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P Wutzler

Publications and source records attributed to P Wutzler.

At least 19 recordsLinked to original sources

Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 2: Varicella-zoster virus infections.

Varicella during pregnancy can be associated with severe illnesses for both the mother and her neonate. Varicella pneumonia must be regarded as a medical emergency, since pregnant women are at risk of life-threatening ventilatory compromise and death. After maternal chickenpox in the first and second trimesters, congenital varicella syndrome may occur in nearly 2% of the cases. The characteristic symptoms consist of skin lesions in dermatomal distribution, neurological defects, eye diseases and skeletal anomalies. If the mother develops varicella rashes between day 4 (5) antepartum and day 2 postpartum, generalized neonatal varicella leading to death in about 20% of the cases has to be expected. Normal zoster has not been shown to be associated with maternal pneumonia, birth defects or problems in the perinatal period. On the basis of the clinical consequences of varicella-zoster virus infections during pregnancy, the present paper summarizes the currently available concepts of prevention, diagnosis and therapy.

Acyclovir↗

Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 1: herpes simplex virus infections.

Primary herpes simplex virus (HSV) infection may lead to severe illness in pregnancy and may be associated with transplacental virus transmission and fetal infection. The consequences may be abortion, stillbirth and congenital malformations. In neonates, the clinical findings after intrauterine HSV infection are characterized by skin lesions, diseases of the eye and neurologic damage. Herpes genitalis of pregnant women at the time of labor may result in life-threatening neonatal herpes. Currently, neither active nor passive immunization is available to prevent HSV infections during pregnancy and in the newborn infant. Therefore, antiviral treatment using aciclovir and/or valaciclovir must be considered in all primary episodes of genital herpes as well as in neonates who show signs of either infection. Clinical herpes lesions of the genitalia and/or positive test for virus detection at the time of delivery are an indication for cesarean section. However, this surgical intervention may be reduced by suppressive treatment of recurrent genital herpes with aciclovir or valaciclovir.

Acyclovir↗

Analysis of repeat units in the R2 region among different Oka varicella-zoster virus vaccine strains and wild-type strains in Germany.

OBJECTIVE: The present study compared the number of R2 repeat units in six different Oka strains and in 54 varicella-zoster virus (VZV) wild-type strains isolated from patients with varicella or zoster in Germany. METHODS: The R2 genomic region was characterized by polymerase chain reaction and sequencing methods. RESULTS: Five VZV Oka vaccine strains showed a number of seven 42-bp units and, in one, eight repeats were found. In 11 VZV wild-type strains isolated from patients with varicella, the copy number ranged between four and eight, and in 43 strains from zoster a similar range between four and nine copies was observed. About 80% of all strains showed between five and seven repeated units. More than one third of strains revealed seven repeats like Oka. CONCLUSIONS: The size of the R2 repeat region can also be different in single Oka vaccine strains. In German VZV wild-type strains, the R2 fragment seems to be not as variable as in Japanese wild-type strains.

Chickenpox↗

Validation of biocides against duck hepatitis B virus as a surrogate virus for human hepatitis B virus.

The use of a surrogate virus, namely duck hepatitis B virus (DHBV), has been recommended for testing the virucidal activity of chemical biocides against hepatitis B virus. To date, however, this model has not been recognized as a standard test in European countries, as its laboratory use is associated with considerable difficulties. As previous studies have demonstrated, several alternative procedures may improve the validation of DHBV infection in a cell culture system. Using indirect immunofluorescent antigen staining and the light cycler real-time polymerase chain reaction (PCR) technique, the virucidal activity of peracetic acid (PAA), povidone-iodine (PVP-I) and formaldehyde was tested against DHBV obtained from congenitally infected ducks or prepared from the transfected hepatoma D2 cell line. The results demonstrated that inactivation of DHBV from the D2 cell line was achieved with lower concentrations of the biocides and within shorter exposure time intervals. These lower concentration-exposure time values for DHBV from D2 cells in comparison with DHBV from infected ducks indicated a higher sensitivity of the virus derived from D2 cells. In addition, concentrations of PAA and PVP-I that significantly inactivated DHBV in suspension tests were not able to destroy the viral genome. In conclusion, DHBV from congenitally infected ducks should be used for virucidal testing of chemical biocides against DHBV; DHBV prepared from D2 cells is unsuitable due to its higher sensitivity to biocides. Indirect immunofluorescent staining allows reliable detection of DHBV infectivity, whereas the hepadnavirucidal effect can be evaluated by quantitative PCR.

