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PubMed2003

Coronavirus 229E-related pneumonia in immunocompromised patients.

Coronaviruses strains 229E and OC43 have been associated with various respiratory illnesses ranging from the self-resolving common cold to severe pneumonia. Although chronic underlying conditions are major determinants of severe respiratory virus infections, few data about coronavirus-related pneumonia in immunocompromised patients are available. Here we report 2 well-documented cases of pneumonia related to coronavirus 229E, each with a different clinical presentation. Diagnosis was made on the basis of viral culture and electron microscopy findings that exhibited typical crown-like particles and through amplification of the viral genome by reverse transcriptase-polymerase chain reaction. On the basis of this report, coronaviruses should be considered as potential causative microorganisms of pneumonia in immunocompromised patients.

Adolescent↗
PubMed1993

Incidence of episodes of acute asthma and acute bronchitis in general practice 1976-87.

The incidence of episodes of acute asthma and acute bronchitis was analysed for an 11-year period and studied in relation to epidemiological data on viral illness and virus isolation data. Between 1976 and 1987, the weekly returns service estimates of the incidence of acute asthmatic episodes in England and Wales increased from 10.2 to 27.1 per 100,000 patients per week (all ages). The increase was most marked in children up to the age of 14 years. Acute bronchitis attack rates (all ages) increased from 78.7 to 111.9 per 100,000 patients over the same period. Because of this rise in rates of acute bronchitis, it is unlikely that labelling shifts contributed to the increase in reported episodes of asthma. These data support the belief that the rise in the prevalence of asthma is real, and also that in the United Kingdom this rise may even be underestimated by partial concealment in the rates of acute bronchitis. In 1987, if 10% of attacks of acute bronchitis were attacks of asthma, this would represent a 41% underestimation of asthma attack rates. Rates for other respiratory illnesses showed a fall over the same period, apart from the common cold which showed an increase. The winter increase in acute bronchitis coincided with viruses with strong seasonal patterns (respiratory syncytial virus, parainfluenza viruses 1 and 2 and influenza A and B), but there was no evidence that these viruses were related to the overall increase in acute asthma attacks over this 11 year period.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1995

Rhinoviruses and cells: molecular aspects.

Recent developments in our understanding of the molecular structure and functioning of the human rhinoviruses are briefly reviewed. The determination of virus structure at near atomic resolution has provided a wealth of information that can be used to help interpret dynamic properties of the virus. The mechanisms involved in capsid assembly, attachment to cell surfaces, uncoating, and the initiation of infection and antibody-mediated neutralization of infectivity can all be examined afresh in the light of the structural data. In addition, molecular techniques for manipulating and analyzing the biological properties of nucleic acids and proteins are providing a wealth of information on details of the replication machinery of the viruses. Probably one of the least understood aspects of viral replication is the precise nature of the interactions between host and viral components during infection. Unfortunately, despite all of these impressive scientific advances the cure for the common cold is still elusive.

Capsid↗
PubMed1997

Viral infections transmitted by food of animal origin: the present situation in the European Union.

The goal of this presentation was to clarify which foods are involved in viral diseases, which viruses are transmitted via food and how to evaluate the risk of a foodborne viral infection. Food items frequently identified as cause of viral disease outbreaks were shellfish harvested in sewage-contaminated water. Another common source of foodborne viral illness was cold food contaminated by infected food handlers. In the European Union the viruses most frequently associated with foodborne illness were hepatitis A virus and the SRSV's. A few isolated cases of foodborne hepatitis E were reported in Mediterranean countries. Compared to other foodborne diseases, those caused by viruses are less severe and seldom fatal. This might be a reason why the problem of viral contamination of food has been neglected. Yet, because many foodborne viral diseases are not recognized either as foodborne or as caused by viruses, the actual number of cases must be assumed to be significantly higher than the reported number. Consequently, food associated diseases of viral origin should be granted more attention.

Animals↗
PubMed1994

Effect of inhalation of hot humidified air on experimental rhinovirus infection.

