Hannah C. Howson-Wells's research while affiliated with Nottingham University Hospitals NHS Trust and other places
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Publications (28)
Background:
The first epidemic wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over a third of care homes reported an outbreak while there was limited testing of hospital patients discharged to care homes.
Aim:
Investigate hospital discharges...
Whole genome sequencing of SARS-CoV-2 has occurred at an unprecedented scale, and can be exploited for characterising outbreak risks at the fine-scale needed to inform control strategies. One setting at continued risk of COVID-19 outbreaks are higher education institutions, associated with student movements at the start of term, close living condit...
Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the...
Background:
Since the emergence of SARS-CoV-2, evolutionary pressure has driven large increases in the transmissibility of the virus. However, with increasing levels of immunity through vaccination and natural infection the evolutionary pressure will switch towards immune escape. Genomic surveillance in regions of high immunity is crucial in detec...
Background:
Human Parainfluenza viruses (HPIV) comprise of four members of the genetically distinct genera of Respirovirus (HPIV1&3) and Orthorubulavirus (HPIV2&4), causing significant upper and lower respiratory tract infections worldwide, particularly in children. However, despite frequent molecular diagnosis, they are frequently considered coll...
The Delta (B.1.617.2) variant was the predominant UK circulating SARS-CoV-2 strain between May and December 2021. How Delta infection compares with previous variants is unknown. This prospective observational cohort study assessed symptomatic adults participating in the app-based COVID Symptom Study who tested positive for SARS-CoV-2 from May 26 to...
Enterovirus D68 (EV-D68) has recently been identified in biennial epidemics coinciding with diagnoses of non-polio acute flaccid paralysis/myelitis (AFP/AFM). We investigated the prevalence, genetic relatedness and associated clinical features of EV-D68 in 193 EV-positive samples from 193 patients in late 2018, UK. EV-D68 was detected in 83 (58 %)...
Mitigation of SARS-CoV-2 transmission from international travel is a priority. We evaluated the effectiveness of travellers being required to quarantine for 14-days on return to England in Summer 2020. We identified 4,207 travel-related SARS-CoV-2 cases and their contacts, and identified 827 associated SARS-CoV-2 genomes. Overall, quarantine was as...
Background Human Parainfluenza viruses (HPIV) comprise of four members of the genetically distinct genera of Respirovirus (HPIV1&3) and Orthorubulavirus (HPIV2&4), causing significant upper and lower respiratory tract infections worldwide, particularly in children. However, despite frequent molecular diagnosis, they are frequently considered collec...
Understanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding c...
Human Parainfluenza viruses (HPIV) are constituted by four members of the genetically distinct genera of Respirovirus (type 1 and 3) and Orthorubulavirus (type 2 and 4), causing significant upper and lower respiratory tract infections in both children and adults worldwide. However, despite frequent molecular diagnosis, they are frequently considere...
Enterovirus D68 (EV-D68) has been recently identified in biennial epidemics coinciding with diagnoses of non-polio acute flaccid paralysis/myelitis (AFP/AFM). We investigated the prevalence, genetic relatedness and associated clinical features of EV-D68 in 194 known EV positive samples from late 2018, UK. EV-D68 was detected in 83 (58%) of the 143...
Vaccination and disease
The United Kingdom has high rates of vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), exceeding 80% of adults. As immunity wanes and social distancing is relaxed, how are rates of illness and severe disease affected by more infectious variants? Elliott et al . used reverse transcription PCR data...
In the early phases of the SARS coronavirus type 2 (SARS-CoV-2) pandemic, testing focused on individuals fitting a strict case definition involving a limited set of symptoms together with an identified epidemiological risk, such as contact with an infected individual or travel to a high-risk area. To assess whether this impaired our ability to dete...
Background
The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility.
Methods
We did an ecological study to examine the associatio...
Introduction. The COVID-19 pandemic, which began in 2020 is testing economic resilience and surge capacity of healthcare providers worldwide. At the time of writing, positive detection of the SARS-CoV-2 virus remains the only method for diagnosing COVID-19 infection. Rapid upscaling of national SARS-CoV-2 genome testing presented challenges: (1) Un...
Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability o...
Background:
Human enteroviruses (EV) are the leading cause of viral meningitis. EV genotyping is predominantly performed through amplification and sequencing of viral capsid protein-1 (VP1), frequently by national reference laboratories (NRLs).
Objective:
To determine the frequency of genotyping failure in our NRL-submitted samples and apply a s...
In the early phases of the SARS coronavirus type 2 (SARS-CoV-2) pandemic, testing focused on individuals fitting a strict case definition involving a limited set of symptoms together with an identified epidemiological risk, such as contact with an infected individual or travel to a high-risk area. To assess whether this impaired our ability to dete...