Animals↗

Genotyping of different varicella vaccine strains.

BACKGROUND: Little is known about single nucleotide polymorphism (SNP) in different lots of varicella vaccines distributed by the manufacturers. Recently, the genetic analysis of several genomic regions revealed a polymorphism in different vaccine lots of Varilrix manufactured by GlaxoSmithKline. These findings need attention since mutations in the vaccine strain could result in changes of virulence and efficacy of the vaccine. OBJECTIVES: To identify SNPs in three varicella vaccine lots of Varilrix and to compare the results with that of Varivax as well as the published sequences of the Oka vaccine strain (V-Oka) and its parental virus (P-Oka). STUDY DESIGN: The open reading frames (ORF) 1, 6, 10, 21, 50, 54, and 62 were analyzed by sequencing of amplified DNA fragments. RESULTS: Wild-type nucleotides identical to that of P-Oka and/or the European wild-type reference strain Dumas and in contrast to V-Oka could be identified in ORF 1 of a Varilrix vaccine lot distributed in 1991. In the ORF 62 probably responsible for attenuation of V-Oka, this vaccine strain contained 16 SNPs which were nearly all wild-type-like. By contrast, different lots of the Varivax vaccine revealed uniform sequencing results. The vaccine Varilrix 1999 showed a high similarity to the Varivax vaccine currently available. CONCLUSIONS: The obvious genetic diversity of different lots of the varicella vaccine Varilrix cannot be explained with the coexistence of several strain variants in the vaccine, but most likely with different seed lot preparations used for vaccine production.

Amino Acid Substitution↗

[Prophylactic influenza vaccination: what is the situation in Germany?].

Vaccination is the most efficacious and cost-effective measure for the prevention of influenza. Although the vaccination rate among the population of Germany has been gradually increasing in the last few years, only 40% of chronically ill persons are vaccinated. As a third of all persons aged over 50 years have a chronic disease, vaccination of those aged 50 years and over, from the those recommended 60 years, should be considered. Such a strategy would be cost-effective both for insurance companies and society as a whole. There are at present no data on ambulatory influenza vaccination rates in children, even though this could reduce the high death rate among this age group and decrease the spread of the disease among the general population. At present all children with an underlying disease and all those in immediate contact with them should be vaccinated. Pregnant women whose expected date of delivery falls within the influenza season should also be vaccinated so that they and their newborn child are protected against influenza.

Adolescent↗

Serological detection of varicella-zoster virus-specific immunoglobulin G by an enzyme-linked immunosorbent assay using glycoprotein antigen.

Since the introduction of varicella vaccination in several countries, there has been an urgent need for commercially available test procedures that allow highly sensitive and specific quantitative determination of the varicella-zoster virus (VZV)-specific immune status, including immunity postimmunization. This study compared the performance of two enzyme-linked immunosorbent assays (ELISAs) for the sensitive and specific determination of VZV-specific immunoglobulin G (IgG) in seronegative and latently infected persons, as well as in vaccinees. One ELISA is based on the detection of antibody to VZV-specific envelope glycoproteins (gp), and the other comprises the whole antigen extract prepared from VZV-infected cells. A modified standard fluorescent-antibody-to-membrane-antigen (FAMA) assay was used as a reference. An excellent sensitivity (100%) in relation to FAMA was demonstrated for the gpELISA (Virion\Serion), while the non-gpELISA (Dade Behring) had a lower sensitivity (83%) when sera from latently infected persons were tested. After postvaccinal immunity was measured, a sensitivity of 87% was achieved with gpELISA, whereas the ELISA incorporating antigen extract of VZV-infected cells had a sensitivity of 78%. Excellent specificity (100%) was calculated for both the gpELISA and the non-gpELISA. In conclusion, SERION ELISA classic VZV IgG is useful for the sensitive and specific quantitative determination of VZV immune status after natural infection. The test can also be recommended for measuring antibody response after varicella vaccination, particularly after the cutoff value was optimized.

