Gregory J Mertz

• MD
• Professor (Full) at University of New Mexico

Background: Andes virus (ANDV) is a zoonotic Orthohantavirus leading to hantavirus cardiopulmonary syndrome. Although most transmissions occur through environmental exposure to rodent faeces and urine, rare person-to-person transmission has been documented, mainly for close contacts. This study investigates the presence and infectivity of ANDV in b...

Hantavirus infections are part of the broad group of viral haemorrhagic fevers. They are also recognised as a distinct model of an emergent zoonotic infection with a global distribution. Many factors influence their epidemiology and transmission, such as climate, environment, social development, ecology of rodent hosts, and human behaviour in endem...

New World hantaviruses are important human pathogens that can cause a severe zoonotic disease called hantavirus cardiopulmonary syndrome (HCPS). HCPS patients can progress quickly to a severe condition with respiratory failure and cardiogenic shock that can be fatal in 30% of the cases. The role of the host’s immune responses in this progression to...

Objectives To determine the relative frequency and prognosis value of proteinuria in hantavirus cardiopulmonary syndrome (HCPS) due to Andes virus. Methods This is an observational analytical study with prospectively obtained data from patients admitted to 12 health centers in 9 Chilean cities between 2001 and 2018. Only patients with confirmed An...

Andes orthohantavirus (ANDV) is the etiologic agent of hantavirus cardiopulmonary syndrome (HCPS), which has a case fatality rate around 35%, with no effective treatment or vaccine available. ANDV neutralizing antibody (NAb) measurements are important for the evaluation of the immune response following infection, vaccination, or passive administrat...

Andes virus (ANDV) is the only hantavirus transmitted between humans through close contact. We detected the genome and proteins of ANDV in breast milk cells from an infected mother in Chile who transmitted the virus to her child, suggesting gastrointestinal infection through breast milk as a route of ANDV person-to-person transmission.

Small mammals present in areas where hantavirus cardiopulmonary syndrome (HCPS) cases had occurred in central and southern Chile were captured and analyzed to evaluate the abundance of rodents and seroprevalence rates of antibodies to Andes orthohantavirus (ANDV). Sampling areas ranged from the Coquimbo to Aysén regions (30-45° S approx.) regions....

Introducción: El síndrome cardiopulmonar por hantavirus (SCPH) es causado en Chile y en el sur de Argentina por el Andes hantavirus (ANDV), el que es endémico en esta zona. La enfermedad causada por ANDV produce un aumento de permeabilidad vascular y filtración de plasma con una alta tasa de letalidad (35%), debido principalmente a insuficiencia re...

Background: Hantavirus cardiopulmonary syndrome (HCPS) has a mortality up to 35-40% and its treatment is mainly supportive. A variable to predict progression from mild to severe disease is unavailable. This study was performed in patients with documented infection by Andes orthohantavirus, and the aim was to find a simple variable to predict progr...

Andes orthohantavirus (ANDV) is an important human pathogen causing hantavirus cardiopulmonary syndrome (HCPS) with a fatality rate of 30% in Chile. Around 60% of all cases have a severe clinical course, while the others have a mild clinical course. The main goal of this study was to understand if the genetic variation of patients is associated wit...

The Andes Orthohantavirus (ANDV), which causes the hantavirus cardiopulmonary syndrome, enters cells via integrins, and a change from leucine to proline at residue 33 in the PSI domain (L33P), impairs ANDV recognition. We assessed the association between this human polymorphism and ANDV infection. We defined susceptible and protective genotypes as...

Background ANDV, agent of hantavirus cardiopulmonary syndrome, enters through integrin cell protein. A change from leucine-to-proline at residues 33 in the PSI-domain (L33P) inhibits ANDV recognition. We assessed the association between this human-variant and ANDV infection. Results We defined susceptible genotype to “TT” (coding leucine) and prote...

