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Dr. Unai Pérez Sautu
LEITAT Technological Center

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0 Molecular Epidemiology
0 Virology
0 high-throughput sequencing
0 genomics and metagenomics
0 Next-generation sequencing (NGS)

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high-throughput sequencing
Molecular Epidemiology

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Journal article
Published: 03 December 2020 in New England Journal of Medicine
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From November 2018 through February 2019, person-to-person transmission of Andes virus (ANDV) hantavirus pulmonary syndrome occurred in Chubut Province, Argentina, and resulted in 34 confirmed infections and 11 deaths. Understanding the genomic, epidemiologic, and clinical characteristics of person-to-person transmission of ANDV is crucial to designing effective interventions. Clinical and epidemiologic information was obtained by means of patient report and from public health centers. Serologic testing, contact-tracing, and next-generation sequencing were used to identify ANDV infection as the cause of this outbreak of hantavirus pulmonary syndrome and to reconstruct person-to-person transmission events. After a single introduction of ANDV from a rodent reservoir into the human population, transmission was driven by 3 symptomatic persons who attended crowded social events. After 18 cases were confirmed, public health officials enforced isolation of persons with confirmed cases and self-quarantine of possible contacts; these measures most likely curtailed further spread. The median reproductive number (the number of secondary cases caused by an infected person during the infectious period) was 2.12 before the control measures were enforced and decreased to 0.96 after the measures were implemented. Full genome sequencing of the ANDV strain involved in this outbreak was performed with specimens from 27 patients and showed that the strain that was present (Epuyén/18-19) was similar to the causative strain (Epilink/96) in the first known person-to-person transmission of hantavirus pulmonary syndrome caused by ANDV, which occurred in El Bolsón, Argentina, in 1996. Clinical investigations involving patients with ANDV hantavirus pulmonary syndrome in this outbreak revealed that patients with a high viral load and liver injury were more likely than other patients to spread infection. Disease severity, genomic diversity, age, and time spent in the hospital had no clear association with secondary transmission. Among patients with ANDV hantavirus pulmonary syndrome, high viral titers in combination with attendance at massive social gatherings or extensive contact among persons were associated with a higher likelihood of transmission. (Funded by the Ministerio de Salud y Desarrollo Social de la Nación Argentina and others.).

ACS Style

Valeria P. Martínez; Nicholas Di Paola; Daniel O. Alonso; Unai Pérez-Sautu; Carla M. Bellomo; Ayelén A. Iglesias; Rocio M. Coelho; Beatriz López; Natalia Periolo; Peter A. Larson; Elyse R. Nagle; Joseph A. Chitty; Catherine B. Pratt; Jorge Díaz; Daniel Cisterna; Josefina Campos; Heema Sharma; Bonnie Dighero-Kemp; Emiliano Biondo; Lorena Lewis; Constanza Anselmo; Camila P. Olivera; Fernanda Pontoriero; Enzo Lavarra; Jens H. Kuhn; Teresa Strella; Alexis Edelstein; Miriam I. Burgos; Mario Kaler; Adolfo Rubinstein; Jeffrey R. Kugelman; Mariano Sanchez-Lockhart; Claudia Perandones; Gustavo Palacios. “Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina. New England Journal of Medicine 2020, 383, 2230 -2241.

AMA Style

Valeria P. Martínez, Nicholas Di Paola, Daniel O. Alonso, Unai Pérez-Sautu, Carla M. Bellomo, Ayelén A. Iglesias, Rocio M. Coelho, Beatriz López, Natalia Periolo, Peter A. Larson, Elyse R. Nagle, Joseph A. Chitty, Catherine B. Pratt, Jorge Díaz, Daniel Cisterna, Josefina Campos, Heema Sharma, Bonnie Dighero-Kemp, Emiliano Biondo, Lorena Lewis, Constanza Anselmo, Camila P. Olivera, Fernanda Pontoriero, Enzo Lavarra, Jens H. Kuhn, Teresa Strella, Alexis Edelstein, Miriam I. Burgos, Mario Kaler, Adolfo Rubinstein, Jeffrey R. Kugelman, Mariano Sanchez-Lockhart, Claudia Perandones, Gustavo Palacios. “Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina. New England Journal of Medicine. 2020; 383 (23):2230-2241.

Chicago/Turabian Style

Valeria P. Martínez; Nicholas Di Paola; Daniel O. Alonso; Unai Pérez-Sautu; Carla M. Bellomo; Ayelén A. Iglesias; Rocio M. Coelho; Beatriz López; Natalia Periolo; Peter A. Larson; Elyse R. Nagle; Joseph A. Chitty; Catherine B. Pratt; Jorge Díaz; Daniel Cisterna; Josefina Campos; Heema Sharma; Bonnie Dighero-Kemp; Emiliano Biondo; Lorena Lewis; Constanza Anselmo; Camila P. Olivera; Fernanda Pontoriero; Enzo Lavarra; Jens H. Kuhn; Teresa Strella; Alexis Edelstein; Miriam I. Burgos; Mario Kaler; Adolfo Rubinstein; Jeffrey R. Kugelman; Mariano Sanchez-Lockhart; Claudia Perandones; Gustavo Palacios. 2020. "“Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina." New England Journal of Medicine 383, no. 23: 2230-2241.

Journal article
Published: 29 August 2020 in Viruses
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Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging human pathogen, endemic in areas of China, Japan, and the Korea (KOR). It is primarily transmitted through infected ticks and can cause a severe hemorrhagic fever disease with case fatality rates as high as 30%. Despite its high virulence and increasing prevalence, molecular and functional studies in situ are scarce due to the limited availability of high-titer SFTSV exposure stocks. During the course of field virologic surveillance in 2017, we detected SFTSV in ticks and in a symptomatic soldier in a KOR Army training area. SFTSV was isolated from the ticks producing a high-titer viral exposure stock. Through the use of advanced genomic tools, we present here a complete, in-depth characterization of this viral stock, including a comparison with both the virus in its arthropod source and in the human case, and an in vivo study of its pathogenicity. Thanks to this detailed characterization, this SFTSV viral exposure stock constitutes a quality biological tool for the study of this viral agent and for the development of medical countermeasures, fulfilling the requirements of the main regulatory agencies.

