Susanne Dudman

• Safety and effectiveness of a recombinant hepatitis E vaccine in women of childbearing age in rural Bangladesh: a phase 4, double-blind, cluster-randomised, controlled trial.

  Zaman K, Julin CH, Aziz AB, Stene-Johansen K, Yunus M, Qadri F, Gurley ES, Sandbu S, Øverbø J, Dembinski JL, Laake I, Bhuiyan TR, Rahman M, Haque W, Khanam M, Clemens JD, Dudman S.Lancet Glob Health. 2024 Aug;12(8):e1288-e1299. doi: 10.1016/S2214-109X(24)00192-X.

• Receipt of hepatitis E vaccine and fetal loss in rural Bangladesh: further analysis of a double-blind, cluster-randomised, controlled trial.

  Aziz AB, Dudman S, Julin CH, Ahmmed F, Stene-Johansen K, Sandbu S, Øverbø J, Dembinski JL, Wisløff T, Rana S, Basunia AH, Haque W, Qadri F, Zaman K, Clemens JD.Lancet Glob Health. 2024 Aug;12(8):e1300-e1311. doi: 10.1016/S2214-109X(24)00193-1.

• Tracing the adaptive evolution of SARS-CoV-2 during vaccine roll-out in Norway.

  Garcia I, Lee Y, Brynildsrud O, Eldholm V, Magnus P, Blomfeldt A, Leegaard TM, Müller F, Dudman S, Caugant DA.Virus Evol. 2023 Dec 20;10(1):vead081. doi: 10.1093/ve/vead081. eCollection 2024 Jan.

• Immunogenicity and safety of a two-dose regimen with hepatitis E virus vaccine in healthy adults in rural Bangladesh: A randomized, double-blind, controlled, phase 2/pilot trial.

  Øverbø J, Aziz A, Zaman K, Clemens J, Halle Julin C, Qadri F, Stene-Johansen K, Biswas R, Islam S, Rahman Bhuiyan T, Haque W, Sandbu S, Elahee ME, Ali M, Dembinski JL, Dudman S.Vaccine. 2023 Jan 27;41(5):1059-1066. doi: 10.1016/j.vaccine.2022.12.064. Epub 2023 Jan 2.

• Smura T, Blomqvist S, Kolehmainen P, Schuffenecker I, Lina B, Böttcher S, Diedrich S, Löve A, Brytting M, Hauzenberger E, Dudman S, Ivanova O, Lukasev A, Fischer TK, Midgley S, Susi P, Savolainen-Kopra C, Lappalainen M, Jääskeläinen AJ. Aseptic meningitis outbreak associated with echovirus 4 in Northern Europe in 2013-2014. J Clin Virol. 2020 Aug;129:104535. doi: 10.1016/j.jcv.2020.104535.Epub 2020 Jul 7. PMID: 32652478.

• Ueland T, Holter JC, Holten AR, Müller KE, Lind A, Bekken GK, Dudman S, Aukrust P, Dyrhol-Riise AM, Heggelund L. Distinct and early increase in circulating MMP-9 in COVID-19 patients with respiratory failure. J Infect. 2020 Sep;81(3):e41-e43. doi: 10.1016/j.jinf.2020.06.061. Epub 2020 Jun 27. PMID: 32603675; PMCID: PMC7320854.

• Gibory M, Dembinski JL, Flem E, Haltbakk I, Dudman SG. Effect of rotavirus vaccine implementation on the prevalence of coinfections with enteric viruses in Norway. J Med Virol. 2020 May 15. doi: 10.1002/jmv.26013. Epub ahead of print. PMID: 32410230.

• Zaman K, Dudman S, Stene-Johansen K, Qadri F, Yunus M, Sandbu S, Gurley ES, Overbo J, Julin CH, Dembinski JL, Nahar Q, Rahman A, Bhuiyan TR, Rahman M, Haque W, Khan J, Aziz A, Khanam M, Streatfield PK, Clemens JD. HEV study protocol : design of a cluster-randomised, blinded trial to assess the safety, immunogenicity and effectiveness of the hepatitis E vaccine HEV 239 (Hecolin) in women of childbearing age in rural Bangladesh. BMJ Open. 2020 Jan 19;10(1):e033702. doi: 10.1136/bmjopen-2019-033702. PMID: 31959609; PMCID: PMC7044974.