Background ANDV is etiologic agent of hantavirus cardiopulmonary syndrome (HCPS) in Chile. Transmission occurs mainly by exposure to aerosolized excretes of infected rodents, person-to-person transmission has also been reported. ANDV infected endothelial cell through αV,β3 integrin at plexin-semaphorin-integrin (PSI) domain. In vitro assays establi...

Andes hantavirus cardiopulmonary syndrome, transmitted by Oligoryzomys longicaudatus, has no approved treatment, a case fatality rate of 35%, and documented person-to-person transmission. An Andes vaccine, highly needed for prevention, is in development. We aimed to evaluate knowledge, attitudes and practices (KAP) regarding hantavirus disease and...

Background: In Chile, Andes virus (ANDV) is the sole aetiological agent of hantavirus cardiopulmonary syndrome (HCPS) with mean annual incidence of 55 cases, 32% case fatality rate (CFR) and no specific treatment. Neutralizing antibody (NAb) titres at hospital admission correlate inversely with HCPS severity. We designed an open trial to explore s...

A fully updated version of this popular, clinically oriented, user-friendly text on infectious disease, with even more helpful graphics, tables, algorithms and images. It is packed full of information on diagnosis, differential diagnosis and therapy. In addition to the traditional organization of organ-system and pathogen-related information, this...

Andes hantavirus (ANDV) causes hantavirus cardiopulmonary syndrome in Chile and is the only hantavirus for which person-to-person transmission has been proven. We describe an outbreak of 5 human cases of ANDV infection in which symptoms developed in 2 household contacts and 2 health care workers after exposure to the index case-patient. Results of...

BACKGROUND: Andes virus (ANDV)-related hantavirus cardiopulmonary syndrome (HCPS) has a 35% case fatality rate in Chile and no specific treatment. In an immunomodulatory approach, we evaluated the efficacy of intravenous methylprednisolone for HCPS treatment, through a parallel-group, placebo-controlled clinical trial. METHODS: Patients aged >2 yea...

Background. Andes virus (ANDV)–related hantavirus cardiopulmonary syndrome (HCPS) has a 35% case fatality rate in Chile and no specific treatment. In an immunomodulatory approach, we evaluated the efficacy of intravenous methylprednisolone for HCPS treatment, through a parallel-group, placebo-controlled clinical trial. Methods. Patients aged >2 yea...

Background: Andes virus (ANDV) is the etiologic agent of hantavirus cardiopulmonary syndrome (HCPS) in Chile, where there have been 680 cases and 238 deaths (35%) through 2010. Competing hypotheses for the pathogenesis of respiratory failure and shock have led to evaluation of antiviral and immunomodulatory therapy. Here we report a placebo-contr...

Hantavirus cardiopulmonary syndrome (HCPS) is a viral zoonosis that may result in cardiogenic shock and respiratory failure with significant associated mortality. Hantavirus infection has been identified throughout much of North, Central, and South America. In the United States 453 cases of HCPS have been reported through September 2006 with a case...

Tularemia is a zoonotic disease caused by Francisella tularensis. Tularemia presents with various clinical illnesses, but meningitis is rare. To describe a patient who developed typhoidal tularemia with atypical acute meningitis and to review the pathogenesis, clinical and laboratory features, and antibiotic drug treatment of reported cases of tula...

Viruses in the genus Hantavirus can cause one of two serious illnesses when transmitted from rodents to humans: hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). Of the two diseases, HPS is more severe with an approximate 40% mortality across the Americas. The high rate of mortality could be reduced if effective t...

The purpose of this review is to summarize the current knowledge regarding the diagnosis and treatment of indigenous new world hantavirus infections. Recent studies have defined the incubation period of new world hantavirus infections, provided additional evidence for person-to-person transmission of Andes virus, described a rapid method for the pr...

The potential incubation period from exposure to onset of symptoms was 7-39 days (median 18 days) in 20 patients with a defined period of exposure to Andes virus in a high-risk area. This period was 14-32 days (median 18 days) in 11 patients with exposure for <48 hours.

