Active surveillance for respiratory virus infections in adults who have undergone bone marrow and peripheral blood stem cell transplantation

Abstract

Summary:Community-acquired respiratory virus (RV) infections are an important cause of disease in immunocompromised adults with cancer. To investigate the viral etiology, incidence, clinical presentation, and outcome of RV infections in an outpatient cohort of adult bone marrow or peripheral blood stem cell transplant (SCT) recipients, we monitored 62 outpatient volunteers from January 1 to April 30, 2001. A nasopharyngeal aspirate was collected from subjects when they reported new respiratory symptoms and tested for RV (influenza A, influenza B, human parainfluenza 1-3, adenovirus, and respiratory syncytial virus) by culture and reverse transcription polymerase chain reaction (RT-PCR) assay. Of 62 subjects enrolled, 27% had received allogeneic SCT and 45% were within 1 year of their transplant. In all, 35 participants (56%) reported 37 episodes of respiratory symptoms. Of the 37 specimens tested, five (14%) were positive for RV by culture and 20 (54%) were positive by RT-PCR. Only six patients with RV infections developed lower respiratory tract illnesses; these patients had received either autologous or allogeneic transplants and developed illnesses between 41 and 2666 days post transplant. Although RV infections were common in SCT outpatients during the RV season, most participants had upper respiratory tract infections, which resolved without the need for hospitalization.

Polymorphisms in the chemokine (C-X-C motif) ligand 10 are associated with invasive aspergillosis after allogeneic stem-cell transplantation and influence CXCL10 epression in monocyte-derived dendritic cells

“…HCMV disease was defined by Ljungman et al, 9 RV infection was defined as influenza A, influenza B, human parainfluenza 1-3, adenovirus, and respiratory syncytial virus detection by culture or reverse transcriptase-polymerase chain reaction (RT-PCR) assay. 10 In a preliminary, add-on study, 1 mL serum from further consecutive patients after alloSCT, (each patient who agreed to participate was included, n ϭ 33, median age 52 years, range [23-64 years], 19/33 males) and from randomly selected laboratory workers (n ϭ 14, median age 28 years, range [23-41 years], 6/14 males) was collected for quantification of CXCL10 levels by ELISA (R&D Systems, Wiesbaden, Germany). Patients suffered from proven or probable IA (6/33) or showed no clinical signs of infection (27/33).…”

Role of Human Polyomaviruses in Respiratory Tract Disease in Young Children

“…Specimens from symptomatic children who tested positive for KIV or WUV were also screened for human bocavirus (HBoV); human metapneumovirus (hMPV); human coronaviruses (HCoV) 229E, NL63, and HKU1; and human picornaviruses (including rhinoviruses [HRV]) by using previously described methods (6)(7)(8)(9)(10)(11)(12). To screen for human parainfl uenzavirus type 4 and HCoV OC43, RNA extraction and reverse transcription were performed as previously described (7).…”

Patient and family education in HSCT: improving awareness of respiratory virus infection and influenza vaccination. A descriptive study and brief intervention

“…According to the health belief model, 21 the likelihood of uptake depends on perceptions of the patient's susceptibility to RV infections, the severity of infection and its consequences; costs and benefits of adopting the measure and barriers to doing so; and external cues such as reminders and persuasive communications. 22 We report findings of a study that aims:- (1) to ascertain what HSCT patients and their family and friends know about the risk of RV infections post-HSCT, and measures to prevent them, and (2) to evaluate a brief educational intervention designed to increase awareness of preventive measures and increase uptake of household influenza vaccination.…”

“…1,2 Although the majority are upper respiratory tract infections, [1][2][3][4][5] pneumonia historically occurs in 16-45% of all RV episodes, [1][2][3] and up to 80% of influenza. 6 Early treatment with oseltamavir has been shown to reduce the incidence of pneumonia in cases of influenza to o30% with an associated mortality o10%.…”