"Super-Spreaders" and Person-to-Person Transmission of Andes Virus in Argentina.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Martínez Valeria P, Di Paola Nicholas, Alonso Daniel O, Pérez-Sautu Unai, Bellomo Carla M, Iglesias Ayelén A, Coelho Rocio M, López Beatriz, Periolo Natalia, Larson Peter A, Nagle Elyse R, Chitty Joseph A, Pratt Catherine B, Díaz Jorge, Cisterna Daniel, Campos Josefina, Sharma Heema, Dighero-Kemp Bonnie, Biondo Emiliano, Lewis Lorena, Anselmo Constanza, Olivera Camila P, Pontoriero Fernanda, Lavarra Enzo, Kuhn Jens H, Strella Teresa, Edelstein Alexis, Burgos Miriam I, Kaler Mario, Rubinstein Adolfo, Kugelman Jeffrey R, Sanchez-Lockhart Mariano, Perandones Claudia, Palacios Gustavo
Аннотация
METHODS: Clinical and epidemiologic information was obtained by means of patient report and from public health centers. Serologic testing, contact-tracing, and next-generation sequencing were used to identify ANDV infection as the cause of this outbreak of hantavirus pulmonary syndrome and to reconstruct person-to-person transmission events.
RESULTS: After a single introduction of ANDV from a rodent reservoir into the human population, transmission was driven by 3 symptomatic persons who attended crowded social events. After 18 cases were confirmed, public health officials enforced isolation of persons with confirmed cases and self-quarantine of possible contacts; these measures most likely curtailed further spread. The median reproductive number (the number of secondary cases caused by an infected person during the infectious period) was 2.12 before the control measures were enforced and decreased to 0.96 after the measures were implemented. Full genome sequencing of the ANDV strain involved in this outbreak was performed with specimens from 27 patients and showed that the strain that was present (Epuyén/18-19) was similar to the causative strain (Epilink/96) in the first known person-to-person transmission of hantavirus pulmonary syndrome caused by ANDV, which occurred in El Bolsón, Argentina, in 1996. Clinical investigations involving patients with ANDV hantavirus pulmonary syndrome in this outbreak revealed that patients with a high viral load and liver injury were more likely than other patients to spread infection. Disease severity, genomic diversity, age, and time spent in the hospital had no clear association with secondary transmission.
CONCLUSIONS: Among patients with ANDV hantavirus pulmonary syndrome, high viral titers in combination with attendance at massive social gatherings or extensive contact among persons were associated with a higher likelihood of transmission. (Funded by the Ministerio de Salud y Desarrollo Social de la Nación Argentina and others.).