BACKGROUND. Ribavirin is active in vitro against hantaviruses, but the findings of an open trial of the use of intravenous ribavirin for the treatment of hantavirus cardiopulmonary syndrome (HCPS) were inconclusive. Subjects with suspected HCPS in the prodrome or cardiopulmonary phase but without shock were eligible for randomization to receive eit...

Streptomycin, an antimicrobial with limited availability, is the treatment of choice for plague, a fulminating and potentially epidemic disease that poses a bioterrorism concern. We evaluated the efficacy of gentamicin and tetracyclines for treating human plague. A medical record review was conducted on all 75 patients with plague who were reported...

Nosocomial transmission of Andes virus has been documented in Argentina, but has not yet been proven in Chile. We studied 215 contacts (106 family member contacts and 109 health care worker contacts) of 20 index cases of hantavirus cardiopulmonary syndrome (HCPS) in Chile. The seroprevalence of IgG antibodies against Andes virus was 1.9% (95% confi...

Cases of human hantavirus disease have been reported in Chile since 1995, most of them in people living in rural and periurban areas. We conducted a peridomestic study of small mammals to evaluate the relationships between the presence of rodents with antibodies to Andes virus confirmed human cases of hantavirus pulmonary syndrome in southcentral C...

Nucleoside analogues against herpes simplex virus (HSV) have been shown to suppress shedding of HSV type 2 (HSV-2) on genital mucosal surfaces and may prevent sexual transmission of HSV. We followed 1484 immunocompetent, heterosexual, monogamous couples: one with clinically symptomatic genital HSV-2 and one susceptible to HSV-2. The partners with H...

In this issue, Roberts et al. report that while HSV-2 was isolated more frequently from genital cultures at a Midwestern university from 1993 to 1997. HSV-1 became the predominant isolate type from 1997 to 2001.(1) Also in this issue. Samra et al. report that while HSV-2 was the predominate cause of genital herpes in Israel in the 1970s, HSV-1 was...

We isolated Andes virus (formal name: Andes virus [ANDV], a species in the genus Hantavirus), from serum of an asymptomatic 10-year-old Chilean boy who died 6 days later of hantavirus pulmonary syndrome (HPS). The serum was obtained 12 days after his grandmother died from HPS and 2 days before he became febrile. No hantavirus immunoglobulin (Ig) G...

This article reports the proceedings of an expert panel discussion on current clinical management practices for the treatment of recurrent genital herpes. The panel reviewed the effectiveness of primary and specialist care settings in the UK and USA and identified the principal clinical needs of patients with recurrent genital herpes. The ideal alt...

To provide a potentially therapeutic intervention and to collect clinical and laboratory data during an outbreak of hantavirus pulmonary syndrome (HPS), 140 patients from the United States with suspected HPS were enrolled for investigational intravenous ribavirin treatment. HPS was subsequently laboratory confirmed in 30 persons and not confirmed i...

The prevalence of genital herpes is increasing in several populations worldwide. Factors that may be contributing to this increase include greater numbers of sexual partners, the high frequency of asymptomatic infections, poor use of safe sexual practices, and possibly the decreased incidence of childhood oral herpes simplex virus infection. Transm...

Intravenous ribavirin was provided non-selectively for investigational open-label use among persons with suspected hantavirus pulmonary syndrome (HPS) in the United States between 4 June 1993 and 1 September 1994. Therapy was initiated prior to laboratory confirmation of hantavirus infection because most deaths from HPS occur within 48 h of hospita...

Intravenous ribavirin was provided non-selectively for investigational open-label use among persons with suspected hantavirus pulmonary syndrome (HPS) in the United States between 4 June 1993 and 1 September 1994. Therapy was initiated prior to laboratory confirmation of hantavirus infection because most deaths from HPS occur within 48 h of hospita...

Hantavirus pulmonary syndrome (HPS) is a severe cardiopulmonary illness resulting in death in approximately 45% of cases. The most frequently recognized etiologic agent of HPS in North America, Sin Nombre virus (SNV), is transmitted to humans from its primary rodent reservoir, Peromyscus maniculatus (deer mouse), by direct contact with infected rod...

