Family outbreak of an infection with a recombinant Coxsackie A virus in eastern Switzerland.

Purpose: We report on an unusual familial outbreak of a coxsackie virus infection in Switzerland in which five family members were affected. Most of the patients presented with signs of meningitis, and four were hospitalized.

Methods: In three individuals, the virus was detected in the cerebrospinal fluid, pharynx, and stool, respectively.

Astrovirus infection in hospitalized infants with severe combined immunodeficiency after allogeneic hematopoietic stem cell transplantation.

Infants with severe primary combined immunodeficiency (SCID) and children post-allogeneic hematopoietic stem cell transplantation (HSCT) are extremely susceptible to unusual infections. The lack of generic tools to detect disease-causing viruses among more than 200 potential human viral pathogens represents a major challenge to clinicians and virologists. We investigated retrospectively the causes of a fatal disseminated viral infection with meningoencephalitis in an infant with gamma C-SCID and of chronic gastroenteritis in 2 other infants admitted for HSCT during the same time period.

Impact of synthetic and biologic disease-modifying antirheumatic drugs on antibody responses to the AS03-adjuvanted pandemic influenza vaccine: a prospective, open-label, parallel-cohort, single-center study.

Objective: To identify the determinants of antibody responses to adjuvanted split influenza A (H1N1) vaccines in patients with inflammatory rheumatic diseases.

Methods: One hundred seventy-three patients (82 with rheumatoid arthritis, 45 with spondylarthritis, and 46 with other inflammatory rheumatic diseases) and 138 control subjects were enrolled in this prospective single-center study. Controls received 1 dose of adjuvanted influenza A/09/H1N1 vaccine, and patients received 2 doses of the vaccine.

Management of resistant mucocutaneous herpes simplex infections in AIDS patients: a clinical and virological challenge.

Background: The use of highly active antiretroviral therapy (HAART) has been associated with a marked decrease in the prevalence of opportunistic infections in HIV-infected patients. However, chronic mucocutaneous herpes simplex virus (HSV) infection remains a difficult clinical challenge.

Objective: The aim of the study was to optimize the diagnosis and follow-up of chronic HSV-2 infection in HIV-infected patients and to correlate clinical data with CD4 cell count, in vitro HSV virological resistance and histology.

False serologic evidence for acute primary toxoplasmosis during liver transplantation for fulminant hepatitis B: a case report.

Acute primary Toxoplasma gondii infection is usually considered to be a contraindication for solid organ transplantation. Recent reports of acute T. gondii infection have highlighted the need to include T.

[From diagnosis to the detection of avian influenza virus].

Until now the avian influenza A (H5N1) virus is only adapted to birds. But even so infections in man are observed sporadically. Why is this possible and how big is the risk that the virus becomes fully adapted to man so that he can be transmitted easily from man to man.

Survival of influenza virus on banknotes.

Successful control of a viral disease requires knowledge of the different vectors that could promote its transmission among hosts. We assessed the survival of human influenza viruses on banknotes given that billions of these notes are exchanged daily worldwide. Banknotes were experimentally contaminated with representative influenza virus subtypes at various concentrations, and survival was tested after different time periods.

[Emerging viral infections].

Emerging, re-emerging, rare or dangerous viruses are regularly citated in news. Most of theses viruses belong to the class 3 and 4. Clinical specimens must be handled with appropriate bio-security conditions, and, for some of them, high security facilities are required.

[Will avian influenza virus become a human virus?].

Since 1997, an Influenza virus of avian origin appears regularly in human causing severe respiratory infections leading to death in half cases. This Influenza A (H5N I) virus which is at the origin of this illness circulates in wild birds and in domestic birds. Million poultry have been regularly infected or slaughtered on 3 continents: Asia, Africa and Europe.

Swiss recommendations for the management of varicella zoster virus infections.

Infections with varicella zoster virus (VZV) are common viral infections associated with significant morbidity. Diagnosis and management are complex, particularly in immunocompromised patients and during pregnancy. The present recommendations have been established by a multidisciplinary panel of specialists and endorsed by numerous Swiss medical societies involved in the medical care of such patients (Appendix).

Cytomegalovirus quantification in plasma by an automated real-time PCR assay.

Background: Sensitive quantitation of cytomegalovirus (CMV) DNA in blood is helpful for the diagnosis of CMV infection or reactivation and the monitoring of transplanted patients.

Objectives: We compared a new PCR assay coupled with an automated extraction system (CMV real-time PCR, Abbott Molecular, Des Plaines, IL, USA) to a previously validated method (ultrasensitive Cobas Amplicor CMV DNA Monitor, Roche Molecular, Indianapolis, IN, USA).

Results: Using limiting dilutions of CMV DNA positive plasma, the two assays had a similar detection threshold ranging between 20 and 45 copies/ml.

Chronic rhinoviral infection in lung transplant recipients.

Rationale: Lung transplant recipients are particularly at risk of complications from rhinovirus, the most frequent respiratory virus circulating in the community.

Objectives: To determine whether lung transplant recipients can be chronically infected by rhinovirus and the potential clinical impact.

Methods: We first identified an index case, in which rhinovirus was isolated repeatedly, and conducted detailed molecular analysis to determine whether this was related to a unique strain or to re-infection episodes.