OBJECTIVE: Nasal inhalation of steam has been proposed as treatment of viral colds on the assumption that increased intranasal temperature will inhibit replication of rhinovirus (RV). The effect of steam inhalation on RV shedding by infected volunteers was examined in this study. DESIGN: Randomized controlled trial. Volunteers experimentally infected with RV were treated with machine-generated humidified air, which was either hot (active) or at room temperature (placebo). Viral shedding was assessed over the 4 days following treatment. SETTING: Local hotel. PARTICIPANTS: Twenty volunteers from the university community who were susceptible to the challenge virus. INTERVENTION: Two 30-minute intranasal treatments, the first at 24 hours after inoculation and the second at 48 hours. The temperature of active vapor was 42 degrees C to 44 degrees C and of placebo vapor was 22 degrees C. MAIN OUTCOME MEASURES: Viral titers in nasal washings on each of 5 days following inoculation. RESULTS: Mean viral titers prior to the first treatment were 10(1.7) tissue culture infectious doses per milliliter in the active group and 10(1.5) in the placebo group. Mean titers for the next 4 days were 10(1.7), and 10(1.7), 10(1.2), and 10(0.9)/mL in the active group and 10(1.8), 10(1.9), 10(1.6), and 10(0.7)/mL in the placebo group (no significant difference). The proportion of volunteers who shed virus on each day was also similar in the two groups. CONCLUSION: Two nasal inhalation treatments with steam had no effect on viral shedding in volunteers with experimental RV colds.

Administration, Inhalation↗
PubMed1999

Non-influenza respiratory viruses may overlap and obscure influenza activity.

OBJECTIVE: To report the number and timing of influenza A isolates, as well as overlapping respiratory viruses. Co-circulating respiratory viruses may obscure the determination of influenza activity. DESIGN: Prospective clinical surveillance for the new onset of respiratory illness followed by viral cultures during seven separate influenza seasons. SETTING: The Wisconsin Veterans Home, a skilled nursing facility for veterans and their spouses. RESULTS: Influenza A isolates were encountered in greater numbers than non-influenza A isolates during three seasons. Seasonal variability is striking. In December 1992, we identified a large outbreak of respiratory illness. Influenza type B was cultured from 102 residents. In December 1995, influenza A was cultured from 285 people in Wisconsin. At that time, we identified outbreaks of respiratory illness in two of our four buildings. Based on statewide data, we suspected an influenza outbreak; however, 26 isolates of parainfluenza virus type 1 were cultured with no influenza. The potential importance of culturing at the end of the season was demonstrated in 1991-1992 when an outbreak of respiratory syncytial virus (RSV) overlapped and extended beyond influenza A activity. CONCLUSIONS: When interpreting new clinical respiratory illnesses as a basis for declaring an outbreak of influenza A, clinicians should realize that co-circulating respiratory viruses can account for clinical illnesses. Clinicians might utilize healthcare dollars efficiently by performing cultures to focus the timing of influenza A chemoprophylaxis. Cultures could be performed when clinical outbreak criteria are approached to confirm an outbreak. Culturing of new respiratory illness could begin again before the anticipated discontinuation of prophylaxis (approximately 2 weeks).

Aged↗
PubMed1986

Intranasal interferon (rIFN-alpha A, Ro 22-8181) for contact prophylaxis against common cold: a randomized, double-blind and placebo-controlled field study.

The prophylactic efficacy of low-dose intranasal recombinant leucocyte interferon alpha (rIFN-alpha A, Ro 22-8181) was investigated under field conditions in 147 families (n = 587 participants), randomized to receive placebo or rIFN-alpha A intranasally in daily doses of 1.5 or 0.3 X 10(6) IU. Treatment was started within 2 days after the appearance of an index case in the household and was continued for 5 days. Clinical data of the index case and of all members of the household were recorded for 10 days. In index cases and all ill contact persons nasal washes were collected for rhinovirus isolation and immunochemical detection of other respiratory viruses. The local tolerance of the intranasal rIFN-alpha A was excellent. Both doses of rIFN-alpha A failed to exert therapeutic effects on established common cold or to prevent the spread of common cold within families. Prophylactic treatment with 1.5 X 10(6) IU did however shorten the duration of the cold (median of 2 days vs. 4 in the placebo group, P = 0.01) and reduced the severity of any ensuing common cold (median total score of 10.5 vs. 30, P less than 0.001). No correlation was found between viral etiology (55% rhinoviruses vs. 13% other respiratory viruses, n = 122 nasal washes) and prophylactic efficacy or clinical severity.

Administration, Intranasal↗
PubMed1991

Psychological stress and susceptibility to the common cold.

BACKGROUND: It is not known whether psychological stress suppresses host resistance to infection. To investigate this issue, we prospectively studied the relation between psychological stress and the frequency of documented clinical colds among subjects intentionally exposed to respiratory viruses. METHODS: After completing questionnaires assessing degrees of psychological stress, 394 healthy subjects were given nasal drops containing one of five respiratory viruses (rhinovirus type 2, 9, or 14, respiratory syncytial virus, or coronavirus type 229E), and an additional 26 were given saline nasal drops. The subjects were then quarantined and monitored for the development of evidence of infection and symptoms. Clinical colds were defined as clinical symptoms in the presence of an infection verified by the isolation of virus or by an increase in the virus-specific antibody titer. RESULTS: The rates of both respiratory infection (P less than 0.005) and clinical colds (P less than 0.02) increased in a dose-response manner with increases in the degree of psychological stress. Infection rates ranged from approximately 74 percent to approximately 90 percent, according to levels of psychological stress, and the incidence of clinical colds ranged from approximately 27 percent to 47 percent. These effects were not altered when we controlled for age, sex, education, allergic status, weight, the season, the number of subjects housed together, the infectious status of subjects sharing the same housing, and virus-specific antibody status at base line (before challenge). Moreover, the associations observed were similar for all five challenge viruses. Several potential stress-illness mediators, including smoking, alcohol consumption, exercise, diet, quality of sleep, white-cell counts, and total immunoglobulin levels, did not explain the association between stress and illness. Similarly, controls for personality variables (self-esteem, personal control, and introversion-extraversion) failed to alter our findings. CONCLUSIONS: Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection.

