Publications by authors named "Fall Amary"

Article Synopsis
  • Enterovirus D68 (EV-D68) is linked to severe respiratory illness and acute flaccid myelitis (AFM), with 2022 showing increased infections but no rise in AFM cases unlike in 2018, which had a significant surge in AFM.
  • A study of 351 EV-D68 cases mainly involved children under 5, revealing that infections in 2018 led to more hospitalizations compared to 2022, and identified specific viral genomic changes associated with severe outcomes.
  • The findings emphasize the need for ongoing viral genomic surveillance to better understand the connections between genomic changes, immune responses, and the severity of diseases like AFM.
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We present a case of mpox recurrence in a transgender woman with AIDS. Her recurrent lesions required several courses of antiviral therapy over a 5-month period and her monkeypox viral genome was subsequently noted to have tecovirimat resistance mutations. Interestingly, she developed a robust orthopoxvirus-specific T-cell response.

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SARS-CoV-2 infection of immunocompromised individuals often leads to prolonged detection of viral RNA and infectious virus in nasal specimens, presumably due to the lack of induction of an appropriate adaptive immune response. Mutations identified in virus sequences obtained from persistently infected patients bear signatures of immune evasion and have some overlap with sequences present in variants of concern. We characterized virus isolates obtained greater than 100 days after the initial COVID-19 diagnosis from two COVID-19 patients undergoing immunosuppressive cancer therapy, wand compared them to an isolate from the start of the infection.

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Respiratory disease, attributed to influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, was reported nationally during the 2023/2024 respiratory viral season. The emergence of novel SARS-CoV-2 variants was considered a significant factor contributing to the rise in COVID-19 cases. Data from the Johns Hopkins Hospital System (JHHS) showed that enterovirus/rhinovirus had also been circulating at high rates.

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Article Synopsis
  • - Influenza, caused by viruses from the Orthomyxoviridae family, affects a significant portion of the population each year, with infection rates varying by age group and geographical location.
  • - This study involved sequencing the genomes of positive influenza samples, identifying predominant types and subtypes, mainly focusing on H1N1pdm09, while assessing changes in key proteins that might impact treatment and vaccine effectiveness.
  • - Findings highlighted the importance of ongoing genomic surveillance to track how influenza viruses evolve seasonally, as well as their potential effects on public health and clinical outcomes.
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Article Synopsis
  • RSV is a major health concern for infants, and this study analyzed its genetic variations and outcomes between August and December 2023 at Johns Hopkins Hospital.
  • The research found that the RSV-B GB5.0.5a genotype was the most common, but infections from RSV-A GA2.3.5 led to higher hospitalization rates.
  • Genetic analysis revealed various mutations in both RSV-A and RSV-B, indicating potential for antibody evasion, and the study aims to support understanding the impact of new RSV vaccines on genetic evolution and mutations.
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Pregnant patients are at greater risk of hospitalization with severe COVID-19 than non-pregnant people. This was a retrospective observational cohort study of remnant clinical specimens from patients who visited acute care hospitals within the Johns Hopkins Health System in the Baltimore, MD-Washington DC, area between October 2020 and May 2022. Participants included confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant people and matched non-pregnant people (the matching criteria included age, race/ethnicity, area deprivation index, insurance status, and vaccination status to ensure matched demographics).

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The circulation of human adenoviruses (HAdV) increased in 2023. In this manuscript, we show that HAdV-B3 was predominant in 2023 in a cohort characterized by the Johns Hopkins Hospital System. We also show that HAdV-B3 was associated with an increase in viral loads in respiratory samples and provide a correlation with the clinical presentations and outcomes.

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Article Synopsis
  • The study examined the circulation and genetic evolution of influenza A(H3N2) viruses during the 2021/2022 and 2022/2023 seasons, focusing on how these factors impacted infection outcomes.
  • A total of 121,683 respiratory samples were tested for influenza, resulting in 6,071 positive cases, with hemagglutinin (HA) sequencing done on 610 samples predominantly consisting of H3N2 viruses.
  • Despite an increase in cases and genetic variation in the 2022/2023 season, there was no significant change in disease severity or clinical outcomes when compared to the previous season.
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Background: During the 2022 mpox outbreak most patients were managed as outpatients, but some required hospitalization. Uncontrolled human immunodeficiency virus (HIV) has been identified as a risk factor for severe mpox.

Methods: Patients with mpox diagnosed or treated within the Johns Hopkins Health System between 1 June and 15 December 2022 were included.

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We conducted an active influenza surveillance in the single pig slaughterhouse in Dakar to investigate the epidemiology and genetic characteristics of influenza A viruses (IAVs) and to provide serologic evidence of avian influenza virus (AIV) infection in pigs at interfaces with human populations in Senegal. Nasal swab and blood samples were collected on a weekly basis from the same animal immediately after slaughter. Influenza A viruses were diagnosed using RT-qPCR and a subset of positive samples for H3 and H1 subtypes were selected for full genome amplification and NGS sequencing.

