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Purpose: to demonstrate a clinical case of whooping cough associated with rhinovirus and parainfluenza infections with an unfavorable outcome in a child 2 months of age. Results. The illness in the infant began acutely with the development of catarrhal syndrome in the form of a moderately expressed serous-mucous discharge from the nose, rare coughing, the addition of intoxication syndrome on the 2nd day (increase in body temperature to 39°C) and an increase in paroxysmal cough by the 5th day from the onset of the disease to 20 times a day, symptoms of respiratory failure. Based on clinical and laboratory data, a diagnosis was made: Whooping cough caused by Bordetella pertussis. Typical. Severe severity. PCR confirmed. Concomitant diagnosis: Viral infection of mixed etiology (Parainfluenza virus type 2, Human Rhinovirus). PCR confirmed. Complications: Community-acquired bilateral polysegmental pneumonia. Severe severity. Respiratory failure III degree. An unfavorable course of the disease was noted with the development of infectious toxic shock, disseminated intravascular coagulation syndrome and multiple organ failure, which led to death on the 12th day from the onset of the disease. This case convincingly shows that the combination of whooping cough with respiratory pathogens is the leading factor determining the complicated course and unfavorable outcome of the disease.

Introduction. The traditional surveillance system for influenza and ARVI provides a general description of epidemics, but does not provide information on the age-related characteristics of the etiology and clinical peculiarities of severe acute respiratory diseases (SARI) in hospitalized patients. Aim. To monitor the etiology of SARI in hospitalized children and adults, assessing the impact of the COVID-19 pandemic on this process. Materials and methods. Standardized clinical and laboratory monitoring of SARI among 18,458 hospitalized patients was carried out in hospitals in three cities of Russia with weekly PCR detection of 11 types of pathogens. Results. According to the investigation of hospitalized patients with SARI for the period from 2018 to 2023, the viral etiology of respiratory diseases was deciphered in 58.3% of cases. Weekly monitoring showed a change in the etiological mosaic of SARI pathogens during the SARS-CoV-2 pandemic with a sharp decrease in the frequency of detection of influenza and respiratory syncytial virus (RSV) during the 2020–2021 season against the background of a significant increase of metapneumovirus and rhinovirus infections in children. During the 2022-2023 season an increase in the proportion of RSV infection in children under 6 years of age (up to 36.2%) was noted against the background of a significant decrease in the frequency of SARS-CoV-2. In the intensive care units (ICU), RSV infection was most often in children during the post-pandemic period (up to 30.1–53.6% of positive cases, p 0.001); in adults, SARS-CoV-2 was mostly detected (76,5–100% of cases, p 0.001). Conclusion. Hospital surveillance data significantly complements the epidemiological information obtained in the traditional surveillance system. Monitoring of infections has shown a continuously changing etiological infrastructure of SARI, with the disappearance of influenza and RSV during the COVID-19 pandemic and their return to circulation in the post-pandemic period.

According to the World Health Organization, acute respiratory viral infections (ARVIs) account for 70–85% of all cases of infectious diseases in the world. High prevalence rates of ARVIs, influenza and COVID-19 require the search for new methods to prevent, treat, and control epidemics. Furthermore, there are significant economic losses due to high incidence and temporary disability rates. ARVIs constitute a heterogenous group of the infectious respiratory tract disorders caused by numerous viruses, such as influenza virus, parainfluenza virus, respiratory syncytial virus, adenovirus, coronavirus, and many other viruses. Symptoms of various ARVIs have much in common and include fever, cough, chest pain, headache, myalgia, asthenia, anosmia, etc. The paper discusses the features of diagnostic search and treatment tactics in seasonal ARVIs, as well as feasibility of preventive measures. The data of meta-analyses and systematic reviews are used to explore the role and potential of zinc, selenium, vitamin C, vitamin A, and vitamin E for prevention and treatment of bronchopulmonary diseases in adults.

There is little known about parainfluenza virus (PIV) infection in adult intensive care unit (ICU) patients. Here, we aim to describe the characteristics, clinical course and outcomes of PIV infection in adults requiring intensive care. In this retrospective study of consecutive patients admitted to our ICU with confirmed PIV infection over a 7-year period, we report the patient characteristics, laboratory tests and prognostic scores on ICU admission. The main outcomes reported are 30-day mortality and organ support required. We included 50 patients (52% male, mean age 67.6 years). The mean PaO2/FiO2 and neutrophil/lymphocyte ratios on ICU admission were 198 ± 82 mmHg and 15.7 ± 12.5. Overall, 98% of patients required respiratory support and 24% required cardiovascular support. The median length of ICU stay was 5.9 days (IQR 3.7–9.1) with a 30-day mortality of 40%. In conclusion, PIV infection in adult ICU patients is associated with significant mortality and morbidity. There were significant differences between patients who presented with primary hypoxemic respiratory failure and hypercapnic respiratory failure. [ABSTRACT FROM AUTHOR]