• Barlinn R, Trogstad L, Rollag H, Frøen F, Magnus P, Dudman SG. Parvovirus B19 DNAemia in pregnant women in relation to perinatal death: A nested case-control study within a large population-based pregnancy cohort. Acta Obstet Gynecol Scand. 2020 Jul;99(7):856-864. doi: 10.1111/aogs.13801. Epub 2020 Jan 28. PMID: 31925774.

• Hayes A, Nguyen D, Andersson M, Antón A, Bailly JL, Beard S, Benschop KSM, Berginc N, Blomqvist S, Cunningham E, Davis D, Dembinski JL, Diedrich S, Dudman SG, Dyrdak R, Eltringham GJA, Gonzales-Goggia S, Gunson R, Howson-Wells HC, Jääskeläinen AJ, López-Labrador FX, Maier M, Majumdar M, Midgley S, Mirand A, Morley U, Nordbø SA, Oikarinen S, Osman H, Papa A, Pellegrinelli L, Piralla A, Rabella N, Richter J, Smith M, Söderlund Strand A, Templeton K, Vipond B, Vuorinen T, Williams C, Wollants E, Zakikhany K, Fischer TK, Harvala H, Simmonds P. A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts. J Med Virol. 2020 Aug;92(8):1065-1074. doi: 10.1002/jmv.25659. Epub 2020 Jan 17. PMID: 31883139.

• Bubba L, Broberg EK, Jasir A, Simmonds P, Harvala H; Enterovirus study collaborators. Circulation of non-polio enteroviruses in 24 EU and EEA countries between 2015 and 2017: a retrospective surveillance study. Lancet Infect Dis. 2020 Mar;20(3):350-361. doi: 10.1016/S1473-3099(19)30566-3. Epub 2019 Dec 20. PMID: 31870905.

• Knoester M et al. Twenty-nine Cases of Enterovirus-D68-associated Acute Flaccid Myelitis in Europe 2016: A Case Series and Epidemiologic Overview.. The Pediatric Infectious Disease Journal. 38(1), s 16- 21. doi: 10.1097/INF.0000000000002188
• Mirinaviciute G, Barlinn R, Dudman S and Flem E. (2019). Immunity to varicella zoster virus among pregnant women in the Norwegian Mother and Child Cohort Study. PLOS ONE.  14(8) . doi: 10.1371/journal.pone.0221084
• Barlinn R, Dudman, S, Trogstad, L, Gibory M, Müller F, Magnus P and Rollag H. (2018). Maternal and congenital cytomegalovirus infections in a population-based pregnancy cohort study. Acta Pathologica, Microbiologica et Immunologica Scandinavica.  126(12), s 899- 906 . doi: 10.1111/apm.12899
• Harvela H et al. (2018). Recommendations for enterovirus diagnostics and characterisation within and beyond Europe. Journal of Clinical Virology. 101, s 11- 17 . doi: 10.1016/j.jcv.2018.01.008
• Milhano N, Borge KS, Bragstad K and Dudman S. (2018). Management strategies of enterovirus D68 outbreaks: current perspectives.. Virus Adaptation and Treatment (Virus adapt. treat.).  10, s 1- 7 . doi: 10.2147/VAAT.S140376
• Siira LL, Nokleby HM, Barlinn R, Riise OR, Aaberge IS and Dudman S (2018). Response to third rubella vaccine dose. Human Vaccines & Immunotherapeutics.  14(10), s 2472- 2477 . doi: 10.1080/21645515.2018.1475814
• Barlinn R, Rollag H, Trogstad L, Vainio K, Basset C, Magnus P and Dudman S. (2017). High incidence of maternal parvovirus B19 infection in a large unselected population-based pregnancy cohort in Norway. Journal of Clinical Virology. 94, s 57- 62 . doi:10.1016/j.jcv.2017.07.010
• Gibory M, Haltbakk I, Flem E, Vainio K, Valcarcel B, Størdal K, Nordbø, SA, Jakobsen K, Haarr, E and Dudman, S (2017). Rotavirus detection in bulk stool and rectal swab specimens in children with acute gastroenteritis in Norway. Journal of Clinical Virology. 97, s 50- 53 . doi: 10.1016/j.jcv.2017.10.017
• Lange, H, Øverbø, J, Borgen, K, Dudman, S, Hoddevik, G, Urdahl, AM, Vold, L and Sjurseth, S (2017). Hepatitis E in Norway: seroprevalence in humans and swine. Epidemiology and Infection. 145(1), s 181- 186 . doi: 10.1017/S0950268816002144
• Voltersvik P, Aqrawi LA, Dudman S, Hungnes, O, Bostad, L, Brokstad KA and Cox, RJ (2016). Pulmonary changes in Norwegian fatal cases of pandemic influenza H1N1 (2009) infection: a morphologic and molecular genetic study. Influenza and Other Respiratory Viruses.  10(6), s 525- 531. doi: 10.1111/irv.12410
• Poelman, R, Schuffenecker, I, Van Leer-Buter, C, Josset, L, Niesters, H, Lina, B, Kran, AMB, Bragstad, K, Dudman, S, Christensen, A et al (2015). European surveillance for enterovirus D68 during the emerging North-American outbreak in 2014. Journal of Clinical Virology. 71;1- 9 . doi: 10.1016/j.jcv.2015.07.296
• Barlinn, R, Vainio, K, Samdal, HH, Nordbø, SA, Nøkleby, H and Dudman, S. (2014). Susceptibility to cytomegalovirus, parvovirus B19 and age-dependent differences in levels of rubella antibodies among pregnant women. Journal of Medical Virology.  86(5), s 820- 826 . doi: 10.1002/jmv.23757