ACS Style

Unai Perez-Sautu; Se Gu; Katie Caviness; Dong Song; Yu-Jin Kim; Nicholas Paola; Daesang Lee; Terry Klein; Joseph Chitty; Elyse Nagle; Heung-Chul Kim; Sung-Tae Chong; Brett Beitzel; Daniel Reyes; Courtney Finch; Russ Byrum; Kurt Cooper; Janie Liang; Jens Kuhn; Xiankun Zeng; Kathleen Kuehl; Kayla Coffin; Jun Liu; Hong Oh; Woong Seog; Byung-Sub Choi; Mariano Sanchez-Lockhart; Gustavo Palacios; Seong Jeong. A Model for the Production of Regulatory Grade Viral Hemorrhagic Fever Exposure Stocks: From Field Surveillance to Advanced Characterization of SFTSV. Viruses 2020, 12, 958 .

AMA Style

Unai Perez-Sautu, Se Gu, Katie Caviness, Dong Song, Yu-Jin Kim, Nicholas Paola, Daesang Lee, Terry Klein, Joseph Chitty, Elyse Nagle, Heung-Chul Kim, Sung-Tae Chong, Brett Beitzel, Daniel Reyes, Courtney Finch, Russ Byrum, Kurt Cooper, Janie Liang, Jens Kuhn, Xiankun Zeng, Kathleen Kuehl, Kayla Coffin, Jun Liu, Hong Oh, Woong Seog, Byung-Sub Choi, Mariano Sanchez-Lockhart, Gustavo Palacios, Seong Jeong. A Model for the Production of Regulatory Grade Viral Hemorrhagic Fever Exposure Stocks: From Field Surveillance to Advanced Characterization of SFTSV. Viruses. 2020; 12 (9):958.

Chicago/Turabian Style

Unai Perez-Sautu; Se Gu; Katie Caviness; Dong Song; Yu-Jin Kim; Nicholas Paola; Daesang Lee; Terry Klein; Joseph Chitty; Elyse Nagle; Heung-Chul Kim; Sung-Tae Chong; Brett Beitzel; Daniel Reyes; Courtney Finch; Russ Byrum; Kurt Cooper; Janie Liang; Jens Kuhn; Xiankun Zeng; Kathleen Kuehl; Kayla Coffin; Jun Liu; Hong Oh; Woong Seog; Byung-Sub Choi; Mariano Sanchez-Lockhart; Gustavo Palacios; Seong Jeong. 2020. "A Model for the Production of Regulatory Grade Viral Hemorrhagic Fever Exposure Stocks: From Field Surveillance to Advanced Characterization of SFTSV." Viruses 12, no. 9: 958.

Research article
Published: 22 June 2020 in PLOS Neglected Tropical Diseases
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Mosquito-borne and sexual transmission of Zika virus (ZIKV), a TORCH pathogen, recently initiated a series of large epidemics throughout the Tropics. Animal models are necessary to determine transmission risk and study pathogenesis, as well screen antivirals and vaccine candidates. In this study, we modeled mosquito and sexual transmission of ZIKV in the African green monkey (AGM). Following subcutaneous, intravaginal or intrarectal inoculation of AGMs with ZIKV, we determined the transmission potential and infection dynamics of the virus. AGMs inoculated by all three transmission routes exhibited viremia and viral shedding followed by strong virus neutralizing antibody responses, in the absence of clinical illness. All four of the subcutaneously inoculated AGMs became infected (mean peak viremia: 2.9 log10 PFU/mL, mean duration: 4.3 days) and vRNA was detected in their oral swabs, with infectious virus being detected in a subset of these specimens. Although all four of the intravaginally inoculated AGMs developed virus neutralizing antibody responses, only three had detectable viremia (mean peak viremia: 4.0 log10 PFU/mL, mean duration: 3.0 days). These three AGMs also had vRNA and infectious virus detected in both oral and vaginal swabs. Two of the four intrarectally inoculated AGMs became infected (mean peak viremia: 3.8 log10 PFU/mL, mean duration: 3.5 days). vRNA was detected in oral swabs collected from both of these infected AGMs, and infectious virus was detected in an oral swab from one of these AGMs. Notably, vRNA and infectious virus were detected in vaginal swabs collected from the infected female AGM (peak viral load: 7.5 log10 copies/mL, peak titer: 3.8 log10 PFU/mL, range of detection: 5–21 days post infection). Abnormal clinical chemistry and hematology results were detected and acute lymphadenopathy was observed in some AGMs. Infection dynamics in all three AGM ZIKV models are similar to those reported in the majority of human ZIKV infections. Our results indicate that the AGM can be used as a surrogate to model mosquito or sexual ZIKV transmission and infection. Furthermore, our results suggest that AGMs are likely involved in the enzootic maintenance and amplification cycle of ZIKV. Zika virus (ZIKV) is primarily maintained in an enzootic cycle involving nonhuman primates and mosquitoes, with epizootics and epidemics occurring when the virus is introduced into naïve populations of nonhuman primates or humans, respectively. While, the primary transmission mechanism of the virus is by the bite on an infected mosquito, ZIKV can also be sexually transmitted. In an effort to develop novel animal models to study ZIKV disease, and to better understand the role of nonhuman primates as amplification and maintenance hosts of ZIKV in nature, we modeled mosquito-borne and sexual transmission of ZIKV in the enzootic host, the African green monkey (AGM). Infection dynamics and neutralizing antibody responses in all three AGM ZIKV models (subcutaneous, intravaginal and intrarectal) in the absence of clinical illness–recapitulated reported generalized human disease course. Furthermore, we detected prolonged shedding with high viral loads and infectious virus in the vaginal swabs collected from an infected female AGM inoculated intrarectally. Notably, these results support limited human clinical evidence that ZIKV transmission can occur during female-to-male vaginal sexual acts, and furthermore indicate the existence of ZIKV super-spreaders. Finally, our results indicate sexual transmission of ZIKV could occur among infected nonhuman primates (e.g. Chlorocebus spp.) in Africa and may serve as a secondary transmission and maintenance mechanism in the absence of mosquito-to-nonhuman primate transmission.