Introduction: Acute necrotizing encephalopathy (ANE) of childhood is a rare inflammatory syndrome, classically associated with preceding febrile illness and followed by fulminant neurological deterioration including encephalopathy, seizures, and focal neurological deficits with multifocal lesions of the thalami, rostral brainstem, and cerebral and cerebellar gray and white matter. ANE is distinctly associated with significant rates of neurological sequelae and death. Multiple infectious and parainfectious etiologies have been associated with ANE, notably influenza A. Case Report: We report two cases of ANE associated with parainfluenza infection. Both children were treated with high-dose methylprednisolone and intravenous immunoglobulin, and one treated with tocilizumab. However, both patients suffered rapid neurological deterioration and death despite aggressive intervention. Conclusion: We present two cases of ANE with rapid neurological deterioration and death despite aggressive medical therapy. Rapid treatment with immunomodulatory treatments can lead to symptomatic recovery of variable degree in some patients. While high-dose steroids, intravenous immunoglobulin, and plasma exchange are common therapies for ANE, some case reports have suggested interleukin-6 (IL-6) blockade with tocilizumab can be beneficial. We report the nineteenth documented child in pediatric literature treated for ANE with tocilizumab, who did not respond to treatment, suggesting the response is heterogeneous and warrants additional investigation.

There is intense interest in developing long-lasting, potent, and broad-spectrum antiviral disinfectants. Ceria nanoparticles (CNPs) can undergo surface redox reactions (Ce3+ ↔ Ce4+) to generate ROS without requiring an external driving force. Here, we tested the mechanism behind our prior finding of potent inactivation of enveloped and non-enveloped RNA viruses by silver-modified CNPs, AgCNP1 and AgCNP2. Treatment of human respiratory viruses, coronavirus OC43 and parainfluenza virus type 5 (PIV5) with AgCNP1 and 2, respectively, prevented virus interactions with host cell receptors and resulted in virion aggregation. Rhinovirus 14 (RV14) mutants were selected to be resistant to inactivation by AgCNP2. Sequence analysis of the resistant virus genomes predicted two amino acid changes in surface-located residues D91V and F177L within capsid protein VP1. Consistent with the regenerative properties of CNPs, surface-applied AgCNP1 and 2 inactivated a wide range of structurally diverse viruses, including enveloped (OC43, SARS-CoV-2, and PIV5) and non-enveloped RNA viruses (RV14 and feline calicivirus; FCV). Remarkably, a single application of AgCNP1 and 2 potently inactivated up to four sequential rounds of virus challenge. Our results show broad-spectrum and long-lasting anti-viral activity of AgCNP nanoparticles, due to targeting of viral surface proteins to disrupt interactions with cellular receptors. [ABSTRACT FROM AUTHOR]

We conducted a phase I clinical trial of the live-attenuated recombinant human parainfluenza virus type 2 (HPIV2) vaccine candidate rHPIV2-15C/948L/∆1724 sequentially in adults, HPIV2-seropositive children, and HPIV2-seronegative children, the target population for vaccination. rHPIV2-15C/948L/∆1724 was appropriately restricted in replication in adults and HPIV2-seropositive children but was overattenuated for HPIV2-seronegative children. [ABSTRACT FROM AUTHOR]

Background: Children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can experience neurological symptoms, but limited data are available on neurological symptoms associated with other respiratory infections. We compared proportions of neurological symptoms in children hospitalized with seizures and respiratory infections, including SARS-CoV-2, influenza, and endemic coronaviruses.Methods: A retrospective cohort study was performed on children admitted for seizures who had positive respiratory polymerase chain reactions for SARS-CoV-2, coronavirus NL63, coronavirus OC34, influenza (A and B), adenovirus, Mycoplasma pneumoniae, or parainfluenza 3 or 4. Primary outcomes were rates of new neurological diagnoses and mortality.Results: A total of 883 children were included. Mortality rates ranged from 0% with M. pneumoniae to 4.9% with parainfluenza 4. Strokes were observed with all infections except for coronavirus OC43 and M. pneumoniae, with the highest rates in parainfluenza 4 (4.9%) and SARS-CoV-2 (5.9%). Compared with other infections, children with SARS-CoV-2 were older, had higher rates of stroke, and lower rates of intubation. The most common brain magnetic resonance imaging (MRI) abnormality was diffusion restriction. Abnormal MRI rates were lower in SARS-CoV-2, compared with patients with other coronavirus (OC). However, rates of stroke, encephalopathy, hypoxic-ischemic encephalopathy, and meningoencephalitis were similar between SARS-CoV-2 and influenza cohorts.Conclusions: In children hospitalized with seizures, higher rates of stroke were observed in SARS-CoV-2 versus OC. Similar rates of neurological symptoms were observed in patients with SARS-CoV-2 and those with influenza. Strokes can occur in children with these viral infections, particularly SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Human parainfluenza viruses (HPIVs) are (−)ssRNA viruses belonging to Paramyoviridaie family. They are one of the leading causes of mortality in infants and young children and can cause ailments like croup, bronchitis, and pneumonia. Currently, no antiviral medications or vaccines are available to effectively treat parainfluenza. This necessitates the search for a novel and effective treatment. Computer-aided drug design (CADD) methodology can be utilized to discover target-based inhibitors with high accuracy in less time. A library of 45 phytocompounds with immunomodulatory properties was prepared. Thereafter, molecular docking studies were conducted to characterize the binding behavior of ligand in the binding pocket of HPIV3 HN protein. The physicochemical properties for screened compounds were computed, and the top hits from docking studies were further analyzed and validated using molecular dynamics simulation studies using the Desmond module of Schrodinger Suite 2021–1, followed by MM/GBSA analysis. The compounds CID:72276 (1) and CID:107905 (2) emerged as lead compounds of our in silico investigation. Further in vitro studies will be required to prove the efficacy of lead compounds as inhibitors and to determine the exact mechanism of their inhibition. Computational studies predict three natural flavonoids to inhibit the HN protein of HPIV3. [ABSTRACT FROM AUTHOR]