The present randomized, double-blind, placebo-controlled, multicenter clinical trial was designed to compare the efficacy and tolerability of sorivudine [1-beta-D-arabinofuranosyl-E-(2-bromovinyl)uracil] and acyclovir for the treatment of dermatomal herpes zoster in human immunodeficiency virus (HIV)-seropositive patients. A total of 170 HIV-seropo...

Coccidiomycosis is a fungal infection that primarily causes pulmonary disease. Extrapulmonary dissemination can occur to the musculoskeletal system with the knee joint most frequently involved. This case report describes a patient with coccidiomycosis whose initial presentation was of a popliteal cyst. The need for aggressive surgical and antibioti...

Recurrent genital herpes is associated with both medical and psychosocial complications for the patient. In addition to physical discomfort, fear of transmitting virus during sexual activity may be of great concern to those infected. Although there is no cure, a limited number of antiviral agents have proven effective in treating individual episode...

Zidovudine is approved for administration in doses given every 4 hours. Less frequent dosing has been used in many clinical trials, but the toxicity and efficacy of such regimens have not been formally compared with the approved regimen. In this multicenter, randomized, double-blind, controlled trial, the safety, tolerance and efficacy of 600 mg of...

Objective: To determine the effect of acyclovir and prednisone treatment of herpes zoster on chronic pain and quality-of-life outcomes. Design: Randomized, double-blind, placebo-controlled study with a 2 × 2 factorial design. Setting: 15 university hospitals or affiliated clinics. Patients: 208 immunocompetent patients older than 50 years of age wh...

Objective: To evaluate the efficacy and safety of oral famciclovir in the suppression of genital herpes. Methods: In this randomized, double-blind, placebo-controlled trial that was performed at 11 university and 9 private ambulatory care referral centers, 375 women who were 18 years of age or older and had a history of 6 or more episodes of geni...

To evaluate the efficacy and safety of oral famciclovir in the suppression of genital herpes. In this randomized, double-blind, placebo-controlled trial that was performed at 11 university and 9 private ambulatory care referral centers, 375 women who were 18 years of age or older and had a history of 6 or more episodes of genital herpes during 12 o...

To determine the effect of acyclovir and prednisone treatment of herpes zoster on chronic pain and quality-of-life outcomes. Randomized, double-blind, placebo-controlled study with a 2 x 2 factorial design. 15 university hospitals or affilliated clinics. 208 immunocompetent patients older than 50 years of age who had localized herpes zoster that de...

Herpes simplex virus type 2 (HSV-2) glycoprotein B (gB-2) gene segments were expressed as recombinant proteins in Escherichia coli. gB-2 recombinant proteins were reacted with human serum immunoglobulin G (IgG) antibodies in Western immunoblot assays. Initially, samples were tested for the presence of HSV-1-specific antibodies and HSV-2-specific an...

To describe the clinical characteristics of a group of patients infected with the newly recognized hantavirus in the Southwestern United States. Case series. Tertiary referral center. All patients with confirmed hantavirus infection admitted to the University of New Mexico Hospital between May 1, 1993 and January 1, 1994. Records of patients with h...

Oral acyclovir is the therapy of choice for treatment of first-episode genital herpes, for suppression of frequently recurrent genital herpes, and, in selected patients, for episodic treatment of recurrent genital herpes. Topical acyclovir therapy is relatively or totally ineffective and is therefore discouraged. Indications for intravenous acyclov...

Definitive diagnosis of acute hantavirus infection requires demonstration of specific IgG and IgM antibodies and a compatible clinical course; most persons with acute illness will also have viral RNA in PBMC which can be detected after RT-PCR amplification. Characteristic hematologic and hemodynamic findings are helpful in establishing a presumptiv...

The clinical benefit of antiviral therapy for recurrent varicella-zoster virus (VZV) infections in immunocompromised patients is not disputed but some aspects of the treatment of zoster in the otherwise healthy individual remain controversial.

