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  1. Artikel: Dengue severity by serotype in 19 years of pediatric clinical studies in Nicaragua.

    Narvaez, Federico / Montenegro, Carlos / Juarez, Jose Guillermo / Zambrana, Jose Victor / Gonzalez, Karla / Arguello, Sonia / Barrios, Fanny / Ojeda, Sergio / Plazaola, Miguel / Sanchez, Nery / Camprubi, Daniel / Kuan, Guillermina / Bailey, Gabriela Paz / Harris, Eva / Balmaseda, Angel

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: Background: Dengue virus, a major global health threat, consists of four serotypes (DENV1-4) that cause a range of clinical manifestations from mild to severe and potentially fatal disease.: Methods: This study, based on 19 years of data from the ... ...

    Abstract Background: Dengue virus, a major global health threat, consists of four serotypes (DENV1-4) that cause a range of clinical manifestations from mild to severe and potentially fatal disease.
    Methods: This study, based on 19 years of data from the Pediatric Dengue Cohort Study and Pediatric Dengue Hospital-based Study in Managua, Nicaragua, investigates the influence of serotype and immune status on dengue severity. Study participants 6 months to 17 years old were followed during their hospital stay or as ambulatory patients, with dengue cases confirmed by molecular, serological, and/or virological methods.
    Results: We enrolled a total of 14071 participants, of whom 2954 (21%) were positive for DENV infection. Of 2425 cases with serotype result by RT-PCR, 541 corresponded to DENV1, 996 to DENV2, 718 to DENV3 and 170 to DENV4. Severe disease was more prevalent among secondary DENV2 and DENV4 cases, while similar disease severity was observed in both primary and secondary DENV1 and DENV3 cases. According to the 1997 World Health Organization (WHO) severity classification, both DENV2 and DENV3 had a higher proportion of severe disease compared to other serotypes, whereas DENV3 had the greatest percentage of severity under the WHO-2009 classification. DENV2 was associated with pleural effusion and low platelet count, while DENV3 correlated with both hypotensive and compensated shock.
    Conclusions: These findings emphasize the critical need for a dengue vaccine with balanced efficacy against all four serotypes, particularly as existing vaccines show variable efficacy by serotype and immune status, posing challenges for comprehensive protection, particularly in dengue-naïve individuals.
    Sprache Englisch
    Erscheinungsdatum 2024-02-13
    Erscheinungsland United States
    Dokumenttyp Preprint
    DOI 10.1101/2024.02.11.24302393
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Humoral correlates of protection against influenza A H3N2 virus infection.

    Hoy, Gregory / Stadlbauer, Daniel / Balmaseda, Angel / Kuan, Guillermina / López, Roger / Carreno Quiroz, Juan Manuel / Ojeda, Sergio / Sánchez, Nery / Yellin, Temima / Plazaola, Miguel / Frutos, Aaron / Krammer, Florian / Gordon, Aubree

    The Journal of infectious diseases

    2024  

    Abstract: Background: Influenza virus remains a threat to human health, but gaps remain in our knowledge of the humoral correlates of protection against influenza virus A/H3N2, limiting our ability to generate effective, broadly protective vaccines. The role of ... ...

    Abstract Background: Influenza virus remains a threat to human health, but gaps remain in our knowledge of the humoral correlates of protection against influenza virus A/H3N2, limiting our ability to generate effective, broadly protective vaccines. The role of antibodies against the hemagglutinin (HA) stalk, a highly conserved but immunologically sub-dominant region, has not been established for influenza virus A/H3N2.
    Methods: Household transmission studies were conducted in Managua, Nicaragua across three influenza seasons. Household contacts were tested for influenza virus infection using RT-PCR. We compared pre-existing antibody levels against full-length hemagglutinin (FLHA), HA stalk, and neuraminidase (NA) measured by enzyme-linked immunosorbent assay (ELISA), along with HA inhibition assay (HAI) titers, between infected and uninfected participants.
    Results: A total of 899 individuals participated in household activation, with 329 infections occurring. A four-fold increase in initial HA stalk titers was independently associated with an 18% decrease in the risk of infection (OR=0.82, 95%CI 0.68-0.98, p=0.04). In adults, anti-HA stalk antibodies were independently associated with protection (OR=0.72, 95%CI 0.54-0.95, p=0.02). However, in 0-14-year-olds, anti-NA antibodies (OR=0.67, 95%CI 0.53-0.85, p<0.01) were associated with protection against infection, but anti-HA stalk antibodies were not.
    Conclusions: The HA stalk is an independent correlate of protection against A/H3N2 infection, though this association is age dependent. Our results support the continued exploration of the HA stalk as a target for broadly protective influenza vaccines but suggest that the relative benefits may depend on age and influenza virus exposure history.
    Sprache Englisch
    Erscheinungsdatum 2024-05-09
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiae258
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Increased influenza severity in children in the wake of SARS-CoV-2.