We report a case of a 34-year-old female who presented to the emergency department with fever, nausea, vomiting, and diarrhea following a suspected foodborne illness. She tested positive for COVID-19, human parainfluenza virus type 4, and enterovirus/rhinovirus in the hospital. She subsequently developed hypoxia, hypotension, and sepsis. Blood work revealed leukocytosis and elevated inflammatory markers. Imaging of her abdomen showed fluid-filled bowel loops suggesting acute gastroenteritis and colitis of infectious or inflammatory etiology. She was initially treated with antibiotics for a suspected bacterial infection. However, her cultures resulted negative and her symptoms slowly improved with supportive care including probiotics and a low-fat diet. Due to her persistent shortness of breath related to her COVID-19 infection, she was started on a course of oral prednisone due to the anti-inflammatory effects of steroids. She was discharged home in stable condition with close outpatient follow-up. This study highlights the clinical challenges of managing multiple viral infections, particularly with concurrent COVID-19., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Review Board of WellSpan Health issued approval Exempt. Written informed consent was taken from the patient. WellSpan Health IRB does not review singular cases. Singular cases are exempt from IRB approval requirements. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bangash et al.)

Social restrictions interrupted the normal respiratory virus circulation in Spring 2020. This report describes virus circulation in the pediatric population before and after the restrictions ended in Finland in September 2021. We used data from the Finnish Infectious Disease Register. Nationwide influenza A and B, rhinovirus, severe acute respiratory syndrome coronavirus 2 (SARS‐Cov‐2), and respiratory syncytial virus (RSV) findings from January 2018 to December 2021. Age stratified (0–4, 5–9, and 10–14 years) weekly incidences per 100 000 children were calculated. School and day‐care closures interrupted completely the circulation of all other respiratory viruses than rhinovirus in spring 2020. After restrictions were relaxed in September 2021, SARS‐Cov‐2 detections increased majorly. We observed high RSV season atypically early. SARS‐Cov‐2 was detected in older children whereas RSV season peaked especially among children aged under 5. Influenza seemed to return to normal circulation. In conclusion, we report that the ending of social restrictions in September 2021 led to an increase in SARS‐Cov‐2 detections and high epidemic peaks of RSV and parainfluenza in atypical timing in children. Our results highlight the importance of continuous pathogen surveillance during the pandemic, as atypical surges of non‐COVID‐19 respiratory viruses were observed. [ABSTRACT FROM AUTHOR]

Social restrictions interrupted the circulation of common respiratory viruses among children in spring 2020. In the winter season 2020–2021, only rhinovirus spread in Finland. As the restrictions were ended in September 2021, we saw record high epidemic peak of parainfluenza. Typically, the epidemic peak is in springtime, but now, it started in the early fall 2021. The monthly incidence among children aged 0–4 years (120 per 100,000 children) was six times higher than the second highest reported monthly incidence (21 per 100,000 children) during the last 10 years. Our finding highlights the importance of active surveillance of viral respiratory pathogens during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Non‐pharmaceutical interventions (NPIs) and voluntary behavioral changes during the COVID‐19 pandemic have influenced the circulation of non‐SARS‐CoV‐2 respiratory infections. We aimed to examine interactions among common non‐SARS‐CoV‐2 respiratory virus and further estimate the impact of the COVID‐19 pandemic on these viruses. Methods: We analyzed incidence data for seven groups of respiratory viruses in New York City (NYC) during October 2015 to May 2021 (i.e., before and during the COVID‐19 pandemic). We first used elastic net regression to identify potential virus interactions and further examined the robustness of the found interactions by comparing the performance of Seasonal Auto Regressive Integrated Moving Average (SARIMA) models with and without the interactions. We then used the models to compute counterfactual estimates of cumulative incidence and estimate the reduction during the COVID‐19 pandemic period from March 2020 to May 2021, for each virus. Results: We identified potential interactions for three endemic human coronaviruses (CoV‐NL63, CoV‐HKU, and CoV‐OC43), parainfluenza (PIV)‐1, rhinovirus, and respiratory syncytial virus (RSV). We found significant reductions (by ~70–90%) in cumulative incidence of CoV‐OC43, CoV‐229E, human metapneumovirus, PIV‐2, PIV‐4, RSV, and influenza virus during the COVID‐19 pandemic. In contrast, the circulation of adenovirus and rhinovirus was less affected. Conclusions: Circulation of several respiratory viruses has been low during the COVID‐19 pandemic, which may lead to increased population susceptibility. It is thus important to enhance monitoring of these viruses and promptly enact measures to mitigate their health impacts (e.g., influenza vaccination campaign and hospital infection prevention) as societies resume normal activities. [ABSTRACT FROM AUTHOR]