• Haque, Warda; Islam, Shaumik; Dudman, Susanne Gjeruldsen; Øverbø, Joakim; Dembinski, Jennifer Lynn & Stene-Johansen, Kathrine [Vis alle 17 forfattere av denne artikkelen] (2026). Long-term immunity and IgG subclass response following Hepatitis E vaccination: A longitudinal cohort study in Matlab, Bangladesh. International Journal of Infectious Diseases. ISSN 1201-9712. 166, s. 1–8. doi: 10.1016/j.ijid.2026.108505. Fulltekst i vitenarkiv
• Rivero-Juarez, Antonio; Velebit, Branko; Johne, Reimar; Abravanel, Florence; Reuter, Gabor & Dudman, Susanne [Vis alle 24 forfattere av denne artikkelen] (2026). ONWARD: A one health, pan-European multidisciplinary network advancing surveillance, research, clinical management and control of zoonotic hepeviruses. Journal of Clinical Virology. ISSN 1386-6532. 184. doi: 10.1016/j.jcv.2026.105944. Fulltekst i vitenarkiv
• Aziz, Asma Binte; Ahmmed, Faisal; Haile, Kassa; Kering, Kelvin; Dudman, Susanne & Halle, Cathinka Lønning [Vis alle 32 forfattere av denne artikkelen] (2026). Risk factors for spontaneous abortion following hepatitis E vaccination during and shortly before pregnancy: Further analysis from a cluster-randomized trial. PLOS ONE. 21(4). doi: 10.1371/journal.pone.0345974. Fulltekst i vitenarkiv
• Kildal, Anders Benjamin; Ueland, Thor; Mirlashari, Mohammad Reza; Nissen-Meyer, Lise Sofie; Granerud, Beathe Kiland & Riise, Anne Margarita Dyrhol [Vis alle 44 forfattere av denne artikkelen] (2026). Serial blood serum measurements of calprotectin and deoxyribonuclease in COVID-19 patients during hospitalization and recovery until one year: a prospective, multicenter, observational study. BMC Infectious Diseases. 26. doi: 10.1186/s12879-026-12939-x. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: To examine circulating calprotectin and deoxyribonuclease (DNase) serum levels during hospitalization in COVID-19 patients, their continuity post-discharge and dynamics in relation to disease severity. Methods: Serum levels were measured in samples collected from 252 COVID-19 patients during hospitalization (admission, days 3–5 and 7–10), at 3 months and after 1 year, and related to admission to intensive care unit (ICU) or high dependency unit (HDU), and 60-day total mortality. Results: During hospitalization, calprotectin and DNase levels were significantly elevated compared to healthy controls (HC). Calprotectin was increased in ICU/HDU patients compared to those at wards during hospitalization and in non-survivors compared to survivors during prolonged hospitalization. High calprotectin levels at admission were associated with male sex, PaO2/FiO2 ratio and national COVID-19 wave 2 and 3 compared to wave 1. High admission levels of both calprotectin and ferritin were associated with an approximately twofold higher odds ratio for ICU/HDU admission than either marker alone. DNase was lower at admission in non-survivors compared to survivors. Post-discharge, DNase but not calprotectin levels remained elevated extending to 1-year follow-up compared to HC. Conclusions: COVID‑19 non‑survivors showed persistently higher calprotectin levels during prolonged hospitalization, and elevated admission calprotectin was associated with later pandemic waves and poorer oxygenation. Incorporating calprotectin with ferritin improved prediction of ICU/HDU admission. DNase levels were lower at admission in non‑survivors, while overall DNase remained elevated from hospitalization through 1‑year follow‑up compared with HC, suggesting a possible role in long‑term COVID‑19–related immune alterations.