Adolescent↗
PubMed1985

Rapid diagnosis of viral infections: a new challenge for the pediatrician.

Pediatricians are likely to encounter a limited number of viruses causing a significant number of problems. Many of these infections, such as the common cold, do not currently require specific viral diagnosis. On the other hand, the rapid diagnosis of some viral infections has become clinically and epidemiologically more important as a result of improved understanding of viral transmissability and recent developments in preventive and therapeutic approaches. Concomitantly, several new diagnostic methods have been applied to many of these agents with increasing numbers of commercial kits. This double-edged sword of the predictably greater availability of means to obtain a rapid specific diagnosis of many viral infections, together with the various problems discussed here which can lead to erroneous management of patients, is becoming an important new challenge to the pediatrician.

Antibodies, Viral↗
PubMed1983

Anti-influenza human T killer cells present an intertypic activity anti-A and -B type viruses in a secondary reaction in vitro.

In man influenza viruses induce a cytolytic T lymphocyte (CTL) activity directed against autologous or HLA-A or -B compatible target cells infected with the immunizing virus. While only type specific CTL are characterized in man, we report here experiments showing intertypic activities of human CTL from donors vaccinated with both A and B type influenza viruses. Their peripheral blood leucocytes (PBL) restimulated in vitro with live influenza virus of one type gave rise to both anti-A and -B activities, when non-infected or Sendaï infected target cells were not lysed. These intertypic activities were restricted by HLA-A or -B antigens and were inhibited by OKT3 antibody. When u.v.-inactivated viruses were used as restimulating antigen, no intertypic CTL were obtained. The results of competition experiments with cold targets show that no common antigens were recognized by anti-A and anti-B CTL. Moreover the restricting HLA-A or -B molecules seen in association with A or B types viruses appeared different in the same experiment, confirming that different antigens were probably involved for the agents of A and B subgroups. This influenza specific intertypic activity was therefore probably due to an intertypic stimulation of type specific CTL activities, possibly arising at the level of T helper cells.

Antigens, Viral↗
PubMed2005

Relationship of pleconaril susceptibility and clinical outcomes in treatment of common colds caused by rhinoviruses.

Pleconaril, a specific inhibitor of human picornaviruses, showed therapeutic efficacy against community-acquired colds caused by rhinoviruses in two placebo-controlled trials. Virological assessments were conducted during these trails, including virus culture and drug susceptibility testing. Nasal mucus samples collected from the enrolled patients were tested for the presence of picornavirus by reverse transcriptase PCR and culture. In total, 827 baseline nasal mucus samples were positive by virus culture (420 in the placebo group and 407 in the pleconaril group). Pleconaril treatment was associated with a more rapid loss of culturable virus. By study day 3, the number of samples positive by culture fell to 282 for the placebo-treated subjects and 202 for the pleconaril-treated subjects (P < 0.0001); and by day 6, the number of samples in the two groups positive by culture fell to 196 and 165, respectively (P = 0.07). The clinical benefit correlated strongly with the pleconaril susceptibility of the baseline virus isolate. Pleconaril-treated subjects infected with the more highly susceptible viruses (50% effective concentration < or = 0.38 microg/ml) experienced a median 1.9- to 3.9-day reduction in symptom duration compared with that for the placebo-treated subjects. By contrast, subjects whose baseline virus isolate susceptibility was >0.38 microg/ml did not benefit from pleconaril treatment. These results indicate that the magnitude of symptomatic improvement in pleconaril-treated subjects with community-acquired colds is related to the drug susceptibility of the infecting virus, clearly linking the antiviral effects of the drug to clinical efficacy. Post-baseline virus isolates with reduced susceptibility or full resistance to pleconaril were recovered from 10.7% and 2.7% of drug-treated subjects, respectively. These patients shed low levels of virus and had no unusual clinical outcomes. Nevertheless, studies on the biologic properties and transmissibility of these variant viruses are warranted.

