14) was never associated with such outbreaks. From AprilBACKGROUND: Adenoviruses can cause outbreaks of febrile respiratory illness in military trainees, but until 2007, adenovirus serotype 14 (Ad14) was never associated with such outbreaks. From April through June 2007, 15 trainees at one base were hospitalized for pneumonia due to Ad14. Subsequent reports of febrile respiratory illness among health care personnel suggested nosocomial transmission. METHODS: Health care personnel participants completed a questionnaire and provided blood and nasal wash specimens for Ad14 diagnostic testing. We defined a confirmed case of Ad14 infection as one with titers > or = 1:80 or nasal wash specimens positive for Ad14 by polymerase chain reaction, whereas a possible case was defined by titers of 1:20 or 1:40. We also collected environmental samples. RESULTS: Among 218 tested health care personnel, 35 (16%) had titers > or = 1:20; of these, 7 had possible cases and 28 had confirmed cases of infection. Confirmed case patients were more likely to report febrile respiratory illness (57% vs 11%; P< .001) and to have had direct contact with patients with Ad14 infection (82% vs 62%; P.04 ). Of the 23 confirmed case patients with direct contact with Ad14-infected patients, 52% reported that patients were not in contact and droplet precautions at the time of exposure. Ad14 was recovered from several hospital surfaces. CONCLUSION: Our findings of possible nosocomial transmission of Ad14 highlight the need to reinforce infection control guidelines.

• Outbreak of Severe Respiratory Disease Associated with Emergent Human Adenovirus Serotype 14 at a US Air Force Training Facility in 2007.

  Authors: Jacqueline E Tate, Michel L Bunning, Lisa Lott, Xiaoyan Lu, John Su, David Metzgar, Lorie Brosch, Catherine A Panozzo, Vincent C Marconi, Dennis J Faix, Mila Prill, Brian Johnson, Dean D Erdman, Vincent Fonseca, Larry J Anderson, Marc-Alain Widdowson

  The Journal of infectious diseases. 05/2009;

  Background. In 2007, a US Air Force training facility reported a cluster of severe respiratory illnesses associated with a rare human adenovirus (Ad) serotype, Ad14. We investigated this outbreak toBackground. In 2007, a US Air Force training facility reported a cluster of severe respiratory illnesses associated with a rare human adenovirus (Ad) serotype, Ad14. We investigated this outbreak to better understand its epidemiology, clinical spectrum, and associated risk factors. Methods. Data were collected from ongoing febrile respiratory illness (FRI) surveillance and from a retrospective cohort investigation. Because an Ad7 vaccine is in development, Ad7 antibody titers in pretraining serum samples from trainees with mild and those with severe Ad14 illness were compared. Results. During 2007, an estimated 551 (48%) of 1147 trainees with FRI were infected with Ad14; 23 were hospitalized with pneumonia, 4 required admission to an intensive care unit, and 1 died. Among cohort members ([Formula: see text]), the Ad14 infection rate was high (50%). Of those infected, 40% experienced FRI. No cohort members were hospitalized. Male sex (risk ratio [RR], 4.7 [95% confidence interval {CI}, 2.2-10.1]) and an ill close contact (RR, 1.6 [95% CI, 1.2-2.2]) were associated with infection. Preexisting Ad7 neutralizing antibodies were found in 7 (37%) of 19 Ad14-positive trainees with mild illness but in 0 of 16 trainees with Ad14 pneumonia ([Formula: see text]). Conclusions. Emergence of Ad14, a rare Ad serotype, caused a protracted outbreak of respiratory illness among military recruits. Most infected recruits experienced FRI or milder illnesses. Some required hospitalization, and 1 died. Natural Ad7 infection may protect against severe Ad14 illness.

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• A Community-Based Outbreak of Severe Respiratory Illness Caused by Human Adenovirus Serotype 14.

  Authors: Paul F Lewis, Mark A Schmidt, Xiaoyan Lu, Dean D Erdman, Mary Campbell, Ann Thomas, Paul R Cieslak, La Donna Grenz, Laura Tsaknardis, Curt Gleaves, Brian Kendall, David Gilbert

  The Journal of infectious diseases. 05/2009;

