Three human coronaviruses are known to exist: human coronavirus 229E (HCoV-229E), HCoV-OC43 and severe acute respiratory syndrome (SARS)-associated coronavirus (SARS-CoV). Here we report the identification of a fourth human coronavirus, HCoV-NL63, using a new method of virus discovery. The virus was isolated from a 7-month-old child suffering from bronchiolitis and conjunctivitis. The complete genome sequence indicates that this virus is not a recombinant, but rather a new group 1 coronavirus. The in vitro host cell range of HCoV-NL63 is notable because it replicates on tertiary monkey kidney cells and the monkey kidney LLC-MK2 cell line. The viral genome contains distinctive features, including a unique N-terminal fragment within the spike protein. Screening of clinical specimens from individuals suffering from respiratory illness identified seven additional HCoV-NL63-infected individuals, indicating that the virus was widely spread within the human population.

LGV testing is recommended for MSM with anorectal chlamydia. If routine LGV serovar typing is unavailable, we propose administration of syndromic LGV treatment for MSM with anorectal chlamydia and either proctitis detected by proctoscopic examination, > 10 white blood cells/high-power field detected on an anorectal smear specimen, or HIV seropositivity.

No abstract

We traced the Chlamydia trachomatis L2b variant in Amsterdam and San Francisco. All recent lymphogranuloma venereum cases in Amsterdam were caused by the L2b variant. This variant was also present in the 1980s in San Francisco. Thus, the current "outbreak" is most likely a slowly evolving epidemic.

HIV incidence is increasing among homosexual attendees of an STD clinic. It is imperative to trace recently infected individuals, because they are highly infectious, and can thus play a key role in the spread of HIV.

Background: Screening and active case finding for Chlamydia trachomatis (CT) is recommended to prevent reproductive morbidity. However insight in community prevalence of gonococcal infections and co-infections with Neisseria gonorrhoea (NG) is lacking.

ReplyTo the Editor-My colleagues and I appreciate the comments of Drs. DeVincenzo and Buckingham [1] on our recently published article [2]. They question the lack of a relationship between the amount of virus shed and severity of illness in respiratory syncytial virus (RSV) disease. We created a carefully modulated illness score that included 16 ventilated patients. In addition to finding no relationship between the amount of virus shed and this summation of the severity of illness, we were struck by the highly variable virus load in both nasal and endotracheal secretions of the 16 ventilated patients.As Drs. DeVincenzo and Buckingham are aware [1], no therapeutic effect of RSV intravenous immune globulin could be demonstrated in the multicenter study from which these patients were drawn. The same was true in the subset of patients we studied at Vanderbilt University Medical Center (Nashville). Hence, we do not feel that this was a confounding variable. Perhaps neither their study [3] nor ours [2] provides a definitive answer to the presence of a modest effect of virus titer on illness severity, especially since neither study can address the peak titer of viral shedding that probably occurs before hospitalization. Both studies suggest that the effect, if any, of virus load on illness severity is modest and that we need to search elsewhere for a complete understanding of RSV pathogenesis.

Background: The functional polymorphism -260 C>T in the LPS sensing TLR4 co-receptor CD14 gene enhances the transcriptional activity and results in a higher CD14 receptor density. Individuals carrying the T/T genotype also have significantly higher serum levels of soluble CD14. The T allele of this polymorphism has recently been linked to Chlamydia pneumoniae infection. We investigated the role of the CD14 -260 C>T polymorphism in the susceptibility to and severity (defined as subfertility and/or tubal pathology) of C. trachomatis infection in Dutch Caucasian women.