Antiviral Agents↗
PubMedDate not supplied

Interferon: mechanisms of action and clinical value.

The antiviral and antitumor mechanisms of action, pharmacokinetics, dosage considerations, and adverse effects of interferon are reviewed, and the results from clinical studies are summarized. Interferons are proteins that can induce a nonspecific resistance to viral infection by several mechanisms, including the inhibition of protein synthesis, inactivation of viral RNA, and enhancement of phagocytic and cytotoxic mechanisms. There are three classifications of interferons on the basis of their antigenic specificities--alpha (alpha), beta (beta), and gamma (gamma) interferon. Interferon is not absorbed from the gastrointestinal tract because it is a protein susceptible to proteolytic digestive enzymes. However, the absorption of alpha-interferon by the intramuscular and subcutaneous routes is nearly complete; peak serum concentrations occur at approximately two hours and four hours following i.m. and s.c. injections, respectively. The usual method of administration is by intramuscular injection, and the doses range from 1 to 10 million units per injection. Since blood concentrations decrease sharply within 24 hours, interferon is usually given on a daily basis, and the duration of therapy varies according to patient response. Adverse effects from interferon are generally transient and reversible. Some success has been reported with the use of interferon in the treatment of chronic hepatitis B infection. Acute fulminant hepatitis infection has also been treated with interferon. Patients with cytomegalovirus infection treated with interferon showed a decrease in the urinary virus but no important clinical benefits. The treatment of varicella-zoster (chicken pox) virus has been successful. The use of interferon by injection to treat influenza and the common cold seems unlikely because of its short duration of action and the self-limited nature of these infections. Varying success has been obtained when malignant tumors have been treated with interferon. Many types of viral infections and tumors have been treated with interferon with varying results. More research must be conducted before a final analysis of the clinical value of interferon can be made.

Child↗
PubMed1997

Prevention of rhinovirus infection in chimpanzees by soluble intercellular adhesion molecule-1.

Intercellular adhesion molecule-1 (ICAM-1) is the cell surface receptor for the major class of human rhinoviruses, and tICAM453, a truncated, soluble form of ICAM-1, has been shown previously to be a potent in vitro inhibitor of rhinovirus. In this report, we have investigated the in vivo efficacy of tICAM453 for the prophylaxis of rhinovirus serotype 16 infection in the chimpanzee. Because chimpanzees do not show clinical symptoms of infection after rhinovirus challenge, infection was followed by measuring antirhinovirus serum antibody responses and detection of virus shedding. By both of these measures, intranasal application of tICAM453 was efficacious in preventing rhinovirus infection in chimpanzees subsequently challenged with infectious doses of virus. These results suggest that the use of soluble rhinovirus receptor to inhibit virus binding to host cells should be feasible in humans.

Administration, Intranasal↗
PubMedDate not supplied

Trials of interferon in respiratory infections in man.

It is not yet clear from these recent volunteer studies (8) and from the results of Merigan et al. (14) what the optimal method and schedule for administering HuIFN should be. Taken together, the results with relatively low doses of interferon (1 to 4 X 10(6) units) plus antihistamine pretreatment, and with multiple doses of HuIFN alpha (total 14 X 10(6) units) indicate the need for better methods of delivery. However, it is of interest that protection was achieved by extremely small amounts of HuIFN alpha protein - Merigan (14) used only about 160 mcg. We anticipate that with better supplies of interferon from HuIFN genes cloned in bacteria, we may seek more efficient means of delivery and obtain better protection of volunteers against respiratory virus infections.

Clinical Trials as Topic↗
PubMed1994

[Infections with respiratory viruses].

Worldwide, acute infections of the respiratory tract are one of the main causes of disease, and the majority of these are due to viruses. As a consequence of the development of new methods, rapid laboratory diagnosis of virus-induced acute respiratory tract infections has greatly improved. An efficient immunoprophylaxis is still only available for influenza virus infections, and recent reports indicate that intravenous administration of immunoglobulins can protect against or reduce the severity of RS virus infections in children. At present, specific antiviral chemotherapy is only available for infections with influenza A virus and for RS-virus-infected children at high risk of a severe course of disease.

Adenoviridae Infections↗
PubMed2006

Thrombophlebitis and upper respiratory tract virus infection.

During an episode of thrombophlebitis, the 72-year-old correspondent came down with a common cold presumably, but not provenly, due to infection by one of the rhinoviruses. During the 96 hr period of coryza, all symptoms of thrombophlebitis vanished completely. There is experimental evidence that rhinovirus infections elicit cytokine production [Stöckl et al. (1999): J Clin Invest 104: 957-965], and that IL-10 can assuage thrombosis in rats [Downing et al. (1998): J Immunol 161: 1471-1476].

Aged↗