  Background. Human adenoviruses (Ads) typically cause mild illnesses in otherwise healthy hosts. We investigated a community-based outbreak that had substantial morbidity caused primarily by Ad14, anBackground. Human adenoviruses (Ads) typically cause mild illnesses in otherwise healthy hosts. We investigated a community-based outbreak that had substantial morbidity caused primarily by Ad14, an uncommon serotype. Methods. We retrospectively reviewed the medical records of all patients with confirmed cases of Ad infection from 1 November 2006 through 31 July 2007 in Oregon. Isolates were typed by sequencing. We analyzed clinical and laboratory variables to identify risk factors for severe Ad14 disease. Results. Ad14 first emerged in Oregon in 2005. Of 67 cases of Ad infection detected during the study period, 40 (60%) involved Ad14. Most of the 38 Ad14-infected patients who had medical records available for review presented with fever and cough; 29 (76%) required hospitalization, 23 (61%) required supplemental oxygen, 18 (47%) required critical care, 9 (24%) required vasopressors, and 7 (18%) died. Lobar infiltrates on chest radiographs suggestive of bacterial pneumonia were common among those needing hospitalization. Older age, chronic underlying condition, low absolute lymphocyte counts, and elevated creatinine levels were associated with severe illness. Except for 1 case of possible hospital transmission, we identified no epidemiological links among patients. Conclusion. Ad14 emerged in Oregon in 2005 and became the predominant circulating type by 2007. Infection with this uncommon virus was primarily associated with a community-acquired pneumonia syndrome and caused substantial morbidity and mortality.

• Systemic infection with enteric adenovirus in immunocompetent child with Haemophilus influenzae disease.

  Authors: Nino Khetsuriani, Suxiang Tong, Xiaoyan Lu, Shannon Reed, Dean Erdman, Angela Campbell, Krongkaew Supawat, Sahas Liamsuwan, Narayanan Jothikumar, Sonja Olsen

  Emerging infectious diseases. 03/2009; 15(2):355-7.

• Novel human rhinoviruses and exacerbation of asthma in children.

  Authors: Nino Khetsuriani, Xiaoyan Lu, W Gerald Teague, Neely Kazerouni, Larry J Anderson, Dean D Erdman

  Emerging infectious diseases. 12/2008; 14(11):1793-6.

  To determine links between human rhinoviruses (HRV) and asthma, we used data from a case-control study, March 2003-February 2004, among children with asthma. Molecular characterization identifiedTo determine links between human rhinoviruses (HRV) and asthma, we used data from a case-control study, March 2003-February 2004, among children with asthma. Molecular characterization identified several likely new HRVs and showed that association with asthma exacerbations was largely driven by HRV-A and a phylogenetically distinct clade of 8 strains, genogroup C.

• A novel group of rhinoviruses is associated with asthma hospitalizations.

  Authors: E Kathryn Miller, Kathryn M Edwards, Geoffrey A Weinberg, Marika K Iwane, Marie R Griffin, Caroline B Hall, Yuwei Zhu, Peter G Szilagyi, Laura-Lee Morin, Luke H Heil, Xiaoyan Lu, John V Williams

  The Journal of allergy and clinical immunology. 12/2008;

  BACKGROUND: Although recent studies have identified new group C human rhinoviruses (HRVCs), their spectrum of pediatric disease is unknown. OBJECTIVE: We sought to determine the presentation andBACKGROUND: Although recent studies have identified new group C human rhinoviruses (HRVCs), their spectrum of pediatric disease is unknown. OBJECTIVE: We sought to determine the presentation and burden of disease caused by HRVCs among young hospitalized children. METHODS: We conducted prospective population-based surveillance in 2 US counties among children less than 5 years of age hospitalized with acute respiratory illness or fever from October 2001 through September 2003. Nasal/throat swabs were obtained and tested for HRVs, as determined by means of RT-PCR and then characterized by means of partial sequencing. RESULTS: Of 1052 children enrolled and tested during the 2-year period, 167 (16%) had HRVs detected. Of 147 samples successfully sequenced, 64 were group A HRVs, 6 were group B HRVs, and 77 were HRVCs. Children with HRVCs were significantly more likely than those with group A HRVs to have underlying high-risk conditions, such as asthma (42% vs 23%, P = .023) and to have had a discharge diagnosis of asthma (55% vs 36%, P = .022). CONCLUSIONS: Overall, HRVCs were detected in 7% of children hospitalized for fever or respiratory conditions and constituted almost half of all rhinovirus-associated hospitalizations, suggesting that this novel group causes a substantial burden of pediatric disease.

• Human bocavirus in tonsillar lymphocytes.

  Authors: Xiaoyan Lu, Linda R Gooding, Dean D Erdman

  Emerging infectious diseases. 09/2008; 14(8):1332-4.

• Development of plaque assays for adenoviruses 40 and 41.

  Authors: Theresa L Cromeans, Xiaoyan Lu, Dean D Erdman, Charles D Humphrey, Vincent R Hill

  Journal of virological methods. 08/2008; 151(1):140-5.