ACS Style

Andrew D. Haddow; Unai Perez-Sautu; Michael R. Wiley; Lynn J. Miller; Adrienne E. Kimmel; Lucia M. Principe; Suzanne E. Wollen-Roberts; Joshua D. Shamblin; Stephanie M. Valdez; Lisa Cazares; William D. Pratt; Franco D. Rossi; Luis Lugo-Roman; Sina Bavari; Gustavo Palacios; Aysegul Nalca; Farooq Nasar; M. Louise M. Pitt. Modeling mosquito-borne and sexual transmission of Zika virus in an enzootic host, the African green monkey. PLOS Neglected Tropical Diseases 2020, 14, e0008107 .

AMA Style

Andrew D. Haddow, Unai Perez-Sautu, Michael R. Wiley, Lynn J. Miller, Adrienne E. Kimmel, Lucia M. Principe, Suzanne E. Wollen-Roberts, Joshua D. Shamblin, Stephanie M. Valdez, Lisa Cazares, William D. Pratt, Franco D. Rossi, Luis Lugo-Roman, Sina Bavari, Gustavo Palacios, Aysegul Nalca, Farooq Nasar, M. Louise M. Pitt. Modeling mosquito-borne and sexual transmission of Zika virus in an enzootic host, the African green monkey. PLOS Neglected Tropical Diseases. 2020; 14 (6):e0008107.

Chicago/Turabian Style

Andrew D. Haddow; Unai Perez-Sautu; Michael R. Wiley; Lynn J. Miller; Adrienne E. Kimmel; Lucia M. Principe; Suzanne E. Wollen-Roberts; Joshua D. Shamblin; Stephanie M. Valdez; Lisa Cazares; William D. Pratt; Franco D. Rossi; Luis Lugo-Roman; Sina Bavari; Gustavo Palacios; Aysegul Nalca; Farooq Nasar; M. Louise M. Pitt. 2020. "Modeling mosquito-borne and sexual transmission of Zika virus in an enzootic host, the African green monkey." PLOS Neglected Tropical Diseases 14, no. 6: e0008107.

Journal article
Published: 01 April 2020 in Emerging Infectious Diseases
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Andes virus is unique among hantaviruses because it can be transmitted from person to person. This mechanism was previously supported by epidemiologic data and genetic evidence based only on partial sequences. We used full-length virus sequencing to confirm person-to-person transmission of this virus in a cluster of 3 cases in Argentina in 2014.

ACS Style

Daniel O. Alonso; Unai Pérez-Sautu; Carla M. Bellomo; Karla Prieto; Ayelén Iglesias; Rocío Coelho; Natalia Periolo; Isabel Domenech; Gabriel Talmon; Romina Hansen; Gustavo Palacios; Valeria P. Martinez. Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014. Emerging Infectious Diseases 2020, 26, 756 -759.

AMA Style

Daniel O. Alonso, Unai Pérez-Sautu, Carla M. Bellomo, Karla Prieto, Ayelén Iglesias, Rocío Coelho, Natalia Periolo, Isabel Domenech, Gabriel Talmon, Romina Hansen, Gustavo Palacios, Valeria P. Martinez. Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014. Emerging Infectious Diseases. 2020; 26 (4):756-759.

Chicago/Turabian Style

Daniel O. Alonso; Unai Pérez-Sautu; Carla M. Bellomo; Karla Prieto; Ayelén Iglesias; Rocío Coelho; Natalia Periolo; Isabel Domenech; Gabriel Talmon; Romina Hansen; Gustavo Palacios; Valeria P. Martinez. 2020. "Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014." Emerging Infectious Diseases 26, no. 4: 756-759.

Articles
Published: 01 January 2019 in Emerging Microbes & Infections
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Despite the advanced PCR-based assays available, a fraction of the pediatric respiratory infections remain unexplained every epidemic season, and there is a perception that novel viruses might be present in these specimens. We systematically collected samples from a prospective cohort of pediatric patients with respiratory infections, that returned negative results by validated molecular RT–PCR assays, and studied them with a target-independent, high-throughput sequencing-based approach. We also included a matched cohort of children with no symptoms of respiratory infection, as a contrast study population. More than fifty percent of the specimens from the group of patients with unexplained respiratory infections were resolved. However, the higher rate of detection was not due to the presence of novel viruses, but to the identification of well-known viral respiratory pathogens. Our results show that already known viral pathogens are responsible for the majority of cases that remain unexplained after the epidemic season. High-throughput sequencing approaches that use pathogen-specific probes are easier to standardize because they ensure reproducible library enrichment and sequencing. In consequence, these techniques might be desirable from a regulatory standpoint for diagnostic laboratories seeking to benefit from the many advantages of these sequencing technologies.

ACS Style

Unai Pérez-Sautu; Michael Wiley; María Iglesias-Caballero; Francisco Pozo; Karla Prieto; Joseph Alex Chitty; María Luz García-García; Cristina Calvo; Inmaculada Casas; Gustavo Palacios. Target-independent high-throughput sequencing methods provide evidence that already known human viral pathogens play a main role in respiratory infections with unexplained etiology. Emerging Microbes & Infections 2019, 8, 1054 -1065.

AMA Style

Unai Pérez-Sautu, Michael Wiley, María Iglesias-Caballero, Francisco Pozo, Karla Prieto, Joseph Alex Chitty, María Luz García-García, Cristina Calvo, Inmaculada Casas, Gustavo Palacios. Target-independent high-throughput sequencing methods provide evidence that already known human viral pathogens play a main role in respiratory infections with unexplained etiology. Emerging Microbes & Infections. 2019; 8 (1):1054-1065.

