PLoS currents最新文献

{"title":"Incidence Prediction for the 2017-2018 Influenza Season in the United States with an Evolution-informed Model.","authors":"Xiangjun Du, Mercedes Pascual","doi":"10.1371/currents.outbreaks.6f03b36587ae74b11353c1127cbe7d0e","DOIUrl":"https://doi.org/10.1371/currents.outbreaks.6f03b36587ae74b11353c1127cbe7d0e","url":null,"abstract":"Introduction: Seasonal influenza is responsible for a high disease burden in the United States and worldwide. Predicting outbreak size in advance can contribute to the timely control of seasonal influenza by informing health care and vaccination planning. Methods: Recently, a process-based model was developed for forecasting incidence dynamics ahead of the season, with the approach validated by several statistical criteria, including an accurate real-time prediction for the past 2016-2017 influenza season before it started. Results: Based on this model and data up to June 2017, a forecast for the upcoming 2017-2018 influenza season is presented here, indicating an above-average, moderately severe, outbreak dominated by the H3N2 subtype. Discussion: The prediction is consistent with surveillance data so far, which already indicate the predominance of H3N2. The forecast for the upcoming 2017-2018 influenza season reinforces the importance of the on-going vaccination campaign.","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":"10 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35954077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Regulators Modulate Muscle Damage in Duchenne Muscular Dystrophy Model.","authors":"Fernanda Bajanca,&nbsp;Laurence Vandel","doi":"10.1371/currents.md.f1e2379fa632f8135577333dd92ca83b","DOIUrl":"https://doi.org/10.1371/currents.md.f1e2379fa632f8135577333dd92ca83b","url":null,"abstract":"<p><p>Histone acetyl transferases (HATs) and histone deacetylases (HDAC) control transcription during myogenesis. HDACs promote chromatin condensation, inhibiting gene transcription in muscle progenitor cells until myoblast differentiation is triggered and HDACs are released. HATs, namely CBP/p300, activate myogenic regulatory and elongation factors promoting myogenesis. HDAC inhibitors are known to improve regeneration in dystrophic muscles through follistatin upregulation. However, the potential of directly modulating HATs remains unexplored. We tested this possibility in a well-known zebrafish model of Duchenne muscular dystrophy. Interestingly, CBP/p300 transcripts were found downregulated in the absence of Dystrophin. While investigating CBP rescuing potential we observed that dystrophin-null embryos overexpressing CBP actually never show significant muscle damage, even before a first regeneration cycle could occur. We found that the pan-HDAC inhibitor trichostatin A (TSA) also prevents early muscle damage, however the single HAT CBP is as efficient even in low doses. The HAT domain of CBP is required for its full rescuing ability. Importantly, both CBP and TSA prevent early muscle damage without restoring endogenous CBP/p300 neither increasing follistatin transcripts. This suggests a new mechanism of action of epigenetic regulators protecting dystrophin-null muscle fibres from detaching, independent from the known improvement of regeneration upon damage of HDACs inhibitors. This study builds supporting evidence that epigenetic modulators may play a role in determining the severity of muscle dystrophy, controlling the ability to resist muscle damage. Determining the mode of action leading to muscle protection can potentially lead to new treatment options for muscular dystrophies in the future.</p>","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35791987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Possible Link Between Pyriproxyfen and Microcephaly.","authors":"Raphael Parens, H Frederik Nijhout, Alfredo Morales, Felipe Xavier Costa, Yaneer Bar-Yam","doi":"10.1371/currents.outbreaks.5afb0bfb8cf31d9a4baba7b19b4edbac","DOIUrl":"10.1371/currents.outbreaks.5afb0bfb8cf31d9a4baba7b19b4edbac","url":null,"abstract":"<p><p>The Zika virus has been the primary suspect in the large increase in incidence of microcephaly in 2015-6 in Brazil. While evidence for Zika being the cause of some of the cases is strong, its role as the primary cause of the large number of cases in Brazil has not been confirmed. Recently, the disparity between the incidences in different geographic locations has led to questions about the virus's role. Here we consider the alternative possibility that the use of the insecticide pyriproxyfen for control of mosquito populations in Brazilian drinking water is the primary cause. Pyriproxifen is a juvenile hormone analog which has been shown to correspond in mammals to a number of fat soluble regulatory molecules including retinoic acid, a metabolite of