• Dudman, Susanne Gjeruldsen; Zerja, Arjana; Hasanoğlu, İmran; Ruta, Simona; Welzen, Berend van & Nicolini, Laura Ambra [Vis alle 12 forfattere av denne artikkelen] (2025). Global vaccination against hepatitis E virus: position paper from the European Society of Clinical Microbiology and Infectious Diseases Viral Hepatitis Study Group. Clinical Microbiology and Infection (CMI). ISSN 1198-743X. 31(2), s. 201–210. doi: 10.1016/j.cmi.2024.11.016. Fulltekst i vitenarkiv Vis sammendrag

  Scope Hepatitis E virus (HEV) is a significant global health issue, impacting both low- and middle-income countries and industrialized nations. HEV genotypes 1 and 2, primarily transmitted through contaminated water, are endemic in low- and middle-income countries, whereas genotypes 3 and 4 are zoonotically transmitted in industrialized regions. Acute HEV infection poses severe risks, particularly to pregnant women and immunocompromised individuals, whereas chronic HEV infection leads to serious complications in those with pre-existing liver disease and transplant recipients. The development of an HEV vaccine offers new prevention opportunities, though its availability and integration into global immunization programmes remain limited. Methods This position paper was developed by the European Society of Clinical Microbiology and Infectious Diseases Viral Hepatitis Study Group through an extensive review of clinical data, safety profiles, efficacy, and immunogenicity of HEV vaccines. The study group focused particularly on high-risk and special populations, synthesizing global health insights and incorporating recommendations from the Strategic Advisory Group of Experts to formulate strategies for wider HEV vaccination use. Questions addressed in the position paper The position paper evaluates the efficacy and safety of HEV vaccines in both general and special populations. It identifies key barriers to the integration of HEV vaccines into routine immunization programmes, including infrastructure limitations, costs, and vaccine accessibility. The paper also proposes strategies to overcome these challenges and improve vaccine distribution. Furthermore, it addresses ways to enhance public awareness and international cooperation to promote HEV vaccination efforts globally. Implications European Society of Clinical Microbiology and Infectious Diseases Viral Hepatitis Study Group recommends HEV vaccination for high-risk groups, including women of childbearing age, patients with chronic liver diseases, and immunosuppressed individuals. Prioritizing investments in vaccine logistics, integrating diagnostics, and educational outreach can enhance uptake.

• Øverbø, Joakim; Dembinski, Jennifer Lynn; Nilsen, Toril Ranneberg; Sriranganathan, Vethanayaki; Dimova-Svetoslavova, Veselka Petrova & Aziz, Asma Binte [Vis alle 13 forfattere av denne artikkelen] (2025). Cellular and Humoral Immune Profiles After Hepatitis E Vaccination and Infection. Viruses. 17(7), s. 1–12. doi: 10.3390/v17070901. Fulltekst i vitenarkiv Vis sammendrag