Acute psychosis was observed in two patients with AIDS who were treated with clarithromycin for disseminated Mycobacterium avium complex infection. The psychosis resolved when treatment with clarithromycin was discontinued and recurred when it was resumed. An adverse response to clarithromycin therapy is a rare but curable cause of acute psychosis...

Hantaviruses are parasites of small mammals, predominantly peridomestic and commensal rodents. They have a worldwide distribution. Hantavirus-related illness occurs in rural areas where humans come into contact with rodents. In most cases human infection is manifested by one of a variety of acute illnesses involving hemorrhagic fever and renal dise...

Questions have arisen regarding the clinical outcome and the possible selection of resistant virus when patients with genital herpes discontinue prolonged chronic acyclovir; 239 immunocompetent patients with a history of frequently recurring genital herpes who stopped successful suppressive therapy after 6 years were studied. Of the patients, 85.8%...

Much has been learned in the last decade about the epidemiology of genital herpes infections, including new information about seroprevalence and the risk of transmission of genital herpes to sex partners and at delivery, Unfortunately, the type-specific serologic assays now routinely used in these studies are not widely available, and commercially...

Among persons with herpes simplex virus type 2 infection, approximately 75% are asymptomatic and can be identified only by serologic testing with type-specific assays. Among serologic assays, the Western immunoblot assay, the glycoprotein G-2 immunodot assay, and the glycoprotein G-2 enzyme immunoassay appear sensitive and type-specific, although t...

Seventy-three immunocompromised patients with disseminated herpes zoster were evaluated in a double-blind controlled trial of acyclovir (n = 37) versus vidarabine (n = 36) therapy. Acyclovir was administered at 30 mg/kg/day at 8-h intervals and vidarabine was given as a continuous 12-h infusion at 10 mg/kg/day for 7 days (longer if resolution of cu...

To determine the risk of sexual transmission of genital herpes simplex virus (HSV) in heterosexual couples. Prospective study of couples who were participants in a clinical trial. Each source partner had symptomatic, recurrent genital HSV, and each susceptible partner was without serologic or clinical evidence of genital herpes. Couples were follow...

Gossypol (I) and its derivatives gossylic nitrile-1,1'-diacetate (II), gossylic iminolactone (III) and gossylic lactone (IV) inhibit the replication of human immunodeficiency virus type 1 in vitro in the order III greater than I greater than II,IV, indicating that derivatives of gossypol can retain antiviral activities. All of the derivatives are l...

Unlike human T cell leukemia-lymphoma virus type I (HTLV-I), HTLV-II has not been convincingly linked to a malignancy. In the first 10 months of serologic screening for HTLV-I/II among blood donors in New Mexico in 1988–1989, HTLV-IIII infection was found in 27 donors. HTLV-IIII infection waspresent in 1.0%–1.6% ofAmerican Indian and 0.16%–0.27% of...

There has been a dramatic increase in patient visits to physicians for evaluation and treatment of genital herpes infections. This has resulted in part from an increase in genital herpes infections, particularly severe, first-episode genital herpes infections in adults without prior HSV-1 infection. Virus culture remains the most sensitive and spec...

To determine the efficacy of a herpes simplex virus type 2 (HSV-2) glycoprotein subunit vaccine, vaccine (50 ILg) or placebo was administered intramuscularly at weeks 0,4, and 22 to 161 persons who lacked HSV-2 antibodies and were sex partners of persons with recurrent genital herpes. The annual rate of acquisition of HSV infection was similar amon...

A multicenter, randomized, investigator-blind controlled trial was conducted to compare the safety and efficacy of a single, whole-body application of 5% permethrin cream with that of 1% lindane lotion for the treatment of scabies in 467 patients. At 14 +/- 3 days after treatment, the mean active lesion count decreased from pretreatment levels of 8...

Transmission of HTLV-I by transfusion is well documented in Japan, where HTLV-I is endemic. In non endemic regions such as the United States, HTLV-I/II infection has been transmitted by transfusion as well, but no effort to distinguish HTLV-I from HTLV-II infection was made in these studies. There is a growing body of evidence that a substantial pr...