vitamin A, with which it has cross-reactivity and whose application during development has been shown to cause microcephaly. Methoprene, another juvenile hormone analog that was approved as an insecticide based upon tests performed in the 1970s, has metabolites that bind to the mammalian retinoid X receptor, and has been shown to cause developmental disorders in mammals. Isotretinoin is another example of a retinoid causing microcephaly in human babies via maternal exposure and activation of the retinoid X receptor in developing fetuses. Moreover, tests of pyriproxyfen by the manufacturer, Sumitomo, widely quoted as giving no evidence for developmental toxicity, actually found some evidence for such an effect, including low brain mass and arhinencephaly-incomplete formation of the anterior cerebral hemispheres-in exposed rat pups. Finally, the pyriproxyfen use in Brazil is unprecedented-it has never before been applied to a water supply on such a scale. Claims that it is not being used in Recife, the epicenter of microcephaly cases, do not distinguish the metropolitan area of Recife, where it is widely used, and the municipality, and have not been adequately confirmed. Given this combination of information about molecular mechanisms and toxicological evidence, we strongly recommend that the use of pyriproxyfen in Brazil be suspended until the potential causal link to microcephaly is investigated further.</p>","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35760733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting Local Zika Virus Transmission in the Continental United States: A Comparison of Surveillance Strategies.","authors":"Steven Russell,&nbsp;Kyle Ryff,&nbsp;Carolyn Gould,&nbsp;Stacey Martin,&nbsp;Michael Johansson","doi":"10.1371/currents.outbreaks.cd76717676629d47704170ecbdb5f820","DOIUrl":"https://doi.org/10.1371/currents.outbreaks.cd76717676629d47704170ecbdb5f820","url":null,"abstract":"<p><strong>Introduction: </strong>The 2015-2017 Zika virus (ZIKV) epidemic in the Americas has driven efforts to strengthen surveillance systems and to develop interventions, testing, and travel recommendations. In the continental U.S. and Hawaii, where limited transmission has been observed, detecting local transmission is a key public health objective. We assessed the effectiveness of three general surveillance strategies for this situation: testing all pregnant women twice during pregnancy, testing blood donations, and testing symptomatic people who seek medical care in an emergency department (ED).</p><p><strong>Methods: </strong>We developed a simulation model for each surveillance strategy and simulated different transmission scenarios with varying population sizes and infection rates. We then calculated the probability of detecting transmission, the number of tests needed, and the number of false positive test results.</p><p><strong>Results: </strong>The probability of detecting ZIKV transmission was highest for testing ED patients with Zika symptoms, followed by pregnant women and blood donors, in that order. The magnitude of the difference in probability of detection between strategies depended on the incidence of infection. Testing ED patients required fewer tests and resulted in fewer false positives than surveillance among pregnant women. The optimal strategy identified was to test ED patients with at least two Zika virus disease symptoms. This case definition resulted in a high probability of detection with relatively few tests and false positives.</p><p><strong>Discussion: </strong>In the continental U.S. and Hawaii, where local ZIKV transmission is rare, optimizing the probability of detecting infections while minimizing resource usage is particularly important. Local surveillance strategies will be influenced by existing public health system infrastructure, but should also consider the effectiveness of different approaches. This analysis demonstrated differences across strategies and indicated that testing symptomatic ED patients is generally a more efficient strategy for detecting transmission than routine testing of pregnant women or blood donors.</p>","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6012008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36294680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess Mortality Related to Chikungunya Epidemics in the Context of Co-circulation of Other Arboviruses in Brazil.","authors":"André Ricardo Ribas Freitas,&nbsp;Luciano Cavalcanti,&nbsp;Andrea Pb Von Zuben,&nbsp;Maria Rita Donalisio","doi":"10.1371/currents.outbreaks.14608e586cd321d8d5088652d7a0d884","DOIUrl":"https://doi.org/10.1371/currents.outbreaks.14608e586cd321d8d5088652d7a0d884","url":null,"abstract":"<p><strong>Introduction: </strong>Chikungunya is an emerging arbovirus that reached the Western Hemisphere at the end of 2013. Studies in the Indian Ocean and India suggest that passive surveillance systems cannot recognize many of deaths associated with chikungunya, which can be inferred by an increase in the overall mortality observed during chikungunya epidemics.