Introduction. Respiratory diseases have always been a serious threat to public health, but in 2020 the situation deteriorated significantly due to the rapid development of the coronavirus infection COVID-19. Due to the lack of available means of ethiotropic therapy and the still insufficient coverage of the general population with vaccination, disinfectants, as well as topical preparations that prevent the penetration of the virus into the body, play an important role in preventing the spread of infection.Aim of the study. This work is devoted to the study of the virucidal activity of the medicine Mestamidin-nos against respiratory viruses, namely influenza A and B viruses, parainfluenza, respiratory syncytial, adenovirus and seasonal coronavirus.Materials and methods. This study was carried out by the suspension method according to MU 3.5.2431-08 “Study and assessment of the virucidal activity of disinfectants”.Results. It was shown that for all studied viruses the use of the compound for 60 minutes led to a complete (up to 0 lgTID50) or sufficient (4 lgTID50) decrease in the viral titer. In the case of a study of a compound with a protein load (imitating strong organic pollution), the effectiveness of the compound was significantly reduced against influenza A viruses, one of the strains of influenza B virus, adenovirus and seasonal coronavirus.Conclusion. Based on the results of the study, it can be concluded that the effective inhibition of pathogens of influenza and acute respiratory infections using the compound MesaMidin®-nos in the absence of strong organic pollution.

Many countries have implemented public health and social measures (PHSMs) to control the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Although the PHSMs are targeted at SARS-CoV-2 transmission control, they directly or indirectly impact the epidemiology of different respiratory viral diseases. The purpose of this study was to investigate the collateral impact of PHSMs used during the coronavirus disease 2019 (COVID-19) pandemic on the epidemiology of other respiratory viruses, including influenza, parainfluenza, respiratory syncytial virus, rhinovirus, and adenovirus infections. We conducted a systematic review of the published literature on changes in the incidence of respiratory viral diseases and detection rates of the respiratory viruses during COVID-19 pandemic, lasting from 2020–2021, published between December 2019 and March 2022 in PubMed, Embase, and Cochrane Library databases. We identified an overall decrease of 23–94% in the incidence of respiratory viral diseases and a decrease of 0–98% in the detection of the viruses. Our study suggests that the PHSMs implemented during COVID-19 pandemic reduced the incidence of respiratory viral diseases and transmission of respiratory viruses. At the time of this study, and as governments relax PHSMs, public health authorities should prepare for a probable increase in the burden of respiratory viral diseases. [ABSTRACT FROM AUTHOR]

Porcine parainfluenza virus 1 (PPIV-1) is a recently emerged respirovirus closely related to human parainfluenza virus 1 (HPIV-1) and Sendai virus (SenV). PPIV-1 has been detected in Asia, the Americas and Europe, but knowledge on its epidemiology and genetic diversity is very limited. In the present study, the complete nucleotide sequences of the fusion (F)-protein gene obtained from samples from 12 Polish and 11 US herds were analysed and compared to previously available genetic data from the Americas, Asia and Europe. The existence of two distinct clades was observed, grouping European sequences and one Hong Kong sequence (clade 1), or one American sequence and three Asian sequences (clade 2). The mean genetic distances measured with the p-distance were 0.04 (S.E., 0.000) within both clades, and 0.095 (S.E., 0.006) between the clades. Moreover, two distinct clusters of highly similar sequences were identified, which corresponded to the geographically distant nurseries and finishing units, from three pig flows within one Polish pig-production company. The obtained data indicate that the two PPIV-1 lineages may have evolved independently in Europe and America. More studies, particularly involving Asian viruses, are necessary to understand the virus' emergence and epidemiology and the role of carriers in the spread of PPIV-1. [ABSTRACT FROM AUTHOR]

Prevention of respiratory viral infection in stem cell transplant patients is important due to its high risk of adverse outcome. This single-centre, mixed methods study, conducted before the severe acute respiratory syndrome coronavirus-2 pandemic, explored the barriers and facilitators to a policy of universal mask use by visitors and healthcare workers, and examined the impact of the first year of introduction of the policy on respiratory viral infection rates compared with preceding years, adjusted for overall incidence. Education around universal mask use was highlighted as being particularly important in policy implementation. A significant decrease in respiratory viral infection was observed following introduction. [ABSTRACT FROM AUTHOR]

Background:  The early identification of outbreaks of both known and novel influenza-like illnesses (ILIs) is an important public health problem., Objective:  This study aimed to describe the design and testing of a tool that detects and tracks outbreaks of both known and novel ILIs, such as the SARS-CoV-2 worldwide pandemic, accurately and early., Methods:  This paper describes the ILI Tracker algorithm that first models the daily occurrence of a set of known ILIs in hospital emergency departments in a monitored region using findings extracted from patient care reports using natural language processing. We then show how the algorithm can be extended to detect and track the presence of an unmodeled disease that may represent a novel disease outbreak., Results:  We include results based on modeling diseases like influenza, respiratory syncytial virus, human metapneumovirus, and parainfluenza for 5 emergency departments in Allegheny County, Pennsylvania, from June 1, 2014, to May 31, 2015. We also include the results of detecting the outbreak of an unmodeled disease, which in retrospect was very likely an outbreak of the enterovirus D68 (EV-D68)., Conclusions:  The results reported in this paper provide support that ILI Tracker was able to track well the incidence of 4 modeled influenza-like diseases over a 1-year period, relative to laboratory-confirmed cases, and it was computationally efficient in doing so. The system was also able to detect a likely novel outbreak of EV-D68 early in an outbreak that occurred in Allegheny County in 2014 as well as clinically characterize that outbreak disease accurately., (©John M Aronis, Ye Ye, Jessi Espino, Harry Hochheiser, Marian G Michaels, Gregory F Cooper. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 13.08.2024.)