Antibodies, Viral↗

Antiviral activities of some Ethiopian medicinal plants used for the treatment of dermatological disorders.

Acokanthera schimperi (Apocynaceae), Euclea schimperi (Ebenaceae), Inula confertiflora (Asteraceae), Melilotus elegans (Leguminosae), and Plumbago zeylanica (Plumbaginaceae), are some of the medicinal plants used in Ethiopia for treatment of various skin disorders. In this study, the antiviral activities of the 80% methanolic extracts of these plants have been examined against coxsackievirus B3 (CVB3), influenza A virus and herpes simplex virus type1 Kupka (HSV-1) using cytopathic effect (CPE) inhibitory assays in HeLa, MDCK, and GMK cells, respectively. In parallel, the cytotoxicity was quantified using a crystal violet uptake assay. The antiviral activity of the most active compound was confirmed with plaque reduction assays. The results revealed that the extracts of Acokanthera schimperi and Euclea schimperi showed antiviral activity against all three tested viruses albeit with unequal efficacy. Whereas the Acokanthera schimperi extract exhibited the strongest activity against CVB3, the extract of Euclea schimperi inhibited influenzavirus A replication most effectively. A weak anti-influenzavirus A activity was also exhibited by the other plant extracts tested. In addition, CVB3 was inhibited by the extracts of Plumbago zeylanica and HSV-1 by Inula confertiflora. Thus, the extracts of these plants, particularly those of Acokanthera schimperi, Euclea schimperi and Inula confertiflora which showed activity against CVB3 and HSV-1 support their traditional use in the treatment of skin diseases of viral origin.

Animals↗

Utilization of the embryonated egg for in vivo evaluation of the anti-influenza virus activity of neuraminidase inhibitors.

Previous studies have shown that embryonated egg provides a convenient and easy to use system for in vivo screening of anti-influenza virus inhibitors. However, it is not known whether this model is suitable for testing neuraminidase (NA) inhibitors, too. Therefore, the present study describes the evaluation of the ion-channel blockers amantadine and rimantadine in comparison with the NA inhibitors oseltamivir and zanamivir by using the influenza A virus hen's egg model. The treatment was started immediately before or after the challenge dose was placed on the chorioallantoic membrane (CAM). Differences between the survival rate of treated and untreated chick embryos infected with influenza A virus were analyzed statistically. As result, the survival rate of chick embryos could be significantly increased when the treatment with amantadine, rimantadine, oseltamivir, or zanamivir was started before the CAM was inoculated with one egg infective dose 50% (EID50) influenza A virus. When the drugs were administered shortly after viral inoculation, significant antiviral efficacy was shown for rimantadine, oseltamivir, and zanamivir. Antiviral efficacy could be demonstrated exclusively for both oseltamivir and zanamivir after the embryos were infected with higher challenge doses of 10(2) EID50 influenza A virus. In conclusion, the NA inhibitors oseltamivir and zanamivir have a significantly better antiviral activity against influenza A virus than amantadine and rimantadine tested in embryonated hen's eggs. Therefore, this model can be a valuable alternative approach for in vivo pre-testing anti-influenza virus activity of NA inhibitors.

Acetamides↗

In vitro activity of cycloSal-nucleoside monophosphates and polyhydroxycarboxylates against orthopoxviruses.

Because variola virus might be used as a pathogen in biological attacks, there is an urgent need to provide effective antiviral drugs for the treatment of orthopoxvirus infections. Thus, the aim of the present study was to test the antiviral activity of 3 pro-nucleotides of the acyclic nucleoside analogues aciclovir (ACV), 3 of penciclovir (PCV) and 38 of the cyclic nucleoside analogue brivudin (BVDU), on the basis of cycloSaligenyl-nucleoside monophosphate approach against vaccinia virus and cowpox virus in vitro. In further experiments, 13 synthetic humic acid-like polymers, so-called polyhydroxycarboxylates, were examined. Antiviral screening was performed by means of the plaque reduction assay and for quantification of the cytotoxicity of the test compounds the XTT-based tetrazolium reduction assay EZ4U was used. As result, three cycloSal-monophosphate derivatives of ACV proved to be potent inhibitors of both vaccinia virus and cowpox virus replication in vitro. Among the tested monophosphate derivatives of cycloSal-PCV and cycloSal-BVDU, selected substances showed a promising antiviral activity against vaccinia virus and cowpox virus. For the polyanionic compounds, no relevant antiviral activity was detected. In conclusion, by the delivery of nucleoside monophosphates from neutral, membrane-permeable prodrugs on the basis of the cycloSaligenyl-nucleotide concept, different ACV, PCV and BVDU derivatives can act as potent and selective inhibitors of orthopoxvirus replication. However, most of the cycloSal-monophosphate derivatives of BVDU had a higher cytotoxicity than their parent nucleosides.