</p><p><strong>Objective: </strong>We assess the mortality associated with chikungunya epidemics in the most affected states in Brazil, from 2015 and 2016.</p><p><strong>Methods: </strong>We studied the monthly mortality by age group, comparing a period without epidemics to a chikungunya epidemic period, which we defined arbitrarily as consecutive months with incidences of more than 50 cases/100,000 persons.</p><p><strong>Results: </strong>We obtained official data from the National System of Reported Diseases (SINAN) and the Mortality Information System (SIM), both maintained by the Ministry of Health. We identified a significant increase in the all-cause mortality rate during chikungunya epidemics, while there was no similar mortality in the previous years, even during dengue epidemics. We estimated an excess of 4,505 deaths in Pernambuco during the chikungunya epidemics (47.9 per 100,000 persons).The most affected age groups were the elderly and those under 1 year of age, and the same pattern occurred in all the states.</p><p><strong>Discussion: </strong>Further studies at other sites are needed to confirm the association between increased mortality and chikungunya epidemics indifferent age groups. If these findings are confirmed, it will be necessary to revise the guidelines to recognize the actual mortality associated with chikungunya and to improve therapeutic approaches and protective measures in the most vulnerable groups.</p>","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35676267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Ebola Virus Disease Surveillance and Prevention in Counties Without Confirmed Cases in Rural Liberia: Experiences from Sinoe County During the Flare-up in Monrovia, April to June, 2016.","authors":"Vera Darling Weah, John S Doedeh, Samson Q Wiah, Emmanuel Nyema, Siafa Lombeh, Jeremias Naiene","doi":"10.1371/currents.outbreaks.2b7f352af0866accbd7e5a82f165432a","DOIUrl":"10.1371/currents.outbreaks.2b7f352af0866accbd7e5a82f165432a","url":null,"abstract":"<p><strong>Introduction: </strong>During the flare-ups of Ebola virus disease (EVD) in Liberia, Sinoe County reactivated the multi-sectorial EVD control strategy in order to be ready to respond to the eventual reintroduction of cases. This paper describes the impacts of the interventions implemented in Sinoe County during the last flare-up in Monrovia, from April 1 to June 9, 2016, using the resources provided during the original outbreak that ended a year ago.</p><p><strong>Methods: </strong>We conducted a descriptive study to describe the key interventions implemented in Sinoe County, the capacity available, the implications for the reactivation of the multi-sectoral EVD control strategy, and the results of the same. We also conducted a cross-sectional study to analyze the impact of the interventions on the surveillance and on infection prevention and control (IPC).</p><p><strong>Results: </strong>The attrition of the staff trained during the original outbreak was low, and most of the supplies, equipment, and infrastructure from the original outbreak remained available. With an additional USD 1755, improvements were observed in the IPC indicators of triage, which increased from a mean of 60% at the first assessment to 77% (P=0.002). Additionally, personnel/staff training improved from 78% to 89% (P=0.04). The percentage of EVD death alerts per expected deaths investigated increased from 26% to 63% (P<0.0001).</p><p><strong>Discussion: </strong>The low attrition of the trained staff and the availability of most supplies, equipment, and infrastructure made the reactivation of the multi-sectoral EVD control strategy fast and affordable. The improvement of the EVD surveillance was possibly affected by the community engagement activities, awareness and mentoring of the health workers, and improved availability of clinicians in the facilities during the flare-up. The community engagement may contribute to the report of community-based events, specifically community deaths. The mentoring of the staff during the supportive supervisions also contributed to improve the IPC indicators.