Chicago/Turabian Style

Unai Pérez-Sautu; Michael Wiley; María Iglesias-Caballero; Francisco Pozo; Karla Prieto; Joseph Alex Chitty; María Luz García-García; Cristina Calvo; Inmaculada Casas; Gustavo Palacios. 2019. "Target-independent high-throughput sequencing methods provide evidence that already known human viral pathogens play a main role in respiratory infections with unexplained etiology." Emerging Microbes & Infections 8, no. 1: 1054-1065.

Journal article
Published: 23 March 2018 in Journal of Infectious Diseases
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The use of ribavirin to treat Crimean-Congo hemorrhagic fever virus (CCHFV) infection has been controversial, based on uncertainties about its antiviral efficacy in clinical case studies. We studied the effect of ribavirin treatment on viral populations in a recent case by deep-sequencing analysis of plasma samples obtained from a CCHFV-infected patient before, during, and after a 5-day regimen of ribavirin treatment. The CCHFV load dropped during ribavirin treatment, and subclonal diversity (transitions) and indels increased in viral genomes during treatment. Although the results are based on a single case, these data demonstrate the mutagenic effect of ribavirin on CCHFV in vivo.

ACS Style

Nicole Espy; Unai Pérez-Sautu; Eva Ramírez De Arellano; Ana Negredo; Michael R Wiley; Sina Bavari; Marta Díaz Menendez; María Paz Sánchez-Seco; Gustavo Palacios. Ribavirin Had Demonstrable Effects on the Crimean-Congo Hemorrhagic Fever Virus (CCHFV) Population and Load in a Patient With CCHF Infection. Journal of Infectious Diseases 2018, 217, 1952 -1956.

AMA Style

Nicole Espy, Unai Pérez-Sautu, Eva Ramírez De Arellano, Ana Negredo, Michael R Wiley, Sina Bavari, Marta Díaz Menendez, María Paz Sánchez-Seco, Gustavo Palacios. Ribavirin Had Demonstrable Effects on the Crimean-Congo Hemorrhagic Fever Virus (CCHFV) Population and Load in a Patient With CCHF Infection. Journal of Infectious Diseases. 2018; 217 (12):1952-1956.

Chicago/Turabian Style

Nicole Espy; Unai Pérez-Sautu; Eva Ramírez De Arellano; Ana Negredo; Michael R Wiley; Sina Bavari; Marta Díaz Menendez; María Paz Sánchez-Seco; Gustavo Palacios. 2018. "Ribavirin Had Demonstrable Effects on the Crimean-Congo Hemorrhagic Fever Virus (CCHFV) Population and Load in a Patient With CCHF Infection." Journal of Infectious Diseases 217, no. 12: 1952-1956.

Journal article
Published: 01 August 2017 in Emerging Infectious Diseases
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Unprotected sexual intercourse between persons residing in or traveling from regions with Zika virus transmission is a risk factor for infection. To model risk for infection after sexual intercourse, we inoculated rhesus and cynomolgus macaques with Zika virus by intravaginal or intrarectal routes. In macaques inoculated intravaginally, we detected viremia and virus RNA in 50% of macaques, followed by seroconversion. In macaques inoculated intrarectally, we detected viremia, virus RNA, or both, in 100% of both species, followed by seroconversion. The magnitude and duration of infectious virus in the blood of macaques suggest humans infected with Zika virus through sexual transmission will likely generate viremias sufficient to infect competent mosquito vectors. Our results indicate that transmission of Zika virus by sexual intercourse might serve as a virus maintenance mechanism in the absence of mosquito-to-human transmission and could increase the probability of establishment and spread of Zika virus in regions where this virus is not present.

ACS Style

Andrew Haddow; Aysegul Nalca; Franco D. Rossi; Lynn J. Miller; Michael Wiley; Unai Perez-Sautu; Samuel C. Washington; Sarah Norris; Suzanne Wollen-Roberts; Joshua D. Shamblin; Adrienne Kimmel; Holly A. Bloomfield; Stephanie M. Valdez; Thomas R. Sprague; Lucia M. Principe; Stephanie A. Bellanca; Stephanie S. Cinkovich; Luis Lugo-Roman; Lisa Cazares; William D. Pratt; Gustavo Palacios; Sina Bavari; Margaret Louise Pitt; Farooq Nasar. High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus. Emerging Infectious Diseases 2017, 23, 1274 -1281.

AMA Style

Andrew Haddow, Aysegul Nalca, Franco D. Rossi, Lynn J. Miller, Michael Wiley, Unai Perez-Sautu, Samuel C. Washington, Sarah Norris, Suzanne Wollen-Roberts, Joshua D. Shamblin, Adrienne Kimmel, Holly A. Bloomfield, Stephanie M. Valdez, Thomas R. Sprague, Lucia M. Principe, Stephanie A. Bellanca, Stephanie S. Cinkovich, Luis Lugo-Roman, Lisa Cazares, William D. Pratt, Gustavo Palacios, Sina Bavari, Margaret Louise Pitt, Farooq Nasar. High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus. Emerging Infectious Diseases. 2017; 23 (8):1274-1281.

Chicago/Turabian Style

Andrew Haddow; Aysegul Nalca; Franco D. Rossi; Lynn J. Miller; Michael Wiley; Unai Perez-Sautu; Samuel C. Washington; Sarah Norris; Suzanne Wollen-Roberts; Joshua D. Shamblin; Adrienne Kimmel; Holly A. Bloomfield; Stephanie M. Valdez; Thomas R. Sprague; Lucia M. Principe; Stephanie A. Bellanca; Stephanie S. Cinkovich; Luis Lugo-Roman; Lisa Cazares; William D. Pratt; Gustavo Palacios; Sina Bavari; Margaret Louise Pitt; Farooq Nasar. 2017. "High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus." Emerging Infectious Diseases 23, no. 8: 1274-1281.