    Hoy, Gregory / Maier, Hannah E / Kuan, Guillermina / Sánchez, Nery / López, Roger / Meyers, Alyssa / Plazaola, Miguel / Ojeda, Sergio / Balmaseda, Angel / Gordon, Aubree

    Influenza and other respiratory viruses

    2023  Band 17, Heft 7, Seite(n) e13178

    Abstract: The SARS-CoV-2 pandemic and subsequent interruption of influenza circulation has lowered population immunity to influenza, especially among children with few prepandemic exposures. Using data from a prospective pediatric cohort study based in Managua, ... ...

    Abstract The SARS-CoV-2 pandemic and subsequent interruption of influenza circulation has lowered population immunity to influenza, especially among children with few prepandemic exposures. Using data from a prospective pediatric cohort study based in Managua, Nicaragua, we compared the incidence and severity of influenza A/H3N2 and influenza B/Victoria between 2022 and two prepandemic seasons. We found a higher incidence of A/H3N2 in older children in 2022 compared with pre-2020 and a higher proportion of severe influenza in 2022, primarily among children aged 0-4, suggesting an influence of the SARS-CoV-2 pandemic on influenza incidence and severity in children.
    Mesh-Begriff(e) Child ; Humans ; Influenza, Human/epidemiology ; SARS-CoV-2 ; Influenza A Virus, H3N2 Subtype ; Cohort Studies ; Prospective Studies ; COVID-19/epidemiology ; Seasons
    Sprache Englisch
    Erscheinungsdatum 2023-07-23
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2274538-5
    ISSN 1750-2659 ; 1750-2640
    ISSN (online) 1750-2659
    ISSN 1750-2640
    DOI 10.1111/irv.13178
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel: Increased Influenza Severity in Children in the Wake of SARS-CoV-2.

    Hoy, Gregory / Maier, Hannah E / Kuan, Guillermina / Sánchez, Nery / López, Roger / Meyers, Alyssa / Plazaola, Miguel / Ojeda, Sergio / Balmaseda, Angel / Gordon, Aubree

    medRxiv : the preprint server for health sciences

    2023  

    Abstract: The SARS-CoV-2 pandemic and subsequent interruption of influenza circulation has lowered population immunity to influenza, especially among children with few pre-pandemic exposures. We compared the incidence and severity of influenza A/H3N2 and influenza ...

    Abstract The SARS-CoV-2 pandemic and subsequent interruption of influenza circulation has lowered population immunity to influenza, especially among children with few pre-pandemic exposures. We compared the incidence and severity of influenza A/H3N2 and influenza B/Victoria between 2022 and two pre-pandemic seasons and found an increased frequency of severe influenza in 2022.
    Sprache Englisch
    Erscheinungsdatum 2023-03-16
    Erscheinungsland United States
    Dokumenttyp Preprint
    DOI 10.1101/2023.03.11.23286858
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Infection-Induced Immunity Is Associated With Protection Against Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Decreased Infectivity.

    Frutos, Aaron M / Kuan, Guillermina / Lopez, Roger / Ojeda, Sergio / Shotwell, Abigail / Sanchez, Nery / Saborio, Saira / Plazaola, Miguel / Barilla, Carlos / Kenah, Eben / Balmaseda, Angel / Gordon, Aubree

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2023  Band 76, Heft 12, Seite(n) 2126–2133

    Abstract: Background: The impact of infection-induced immunity on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has not been well established. Here we estimate the effects of prior infection induced immunity in adults and children on ... ...

