Effects of Coronavirus Disease Pandemic on Tuberculosis Notifications,Malawi

The coronavirus disease (COVID-19) pandemic might affect tuberculosis (TB) diagnosis and patient care. We analyzed a citywide electronic TB register in Blantyre, Malawi and interviewed TB officers. Malawi did not have an official COVID-19 lockdown but closed schools and borders on March 23, 2020. In an interrupted time series analysis, we noted an immediate 35.9% reduction in TB notifications in April 2020; notifications recovered to near prepandemic numbers by December 2020. However, 333 fewer cumulative TB notifications were received than anticipated. Women and girls were affected more (30.7% fewer cases) than men and boys (20.9% fewer cases). Fear of COVID-19 infection, temporary facility closures, inadequate personal protective equipment, and COVID-19 stigma because of similar symptoms to TB were mentioned as reasons for fewer people being diagnosed with TB. Public health measures could benefit control of both TB and COVID-19, but only if TB diagnostic services remain accessible and are considered safe to attend.     

Fecal Excretion of Mycobacterium leprae,Burkina Faso

Mycobacterium leprae was detected by optical microscopy, fluorescent in situ hybridization, and molecular detection in feces collected for the diagnosis of Entamoeba coli enteritis in a leprosy patient in Burkina Faso. This observation raises questions about the role of fecal excretion of M. leprae in the natural history and diagnosis of leprosy.     

SARS-CoV-2 Aerosol Exhaled by Experimentally Infected Cynomolgus Monkeys

We analyzed size of severe acute respiratory coronavirus 2 (SARS-CoV-2) aerosol particles shed by experimentally infected cynomolgus monkeys. Most exhaled particles were small, and virus was mainly released early during infection. By postinfection day 6, no virus was detected in breath, but air in the isolator contained large quantities of aerosolized virus.     

Characteristics and Risk Factors of Hospitalized and Nonhospitalized COVID-19 Patients,Atlanta, Georgia,USA, March–April 2020

We compared the characteristics of hospitalized and nonhospitalized patients who had coronavirus disease in Atlanta, Georgia, USA. We found that risk for hospitalization increased with a patient’s age and number of concurrent conditions. We also found a potential association between hospitalization and high hemoglobin A1c levels in persons with diabetes.     

Cross-Sectional Serosurvey of Companion Animals Housed with SARS-CoV-2–Infected Owners,Italy

We conducted a serologic survey among dogs and cats in Italy to detect antibodies against severe acute respiratory syndrome virus 2 (SARS-CoV-2). We found that SARS-CoV-2 seroprevalence was higher among cats (16.2%) than dogs (2.3%). In addition, seroprevalence was higher among animals living in close contact with SARS-CoV-2–positive owners.     

Emergence of SARS-CoV-2 B.1.1.7 Lineage at Outpatient Testing Site,Berlin, Germany,January–March 2021

Within 5 weeks in 2021, B.1.1.7 became the dominant severe acute respiratory syndrome coronavirus 2 lineage at an outpatient testing site in Berlin, Germany. Compared with outpatients with wild-type virus infection, patients with B.1.1.7 had similar cycle threshold values, more frequent sore throat and travel history, and less frequent anosmia/ageusia.     

Prevalence of Middle East Respiratory Syndrome Coronavirus in Dromedary Camels,Tunisia

Free-roaming camels, especially those crossing national borders, pose a high risk for spreading Middle East respiratory syndrome coronavirus (MERS-CoV). To prevent outbreaks, active surveillance is necessary. We found that a high percentage of dromedaries in Tunisia are MERS-CoV seropositive (80.4%) or actively infected (19.8%), indicating extensive MERS-CoV circulation in Northern Africa.     