Journal article
Published: 01 January 2016 in Pediatric Infectious Disease Journal
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The incidence of enterovirus D68 (EV-D68) and the spectrum of clinical disease in children are not well known in European countries. We have designed a study with the objective of describing the clinical impact of EV-D68 detected in children with respiratory tract infections.As a part of a prospective study to identify the etiology and clinical characteristics of viral respiratory infections in children in Spain, we performed the analysis of the cases of EV infections in all children hospitalized in a secondary hospital in Madrid, during the epidemic respiratory season 2012-2013. A second group of samples was corresponded to infants of the same area, with ambulatory respiratory infection or asymptomatic. Phylogenetic EV-D68 analysis was made using the viral protein 1 gene (VP1). Clinical data of EV-D68 patients were compared with those infected by rhinovirus in the same period and population.The study population consisted of 720 patients corresponding to 399 episodes of hospitalization for respiratory causes, 44 episodes of ambulatory respiratory infections and 277 children determined as a healthy control group. A total of 22 patients were positive for EVs (3.05%), and 12 of them were specifically typed as EV-D68 (11/443 respiratory infections, 2.5%). The most frequent diagnosis in the 10 hospitalized children with EV-D68 detection was recurrent wheezing. Hypoxia was present in 70% of cases, but admission in the intensive care unit was not required. No neurological signs or symptoms were observed. One patient had an ambulatory mild bronchiolitis and another was asymptomatic. No differences were found with rhinovirus infections except less duration of hypoxia and fever in EV-D68 group.EV-D68 infections were detected in 3.05% of respiratory studied samples (2.5% of admissions). The infection was associated with wheezing episodes with hypoxia. No admissions to intensive care unit or neurological symptoms were found.

ACS Style

Cristina Calvo; María Teresa Cuevas; Francisco Pozo; María Luz García-García; Mar Molinero; Ana Calderón; Mónica Gonzalez-Esguevillas; Unai Pérez-Sautu; Inmaculada Casas. Respiratory Infections by Enterovirus D68 in Outpatients and Inpatients Spanish Children. Pediatric Infectious Disease Journal 2016, 35, 45 -49.

AMA Style

Cristina Calvo, María Teresa Cuevas, Francisco Pozo, María Luz García-García, Mar Molinero, Ana Calderón, Mónica Gonzalez-Esguevillas, Unai Pérez-Sautu, Inmaculada Casas. Respiratory Infections by Enterovirus D68 in Outpatients and Inpatients Spanish Children. Pediatric Infectious Disease Journal. 2016; 35 (1):45-49.

Chicago/Turabian Style

Cristina Calvo; María Teresa Cuevas; Francisco Pozo; María Luz García-García; Mar Molinero; Ana Calderón; Mónica Gonzalez-Esguevillas; Unai Pérez-Sautu; Inmaculada Casas. 2016. "Respiratory Infections by Enterovirus D68 in Outpatients and Inpatients Spanish Children." Pediatric Infectious Disease Journal 35, no. 1: 45-49.

Journal article
Published: 10 July 2014 in Eurosurveillance
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The Y155H amino acid substitution in the neuraminidase gene (NA) has previously been associated with highly reduced inhibition by neuraminidase inhibitors in the seasonal H1N1 influenza A virus which circulated in humans before the 2009 pandemic. During the 2012/13 epidemic season in Spain, two A(H1N1)pdm09 viruses bearing the specific Y155H substitution in the NA were detected and isolated from two patients diagnosed with severe respiratory syndrome and pneumonia requiring admission to the intensive care unit. Contrary to what was observed in the seasonal A(H1N1) viruses, neither of the Y155H A(H1N1)pdm09 viruses described here showed a phenotype of reduced inhibition by NAIs as determined by the neuraminidase enzyme inhibition assay (MUNANA). High-throughput sequencing of the NA of both Y155H viruses showed that they were composed to >99% of H155 variants. We believe that this report can contribute to a better understanding of the biological significance of amino acid substitutions in the neuraminidase protein with regard to susceptibility of influenza viruses to neuraminidase inhibitors. This is of critical importance for optimal management of influenza disease patients.

ACS Style

U Perez-Sautu; Francisco Pozo; Isabel Cuesta; Sara Monzón; A Calderon; M Gonzalez; M Molinero; I Lopez-Miragaya; S Rey; A Cañizares; G Rodriguez; C Gonzalez-Velasco; A Lackenby; Inmaculada Casas. Y155H amino acid substitution in influenza A(H1N1)pdm09 viruses does not confer a phenotype of reduced susceptibility to neuraminidase inhibitors. Eurosurveillance 2014, 19, 20849 .

AMA Style

U Perez-Sautu, Francisco Pozo, Isabel Cuesta, Sara Monzón, A Calderon, M Gonzalez, M Molinero, I Lopez-Miragaya, S Rey, A Cañizares, G Rodriguez, C Gonzalez-Velasco, A Lackenby, Inmaculada Casas. Y155H amino acid substitution in influenza A(H1N1)pdm09 viruses does not confer a phenotype of reduced susceptibility to neuraminidase inhibitors. Eurosurveillance. 2014; 19 (27):20849.

Chicago/Turabian Style

U Perez-Sautu; Francisco Pozo; Isabel Cuesta; Sara Monzón; A Calderon; M Gonzalez; M Molinero; I Lopez-Miragaya; S Rey; A Cañizares; G Rodriguez; C Gonzalez-Velasco; A Lackenby; Inmaculada Casas. 2014. "Y155H amino acid substitution in influenza A(H1N1)pdm09 viruses does not confer a phenotype of reduced susceptibility to neuraminidase inhibitors." Eurosurveillance 19, no. 27: 20849.