Four hundred sixty-six female patients were enrolled in a randomized study that compared the clinical efficacies of single oral doses of cefuroxime axetil and amoxicillin with probenecid in the treatment of uncomplicated gonorrhea. Two hundred ninety-five patients had culture-positive gonococcal infections and completed the investigation. Cure rate...

This article has no abstract; the first 100 words appear below. RECURRENT herpes simplex virus (HSV) infections are frequent in patients with the acquired immunodeficiency syndrome (AIDS). Although they are usually self-limiting in the normal host, such infections may produce extensive and persistent ulcerative disease in compromised hosts.¹ Severa...

All patients attending a sexually transmitted disease (STD) clinic were offered voluntary, anonymous human immunodeficiency virus (HIV)-antibody testing and counseling as part of routine clinical evaluation. During a three-month evaluation period, 82% of patients accepted HIV testing. Testing was accepted equally by men and women and by heterosexua...

In Year 1 of this two-year trial, patients with six or more genital herpes recurrences in the past year received suppressive treatment with either acyclovir, 400 mg, or placebo, orally twice daily for one year, and physician-documented recurrences were treated with open-labeled acyclovir, 200 mg, orally five times per day for five days (acute treat...

Normal adults with six or more episodes of genital herpes in the previous year were enrolled in a one-year, multicenter, double-blind trial comparing placebo with 400 mg of acyclovir administered orally twice daily. Patients with episodes during the study were offered 200 mg of acyclovir administered orally five times daily for five days; this allo...

Normal adults with six or more episodes of genital herpes in the previous year were enrolled in a one-year, multicenter, double-blind trial comparing placebo with 400 mg of acyclovir administered orally twice daily. Patients with episodes during the study were offered 200 mg of acyclovir administered orally five times daily for five days; this allo...

To determine the risk of transmission of genital herpes simplex virus (HSV) infection, we prospectively studied, for a median of six months, 38 couples who had been together for a median of 10 mo. In each couple, one partner had a history of symptomatic genital herpes and one did not. At entry, of the 38 asymptomatic, exposed partners, 21 were sero...

Twenty-nine patients with first-episode rectal herpes simplex virus infection were enrolled in a double-blind trial of oral acyclovir, 400 mg five times daily, vs placebo treatment. Eighty percent of those receiving acyclovir compared with 25% of placebo recipients no longer had herpes simplex virus isolated from their rectal lesions three days aft...

The plasma endotoxin levels of 16 severely malnourished Thai children were determined by the Limulus amebocyte lysate assay. Endotoxemia was present in seven children (44%) on admission to the hospital and was associated with the coexistence of vitamin A deficiency. Protein-energy malnutrition is associated with the presence of endotoxemia.

The plasma endotoxin levels of 16 severely malnourished Thai children were determined by the Limulus amebocyte lysate assay. Endotoxemia was present in seven children (44%) on admission to the hospital and was associated with the coexistence of vitamin A deficiency. Protein‐energy malnutrition is associated with the presence of endotoxemia.

Oral acyclovir is the treatment of choice for most patients with first episode genital herpes (Table 2). Therapy of first episode herpes may not be indicated in patients whose symptoms and lesions are clearly resolving at the time of presentation, and intravenous acy-clovir therapy should be considered in patients with first episode herpes who requ...

Before 1985 only five cases of the acquired immunodeficiency syndrome (AIDS) had been diagnosed in New Mexico, and there was no information regarding prevalence of antibody to the human immunodeficiency virus (HIV). Of 166 gay and bisexual men tested in 1985 in New Mexico, 20% were found to have antibody to HIV. Of 153 responding participants, 107...

Twenty-two volunteers seronegative for antibodies to herpes simplex virus (HSV) were enrolled in a trial to determine tolerance and immunogenicity of an HSV-2 glycoprotein subunit vaccine. Vaccine was administered at days 0, 28, and 140, and sera were obtained on days 0, 7, 14, 21, 28, 35, 49, 56, 140, 147, and 365 for determination of HSV neutrali...