ABCB4基因突变合并巨细胞病毒感染致婴儿胆汁淤积症的诊治分析并文献复习

目的探讨ABCB4基因突变合并巨细胞病毒(CMV)感染致婴儿胆汁淤积症(IC)患儿的临床特征、基因检测结果和诊治方案。 方法选择2019年8月3日,于中山大学附属第七医院就诊并确诊为ABCB4基因突变合并CMV感染致IC的1例婴儿(女性,生后9个月)为研究对象。回顾性分析其临床病例资料,包括临床特征、实验室检查结果及基因检测结果。同时,检索国内外数据库中ABCB4基因突变所致IC患儿的相关文献,并进行文献复习。本研究遵循的程序符合2013年新修订的《世界医学协会赫尔辛基宣言》要求。 结果本例IC患儿在本院诊治结果如下。①病史采集：系G₂P₂,足月顺产,外观无异常,否认新生儿黄疸病史,生后2个月龄时出现皮肤及巩膜呈暗绿色,伴反复呕奶,当地医院治疗并诊断为胆汁淤积性肝病、CMV感染和泌尿系统感染,抗病毒治疗2周后好转出院。出院时,其血清总胆汁酸(sTBA)为152.8 μmol/L,CMV-DNA<4×10² copies/mL,口服熊去氧胆酸胶囊10 mg/(kg·d)治疗后,皮肤暗绿色逐渐消退,大、小便正常。出院后定期监测肝功能,sTBA、γ-谷氨酰转肽酶(GGT)仍然较正常值增高。②实验室检查：血清CMV免疫球蛋白(Ig)G抗体呈阳性、CMV IgM抗体呈阴性,CMV-DNA<55×10² copies/mL。基因检测结果：患儿及其父亲均携带ABCB4基因杂合变异。治疗结果：经口服熊去氧胆酸胶囊10 mg/(kg·d)及谷胱甘肽片0.1 g/次× 3次/d治疗后,对患儿定期复查sTBA、GGT。随访到18个月龄时,其各项指标逐渐恢复正常范围。③文献复习结果：共计检索到8篇国内外报道的因ABCB4基因突变引起IC相关文献,纳入14例IC患儿,均被诊断为进行性家族性肝内胆汁淤积3型(PFIC3),伴肝大,sTBA、GGT水平升高等。14例IC患儿中,共检测到ABCB4基因突变位点20个。其中,9例IC患儿接受熊去氧胆酸治疗,7例随访结果显示临床症状及实验室检查指标有所好转。 结论携带ABCB4基因突变,可引起IC。对于sTBA升高、肝酶异常的病因不明确、治疗效果不佳IC患儿,建议完善基因检测进一步排查ABCB4基因突变所致胆汁淤积症。     

Cellular Immunity in COVID-19 Convalescents with PCR-Confirmed Infection but with Undetectable SARS-CoV-2–Specific IgG

We investigated immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among a group of convalescent, potential blood donors in Germany who had PCR-confirmed SARS-CoV-2 infection. Sixty days after onset of symptoms, 13/78 (17%) study participants had borderline or negative results to an ELISA detecting IgG against the S1 protein of SARS-CoV-2. We analyzed participants with PCR-confirmed infection who had strong antibody responses (ratio >3) as positive controls and participants without symptoms of SARS-CoV-2 infection and without household contact with infected patients as negative controls. Using interferon-γ ELISpot, we observed that 78% of PCR-positive volunteers with undetectable antibodies showed T cell immunity against SARS-CoV-2. We observed a similar frequency (80%) of T-cell immunity in convalescent donors with strong antibody responses but did not detect immunity in negative controls. We concluded that, in convalescent patients with undetectable SARS-CoV-2 IgG, immunity may be mediated through T cells.     

Etiology of Severe Acute Respiratory Infections,Bangladesh, 2017

In April 2017, surveillance detected a surge in severe acute respiratory infections (SARI) in Bangladesh. We collected specimens from SARI patients and asymptomatic controls for analysis with multipathogen diagnostic tests. Influenza A(H1N1)pdm09 was associated with the SARI epidemic, suggesting that introducing vaccines and empiric antiviral drugs could be beneficial.