Background Invasive pulmonary aspergillosis (IPA) is increasingly recognized as a complication of severe influenza and coronavirus disease 2019. The extent to which other respiratory viral infections (RVIs) predispose to IPA is unclear. Methods We performed a retrospective review of IPA occurring within 90 days of respiratory syncytial virus (RSV), parainfluenza, or adenovirus infections (noninfluenza respiratory viral infections [NI-RVIs]) in patients who underwent solid organ transplant between 1/15/2011 and 12/19/2017. Results At a median post-transplant follow-up of 43.4 months, 221 of 2986 patients (7.4%) developed 255 RSV, parainfluenza, or adenovirus infections. IPA complicating these NI-RVIs was exclusively observed in lung and small bowel transplant recipients, in whom incidence was 5% and 33%, respectively. Cumulative prednisone doses >140mg within 7 days and pneumonia at the time of NI-RVI were independent risk factors for IPA (odds ratio [OR], 22.6; 95% CI, 4.5–112; and OR, 7.2; 95% CI, 1.6–31.7; respectively). Mortality at 180 days following NI-RVI was 27% and 7% among patients with and without IPA, respectively (P  = .04). Conclusions In conclusion, IPA can complicate RSV, parainfluenza, and adenovirus infection in lung and small bowel transplant recipients. Future research is needed on the epidemiology of IPA complicating various RVIs. In the interim, physicians should be aware of this complication. [ABSTRACT FROM AUTHOR]

Two experimental challenge studies were conducted to evaluate the pathogenesis of a porcine parainfluenza virus type 1 (PPIV-1) isolate. Four-week-old conventional (CON) pigs were challenged in Study 1 and six-week-old caesarean derived/colostrum deprived (CDCD) pigs were challenged in Study 2. Results indicate that PPIV-1 shedding and replication occur in the upper and lower respiratory tracts of CON and CDCD pigs as detected by RT-qPCR and immunohistochemistry. Mild macroscopic lung lesions were observed in CON pigs but not in CDCD pigs. Microscopic lung lesions were mild and consisted of peribronchiolar lymphocytic cuffing and epithelial proliferation in CON and CDCD pigs. Serum neutralizing antibodies were detected in the CON and CDCD pigs by 14 and 7 days post inoculation, respectively. This study provides evidence that in spite of PPIV-1 infection and replication in challenged swine, significant clinical respiratory disease was not observed. • PPIV-1 replicated in the respiratory tract of experimentally inoculated pigs. • PPIV-1 challenged pigs shed virus in nasal swabs for approximately two weeks. • Respiratory clinical signs were not observed in PPIV-1 inoculated pigs. • Indirect contact pigs became infected after exposure to inoculated pigs. • Serum virus neutralizing antibody was detected in PPIV-1 inoculated pigs. [ABSTRACT FROM AUTHOR]

DAS181, (study drug, Fludase®) was developed for treatment of influenza and parainfluenza infections. Delivered by inhalation, DAS181 cleaves sialic acid receptors from respiratory epithelial cells. Treatment of influenza for three days with DAS181 reduced viral shedding. To increase deposition in the upper airways and decrease systemic absorption, the particle size was increased to 10μm. We conducted two Phase I trials with three cohorts, randomized 2:1, active drug to placebo. The initial cohort got a single 20mg dose of DAS181, or placebo; the second, 20mg DAS181 or placebo for 10days, and the third got 20mg of DAS181 or placebo for 3days. Formulations differed slightly in their excipients. Subjects in the 1- and 3-day cohorts completed dosing without serious adverse events. Two subjects in the 10-day cohort stopped at Day 9 after developing respiratory and systemic symptoms, and a third experienced a decrease in FEV1 (Forced Expiratory Volume in 1s) after the 9th dose and a further decline after the 10th dose. Plasma DAS181, in the 10-day cohort, peaked and began falling before the last dose. Antibodies, predominately IgG with neutralizing activity, were detected in 15/18 subjects by Day 30. The highest IgG concentrations were in the 10-day cohort. The respiratory adverse events occurring after seven days and rapid drug clearance during continued dosing are consistent with the induction of DAS181 antibodies. This could preclude use of this medication for longer than seven days or for repeated courses. (These studies have been registered at ClinicalTrials.gov under registration Nos. NCT 00527865 and NCT 01651494.).

Influenza virus is the most frequently reported viral cause of rhabdomyolysis and case reports of rhabdomyolysis associated with parainfluenza virus are rare. We describe a seven month old child with Parainfluenza type 3 infection associated with rhabdomyolysis.