    Abstract Background: The impact of infection-induced immunity on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has not been well established. Here we estimate the effects of prior infection induced immunity in adults and children on SARS-CoV-2 transmission in households.
    Methods: We conducted a household cohort study from March 2020-November 2022 in Managua, Nicaragua; following a housheold SARS-CoV-2 infection, household members are closely monitored for infection. We estimate the association of time period, age, symptoms, and prior infection with secondary attack risk.
    Results: Overall, transmission occurred in 70.2% of households, 40.9% of household contacts were infected, and the secondary attack risk ranged from 8.1% to 13.9% depending on the time period. Symptomatic infected individuals were more infectious (rate ratio [RR] 21.2, 95% confidence interval [CI]: 7.4-60.7) and participants with a prior infection were half as likely to be infected compared to naïve individuals (RR 0.52, 95% CI:.38-.70). In models stratified by age, prior infection was associated with decreased infectivity in adults and adolescents (secondary attack risk [SAR] 12.3, 95% CI: 10.3, 14.8 vs 17.5, 95% CI: 14.8, 20.7). However, although young children were less likely to transmit, neither prior infection nor symptom presentation was associated with infectivity. During the Omicron era, infection-induced immunity remained protective against infection.
    Conclusions: Infection-induced immunity is associated with decreased infectivity for adults and adolescents. Although young children are less infectious, prior infection and asymptomatic presentation did not reduce their infectivity as was seen in adults. As SARS-CoV-2 transitions to endemicity, children may become more important in transmission dynamics.
    Mesh-Begriff(e) Adult ; Child ; Adolescent ; Humans ; Child, Preschool ; COVID-19 ; SARS-CoV-2 ; Cohort Studies ; Family Characteristics ; Nicaragua/epidemiology
    Sprache Englisch
    Erscheinungsdatum 2023-02-07
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciad074
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  6. Artikel: High co-circulation of influenza and SARS-CoV-2.

    Kubale, John T / Frutos, Aaron M / Balmaseda, Angel / Saborio, Saira / Ojeda, Sergio / Barilla, Carlos / Sanchez, Nery / Shotwell, Abigail / Meyers, Alyssa / Lopez, Roger / Plazaola, Miguel / Kuan, Guillermina / Gordon, Aubree

    medRxiv : the preprint server for health sciences

    2022  

    Abstract: In the first two years of the COVID-19 pandemic, influenza transmission decreased substantially worldwide meaning that health systems were not faced with simultaneous respiratory epidemics. In 2022, however, substantial influenza transmission returned to ...

    Abstract In the first two years of the COVID-19 pandemic, influenza transmission decreased substantially worldwide meaning that health systems were not faced with simultaneous respiratory epidemics. In 2022, however, substantial influenza transmission returned to Nicaragua where it co-circulated with SARS-CoV-2 causing substantial disease burden.
    Sprache Englisch
    Erscheinungsdatum 2022-09-17
    Erscheinungsland United States
    Dokumenttyp Preprint
    DOI 10.1101/2022.09.13.22279740
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel: SARS-CoV-2 and endemic coronaviruses: Comparing symptom presentation and severity of symptomatic illness among Nicaraguan children.

    Frutos, Aaron M / Kubale, John / Kuan, Guillermina / Ojeda, Sergio / Vydiswaran, Nivea / Sanchez, Nery / Plazaola, Miguel / Patel, May / Lopez, Roger / Balmaseda, Angel / Gordon, Aubree

    medRxiv : the preprint server for health sciences

    2022  

    Abstract: It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, ...