The COVID-19 pandemic, which began in 2020 is testing economic resilience and surge capacity of healthcare providers worldwide. At time of writing, positive detection of the SARS-CoV-2 virus remains the only method for diagnosing COVID-19 infection. Rapid upscaling of national SARS-CoV-2 genome testing presented challenges: 1) Unpredictable supply...
Background
Since its first isolation in 2005, Human Bocavirus (HBoV) has been repeatedly associated with acute respiratory tract infections, although its role in pathogenicity remains unclear due to high co-infection rates.
Objectives
To assess HBoV prevalence and associated disease in a cohort of respiratory patients in the East Midlands, UK betw...
PCR detection has become the gold standard for diagnosis and typing of enterovirus (EVs) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using appropriate sample types and high assay sensitivity since viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. T...
Citations
... This may be attributable to the described significant escape from neutralizing antibodies by Omicron. 16,28 It has previously been shown that vaccineinduced neutralizing antibodies provided a correlate of protection against infection with the ancestral strain or relatively homologous VOCs. 29,30 Our results complement these data and demonstrates that S-binding IgG antibody levels provide a correlate of protection against fatality related to infections with VOCs. ...
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... The emergence of mutations in the SARS-CoV-2 virus, the causative agent of COVID-19, has presented new challenges in controlling the spread of the disease and managing its severity. Mutations can lead to changes in the transmissibility of the virus and impact the clinical presentation, potentially affecting the effectiveness of diagnostic tests and treatments [63,64] To effectively address these challenges, several strategies have been implemented to control transmissibility and manage disease severity. ...
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... More than 700,000 cases of SARS-CoV-2 infection were reported at colleges and universities in the United States between the beginning of the pandemic in January 2020 and the end of the spring term in May 2021 [2]. High caseloads have resulted in many institutions shutting down campus facilities and transitioning to online learning [3][4][5]. ...
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... Indeed, no positive clinical phase III trial results have been reported for camostat in context with COVID-19 yet, but there are negative data [55,56]. Meanwhile, the SARS-CoV-2 variant omicron uses an altered cell entry pathway, favouring a TMPRSS2-independent endosomal entry pathway [57], rendering camostat ineffective. ...
... Conversely, in an opportunistic analysis of individuals who were recruited with SARS-CoV-2 negative statuses but had first infections between rounds of cognitive assessment, we found much less convincing evidence of cognitive sequelae for these later COVID-19 infections. Such infections occurred after vaccination against SARS-CoV-2 (99%) and skewed towards shorter durations than infections before Round 1, which may reflect our sampling strategy, as well as the reduced likelihood of long COVID (illness duration ≥ 4 weeks) for more recent delta vs. alpha and omicron vs. delta variants [48,49], and following vaccination [50]. ...
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... In the same year, EV-D68 was also reported in Europe, Southeast Asia and Chile (Holm-Hansen et al., 2016). Since 2014, EV-D68 outbreaks have occurred in a biennial pattern between 2016 and 2018, typically in even years in temperate climates (Howson-Wells et al., 2022) and emerging most frequently in the USA, Europe, Argentina and Taiwan (Knoester et al., 2017;Hu and Chang, 2020). While EV-D68 typically peaks in late summer and autumn in temperate climates (Hodcroft et al., 2022), an off-season upsurge was observed across Europe during the 2019-2020 winter season (Midgley et al., 2020). ...
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... S evere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an etiological agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has infected over 750 million people globally, with 1% mortality rate (World Health Organization, accessed 8 February 2023) (1). During this enormous human health crisis, whole-genome sequencing (WGS) has enabled public health agencies to identify circulating SARS-CoV-2 variants, understand vaccine breakthroughs and transmission patterns, and contact tracing investigations (2,3). WGS involves library preparation, sequencing, and bioinformatics data analysis. ...
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... Furthermore, IHEs could drive transmission to surrounding communities, which can be more susceptible to severe disease than IHE populations [1][2][3][4] . Many IHEs reported outbreaks of COVID-19 shortly after the 2020-2021 academic year began 3,[5][6][7][8][9] . Cases also increased rapidly during this time in US counties that had IHEs 1,3,10 , although increases were less severe in counties with IHEs that implemented mitigation measures including online instruction and SARS-CoV-2 surveillance testing 11 . ...
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... After March 2021, lockdown restrictions were slowly lifted with phased reopenings [10]. Combined with the emergence of the Delta variant in England in April 2021, which has been linked to even greater levels of transmissibility than prior variants [11,12] and reduced vaccine effectiveness [13], the pandemic once more entered a phase of growth leading to high prevalence [14]. The last easing on 19 July 2021 removed all domestic legal restrictions and saw society reopen to an extent not seen since March 2020 [15]. ...
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... The first confirmed cases of COVID-19 in the UK were on the 29 th January 2020, when two Chinese nationals fell ill in York. The earliest known person to contract COVID-19 within the UK is believed to be a 75-year-old woman from Nottinghamshire, who tested positive on the 21 st February 2020 [22]. She is also understood to be the first victim of COVID-19 in the UK. ...
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