Survival in lung transplant recipients (LTRs) lags behind heart, liver, and kidney transplant, in part due to the direct and indirect effects of infection. LTRs have increased susceptibility to infection due to the combination of a graft continually exposed to the outside world, multiple mechanisms for impaired mucus clearance, and immunosuppression. Community-acquired respiratory viral infections (CARVs) are common in LTRs. Picornaviruses have roughly 40% cumulative incidence followed by respiratory syncytial virus and coronaviruses. Although single-center retrospective and prospective series implicate CARV in rejection and mortality, conclusive evidence for and well-defined mechanistic links to long-term outcome are lacking. Treatment of viral infections can be challenging except for influenza. Future studies are needed to develop better treatments and clarify the links between CARV and long-term outcomes. [ABSTRACT FROM AUTHOR]

Human parainfluenza virus type III (HPIV3) is a common respiratory pathogen that afflicts children and can be fatal in vulnerable populations, including the immunocompromised. There are currently no effective vaccines or therapeutics available, resulting in tens of thousands of hospitalizations per year. In an effort to discover a protective antibody against HPIV3, we screened the B cell repertoires from peripheral blood, tonsils, and spleen from healthy children and adults. These analyses yielded five monoclonal antibodies that potently neutralized HPIV3 in vitro. These HPIV3-neutralizing antibodies targeted two non-overlapping epitopes of the HPIV3 F protein, with most targeting the apex. Prophylactic administration of one of these antibodies, PI3-E12, resulted in potent protection against HPIV3 infection in cotton rats. Additionally, PI3-E12 could also be used therapeutically to suppress HPIV3 in immunocompromised animals. These results demonstrate the potential clinical utility of PI3-E12 for the prevention or treatment of HPIV3 in both immunocompetent and immunocompromised individuals.

Many countries have implemented public health and social measures (PHSMs) to control the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Although the PHSMs are targeted at SARS-CoV-2 transmission control, they directly or indirectly impact the epidemiology of different respiratory viral diseases. The purpose of this study was to investigate the collateral impact of PHSMs used during the coronavirus disease 2019 (COVID-19) pandemic on the epidemiology of other respiratory viruses, including influenza, parainfluenza, respiratory syncytial virus, rhinovirus, and adenovirus infections. We conducted a systematic review of the published literature on changes in the incidence of respiratory viral diseases and detection rates of the respiratory viruses during COVID-19 pandemic, lasting from 2020–2021, published between December 2019 and March 2022 in PubMed, Embase, and Cochrane Library databases. We identified an overall decrease of 23–94% in the incidence of respiratory viral diseases and a decrease of 0–98% in the detection of the viruses. Our study suggests that the PHSMs implemented during COVID-19 pandemic reduced the incidence of respiratory viral diseases and transmission of respiratory viruses. At the time of this study, and as governments relax PHSMs, public health authorities should prepare for a probable increase in the burden of respiratory viral diseases.

Acute fulminant myocarditis (AFM) is a clinical condition that can lead to sudden onset of rapidly progressing cardiogenic shock with significant arrhythmia and possible cardiac arrest. Mechanical circulation support has been reported to provide effective cardiac support in patients with AFM. In this article, we aimed to present the case of a 14-year-old girl with AFM who experienced a cardiogenic shock and resistant ventricular tachycardia unresponsive to medical treatment; however, she could be successfully treated with veno-arterial extracorporeal membrane oxygenation and discharged without neurological sequelae from the hospital. [ABSTRACT FROM AUTHOR]

Treatment of respiratory viral infections remains a global health concern, mainly due to the inefficacy of available drugs. Therefore, the discovery of novel antiviral compounds is needed; in this context, antimicrobial peptides (AMPs) like temporins hold great promise. Here, we discovered that the harmless temporin G (TG) significantly inhibited the early life‐cycle phases of influenza virus. The in vitro hemagglutinating test revealed the existence of TG interaction with the viral hemagglutinin (HA) protein. Furthermore, the hemolysis inhibition assay and the molecular docking studies confirmed a TG/HA complex formation at the level of the conserved hydrophobic stem groove of HA. Remarkably, these findings highlight the ability of TG to block the conformational rearrangements of HA2 subunit, which are essential for the viral envelope fusion with intracellular endocytic vesicles, thereby neutralizing the virus entry into the host cell. In comparison, in the case of parainfluenza virus, which penetrates host cells upon a membrane‐fusion process, addition of TG to infected cells provoked ~1.2 log reduction of viral titer released in the supernatant. Nevertheless, at the same condition, an immunofluorescent assay showed that the expression of viral hemagglutinin/neuraminidase protein was not significantly reduced. This suggested a peptide‐mediated block of some late steps of viral replication and therefore the impairment of the extracellular release of viral particles. Overall, our results are the first demonstration of the ability of an AMP to interfere with the replication of respiratory viruses with a different mechanism of cell entry and will open a new avenue for the development of novel therapeutic approaches against a large variety of respiratory viruses, including the recent SARS‐CoV2. [ABSTRACT FROM AUTHOR]

Human Parainfluenza Virus-3 (HPIV3) causes severe respiratory illness in immunocompromised patients and lacks approved anti-viral therapies. A phase I study of adoptively transferred virus-specific T-cells (VSTs) targeting HPIV3 following bone marrow transplantation is underway (NCT03180216). We sought to identify immunodominant epitopes within HPIV3 Matrix protein and their cross-reactivity against related viral proteins. VSTs were generated from peripheral blood of healthy donors by ex-vivo expansion after stimulation with a 15-mer peptide library encompassing HPIV3 matrix protein. Epitope mapping was performed using IFN-γ ELIspot with combinatorial peptide pools. Flow cytometry was used to characterize products with intracellular cytokine staining. In 10 VST products tested, we discovered 12 novel immunodominant epitopes. All products recognized an epitope at the C-terminus. On IFN-γ ELISpot, individual peptides eliciting activity demonstrated mean IFN-γ spot forming units per well (SFU)/1x105 cells of 115.5 (range 24.5–247.5). VST products were polyfunctional, releasing IFN-γ and TNF-α in response to identified epitopes, which were primarily HLA Class II restricted. Peptides from Human Parainfluenza Virus-1 corresponding to the HPIV3 epitopes showed cross-reactivity for HPIV1 in 11 of 12 tested epitopes (mean cross reactivity index: 1.19). Characterization of HPIV3 epitopes may enable development of third-party VSTs to treat immune suppressed patients with HPIV infection.