    Abstract It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, it is unclear if SARS-CoV-2 infections are distinct in symptom presentation, duration, and severity from endemic coronavirus infections in children. We compared symptom risk and duration of endemic human coronavirus (HCoV) infections from 2011-2016 with SARS-CoV-2 infections from March 2020-September 2021 in a Nicaraguan pediatric cohort. Blood samples were collected from study participants annually in February-April. Respiratory samples were collected from participants that met testing criteria. Blood samples collected in were tested for SARS-CoV-2 antibodies and a subset of 2011-2016 blood samples from four-year-old children were tested for endemic HCoV antibodies. Respiratory samples were tested for each of the endemic HCoVs from 2011-2016 and for SARS-CoV-2 from 2020-2021 via rt-PCR. By April 2021, 854 (49%) cohort participants were ELISA positive for SARS-CoV-2 antibodies. Most participants had antibodies against one alpha and one beta coronavirus by age four. We observed 595 symptomatic endemic HCoV infections from 2011-2016 and 121 symptomatic with SARS-CoV-2 infections from March 2020-September 2021. Symptom presentation of SARS-CoV-2 infection and endemic coronavirus infections were very similar, and SARS-CoV-2 symptomatic infections were as or less severe on average than endemic HCoV infections. This suggests that, for children, SARS-CoV-2 may be just another endemic coronavirus. However, questions about the impact of variants and the long-term effects of SARS-CoV-2 remain.
    Sprache Englisch
    Erscheinungsdatum 2022-02-03
    Erscheinungsland United States
    Dokumenttyp Preprint
    DOI 10.1101/2021.12.09.21267537
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  8. Artikel: Infection-induced immunity is associated with protection against SARS-CoV-2 infection, but not decreased infectivity during household transmission.

    Frutos, Aaron M / Kuan, Guillermina / Lopez, Roger / Ojeda, Sergio / Shotwell, Abigail / Sanchez, Nery / Saborio, Saira / Plazaola, Miguel / Barilla, Carlos / Kenah, Eben / Balmaseda, Angel / Gordon, Aubree

    medRxiv : the preprint server for health sciences

    2022  

    Abstract: Background: Understanding the impact of infection-induced immunity on SARS-CoV-2 transmission will provide insight into the transition of SARS-CoV-2 to endemicity. Here we estimate the effects of prior infection induced immunity and children on SARS-CoV- ...

    Abstract Background: Understanding the impact of infection-induced immunity on SARS-CoV-2 transmission will provide insight into the transition of SARS-CoV-2 to endemicity. Here we estimate the effects of prior infection induced immunity and children on SARS-CoV-2 transmission in households.
    Methods: We conducted a household cohort study between March 2020-June 2022 in Managua, Nicaragua where when one household member tests positive for SARS-CoV-2, household members are closely monitored for SARS-CoV-2 infection. Using a pairwise survival model, we estimate the association of infection period, age, symptoms, and infection-induced immunity with secondary attack risk.
    Results: Overall transmission occurred in 72.4% of households, 42% of household contacts were infected and the secondary attack risk was 13.0% (95% CI: 11.7, 14.6). Prior immunity did not impact the probability of transmitting SARS-CoV-2. However, participants with pre-existing infection-induced immunity were half as likely to be infected compared to naïve individuals (RR 0.53, 95% CI: 0.39, 0.72), but this reduction was not observed in children. Likewise, symptomatic infected individuals were more likely to transmit (RR 24.4, 95% CI: 7.8, 76.1); however, symptom presentation was not associated with infectivity of young children. Young children were less likely to transmit SARS-CoV-2 than adults. During the omicron era, infection-induced immunity remained protective against infection.
    Conclusions: Infection-induced immunity is associated with protection against infection for adults and adolescents. While young children are less infectious, prior infection and asymptomatic presentation did not reduce their infectivity as was seen in adults. As SARS-CoV-2 transitions to endemicity, children may become more important in transmission dynamics.
    Article summary: Infection-induced immunity protects against SARS-CoV-2 infection for adolescents and adults; however, there was no protection in children. Prior immunity in an infected individual did not impact the probability they will spread SARS-CoV-2 in a household setting.
    Sprache Englisch
    Erscheinungsdatum 2022-10-11
    Erscheinungsland United States
    Dokumenttyp Preprint
    DOI 10.1101/2022.10.10.22280915
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  9. Artikel ; Online: SARS-CoV-2 and endemic coronaviruses: Comparing symptom presentation and severity of symptomatic illness among Nicaraguan children.

    Frutos, Aaron M / Kubale, John / Kuan, Guillermina / Ojeda, Sergio / Vydiswaran, Nivea / Sanchez, Nery / Plazaola, Miguel / Patel, May / Lopez, Roger / Balmaseda, Angel / Gordon, Aubree

    PLOS global public health

    2022  Band 2, Heft 5

    Abstract: It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, ...

