Efficacy and Long-Term Outcomes of Palivizumab Prophylaxis to Prevent Respiratory Syncytial Virus Infection in Infants with Cystic Fibrosis in Northern Ireland

BACKGROUND: RSV causes considerable morbidity and mortality in children. In cystic fibrosis (CF) viral infections are associated with worsening respiratory symptoms and bacterial colonization. Palivizumab is effective in reducing RSV hospitalization in high risk patient groups. Evidence regarding its effectiveness and safety in CF is inconclusive. CF screening in N. Ireland enabled timely palivizumab prophylaxis, becoming routine in 2002.

OBJECTIVES: To determine the effect of palivizumab on RSV-related hospitalization and compare lung function and bacterial colonization at age 6 years for those born pre- and post-introduction of palivizumab prophylaxis.

METHODS: A retrospective audit was conducted for all patients diagnosed with CF during the period from 1997 to 2007 inclusive. RSV-related hospitalization, time to Pseudomonas aeruginosa (PA) 1st isolate, lung function and growth parameters were recorded. Comparisons were made for outcomes pre- and post-introduction of routine palivizumab administration in 2002. A cost evaluation was also performed.

RESULTS: Ninety-two children were included; 47 pre- and 45 post-palivizumab introduction. The overall RSV-positive hospitalization rate was 13%. The relative risk of RSV infection in palivizumab non-recipients versus recipients was 4.78 (95%CI: 1.1-20.7), P = 0.027. Notably, PA 1st isolate was significantly earlier in the palivizumab recipient cohort versus non-recipient cohort (median 57 vs. 96 months, P < 0.025) with a relative risk of 2.5. Chronic PA infection at 6 years remained low in both groups, with similar lung function and growth parameters. Total costs were calculated at £96,127 ($151,880) for the non-recipient cohort versus £137,954 ($217,967) for the recipient cohort.

CONCLUSION: Palivizumab was effective in reducing RSV-related hospitalization infection in CF patients. Surprisingly, we found a significantly earlier time to 1st isolate of PA in palivizumab recipients which we could not explain by altered or improved diagnostic tests. 

Variabilidade genómica de Citrus tristeza virus e transformação genética de Citrus aurantium L. com vista à obtenção de resistência

Tese de dout., Biologia, Faculdade de Engenharia de Recursos Naturais, Univ. do Algarve, 2003

Molecular determinants of virus-like nanoparticle assembly in vitro and in animal cell culture

Tese de doutoramento, Ciências Biotecnológicas (Engenharia Bioquímica), Faculdade de Ciências e Tecnologia, Univ. do Algarve, 2011

Estudo preliminar do efeito supressor de genes do Citrus tristeza virus (CTV) no silenciamento pós-transcripcional em Nicotiana benthamiana

Dissertação de mest., Engenharia Biológica, Faculdade de Ciências e Tecnologia, Univ. do Algarve, 2011

Molecular characterization of Citrus tristeza virus isolates from Cyprus on the basis of the coat protein gene

Within the context of a program in Cyprus for the control of Citrus tristeza virus (CTV), the coat protein (CP) genes of 12 local isolates of the virus that induced different symptoms on host trees, were compared to those of known isolates. The CP genes were reverse-transcribed (RT) and amplified by polymerase chain reaction (PCR) and the resulting amplicons were cloned and sequenced. Nucleotide sequence analysis revealed no signs of geographic speciation. All the sequences obtained clustered close to those of previously known isolates of worldwide origin that are in five distinct groups. The nucleotide diversity was high compared to that found using a worldwide database of CP gene sequences. These data support the existence of different CTV introductions into Cyprus or an introduction from a location in which CTV is relatively diverse. Some of the isolates induced stem pitting on branches of grapefruit and sweet orange. Such isolates have not been noted often in the Mediterranean basin. They were close in CP sequence to isolate B249 from Venezuela, which induces stem pitting, and are of particular concern for the whole region.

First report of Citrus tristeza virus in the State Union of Serbia and Montenegro.

Citrus production in the State Union of Serbia and Montenegro has a strategic importance to the agricultural sector. Approximately 400,000 trees are now grown in the major citrus producing region, which is the Montenegrin Coastal Region. Satsuma mandarins and lemons grafted on Poncirus trifoliata are the most cultivated varieties. In December 2003, eight samples taken from the coastal region close to the towns of Bar and Ulcinj were analyzed using enzyme- linked immunosorbent assay (ELISA) with SP7 antibodies produced at Universidade do Algarve, Portugal (3). Further analysis was done using immunocapture-reverse transcription-polymerase chain reaction (IC-RT-PCR) targeting the entire coat protein (CP) gene (forward primer CTV1: 5(prime)- ATGGACGACGAAACAAAGAA-3(prime) and reverse primer CTV10: 5 (prime)-ATCAACGTGTGTTGAATTTCC-3(prime)). Using both techniques, seven of eight samples analyzed were found to be infected by Citrus tristeza virus (CTV), including samples from five trees that exhibited chlorosis, gummosis, and fruit deformation, and two trees that were symptomless.

Occurrence of stem-pitting strains of Citrus tristeza virus in Croatia

Citrus is grown in Croatia (approximately 1,500 ha of citrus groves) on the Dalmatian Coast and Islands between 42 and 43°30'N. The major species, Citrus unshiu Marc. (Satsuma mandarin), is grafted on trifoliate rootstock. The presence of Citrus tristeza virus (CTV) in Satsumas in the Neretva Valley Region was previously reported (3). During the course of a biomolecular characterization of isolates from Croatia, 15 budsticks were collected from field- infected, enzyme-linked immunosorbent assay (ELISA)-positive sources during the autumn of 2003 near Kaštela, Split, Metković (Neretva Valley), and on the island of Vis. Isolates were propagated by graft transmission to Madam Vinous sweet orange (SwO) and maintained in an insect-proof greenhouse at 21 to 33° C.