Journal article
Published: 10 July 2014 in Eurosurveillance
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ACS Style

U Perez-Sautu; F Pozo; I Cuesta; S Monzon; A Calderon; M Gonzalez; M Molinero; I Lopez-Miragaya; S Rey; A Cañizares; G Rodriguez; C Gonzalez-Velasco; A Lackenby; I Casas. Y155H amino acid substitution in influenza A(H1N1)pdm09 viruses does not confer a phenotype of reduced susceptibility to neuraminidase inhibitors. Eurosurveillance 2014, 19, 1 .

AMA Style

U Perez-Sautu, F Pozo, I Cuesta, S Monzon, A Calderon, M Gonzalez, M Molinero, I Lopez-Miragaya, S Rey, A Cañizares, G Rodriguez, C Gonzalez-Velasco, A Lackenby, I Casas. Y155H amino acid substitution in influenza A(H1N1)pdm09 viruses does not confer a phenotype of reduced susceptibility to neuraminidase inhibitors. Eurosurveillance. 2014; 19 (27):1.

Chicago/Turabian Style

U Perez-Sautu; F Pozo; I Cuesta; S Monzon; A Calderon; M Gonzalez; M Molinero; I Lopez-Miragaya; S Rey; A Cañizares; G Rodriguez; C Gonzalez-Velasco; A Lackenby; I Casas. 2014. "Y155H amino acid substitution in influenza A(H1N1)pdm09 viruses does not confer a phenotype of reduced susceptibility to neuraminidase inhibitors." Eurosurveillance 19, no. 27: 1.

Journal article
Published: 20 January 2012 in BMC Infectious Diseases
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Men who have sex with men (MSM) are a known group at risk for hepatitis A and outbreaks among this group are frequent. In Barcelona, vaccination for MSM has been recommended since 1994. In 1998 a vaccination campaign among preadolescents was implemented and an immunization program in gay bathhouses began in 2004. Objective: to asses the incidence of hepatitis A in adults in Barcelona from 1989 to 2010 and to evaluate the outbreaks among MSM including all genotypes involved.

ACS Style

Cecilia Tortajada; Saunas Working Group; Patricia G De Olalla; Elia Diez; Rosa M Pinto; Albert Bosch; Unai Perez; Milagros Sanz; Joan A Caylà. Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches. BMC Infectious Diseases 2012, 12, 11 -11.

AMA Style

Cecilia Tortajada, Saunas Working Group, Patricia G De Olalla, Elia Diez, Rosa M Pinto, Albert Bosch, Unai Perez, Milagros Sanz, Joan A Caylà. Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches. BMC Infectious Diseases. 2012; 12 (1):11-11.

Chicago/Turabian Style

Cecilia Tortajada; Saunas Working Group; Patricia G De Olalla; Elia Diez; Rosa M Pinto; Albert Bosch; Unai Perez; Milagros Sanz; Joan A Caylà. 2012. "Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches." BMC Infectious Diseases 12, no. 1: 11-11.

Journal article
Published: 28 November 2011 in Environmental Microbiology
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Human noroviruses (NoV) were quantified and characterized in an 18 month survey conducted along the Llobregat river catchment in Spain. Sample types included freshwater, untreated and treated wastewater and drinking water. High NoV genome copy numbers were reported, reaching up to 106 l−1 and 109 l−1 in freshwater and raw sewage respectively. In both types of samples, GII NoV genome copies outnumbered those of GI, although without significance. All samples of semi‐treated and treated drinking water were negative for NoV. A clear seasonality of NoV occurrence was observed both in river water and sewage samples, with significantly higher genome copy numbers in the cold than in the warm months period. Mean NoV log reduction rates after biological treatment of sewage were 2.2 and 3.1 for GI and GII respectively. A total of 77 NoV strains isolated in the Llobregat river catchment could be phylogenetically characterized, 44 belonging to GI and 33 to GII. The most prevalent genotype was GI.4, followed by GII.4 and GII.21. Several variants of the pandemic GII.4 strain were detected in the environment, corroborating their circulation among the population.

ACS Style

Unai Pérez-Sautu; Daisuke Sano; Susana Guix; Georg Kasimir; Rosa M. Pintó; Albert Bosch. Human norovirus occurrence and diversity in the Llobregat river catchment, Spain. Environmental Microbiology 2011, 14, 494 -502.

AMA Style

Unai Pérez-Sautu, Daisuke Sano, Susana Guix, Georg Kasimir, Rosa M. Pintó, Albert Bosch. Human norovirus occurrence and diversity in the Llobregat river catchment, Spain. Environmental Microbiology. 2011; 14 (2):494-502.

Chicago/Turabian Style

Unai Pérez-Sautu; Daisuke Sano; Susana Guix; Georg Kasimir; Rosa M. Pintó; Albert Bosch. 2011. "Human norovirus occurrence and diversity in the Llobregat river catchment, Spain." Environmental Microbiology 14, no. 2: 494-502.

Journal article
Published: 31 October 2011 in Journal of Clinical Virology
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In spite of annual vaccination campaigns, hepatitis A cases increased in Catalonia (North-East Spain) in the period 2002-2005 calling for the elucidation of the underlying mechanisms associated to the epidemiological shifts.The molecular characterization of the circulating strains to trace their origin and the study of the effects of vaccination on the incidence of sporadic and outbreak-associated cases.Forty-eight different hepatitis A virus (HAV) strains isolated from sporadic and outbreaks cases during 2005-2009 in Catalonia were molecularly characterized.Seventeen out of 48 strains were imported from endemic areas through traveling, immigration and food trade, 12 were endemic strains circulating in the men having sex with men (MSM) group and 1 was from a Roman child. The remaining 18 could not be associated to any specific origin and thus were considered autochthonous. Forty-eight percent of the strains belonged to subgenotype IA, 40% to subgenotype IB and 2% to subgenotype IIIA. The remaining 10% belonged to an undetermined subgenotype equidistant from IA and IB.During the period 2005-2009, the annual attack rates remained around 3.5 and even increased up to 6.5 in the first half of 2009. This increase with respect to the period 1999-2001, in which vaccination campaigns started to be implemented, is explained by an increase in the number of outbreaks. The predominant subgenotypes were IA and IB. However a considerable amount of strains imported from Peru through consumption of contaminated shellfish belonged to an undeterminded subgenotype that may constitute a new candidate subgenotype IC.