    Abstract It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, it is unclear if SARS-CoV-2 infections are distinct in symptom presentation, duration, and severity from endemic coronavirus infections in children. We compared symptom risk and duration of endemic human coronavirus (HCoV) infections from 2011-2016 with SARS-CoV-2 infections from March 2020-September 2021 in a Nicaraguan pediatric cohort. Blood samples were collected from study participants annually in February-April. Respiratory samples were collected from participants that met testing criteria. Blood samples collected in were tested for SARS-CoV-2 antibodies and a subset of 2011-2016 blood samples from four-year-old children were tested for endemic HCoV antibodies. Respiratory samples were tested for each of the endemic HCoVs from 2011-2016 and for SARS-CoV-2 from 2020-2021 via rt-PCR. By April 2021, 854 (49%) cohort participants were ELISA positive for SARS-CoV-2 antibodies. Most participants had antibodies against one alpha and one beta coronavirus by age four. We observed 595 symptomatic endemic HCoV infections from 2011-2016 and 121 symptomatic with SARS-CoV-2 infections from March 2020-September 2021. Symptom presentation of SARS-CoV-2 infection and endemic coronavirus infections were very similar, and SARS-CoV-2 symptomatic infections were as or less severe on average than endemic HCoV infections. This suggests that, for children, SARS-CoV-2 may be just another endemic coronavirus. However, questions about the impact of variants and the long-term effects of SARS-CoV-2 remain.
    Sprache Englisch
    Erscheinungsdatum 2022-05-25
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2767-3375
    ISSN (online) 2767-3375
    DOI 10.1371/journal.pgph.0000414
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  10. Artikel ; Online: SARS-CoV-2 infection-induced immunity and the duration of viral shedding: Results from a Nicaraguan household cohort study.

    Maier, Hannah E / Plazaola, Miguel / Lopez, Roger / Sanchez, Nery / Saborio, Saira / Ojeda, Sergio / Barilla, Carlos / Kuan, Guillermina / Balmaseda, Angel / Gordon, Aubree

    Influenza and other respiratory viruses

    2022  Band 17, Heft 1, Seite(n) e13074

    Abstract: Background: Much of the world's population has been infected with SARS-CoV-2. Thus, immunity from prior infection will play a critical role in future SARS-CoV-2 transmission. We investigated the impact of infection-induced immunity on viral shedding ... ...

    Abstract Background: Much of the world's population has been infected with SARS-CoV-2. Thus, immunity from prior infection will play a critical role in future SARS-CoV-2 transmission. We investigated the impact of infection-induced immunity on viral shedding duration and viral load.
    Methods: We conducted a household cohort study in Managua, Nicaragua, with an embedded transmission study that closely monitors participants regardless of symptoms. Real-time reverse-transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assays (ELISAs) were used to measure infections and seropositivity, respectively. Blood samples were collected twice annually and surrounding household intensive monitoring periods. We used accelerated failure time models to compare shedding times. Participants vaccinated ≥14 days prior to infection were excluded from primary analyses.
    Results: There were 600 RT-PCR-confirmed SARS-CoV-2 infections in unvaccinated participants between May 1, 2020, and March 10, 2022, with prior ELISA data. Prior infection was associated with 48% shorter shedding times (event time ratio [ETR] 0.52, 95% CI: 0.39-0.69, mean shedding: 13.7 vs. 26.4 days). A fourfold higher anti-SARS-CoV-2 spike titer was associated with 17% shorter shedding (ETR 0.83, 95% CI: 0.78-0.90). Similarly, maximum viral loads (lowest cycle threshold [CT]) were lower for previously infected individuals (mean CT 29.8 vs. 28.0, p = 4.02 × 10
    Conclusions: Prior infection-induced immunity was associated with shorter viral shedding and lower viral loads, which may be important in the transition from pandemic to endemicity.
    Mesh-Begriff(e) Adult ; Child ; Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Cohort Studies ; Virus Shedding ; COVID-19 Testing
    Sprache Englisch
    Erscheinungsdatum 2022-12-01
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2274538-5
    ISSN 1750-2659 ; 1750-2640
    ISSN (online) 1750-2659
    ISSN 1750-2640
    DOI 10.1111/irv.13074
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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