Introduction: More than 93,000 cases of coronavirus disease have been reported worldwide. We describe the epidemiology, clinical course, and virologic characteristics of the first 12 U.S. patients with COVID-19. Methods:We collected demographic, exposure, and clinical information from 12 patients confirmed by CDC during January 20-February 5, 2020 to have COVID-19. Respiratory, stool, serum, and urine specimens were submitted for SARS-CoV-2 rRT-PCR testing, virus culture, and whole genome sequencing. Results:Among the 12 patients, median age was 53 years (range: 21-68); 8 were male, 10 had traveled to China, and two were contacts of patients in this series. Commonly reported signs and symptoms at illness onset were fever (n=7) and cough (n=8). Seven patients were hospitalized with radiographic evidence of pneumonia and demonstrated clinical or laboratory signs of worsening during the second week of illness. Three were treated with the investigational antiviral remdesivir. All patients had SARS-CoV-2 RNA detected in respiratory specimens, typically for 2-3 weeks after illness onset, with lowest rRT-PCR Ct values often detected in the first week. SARS-CoV-2 RNA was detected after reported symptom resolution in seven patients. SARS-CoV-2 was cultured from respiratory specimens, and SARS-CoV-2 RNA was detected in stool from 7/10 patients. Conclusions:In 12 patients with mild to moderately severe illness, SARS-CoV-2 RNA and viable virus were detected early, and prolonged RNA detection suggests the window for diagnosis is long. Hospitalized patients showed signs of worsening in the second week after illness onset.for use under a CC0 license.
Degenerate oligonucleotides (derived from conserved regions of PLB1 genes from S. cerevisiae and other fungi) were used to amplify PLB1 homolog fragments from C. albicans and C. tropicalis by using the polymerase chain reaction. The C. albicans PLB1 fragment was then used as a probe to clone the full-length gene and to monitor PLB1 mRNA expression. The C. albicans PLB1 gene consists of a 1815-bp open reading frame encoding a putative protein of 605 amino acids. It contains the highly conserved Gly-X-Ser-X-Gly catalytic motif, found in all lipolytic enzymes, and exhibits significant homology with other fungal PLB1 gene products (V63% similarity, V45% identity). Blastospores and pseudohyphae expressed higher levels of PLB1 mRNA than germ-tube-forming cells. TUP1, a general transcriptional repressor, may regulate PLB1 expression in C. albicans, since PLB1 expression was the highest in tup1v mutants and did not vary in response to environmental stimuli. Together, these results suggest that expression of the C. albicans PLB1 gene is regulated as a function of morphogenic transition. z
Trypsin-like protease activity, hemagglutination activity, and accumulation of heme-containing compounds (black pigment) are considered to be virulence factors of Porphyromonas gingivalis. Transposon-mutagenesis was used for the first time to isolate pigment-deficient mutants. These mutants exhibited simultaneous deficiency in trypsin-like protease activity and hemagglutination activity. Two major membrane-associated proteins, observed by SDS-PAGE with the parent strain, were essentially absent from the mutant strains. Immunoblot analysis indicated that these two proteins correspond to putative hemagglutinin and hemagglutinin/protease products of P. gingivalis. Each mutant contained only one transposon insertion, thus the pleiotropic phenotype resulted from single site-specific mutations. The results indicate that trypsin-like protease activity is required for accumulation of protoheme from hemoglobin by P. gingivalis and that genetic and/or physiological linkage exists between trypsin-like protease activity and hemagglutination activity.
T he public health community anticipated widespread co-circulation of infl uenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease (COVID-19), during the 2020-21 infl uenza season. However, infl uenza activity in California was unusually low (1). The California Department of Public Health (CDPH; Richmond, California, USA) matched positive infl uenza test results with SARS-CoV-2 test results to assess the occurrence of infl uenza and SARS-CoV-2 co-infections in California. The StudyCalifornia laboratories and medical providers must report all positive and nonpositive (i.e., negative, inconclusive, or invalid) SARS-CoV-2 laboratory results to their local health jurisdictions (LHJs) (2). For infl uenza, only positive results that can be submitted electronically by laboratories are reportable. Most data are reported directly to CDPH's web-based platform, California Reportable Diseases Information Exchange (CalREDIE). CalREDIE assigns electronic laboratory reports a unique identifi er, personID, that can be used to link the same person across different disease reports. CalREDIE is used by 59 of California's 61 LHJs for disease tracking and reporting. Two LHJs, Los Angeles and San Diego, which represent one third of California's population, do not use CalREDIE directly; we excluded data from those LHJs.We matched positive molecular infl uenza test results reported during September 1, 2020-April 30, 2021, with positive and nonpositive molecular SARS-CoV-2 test results to identify co-infections. We matched positive infl uenza results with nonpositive SARS-CoV-2 results to determine whether persons infected with infl uenza were negative for SARS-CoV-2 or were potentially not tested for SARS-CoV-2. We deduplicated all positive infl uenza tests results and excluded antigen test results.We matched laboratory results fi rst using Cal-REDIE personID, then by name and date of birth, and fi nally by manual record review if positive infl uenza results did not match to SARS-CoV-2 results by per-sonID or name and date of birth (Figure 1). If a person had both positive and nonpositive SARS-CoV-2 results within 7 days of a positive infl uenza result, we used the positive SARS-CoV-2 result in the analysis. Persons with both positive infl uenza and SARS-CoV-2 test results with ≤7 days between specimen collection dates met criteria for infl uenza and SARS-CoV-2 co-infection. We analyzed co-infection data by week of illness onset and geographic distribution. We summarized co-infected persons by age, race and ethnicity, sex, hospitalization, and survival status. We completed all analyses using SAS version 9.4 (SAS Institute, http://www.sas.com). This study received a nonresearch determination from the California Committee for the Protection of Human Subjects.CDPH received 258 positive infl uenza test results during September 1, 2020-April 30, 2021, and >21.1 million SARS-CoV-2 total test results. Among positive infl uenza results, 255 (99%) matched with a SARS-CoV-2 test result (po...
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