  Hepatitis E virus (HEV) causes significant morbidity and mortality globally, particularly affecting vulnerable populations such as pregnant women. HEV239 (Hecolin®), a recombinant vaccine containing the immunodominant protruding (E2) domain of the HEV capsid protein, has demonstrated effectiveness, yet detailed human cellular immune responses remain understudied. This study characterized humoral and cellular immune responses following vaccination with HEV239 or natural HEV infection in healthy Bangladeshi women aged 16–39 years. Using dual IFNγ and IL-4 ELISpot assays, we found robust, predominantly Th1-mediated cellular responses at 30 days after the third vaccine dose, comparable to responses during acute infection. Longitudinal antibody assessments confirmed sustained antibody production, primarily against the E2 domain of genotypes 1 and 3, persisting up to two years post-vaccination. Despite limitations related to sample size and assay sensitivity, our findings underscore the immunogenic potential of HEV239 and support a broader use in HEV-endemic regions.

• Săndulescu, Oana; Dudman, Susanne Gjeruldsen; Gmizic, Ivana; Garcia, Federico; Harvala, Heli & Hasanoglu, Imran [Vis alle 20 forfattere av denne artikkelen] (2025). Global hepatitis C elimination: Updates, challenges, and opportunities from real-world experiences in Europe and North America. Hepatology. ISSN 0270-9139. doi: 10.1097/hep.0000000000001548. Fulltekst i vitenarkiv
• Hirvonen, Aurora; Johannesen, Caroline Klint; Simmonds, Peter; Fischer, Thea K.; Harvala, Heli & Benschop, Kimberley S.M. [Vis alle 50 forfattere av denne artikkelen] (2025). Sustained circulation of enterovirus D68 in Europe in 2023 and the continued evolution of enterovirus D68 B3-lineages associated with distinct amino acid substitutions in VP1 protein. Journal of Clinical Virology. ISSN 1386-6532. 178. doi: 10.1016/j.jcv.2025.105785. Fulltekst i vitenarkiv Vis sammendrag

  Background Enterovirus D68 (EV-D68) causes respiratory disease ranging from mild to severe and in rare cases a paralytic syndrome, called acute flaccid myelitis (AFM). Since the global EV-D68 outbreak in 2014, the virus has mainly circulated in biennial epidemic cycles with peaks detected during even years. However, following the COVID-19 pandemic, the seasonal pattern of EV-D68 has been characterized by large yearly upsurges. Here, we describe the circulation of EV-D68 in Europe in 2023 and track its genetic evolution. Study design Data was compiled from members of the European Non-Polio Network (ENPEN). This included monthly data on the total number of EV samples tested, EV positive samples, EV-D68 positive samples and cases, and other EV positive samples detected in 2023. Information on sample types and surveillance system was recorded. Sequence data from the VP1 gene was used for phylogenetic and amino acid sequence analysis. Results EV was detected in 13,585 out of 203,622 diagnostic samples tested (6.7 %), of which 402 (3.0 %) were determined as EV-D68, representing 386 cases. EV-D68 infections peaked in October 2023 (136/386; 35.2 %). 267/386 (69.2 %) of EV-D68 cases were captured through clinical EV surveillance, almost all of which (202/204 of positive samples with sample type information) were detected in respiratory specimens. Phylogenetic analysis performed on 99 VP1 sequences revealed a distinct B3-derived lineage with a previously undescribed residue change, D554E, in Europe. Conclusions The study documents sustained circulation of EV-D68 in Europe in 2023, the evolution of B3-derived lineages, and appearance of previously undescribed amino acid substitutions in Europe. This stresses the need for continuous EV-D68 surveillance and harmonization of EV-D68 detection practices towards better data comparability across countries.

• Schrijver, Sten de; Vanhulle, Emiel; Ingenbleek, Anne; Alexakis, Leonidas; Johannesen, Caroline Klint & Broberg, Eeva K [Vis alle 50 forfattere av denne artikkelen] (2025). Epidemiological and Clinical Insights into Enterovirus Circulation in Europe, 2018–2023: A Multicenter Retrospective Surveillance Study. Journal of Infectious Diseases. ISSN 0022-1899. 232(1), s. e104–e115. doi: 10.1093/infdis/jiaf179. Fulltekst i vitenarkiv Vis sammendrag