Porcine parainfluenza virus 1 (PPIV-1) is a recently emerged respirovirus closely related to human parainfluenza virus 1 (HPIV-1) and Sendai virus (SenV). PPIV-1 has been detected in Asia, the Americas and Europe, but knowledge on its epidemiology and genetic diversity is very limited. In the present study, the complete nucleotide sequences of the fusion (F)-protein gene obtained from samples from 12 Polish and 11 US herds were analysed and compared to previously available genetic data from the Americas, Asia and Europe. The existence of two distinct clades was observed, grouping European sequences and one Hong Kong sequence (clade 1), or one American sequence and three Asian sequences (clade 2). The mean genetic distances measured with the p-distance were 0.04 (S.E., 0.000) within both clades, and 0.095 (S.E., 0.006) between the clades. Moreover, two distinct clusters of highly similar sequences were identified, which corresponded to the geographically distant nurseries and finishing units, from three pig flows within one Polish pig-production company. The obtained data indicate that the two PPIV-1 lineages may have evolved independently in Europe and America. More studies, particularly involving Asian viruses, are necessary to understand the virus’ emergence and epidemiology and the role of carriers in the spread of PPIV-1.

The research goal is to study the performance of INF-а, INF-y and IL-1(3 in children with acute respiratory viral infection (ARVI) depending on etiology, the presence of mixed infection, disease severity, presence of complications, the concentration of thyroid hormones. Material and Methods. Examined 147 patients aged from 1 to 10 years at the outbreak of the ARVI and 15 healthy children. Patients in the midst of acute respiratory infections was conducted to determine levels of IL-1(3, INF-а, INF-y, triiodothyronine (T3) and free thyroxine free (T4) by ELISA using standard test kits JSC "Vector-best" (Koltsovo, Novosibirsk region). Results. It was showed elevated level of INF-y in patients with PC-infection in comparison with the same indicator in healthy children. Set the increased level of INF-а in severe ARVI and the level of INF-y at medium severe form. It was showed increased levels of INF-y in patients with mixed infection. In children with complications, the level of IL-1 (3 was lower almost in 2.4 times, than in children without complications. Among patients with complications, the highest numbers of INF-а were detected in children with pneumonia and INF-y increased in patients with bronchitis. When conducting correlation analysis, the highest rates of INF-а were observed in children with the syndrome of "low T3", and INF-y in children as low T3 and low T4. Conclusion. An increase in the level of INF-y in patients with RS infection was found. Revealed that in children in acute period of SARS levels IL-1 IS, INF-а do not depend on the etiological factor of SARS. These indicators are influenced by the severity of the disease, which in our study was due to the development of mixed infection, the presence and nature of complications. High rates of INF-а and INF-y have significant inverse correlation with the level of T3, which reflects the degree of intoxication in the acute period of infectious diseases.

This is a semiautobiographical and scientific account of my time in the Doherty Laboratory from 1994 to 1999. It includes personal vignettes as well as discussion of how our work has impacted the fields of influenza, respiratory infections and immunity. I also point out the long-term impacts on my career. [ABSTRACT FROM AUTHOR]

Parainfluenza virus type 3 (PIV-3) can infect a wide variety of mammals including humans, domestic animals, and wild animals. In the present study, bovine parainfluenza virus type 3 (BPIV-3) was isolated from nasal swabs of Egyptian cattle presenting with clinical signs of mild pneumonia. The virus was isolated in Madin-Darby bovine kidney (MDBK) cells and confirmed by reverse transcription-polymerase chain reaction (RT-PCR). The complete genome of Egyptian BPIV-3 strain was sequenced by using next generation (Illumina) sequencing. The new isolate classified with genotype A of BPIV-3 and was closely related to the Chinese NM09 strain (JQ063064). Subsequently in 2015–16, a molecular surveillance study was undertaken by collecting and testing samples from cattle and buffaloes with respiratory tract infections. The survey revealed a higher rate of BPIV-3 infection in cattle than in buffaloes. The infection was inversely proportional to the age of the animals and to warm weather. This report should form a basis for further molecular studies on animal viruses in Egypt.