Acyclovir↗

Alternative methods for validation of cell culture infection with duck hepatitis B virus.

Hepatitis B virus (HBV) is an important virus used in disinfection procedures for blood spillage. However, validation of HBV inactivation is difficult, since there are no feasible infectivity assays. In some countries, the duck HBV (DHBV) is recognized as a suitable model for testing antiviral activity of chemical biocides against HBV. Currently, DHBV-infected ducks are required for preparation of the test virus as well as eggs from DHBV-free flocks for testing DHBV infectivity. To improve the practicality of the system, we suggested to use commercially available embryonated duck eggs for preparation of DHBV-susceptible hepatocyte cultures and to exclude infected hepatocytes by pre-screening with qualitative detection of DHBV DNA using polymerase chain reaction (PCR). A standardized DHBV test virus was prepared from the DHBV DNA-transfected hepatoma cell line D2, which contained 10(11)DHBV DNA molecules per mL detected by light cycler real-time PCR. Infection of cell cultures was most efficient 4 days after plating. The best identification of infected cultures was possible 6 days after infection with immunofluorescence using an antiserum against DHBV surface antigen.

Animals↗

[Varicella during pregnancy. 2. Diagnosis, prevention and therapy].

Varicella belongs to serious infections during pregnancy. After introduction of prophylaxis by vaccination, there is a particular interest to learn more about the consequences of maternal varicella for the infant. As part 2, the present paper reviews the current possibilities of diagnosis, prevention and therapy of varicella-zoster virus infections during pregnancy.

Chickenpox↗

[Varicella during pregnancy. 1: Epidemiology and clinical aspects].

Varicella belongs to serious infections during pregnancy. After introduction of prophylaxis by vaccination, there is a particular interest to learn more about the consequences of maternal varicella for the infant. In the first part, the present paper reviews the currently available knowledge about the epidemiology and clinical consequences of varicella-zoster virus infections during pregnancy.

Chickenpox↗

Transformation of rabbit lymphocytes by an Epstein-Barr virus-related herpesvirus from Macaca arctoides.

Herpesvirus Macaca arctoides (HVMA), an Epstein-Barr virus (EBV)-related herpesvirus of macaque origin, induces malignant lymphomas in rabbits. To get more insights into the oncogenesis of the EBV/HVMA infection the aim of the present study was to prove the in vitro transforming ability of HVMA for rabbit lymphocytes as well as human umbilical cord blood lymphocytes. As a result, B-cell transformation could be demonstrated after infection with HVMA in all mononuclear cell samples of 20 rabbits. The transformation was evaluated microscopically and confirmed by the expression of EBV-related nuclear antigens. The transforming activity led to the establishment of permanent rabbit lymphoblastoid cell lines cultured up to more than 90 passages. The cell lines contained EBV-like HVMA-DNA. Interestingly, the transformed rabbit lymphocytes showed chromosomal abnormalities with a subtetraploid karyotype. The low extent of lytic cycle-dependent expression of virus capsid antigen in the established cell lines increased after treatment with the inducing agents iododeoxyuridine and mitomycin C. In contrast, no transformation could be induced after exposure of human umbilical cord blood lymphocytes to HVMA. The permanent rabbit lymphoblastoid cell lines provide a model for further studies on the role of EBV/HVMA in oncogenesis of lymphomas. In addition, it might be suitable for testing potential antiviral compounds in vitro.

Animals↗

[Antibodies against vaccine-preventable diseases in pregnant women and their offspring. Diphtheria, pertussis, tetanus].