  Background Enteroviruses (EV) cause yearly outbreaks with severe infections, particularly in young children. This study investigates EV circulation, age, and clinical presentations in Europe from 2018 to 2023. Methods Aggregated data were requested from the European Centre for Disease Prevention and Control National Focal Points for Surveillance and European Non-Polio Enterovirus Network. Data included detection month, specimen type, age group, and clinical presentation for the 10 most commonly reported EV types per year. Results Twenty-eight institutions (16 countries) reported 563 654 EV tests during the study period with 33 265 (5.9%) EV positive. Forty-two types were identified (n = 11 605 cases) with echovirus 30 (E30), coxsackievirus A6 (CVA6), EV-D68, E9, E11, CVB5, E18, CVB4, EV-A71, and E6 most frequently reported. E30 declined after 2018/2019, while CVA6, CVB5, E9, E11, and EV-D68 were prevalent both before and after the coronavirus disease 2019 (COVID-19) pandemic, and CVB4 and E18 were prevalent after the pandemic. A shift in seasons (summer to fall) and specimen positivity (feces to respiratory) was observed. Neurological signs predominated among EV-A71, CVB4, CVB5, E6, E9, E11, E18, and E30 (30%–72%). CVB4, CVB5, E9, E11, and E18 were frequently reported among neonates (18%–32%). CVA6 was frequently associated with hand, foot and mouth disease, and EV-D68 with respiratory infections. Paralysis was reported among 22 infections, associated with 10 nonpolio types. Conclusions This study emphasizes the widespread circulation and severity of EV infections in Europe, as well as the (re)emergence of specific types postpandemic. Our findings highlight the need for continuous EV surveillance to monitor variation in circulation, age, and clinical presentations, including paralysis among nonpolio EV infections.

• Granerud, Beathe Kiland; Kaarbø, Mari; Al-Baldawi, Huda; Heggelund, Lars; Tveita, Anders & Müller, Karl Erik [Vis alle 42 forfattere av denne artikkelen] (2025). Droplet Digital PCR or Real-Time PCR as a Method for Quantifying SARS-CoV-2 RNA in Plasma-Is There a Difference? Viruses. 17(6). doi: 10.3390/v17060772. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this study is to ascertain whether qRT-PCR (reverse transcriptase real-time PCR) or RT-ddPCR (reverse transcriptase digital droplet PCR) is more effective for detecting SARS-CoV-2 RNA (severe acute respiratory syndrome coronavirus 2 RNA) in blood plasma from COVID-19 (coronavirus infectious disease-19) patients. The E-gene of SARS-CoV-2 RNA was quantified using both methods in 128 plasma samples from 70 hospitalized patients, followed by a statistical analysis to compare the sensitivity and concordance between the methods. Out of the 128 samples, 89 yielded consistent results irrespective of the method used, whereas 39 samples showed discrepancies between the two different methods. RT-ddPCR frequently registered higher viral quantities compared to qRT-PCR; however, the results did not demonstrate a clear superiority in sensitivity for RT-ddPCR. Although RT-ddPCR registered higher viral quantities, this study concludes that both methods provide comparable results for detecting SARS-CoV-2 E-gene RNA in plasma.

• Citarella, Barbara Wanjiru; Kartsonaki, Christiana; Ibáñez-Prada, Elsa D.; Gonçalves, Bronner P.; Baruch, Joaquin & Escher, Martina [Vis alle 1 859 forfattere av denne artikkelen] (2024). Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms. Heliyon. 10(10). doi: 10.1016/j.heliyon.2024.e29591. Fulltekst i vitenarkiv Vis sammendrag

  Background COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.

• Cho, Sung-Min; Premraj, Lavienraj; Battaglini, Denise; Fanning, Jonathon Paul; Suen, Jacky & Bassi, Gianluigi Li [Vis alle 605 forfattere av denne artikkelen] (2024). Sex differences in post-acute neurological sequelae of SARS-CoV-2 and symptom resolution in adults after coronavirus disease 2019 hospitalization: an international multi-centre prospective observational study. Brain Communications. 6(2). doi: 10.1093/braincomms/fcae036. Fulltekst i vitenarkiv Vis sammendrag