A prospective hospital-based study of the clinical impact of non-severe acute respiratory syndrome (Non-SARS)-related human coronavirus infection.

Background: In addition to the human coronaviruses (HCoVs) OC43 and 229E, which have been known for decades to cause infection in humans, 2 new members of this genus have recently been identified: HCoVs NL63 and HKU1. Their impact as a cause of respiratory tract disease in adults at risk for complications needs to be established.

Methods: We prospectively assessed the clinical impact of coronavirus infection (excluding cases of severe acute respiratory syndrome) among hospitalized adults.

Lower respiratory viral illnesses: improved diagnosis by molecular methods and clinical impact.

We assessed the frequency and the potential role of respiratory viruses on disease outcomes in hospitalized patients and lung transplant recipients who underwent a bronchoalveolar lavage (BAL) for an acute respiratory infection. BAL specimens (148) were analyzed by reverse transcription-polymerase chain reaction for the presence of 11 different viruses, as well as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Respiratory viruses were identified in 34 of 117 BAL specimens (29%) obtained in patients with a suspected respiratory infection and in only 2 of 31 control subjects (7%) (p < 0.

Amplicon sequencing and improved detection of human rhinovirus in respiratory samples.

Improved knowledge of the genotypic characteristics of human rhinovirus (HRV) is required, as are nucleic detection assays with the capacity to overcome both the similarities between members of the family Picornaviridae and the wide diversity of different HRV serotypes. The goal of the present study was to investigate the variability and the genotypic diversity of clinical strains circulating in the community. Since most reverse transcription (RT)-PCR assays available cannot differentiate HRV from other members of the family Picornaviridae, we also validated an assay specific for HRV detection.

Respiratory viruses and severe lower respiratory tract complications in hospitalized patients.

Background: Acute respiratory viral infections are generally self-limited in healthy subjects but can lead to severe complications in immunocompromised hosts. We report the clinical impact of acute lower respiratory tract viral infections in hospitalized patients.

Materials And Methods: Of 1,001 fiberoptic bronchoscopies performed during a period of 5 years, 33 BAL samples were positive for respiratory viruses by cell culture.

The use of near patient tests in influenza surveillance: Swiss experience and EISS recommendations.

Surveillance requires time for analysis and for the communication to physicians. In order to reduce this delay, a new surveillance system based on the use of a near patient test (NPT) has been evaluated. The high specificity of NPT together with the rapidity in obtaining the results, make these tests attractive for surveillance of influenza epidemic in community practice.

[Respiratory tract viruses].

The respiratory tract is the site of entrance of many viruses. However, not all of them cause symptomatic respiratory infections. In the past the clinical significance of some viruses was underestimated.

Monitoring of cytomegalovirus infection in solid-organ transplant recipients by an ultrasensitive plasma PCR assay.

Early and accurate monitoring of cytomegalovirus (CMV) infection in solid-organ transplant recipients is of major importance. We have assessed the potential benefit of an ultrasensitive plasma-based PCR assay for renal transplant recipients. The pp65 CMV antigen (pp65 Ag) assay using leukocytes was employed as a routine test for the monitoring of CMV in 23 transplant recipients.

Rapid antigen testing for the surveillance of influenza epidemics.

Objective: To assess the use of a 'near patient' test for rapid antigen detection to obtain the more timely acquisition of data for the surveillance of influenza epidemics.

Methods: To the classical cell culture system used for the surveillance of influenza, a 'near patient' test was added. The cell culture method was applied for the detection of influenza virus in specimens sent to our laboratory.

Human infection by a swine influenza A (H1N1) virus in Switzerland.

The isolation of A/Switzerland/8808/2002 provides further evidence of sporadic human infection by contemporary swine influenza A H1N1 viruses, antigenically and genetically distinct from H1N1 viruses circulating in the human population. Together with the recent emergence of human-swine-avian reassortant viruses in pig populations in Europe and North America, frequent transmission between swine and human populations emphasises the potential for the emergence in pigs of novel subtypes with the capacity to cause major human epidemics.

Improved monitoring of cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation by an ultrasensitive plasma DNA PCR assay.

Cytomegalovirus (CMV) DNA amplification assays in plasma have shown limited sensitivity compared to the detection of pp65 antigen in leukocytes. Our goal was to increase the sensitivity of a commercial CMV DNA PCR quantitative assay. After modification, the new assay was able to reproducibly detect 20 CMV DNA copies/ml of plasma.

Evaluation of an optical immunoassay for the rapid detection of influenza A and B viral antigens.

An optical immunoassay for the rapid detection of influenza types A and B viral antigens, FLU OIA (Biostar, USA), was prospectively compared with antigen detection methods and cell culture on 400 respiratory specimens during an influenza outbreak that occurred in Switzerland in 1998/1999. The FLU OIA had an overall sensitivity of 64.4% (95%CI, 56.

Detection of enteroviruses in the cerebrospinal fluid by polymerase chain reaction: prospective study of impact on the management of hospitalized children.

A polymerase chain reaction kit (AMPLICOR EV) for the detection of enteroviruses (EV-PCR) in the cerebrospinal fluid (CSF) was evaluated in clinical conditions in a prospective blinded-intention study. Forty-three children (mean age 2.7 years) hospitalized for suspected meningitis or fever of unclear etiology were enrolled.