ACS Style

Unai Pérez-Sautu; M. Isabel Costafreda; Josep Lite; Rosa Sala; Irene Barrabeig; Albert Bosch; Rosa M. Pintó. Molecular epidemiology of hepatitis A virus infections in Catalonia, Spain, 2005–2009: Circulation of newly emerging strains. Journal of Clinical Virology 2011, 52, 98 -102.

AMA Style

Unai Pérez-Sautu, M. Isabel Costafreda, Josep Lite, Rosa Sala, Irene Barrabeig, Albert Bosch, Rosa M. Pintó. Molecular epidemiology of hepatitis A virus infections in Catalonia, Spain, 2005–2009: Circulation of newly emerging strains. Journal of Clinical Virology. 2011; 52 (2):98-102.

Chicago/Turabian Style

Unai Pérez-Sautu; M. Isabel Costafreda; Josep Lite; Rosa Sala; Irene Barrabeig; Albert Bosch; Rosa M. Pintó. 2011. "Molecular epidemiology of hepatitis A virus infections in Catalonia, Spain, 2005–2009: Circulation of newly emerging strains." Journal of Clinical Virology 52, no. 2: 98-102.

Journal article
Published: 01 April 2011 in Emerging Infectious Diseases
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Six hepatitis A virus antigenic variants that likely escaped the protective effect of available vaccines were isolated, mostly from men who have sex with men. The need to complete the proper vaccination schedules is critical, particularly in the immunocompromised population, to prevent the emergence of vaccine-escaping variants.

ACS Style

Unai Pérez-Sautu; M. Isabel Costafreda; Joan A. Caylà; Cecilia Tortajada; Josep Lite; Albert Bosch; Rosa M. Pintó. Hepatitis A Virus Vaccine Escape Variants and Potential New Serotype Emergence. Emerging Infectious Diseases 2011, 17, 734 -737.

AMA Style

Unai Pérez-Sautu, M. Isabel Costafreda, Joan A. Caylà, Cecilia Tortajada, Josep Lite, Albert Bosch, Rosa M. Pintó. Hepatitis A Virus Vaccine Escape Variants and Potential New Serotype Emergence. Emerging Infectious Diseases. 2011; 17 (4):734-737.

Chicago/Turabian Style

Unai Pérez-Sautu; M. Isabel Costafreda; Joan A. Caylà; Cecilia Tortajada; Josep Lite; Albert Bosch; Rosa M. Pintó. 2011. "Hepatitis A Virus Vaccine Escape Variants and Potential New Serotype Emergence." Emerging Infectious Diseases 17, no. 4: 734-737.

Journal article
Published: 01 February 2011 in Applied and Environmental Microbiology
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Human sapoviruses (SaVs) were quantified and characterized in an 18-month survey conducted along the Llobregat river catchment area in Spain. Sample types included freshwater, untreated and treated wastewater, and drinking water. All genogroups were recovered, and a seasonal distribution was observed. This is the first report of SaV quantification and genotyping in the environment outside Japan.

ACS Style

Daisuke Sano; Unai Pérez-Sautu; Susana Guix; Rosa Maria Pintó; Takayuki Miura; Satoshi Okabe; Albert Bosch. Quantification and Genotyping of Human Sapoviruses in the Llobregat River Catchment, Spain. Applied and Environmental Microbiology 2011, 77, 1111 -1114.

AMA Style

Daisuke Sano, Unai Pérez-Sautu, Susana Guix, Rosa Maria Pintó, Takayuki Miura, Satoshi Okabe, Albert Bosch. Quantification and Genotyping of Human Sapoviruses in the Llobregat River Catchment, Spain. Applied and Environmental Microbiology. 2011; 77 (3):1111-1114.

Chicago/Turabian Style

Daisuke Sano; Unai Pérez-Sautu; Susana Guix; Rosa Maria Pintó; Takayuki Miura; Satoshi Okabe; Albert Bosch. 2011. "Quantification and Genotyping of Human Sapoviruses in the Llobregat River Catchment, Spain." Applied and Environmental Microbiology 77, no. 3: 1111-1114.

Journal article
Published: 30 June 2010 in Water Research
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The presence of Arcobacter species in faecally contaminated environmental waters has previously been studied. However, the ability to eliminate Arcobacter during the water treatment processes that produce drinking water has been little studied. We have investigated the prevalence and diversity of Arcobacter spp. throughout the year at 12 sampling points in the Llobregat River catchment (Catalonia, Spain) including 3 sites at a drinking water treatment plant. Positive samples for Arcobacter spp., came predominantly from the most faecally polluted sites. Recovery rates from all sites were greater in the spring (91.7%) and summer (83.3%) than in autumn and winter (75.0% in both cases), but this trend was not statistically evaluated due to the limited number of samples. Among the 339 colonies analyzed, the most prevalent species by multiplex PCR and 16S rDNA restriction fragment length polymorphism were Arcobacter butzleri (80.2%), followed by Arcobacter cryaerophilus (19.4%) and Arcobacter skirrowii (0.3%). Isolates showed a high genotype diversity as determined by the enterobacterial repetitive intergenic consensus PCR. In fact, 91.2% (309/339) of the colonies had different genotypes, i.e. 248 of them among the 275 isolates of A. butzleri and 60 among the 63 isolates of A. cryaerophilus and 1 genotype of A. skirrowii. Arcobacter was never detected or isolated from finished drinking water, demonstrating that water treatment is effective in removing Arcobacter species.

ACS Style

Luis Collado; Georg Kasimir; Unai Perez; Albert Bosch; Rosa Pinto; Gemma Saucedo; Josep M. Huguet; Maria Jose Figueras. Occurrence and diversity of Arcobacter spp. along the Llobregat River catchment, at sewage effluents and in a drinking water treatment plant. Water Research 2010, 44, 3696 -3702.