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Article Synopsis
  • Adenovirus F41 is known for causing gastroenteritis but can also lead to severe infections, especially in immunocompromised individuals.
  • An adult patient with several underlying health issues, including cancer and liver disease, developed a severe disseminated adenovirus infection and showed detectable viral loads in stool, plasma, and urine.
  • Unfortunately, despite starting antiviral treatment, the patient's condition worsened rapidly, leading to his death just two days after treatment began.
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The 2022 multicountry mpox outbreak concurrent with the ongoing Coronavirus Disease 2019 (COVID-19) pandemic further highlighted the need for genomic surveillance and rapid pathogen whole-genome sequencing. While metagenomic sequencing approaches have been used to sequence many of the early mpox infections, these methods are resource intensive and require samples with high viral DNA concentrations. Given the atypical clinical presentation of cases associated with the outbreak and uncertainty regarding viral load across both the course of infection and anatomical body sites, there was an urgent need for a more sensitive and broadly applicable sequencing approach.

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The rapidity with which SARS-CoV-2 XBB variants rose to predominance has been alarming. We used a large cohort of patients diagnosed with Omicron infections between September 2022 and mid-February 2023 to evaluate the likelihood of admission or need for supplemental oxygen in patients infected with XBB variants. Our data showed no significant association between XBB or XBB.

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Human adenoviruses (HAdVs) are double-stranded DNA viruses that can cause a wide spectrum of disease, including respiratory infections. Little is known about the value of respiratory HAdV quantification and its correlation with disease severity. In this study, we developed a quantitative HAdV droplet digital PCR (ddPCR) assay to study the association between viral loads, circulating types, and clinical outcomes.

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Importance: Pregnant women are at increased risk of severe COVID-19, but the contribution of viral RNA load, the presence of infectious virus, and mucosal antibody responses remain understudied.

Objective: To evaluate the association of COVID-19 outcomes following confirmed infection with vaccination status, mucosal antibody responses, infectious virus recovery and viral RNA levels in pregnant compared with non-pregnant women.

Design: A retrospective observational cohort study of remnant clinical specimens from SARS-CoV-2 infected patients between October 2020-May 2022.

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Background: Enteroviruses (EVs) are predominant causes of a spectrum of neurological diseases. To better understand the origins of the outbreaks of disease associated with EV, it is essential to develop an efficient surveillance system that identifies the circulating EVs and correlate their genomic evolution with the disease presentations.

Methods: The clinical presentations of patients with positive EV from cerebrospinal fluid (CSF) between 2014 and 2022, diagnosed at the Johns Hopkins Medical Microbiology Laboratory, were compared from year to year.

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Article Synopsis
  • The study focused on the epidemiology and genetic diversity of seasonal human coronaviruses (HCoVs) in Senegal over a nine-year period.
  • Among nearly 10,000 samples collected, 406 tested positive for HCoVs, with OC43 being the most prevalent.
  • The findings emphasized the need for ongoing public health monitoring of HCoVs, especially in vulnerable populations like children under five and in relation to co-infections with other viruses.
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Background: An increase in influenza like illness in children and adolescents at the Johns Hopkins Health system during summer 2022 was associated with increased positivity for enterovirus/ rhinovirus. We sought to characterize the epidemiology and viral evolution of enterovirus D68 (EV-D68).

Methods: A cohort of remnant respiratory samples tested at the Johns Hopkins Microbiology Laboratory was screened for EV-D68.

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Dengue virus (DENV) was detected in Senegal in 1979 for the first time. Since 2017, unprecedented frequent outbreaks of DENV were noticed yearly. In this context, epidemiological and molecular evolution data are paramount to decipher the virus diffusion route.

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Background: Prior observation has shown differences in COVID-19 hospitalization risk between SARS-CoV-2 variants, but limited information describes hospitalization outcomes.

Methods: Inpatients with COVID-19 at 5 hospitals in the eastern United States were included if they had hypoxia, tachypnea, tachycardia, or fever, and SARS-CoV-2 variant data, determined from whole-genome sequencing or local surveillance inference. Analyses were stratified by history of SARS-CoV-2 vaccination or infection.

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Background: The variant of concern Omicron has become the sole circulating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant for the past several months. Omicron subvariants BA.1, BA.

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Article Synopsis
  • The 2022 monkeypox outbreak amid the COVID-19 pandemic underscored the essential need for improved genomic surveillance and rapid whole genome sequencing methods.
  • Traditional metagenomic sequencing requires high viral DNA samples and is resource-intensive, prompting the development of a more sensitive approach using PrimalSeq, originally designed for Zika virus, now adapted for monkeypox.
  • Findings showed that amplicon-based sequencing resulted in better genome coverage, especially in samples with lower viral loads, leading to a recommendation of using samples with PCR cycle thresholds below 31 Ct to optimize sequencing efforts.
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We investigated the epidemiology of measles and rubella infections in Senegal based on data from twelve consecutive years of laboratory-based surveillance (2010−2021) and conducted phylogenetic analyses of circulating measles viruses. Sera from measles-suspected cases were collected and tested for measles and rubella-specific IgM antibodies using enzyme-linked immunosorbent assays (ELISA). Throat swabs were collected from patients with clinically diagnosed measles for confirmation by reverse-transcription polymerase chain reaction (RT-PCR) and viral genotyping.

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