</p>","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35601198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Regulators Modulate Muscle Damage in Duchenne Muscular Dystrophy Model","authors":"F. Bajanca, L. Vandel","doi":"10.1101/211870","DOIUrl":"https://doi.org/10.1101/211870","url":null,"abstract":"Histone acetyl transferases (HATs) and histone deacetylases (HDAC) control transcription during myogenesis. HDACs promote chromatin condensation, inhibiting gene transcription in muscle progenitor cells until myoblast differentiation is triggered and HDACs are released. HATs, namely CBP/p300, activate myogenic regulatory and elongation factors promoting myogenesis. HDAC inhibitors are known to improve regeneration in dystrophic muscles through follistatin upregulation. However, the potential of directly modulating HATs remains unexplored. We tested this possibility in a well-known zebrafish model of Duchenne muscular dystrophy. Interestingly, CBP/p300 transcripts were found downregulated in the absence of Dystrophin. While investigating CBP rescuing potential we observed that dystrophin-null embryos overexpressing CBP actually never show significant muscle damage, even before a first regeneration cycle could occur. We found that the pan-HDAC inhibitor trichostatin A (TSA) also prevents early muscle damage, however the single HAT CBP is as efficient even in low doses. The HAT domain of CBP is required for its full rescuing ability. Importantly, both CBP and TSA prevent early muscle damage without restoring endogenous CBP/p300 neither increasing follistatin transcripts. This suggests a new mechanism of action of epigenetic regulators protecting dystrophin-null muscle fibres from detaching, independent from the known improvement of regeneration upon damage of HDACs inhibitors. This study builds supporting evidence that epigenetic modulators may play a role in determining the severity of muscle dystrophy, controlling the ability to resist muscle damage. Determining the mode of action leading to muscle protection can potentially lead to new treatment options for muscular dystrophies in the future.","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41654469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza A Virus Infection Damages Zebrafish Skeletal Muscle and Exacerbates Disease in Zebrafish Modeling Duchenne Muscular Dystrophy.","authors":"Michelle Goody,&nbsp;Denise Jurczyszak,&nbsp;Carol Kim,&nbsp;Clarissa Henry","doi":"10.1371/currents.md.8a7e35c50fa2b48156799d3c39788175","DOIUrl":"https://doi.org/10.1371/currents.md.8a7e35c50fa2b48156799d3c39788175","url":null,"abstract":"INTRODUCTION: Both genetic and infectious diseases can result in skeletal muscle degeneration, inflammation, pain, and/or weakness. Duchenne muscular dystrophy (DMD) is the most common congenital muscle disease. DMD causes progressive muscle wasting due to mutations in Dystrophin. Influenza A and B viruses are frequently associated with muscle complications, especially in children. Infections activate an immune response and immunosuppressant drugs reduce DMD symptoms. These data suggest that the immune system may contribute to muscle pathology. However, roles of the immune response in DMD and Influenza muscle complications are not well understood. Zebrafish with dmd mutations are a well-characterized model in which to study the molecular and cellular mechanisms of DMD pathology. We recently showed that zebrafish can be infected by human Influenza A virus (IAV). Thus, the zebrafish is a powerful system with which to ask questions about the etiology and mechanisms of muscle damage due to genetic and/or infectious diseases. METHODS: We infected zebrafish with IAV and assayed muscle tissue structure, sarcolemma integrity, cell-extracellular matrix (ECM) attachment, and molecular and cellular markers of inflammation in response to IAV infection alone or in the context of DMD. RESULTS: We find that IAV-infected zebrafish display mild muscle degeneration with sarcolemma damage and compromised ECM adhesion. An innate immune response is elicited in muscle in IAV-infected zebrafish: NFkB signaling is activated, pro-inflammatory cytokine expression is upregulated, and neutrophils localize to sites of muscle damage. IAV-infected dmd mutants display more severe muscle damage than would be expected from an additive effect of dmd mutation and IAV infection, suggesting that muscle damage caused by Dystrophin-deficiency and IAV infection is synergistic. DISCUSSION: These data demonstrate the importance of preventing IAV infections in individuals with genetic muscle diseases. Elucidating the mechanisms of immune-mediated muscle damage will not only apply to DMD and IAV, but also to other conditions where the immune system, inflammation, and muscle tissue are known to be affected, such as autoimmune diseases, cancer, and aging.","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35601199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The United Nations Material Assistance to Survivors of Cholera in Haiti: Consulting Survivors and Rebuilding Trust.","authors":"Phuong N Pham,&nbsp;Niamh Gibbons,&nbsp;Patrick Vinck","doi":"10.1371/currents.dis.1b01af244fe3d76d6a7013e2f1e3944d","DOIUrl":"https://doi.org/10.1371/currents.dis.1b01af244fe3d76d6a7013e2f1e3944d","url":null,"abstract":"<p><strong>Introduction: </strong>In August 2016, the United Nations (U.N.) Secretary General acknowledged the U.N.'s role in the cholera epidemic that has beset Haiti since 2010. Two months later, the Secretary General issued a historic apology to the Haitian people before the U.N. General Assembly, for the organization's insufficient response to the cholera outbreak. These steps are part of the U.N.'s \"new approach\" to cholera in Haiti, which also includes launching a material assistance package for those most affected by cholera.