AMA Style

Luis Collado, Georg Kasimir, Unai Perez, Albert Bosch, Rosa Pinto, Gemma Saucedo, Josep M. Huguet, Maria Jose Figueras. Occurrence and diversity of Arcobacter spp. along the Llobregat River catchment, at sewage effluents and in a drinking water treatment plant. Water Research. 2010; 44 (12):3696-3702.

Chicago/Turabian Style

Luis Collado; Georg Kasimir; Unai Perez; Albert Bosch; Rosa Pinto; Gemma Saucedo; Josep M. Huguet; Maria Jose Figueras. 2010. "Occurrence and diversity of Arcobacter spp. along the Llobregat River catchment, at sewage effluents and in a drinking water treatment plant." Water Research 44, no. 12: 3696-3702.

Short communication
Published: 30 September 2008 in Journal of Clinical Virology
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Acute infectious gastroenteritis causes substantial morbidity and economic loss. The aetiology, epidemiology, and clinical features of acute viral gastroenteritis outbreaks reported during 1 year in Catalonia were investigated. This was a population-based study in which enzyme immunoassay and reverse transcriptase-polymerase chain reaction (RT-PCR) techniques were used to determine the presence of virus in stool specimens from outbreaks clinically and epidemiologically compatible with a viral aetiology and negative for bacteria, parasites and toxins. Sixty outbreaks affecting 1791 people were evaluated. Fifty-five outbreaks were positive for norovirus, four were positive for norovirus and other microorganisms (adenovirus, astrovirus, S. Typhimurium and V. parahaemolyticus in one each). Thirty-seven percentage of the outbreaks occurred in collective catering; 18.3% in nursing homes; 10% in hospitals and long-term-care facilities. Foodborne transmission accounted for 50% of outbreaks. Norovirus genotype GGII.4 accounted for 42% of all the outbreaks, being more prevalent in nursing homes, hospital and long-term-care facilities. The large number of norovirus outbreaks and resulting health service demand and absenteeism indicate that acute gastroenteritis caused by norovirus is an important health problem in Catalonia. Preventive measures should target education and control of food handlers, and immediate specific control measures should be adopted in institutions.

ACS Style

Angela Domínguez; Nuria Torner; Laura Ruíz; Ana Martínez; Irene Barrabeig; Neus Camps; Pere Godoy; Sofia Minguell; Ignasi Parrón; Analía Pumarés; Maria Rosa Sala; Rosa Bartolomé; Unai Pérez; Mercedes De Simón; Rebeca Montava; Javier Buesa. Aetiology and epidemiology of viral gastroenteritis outbreaks in Catalonia (Spain) in 2004–2005. Journal of Clinical Virology 2008, 43, 126 -131.

AMA Style

Angela Domínguez, Nuria Torner, Laura Ruíz, Ana Martínez, Irene Barrabeig, Neus Camps, Pere Godoy, Sofia Minguell, Ignasi Parrón, Analía Pumarés, Maria Rosa Sala, Rosa Bartolomé, Unai Pérez, Mercedes De Simón, Rebeca Montava, Javier Buesa. Aetiology and epidemiology of viral gastroenteritis outbreaks in Catalonia (Spain) in 2004–2005. Journal of Clinical Virology. 2008; 43 (1):126-131.

Chicago/Turabian Style

Angela Domínguez; Nuria Torner; Laura Ruíz; Ana Martínez; Irene Barrabeig; Neus Camps; Pere Godoy; Sofia Minguell; Ignasi Parrón; Analía Pumarés; Maria Rosa Sala; Rosa Bartolomé; Unai Pérez; Mercedes De Simón; Rebeca Montava; Javier Buesa. 2008. "Aetiology and epidemiology of viral gastroenteritis outbreaks in Catalonia (Spain) in 2004–2005." Journal of Clinical Virology 43, no. 1: 126-131.

Comparative study
Published: 14 April 2008 in BMC Infectious Diseases
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Noroviruses are one of the principal biological agents associated with the consumption of contaminated food. The objective of this study was to analyse the size and epidemiological characteristics of foodborne outbreaks of gastroenteritis in Catalonia, a region in the northeast of Spain.

ACS Style

Ana Martinez; The Catalan Viral Gastroenteritis Study Group; Angela Dominguez; Nuria Torner; Laura Ruiz; Neus Camps; Irene Barrabeig; Cesar Arias; Josep Alvarez; Pere Godoy; Pilar Jorgina Balaña; Analia Pumares; Rosa Bartolome; Dolors Ferrer; Unai Perez; Rosa Pinto; Javier Buesa. Epidemiology of foodborne Norovirus outbreaks in Catalonia, Spain. BMC Infectious Diseases 2008, 8, 47 -47.

AMA Style

Ana Martinez, The Catalan Viral Gastroenteritis Study Group, Angela Dominguez, Nuria Torner, Laura Ruiz, Neus Camps, Irene Barrabeig, Cesar Arias, Josep Alvarez, Pere Godoy, Pilar Jorgina Balaña, Analia Pumares, Rosa Bartolome, Dolors Ferrer, Unai Perez, Rosa Pinto, Javier Buesa. Epidemiology of foodborne Norovirus outbreaks in Catalonia, Spain. BMC Infectious Diseases. 2008; 8 (1):47-47.

Chicago/Turabian Style

Ana Martinez; The Catalan Viral Gastroenteritis Study Group; Angela Dominguez; Nuria Torner; Laura Ruiz; Neus Camps; Irene Barrabeig; Cesar Arias; Josep Alvarez; Pere Godoy; Pilar Jorgina Balaña; Analia Pumares; Rosa Bartolome; Dolors Ferrer; Unai Perez; Rosa Pinto; Javier Buesa. 2008. "Epidemiology of foodborne Norovirus outbreaks in Catalonia, Spain." BMC Infectious Diseases 8, no. 1: 47-47.