  Enteric adenoviruses, important agents of infantile gastroenteritis, are difficult to culture with low titers and limited CPE. Consequently, few plaque assays have been reported and none are usedEnteric adenoviruses, important agents of infantile gastroenteritis, are difficult to culture with low titers and limited CPE. Consequently, few plaque assays have been reported and none are used routinely by investigators who may need reproducible quantitative assays for these viruses. CPE in A549 cells (an epithelial lung carcinoma cell line) was induced by isolates of human adenovirus (HAdV) serotypes 40 or 41 that were obtained by prior limited passage in primary cynmolgous monkey kidney (pCMK), human embryonic kidney (HEK), and Graham 293 cells. CPE with HAdV 40 (Dugan strain) and HAdV 41 (Tak strain) inoculated in A549 cells was also observed. Monolayers of A549 cells were inoculated with a low multiplicity of infection (MOI) of the archived stock isolates and harvested at days 10-14 with full CPE. Subsequent passages were harvested in as few as 7 days with 100% CPE to prepare virus stocks for plaque assay. Large individual plaques under agarose overlay were picked prior to staining and clonal stocks prepared. Titers of final stock preparations after six to eight passages in A549 cells were in the range of 5x10(7)-1x10(8)PFU/ml, which provides adequate virus for quantitative recovery studies. The particle to infectivity (P:I) ratios of the early passages of virus stocks were in the range reported previously. The ratio of non-infectious to infectious particles decreased with successive passages of HAdVs 40 and 41 in A549 cells. The specificity of the assay was confirmed by neutralization of plaques with type-specific antisera. Furthermore, sequence analysis of the HAdVs 40 and 41 plaque forming stocks ruled out contamination with any other HAdVs. The plaque assay developed will be useful for evaluation of virus recovery methods from water, food or other environmental matrices, as well as determination of the efficacy of water treatment techniques for inactivation of these viruses.

• Real-time reverse transcription-PCR assay for comprehensive detection of human rhinoviruses.

  Authors: Xiaoyan Lu, Brian Holloway, Ryan K Dare, Jane Kuypers, Shigeo Yagi, John V Williams, Caroline B Hall, Dean D Erdman

  Journal of clinical microbiology. 03/2008; 46(2):533-9.

  Human rhinoviruses (HRVs) are important contributors to respiratory disease, but their healthcare burden remains unclear, primarily because of the lack of sensitive, accurate, and convenient means ofHuman rhinoviruses (HRVs) are important contributors to respiratory disease, but their healthcare burden remains unclear, primarily because of the lack of sensitive, accurate, and convenient means of determining their causal role. To address this, we developed and clinically validated the sensitivity and specificity of a real-time reverse transcription-PCR (RT-PCR) assay targeting the viral 5' noncoding region defined by sequences obtained from all 100 currently recognized HRV prototype strains and 85 recently circulating field isolates. The assay successfully amplified all HRVs tested and could reproducibly detect 50 HRV RNA transcript copies, with a dynamic range of over 7 logs. In contrast, a quantified RNA transcript of human enterovirus 68 (HEV68) that showed the greatest sequence homology to the HRV primers and probe set was not detected below a concentration of 5 x 10(5) copies per reaction. Nucleic acid extracts of 111 coded respiratory specimens that were culture positive for HRV or HEV were tested with the HRV real-time RT-PCR assay and by two independent laboratories that used different in-house HRV/HEV RT-PCR assays. Eighty-seven HRV-culture-positive specimens were correctly identified by the real-time RT-PCR assay, and 4 of the 24 HEV-positive samples were positive for HRV. HRV-specific sequences subsequently were identified in these four specimens, suggesting HRV/HEV coinfection in these patients. The assay was successfully applied in an investigation of a coincidental outbreak of HRV respiratory illness among laboratory staff.

• Identification of adenoviruses in specimens from high-risk pediatric stem cell transplant recipients and controls.

  Authors: Xiaotian Zheng, Xiaoyan Lu, Dean D Erdman, Evan J Anderson, Judith A Guzman-Cottrill, Morris Kletzel, Ben Z Katz

  Journal of clinical microbiology. 02/2008; 46(1):317-20.

  Adenovirus infection is an important cause of morbidity and mortality in stem cell transplant recipients. We report species and type-specific analysis from a prospective study of high-risk adenovirusAdenovirus infection is an important cause of morbidity and mortality in stem cell transplant recipients. We report species and type-specific analysis from a prospective study of high-risk adenovirus infections following hematopoietic progenitor cell transplantation prior to, during, and after treatment with cidofovir, as well as species analysis of contemporaneously collected samples from control patients. Nine different adenovirus types representing all six recognized species were identified, and mixed infections were commonly found in this group of patients.