</p><p><strong>Methods: </strong>This paper draws on the authors' experience and findings from consultations with more than 60,000 victims and communities affected by disasters and violence in a dozen countries. We reviewed the literature on best practices for consultation with and outreach to communities affected by development and transitional justice programming, and reviewed our own findings from previous studies with a view to identifying recommendations for ensuring that the assistance package reflects the views of people affected by cholera.</p><p><strong>Results: </strong>The assistance package program is an opportunity to rebuild the relationship between the victims and the United Nations. This can only be achieved if victims are informed and engaged in the process. This consultation effort is also an opportunity to answer a set of key questions related to the nature, structure, and implementation of the victims' assistance program, but also how the program may be designed to contribute to rebuilding Haitians' confidence in the U.N. as an institution that promotes peace, human rights, and development.</p><p><strong>Discussion: </strong>We recommend that the consultations must be accompanied by an outreach effort that provides clear, accurate information on the assistance program, so that it begins to establish a dialogue between the U.N. and cholera victims. Finally, we conclude by offering a number of concrete next steps that the U.N. can take to kick start the consultation process.</p>","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35601197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Outbreak of Pseudomonas Aeruginosa Infection Linked to a \"Black Friday\" Piercing Event.","authors":"Peter MacPherson,&nbsp;Katherine Valentine,&nbsp;Victoria Chadderton,&nbsp;Evdokia Dardamissis,&nbsp;Ian Doig,&nbsp;Andrew Fox,&nbsp;Sam Ghebrehewet,&nbsp;Tom Hampton,&nbsp;Ken Mutton,&nbsp;Claire Sherratt,&nbsp;Catherine M McCann","doi":"10.1371/currents.outbreaks.51af24797f6f856a9861b5ddabc7db58","DOIUrl":"https://doi.org/10.1371/currents.outbreaks.51af24797f6f856a9861b5ddabc7db58","url":null,"abstract":"<p><strong>Introduction: </strong>Outbreaks linked to cosmetic piercing are rare, but can cause significant illness. We report the investigation and management of a point-source outbreak that occurred during a Black Friday promotional event in North West England.</p><p><strong>Methods: </strong>Outbreak investigation was led by Public Health England, and included active case finding among individuals pierced at a piercing premises between 25/11/2016 (Black Friday) and 7/12/2016. Detailed epidemiological, environmental (including inspection and sampling), and microbiological investigation was undertaken.</p><p><strong>Results: </strong>During the Black Friday event (25/11/2016), 45 people were pierced (13 by a newly-appointed practitioner). Eleven cases were identified (7 microbiologically-confirmed, 2 probable, and 2 possible). All cases had clinical signs of infection around piercing sites, and five required surgical intervention, with varying degrees of post-operative disfigurement. All confirmed and probable cases had a scaffold piercing placed with a guide bar by the newly-appointed practitioner. <i>Pseudomonas aeruginosa</i>, indistinguishable at nine-locus variable-number tandem repeat loci, was isolated from four of the confirmed cases, and from pre- and post-flush samples from five separate water taps (three sinks) in the premises. Water samples taken after remedial plumbing work confirmed elimination of Pseudomonas contamination.</p><p><strong>Discussion: </strong>Although high levels of Pseudomonas water contamination and some poor infection control procedures were identified, infection appeared to require additional exposure to an inexperienced practitioner, and the more invasive scaffold piercing. A proactive collaborative approach between piercers and health and environmental officials is required to reduce outbreak risk, particularly when unusually large events are planned.</p>","PeriodicalId":74464,"journal":{"name":"PLoS currents","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35601173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}