In the eastern part of Germany, the age of primigravid women has increased from the end of the 2nd decade to the second half of the 3rd decade since 1990. This might influence the vaccine-induced immunity in pregnant women as well as their newborns. The objective of the present study was to examine the influence of the higher age of pregnant women on antibody protection. Maternal and cord blood samples of 290 women in the eastern part of Germany with a mean age of 28 years were analyzed for antibodies against the vaccine-preventable diseases diphtheria, pertussis, and tetanus. Compared with the data on vaccination history, the seroprevalence rate of tetanus was significantly enhanced and the seroprevalence rate of diphtheria and pertussis was significantly reduced. Detectable levels of antibodies against tetanus toxin were found in 93% of the mothers, against diphtheria toxin in 70%, and against Bordetella pertussis in 37%. Cord blood samples had a significantly higher prevalence of antibodies against pertussis and diphtheria in comparison to maternal probes. In addition,there were significantly enhanced antibody concentrations against diphtheria toxin in the newborns. In conclusion, the prevalence of antibodies determined suggests they are insufficient for protecting the newborns efficiently against pertussis and diphtheria in spite of the evidence for an active placental antibody transfer.

Adult↗

[Antibodies against vaccine-preventable diseases in pregnant women and their offspring. Measles, mumps, rubella, poliomyelitis, and varicella].

In the eastern part of Germany, the age of primigravid women has clearly increased since 1990. This may change the protection provided by antibodies in pregnant women as well as their newborns. The objective of the present study was to assess antibodies against vaccine-preventable viral infectious diseases in pregnant women and their offspring to draw conclusions about their protection. Maternal and cord blood samples of 290 women from the eastern part of Germany with a mean age of 28 years were analyzed for antibodies against measles, mumps, rubella, poliomyelitis, and varicella. The study showed that the pregnant women had detectable levels of antibodies against measles virus in 79%, against mumps virus in 96%, against rubella virus in 87%, against polioviruses types 1-3 in 62-64%, and against varicella-zoster virus (VZV) in 97% of the cases. The seroprevalence of the antibodies in the newborns were not significantly different from those of their mothers. When antibody titers of mothers and newborns were compared, significantly higher titers to VZV could be detected in the cord blood sera of newborns. It is suggested that the prevalence of antibodies against measles and poliomyelitis is insufficient to protect the newborns efficiently. An immunity gap of 13% against rubella in mothers results in a potential risk for a congenital rubella syndrome in newborns. Despite the high seroprevalence of rubella and chickenpox, there is considerable potential for infections during pregnancy and neonatal period.

Antibodies, Viral↗

Antiviral treatment and prophylaxis of influenza in primary care: German recommendations.

Antiviral drugs are a valuable supplementation to vaccines for the control and prevention of influenza. In Germany, for treating influenza amantadine, oseltamivir and zanamivir are approved. Amantadine and oseltamivir are also licensed for prophylactic use. On behalf of the Paul-Ehrlich-Society of Germany and the German Association for the Control of Virus Diseases, as two independent scientific societies, the first consensus Conference on the Antiviral Treatment and Prophylaxis of Influenza was held in June 2002. Based on the available data of clinical studies an expert group developed the following recommendations for the appropriate clinical use of the antiviral drugs: (1) since oseltamivir (orally administered) and zanamivir (administered by inhalation) have apparently similar clinical efficacy both drugs can be used alternatively for treatment. (2) Amantadine is not an alternative to the neuraminidase (NA) inhibitors because it is not effective against influenza B viruses, it frequently selects resistant virus mutants and it can cause adverse events. (3) When influenza is prevalent in the community patients with the clinical diagnosis of influenza should be treated with neuraminidase inhibitors if the symptoms are lasting not longer than 48 h. (4) Immunocompetent patients with a non-febrile illness and patients with a symptom history of more than 2 days should not be treated with antiviral drugs. (5) Although there are no data from clinical trials immunocompromised patients should also be treated when influenza has been diagnosed. (6) The prophylactic use of antiviral drugs can be recommended for persons with close contact to acutely ill persons and no recent vaccination against influenza. (7) The use of anti-influenza drugs have to be considered for prophylaxis in pandemics. A precondition for the adequate use of anti-influenza drugs in the primary medical care is the timely information on the local influenza situation delivered by surveillance systems.

Acetamides↗