Haemophilus parainfluenzae is an unusual causative organism of invasive bacterial infection in adults and children. Mortality and morbidity secondary to Haemophilus parainfluenzae have been documented in the literature. We present a rare case of a premature infant with early onset sepsis caused by Haemophilus parainfluenzae, who was born to a primigravida with chorioamnionitis. The infant was successfully treated for 10 days with antibiotics with no complications. [ABSTRACT FROM AUTHOR]

We tested sera of 24 free-ranging European brown bears (Ursus arctos) from six regions of Slovakia for antibodies to 10 viral agents. We tested sera by an indirect fluorescence antibody test for antibodies to canine distemper virus (CDV), canine coronavirus (CCV), canine parvovirus type 2 (CPV-2), canine adenovirus, canine parainfluenza virus type 2 (CPIV-2), and canine herpesvirus type 1 (CHV-1). We used an enzyme-linked immunosorbent assay for detection of antibodies to hepatitis E virus, bluetongue virus, West Nile virus (WNV), and Aujeszky's disease virus (ADV). We detected antibodies to CDV, CHV-1, CPV-2, CPIV-2, CCV, WNV, and ADV in seven (29%), three (12%), two (8%), two (8%), one (4%), one (4%), and one (4%) bear, respectively. Evidence of exposure of free-ranging European brown bears to CCV and ADV has not been reported. [ABSTRACT FROM AUTHOR]

Aerosolized ribavirin has been used in pediatric immunocompromised patients to treat acute respiratory viral infections, but oral ribavirin may be a less expensive alternative that allows for outpatient therapy. Oral ribavirin has compared favorably to aerosolized ribavirin in adult studies, but data on safety are lacking in pediatric populations. Four cases are described in which oral ribavirin was used to treat viral respiratory infections in recipients of allogeneic hematopoietic stem cell transplants at a Children's Hospital, demonstrating safety and feasibility. [ABSTRACT FROM AUTHOR]

Background Parainfluenza virus (PIV) is a cause of respiratory tract infection in children and the immunocompromised population, but its clinical manifestations, impact, and outcomes in hospitalized adults are not well studied. Methods This retrospective study included adults (≥18 years old) admitted to Northwestern Memorial Hospital or Prentice Women's Hospital (both in Chicago, Illinois) between 1 August 2009 and 31 July 2016 with a positive molecular test result for PIV. Epidemiologic, clinical, and outcomes data were collected from the enterprise data warehouse and patient electronic health records after institutional review board approval. Descriptive statistics were used to summarize the data. Results A total of 550 adults with a positive molecular test for PIV were identified. Differences in seasonality, clinical presentation, and prevalence between the different PIV serotypes (PIV-1, PIV-2, and PIV-3) were identified. The most common signs/symptoms were cough (88%), productive sputum (55%), fever (63%), and dyspnea (49%). Of the patients administered antibiotics, 349 (79.6%) had no confirmed bacterial infection throughout their hospitalization. The average length of hospitalization was 7.7 days. Presence of bacterial coinfection (P =.01), fungal coinfection (P <.01), decreased body mass index (P =.03), and increased respiratory rate (P <.01) were associated with significant differences in mortality rates. Conclusions PIV infection is associated with substantial morbidity in hospitalized adults. Such data will be useful in understanding the impact on epidemiology and outcomes if a PIV-specific vaccine becomes available. Furthermore, this highlights the need for novel preventive and therapeutic approaches to PIV infection. [ABSTRACT FROM AUTHOR]

Febrile seizure (FS) in children is a common complication of infections with respiratory viruses and hand, foot and mouth disease (HFMD). We conducted a retrospective ecological time-series analysis to determine the temporal relationship between hospital attendances for FS and HFMD or respiratory virus infections. Epilepsy attendance was used as a control. Data from 2004 to 2012 FS and epilepsy hospital attendance, HFMD notifications to the Ministry of Health and from laboratory-confirmed viral respiratory infections among KK Women's and Children's Hospital inpatients were used. A multivariate linear regression analysis was conducted to evaluate the relationship between FS and the virus time series. Relative risks of FS by age were calculated using Bayesian statistical methods. Paediatric accident and emergency (A&E) attendances for FS were found to be associated with influenza A (extra 0.47 FS per influenza A case), B (extra 0.32 per influenza B case) and parainfluenza 3 (extra 0.35 per parainfluenza type 3 case). However, other viruses were not significantly associated with FS. None of the viruses were associated with epileptic seizure attendance. Influenza A, B and parainfluenza 3 viruses contributed to the burden of FS resulting in A&E attendance. Children at risk of FS should be advised to receive seasonal influenza vaccination. [ABSTRACT FROM AUTHOR]

Presently described is the case of an 11-month-old-girl diagnosed with acute urticaria due to parainfluenza virus type 3 (PIV-3). This rare etiological agent of urticaria was isolated from a nasopharyngeal swab after the development of bronchiolitis. The patient had received treatment at another clinic for a maculopapular skin eruption, rhinorrhea, fever, and a cough; however, after a lack of response and a progression of symptoms, she was brought to our pediatric allergy and immunology polyclinic. A physical examination revealed diffuse and resistant urticarial plaques on the body and she was admitted for further evaluation and therapy. Bronchiolitis developed and auscultation on the second day of admission revealed bilateral subcrepitant rales and wheezing. Treatment with salbutamol 6x0.15 mg/kg/dose was initiated, and pheniramine 1.4 mg/kg/day (in 2 doses) and ranitidine 2 mg/kg/day (in 2 doses) were added for the urticaria. PIV-3 was isolated from a nasopharyngeal swab. It is important to remember that viral infections can have a significant role in the etiology of acute urticaria in childhood. A detailed medical history and laboratory evaluations for infection may be needed for a thorough differential diagnosis and evaluation of etiological factors in urticarial disease. [ABSTRACT FROM AUTHOR]