Caraterização dos supressores p20 e p23 do Citrus tristeza virus e avaliação da possibilidade da sua inibição

No presente trabalho pretendeu-se caracterizar a capacidade supressora das proteínas p20 e p23 de diferentes grupos filogenéticos do CTV e o possível silenciamento da p23 de forma a ser incluída numa estratégia de proteção. A atividade supressora local da proteína p23 de todos os grupos filogenéticos foi caracterizada em Nicotiana benthamiana da linha 16C. Todas as proteínas testadas foram capaz de suprimir o silenciamento local, mas não o silenciamento a curta distância. A supressão local mais eficiente verificou-se para a p23 do Gp 5 e a menos eficiente para os isolados dos Gps 2 e M. Surpreendentemente, a p23 do Gp 5 aboliu completamente o silenciamento sistémico, sugerindo que existe uma relação entre a intensidade do silenciamento local e sistémico. A capacidade supressora local conjunta das proteínas p20 e p23 foi avaliada. A coexpressão de ambas as proteínas revelou atividade supressora mais forte comparada com a capacidade de cada proteína individual, mesmo quando inoculada com metade da densidade ótica, sugerindo a existência de sinergismo entre as proteínas p20 e p23. Para analisar as propriedades supressoras a longo prazo, as proteínas p20 e p23 foram inseridas no vetor viral TRV que assegurou a sua disseminação pela planta e expressão por um período mais alargado. Foram observados sintomas em N. benthamiana para todas as modalidades testadas, tais como, nanismo da planta, lesões necróticas severas nas folhas inoculadas e nas folhas novas ligeiros sintomas de mosaico e enrolamento. Contudo, sistemicamente não foram registadas diferenças na capacidade supressora das proteínas p20 e p23. A possibilidade para silenciar sistemicamente a proteína p23 quando incluída num genoma viral foi avaliada através do uso de plantas e enxertos transgénicos para a p23. A estratégia que envolve o uso de enxertos transgénicos parece indicar resultados promissores que conduzem ao silenciamento da p23, contudo, são resultados que devem ser encarados como preliminares.

Caracterização de variantes de Grapevine Fanleaf Virus (GFLV), Arabis Mosaic Virus (ARMV) e respectivos RNAS satélites presentes em castas portuguesas de Vitis Vinifera

Dissertação de mestrado, Biologia Molecular e Microbiana, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Activities of an aqueous plant extract against Herpes simplex virus type 2 (HSV 2): role in virus replication and progeny yield

Tese de mestrado, Biologia Molecular e Genética, Universidade de Lisboa, Faculdade de Ciências, 2015

Structural proteins of enveloped virus : from biochemistry to molecular medicine : a focus on dengue virus

Tese de doutoramento, Ciências Biomédicas (Bioquímica Médica), Universidade de Lisboa, Faculdade de Medicina, 2016

A quantitative evaluation of three hand drying methods and the potential for dissemination of virus particles into the environment

The importance of hand hygiene in reducing the spread of pathogens has been long established and this has been highlighted recently in initiatives such as the NHS’s ‘clean your hands’ campaign. However, much of the focus on hand hygiene has concerned effective hand washing; there has been less emphasis on hand drying and its role in hygienic practices. This study aimed to compare three hand drying methods namely paper towels, a warm air dryer and a jet air dryer for their relative ability to disseminate virus particles into the washroom environment during hand drying. A bacteriophage model was used to compare these methods; hands were artificially contaminated with MS2 phage and dried using each device. Both air sampling and contact plates were assessed and a plaque assay was used to quantify virus dissemination. Samples were collected at set times, heights, angles and distances around each device. Both air sampling and contact plate results indicated that the jet air dryer produced significantly more virus dispersal than either paper towels or the warm air dryer in terms of quantity, distance travelled and the time spent circulating in the air around the device and potentially in the washroom environment.

Evaluation of the potential for virus dispersal during hand drying: a comparison of three methods

Aims To use a MS2 bacteriophage model to compare three hand-drying methods, paper towels (PT), a warm air dryer (WAD) and a jet air dryer (JAD), for their potential to disperse viruses and contaminate the immediate environment during use. Methods and Results Participants washed their gloved hands with a suspension of MS2 bacteriophage and hands were dried with one of the three hand-drying devices. The quantity of MS2 present in the areas around each device was determined using a plaque assay. Samples were collected from plates containing the indicator strain, placed at varying heights and distances and also from the air. Over a height range of 0.15-1.65 m, the JAD dispersed an average of >60 and >1300-fold more plaque-forming units (pfu) compared to the WAD and PT (P <0.0001), respectively. The JAD dispersed an average of >20 and >190-fold more pfu in total compared to WAD and PT at all distances tested up to 3 m (P <0.01), respectively. Air samples collected around each device 15 minutes after use indicated that the JAD dispersed an average of >50 and >100-fold more pfu compared to the WAD and PT (P <0.001), respectively. Conclusions Use of the JAD lead to significantly greater and further dispersal of MS2 bacteriophage from artificially contaminated hands when compared to the WAD and PT. Significance and Impact of Study The choice of hand drying device should be considered carefully in areas where infection prevention concerns are paramount, such as healthcare settings and the food industry.