  Although it is known that coronavirus disease 2019 can present with a range of neurological manifestations and in-hospital complications, sparse data exist on whether these initial neurological symptoms of coronavirus disease 2019 are closely associated with post-acute neurological sequelae of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2; PANSC) and whether female versus male sex impacts symptom resolution. In this international, multi-centre, prospective, observational study across 407 sites from 15 countries (30 January 2020 to 30 April 2022), we report the prevalence and risk factors of PANSC among hospitalized adults and investigate the differences between males and females on neurological symptom resolution over time. PANSC symptoms included altered consciousness/confusion, fatigue/malaise, anosmia, dysgeusia and muscle ache/joint pain, on which information was collected at index hospitalization and during follow-up assessments. The analysis considered a time to the resolution of individual and all neurological symptoms. The resulting times were modelled by Weibull regression, assuming mixed-case interval censoring, with sex and age included as covariates. The model results were summarized as cumulative probability functions and age-adjusted and sex-adjusted median times to resolution. We included 6862 hospitalized adults with coronavirus disease 2019, who had follow-up assessments. The median age of the participants was 57 years (39.2% females). Males and females had similar baseline characteristics, except that more males (versus females) were admitted to the intensive care unit (30.5 versus 20.3%) and received mechanical ventilation (17.2 versus 11.8%). Approximately 70% of patients had multiple neurological symptoms at the first follow-up (median = 102 days). Fatigue (49.9%) and myalgia/arthralgia (45.2%) were the most prevalent symptoms of PANSC at the initial follow-up. The reported prevalence in females was generally higher (versus males) for all symptoms. At 12 months, anosmia and dysgeusia were resolved in most patients, although fatigue, altered consciousness and myalgia remained unresolved in >10% of the cohort. Females had a longer time to the resolution (5.2 versus 3.4 months) of neurological symptoms at follow-up for those with more than one neurological symptom. In the multivariable analysis, males were associated with a shorter time to the resolution of symptoms (hazard ratio = 1.53; 95% confidence interval = 1.39–1.69). Intensive care unit admission was associated with a longer time to the resolution of symptoms (hazard ratio = 0.68; 95% confidence interval = 0.60–0.77). Post-discharge stroke was uncommon (0.3% in females and 0.5% in males). Despite the methodological challenges involved in the collection of survey data, this international multi-centre prospective cohort study demonstrated that PANSC following index hospitalization was high. Symptom prevalence was higher and took longer to resolve in females than in males. This supported the fact that while males were sicker during acute illness, females were disproportionately affected by PANSC.

• Bubba, Laura; Broberg, Eeva K.; Fischer, Thea K.; Simmonds, Peter; Harvala, Heli & Dudman, Susanne Gjeruldsen (2024). Parechovirus A Circulation and Testing Capacities in Europe, 2015–2021. Emerging Infectious Diseases. ISSN 1080-6040. 30(2). doi: 10.3201/eid3002.230647. Fulltekst i vitenarkiv
• Landaas, Elisabeth Toverud; Klundby, Ingvild; Knudsen, Per Kristian; Kran, Anne-Marte Bakken; Dudman, Susanne Gjeruldsen & Lind, Andreas [Vis alle 7 forfattere av denne artikkelen] (2024). Emergence of enterovirus D68 in a Norwegian paediatric population 2012-2022. Frontiers in Virology. 4, s. 1–7. doi: 10.3389/fviro.2024.1358963. Fulltekst i vitenarkiv Vis sammendrag

  Background: Enterovirus D68 (EV-D68) primarily causes respiratory infection, occasionally manifesting with neurological symptoms. Outbreak reports have been published from various countries including Norway, but a longitudinal study on EV-D68 prevalence in Northern Europe is lacking. Methods: Respiratory samples from children ≤14 years received at Oslo University Hospital in the years 2012-2022 were examined for EV-D68. Samples from 2012-2015 were retrospectively screened using a semi-specific RT-PCR, with positive samples confirmed by an EV-D68 specific RT-PCR. Samples from 2016-2022 underwent routine diagnostics with the EV-D68 specific RT-PCR. Results: Among the 22,911 samples tested, EV-D68 was detected in 338 samples (324 patients). Most EV-D68 cases occurred in August to December. The highest detection rate was recorded in 2014, 2016 and 2022 (6.0%, 7.8% and 6.6% of samples from August-December). Lower frequencies were observed in 2018 and 2019 (1.0% and 2.4%), and in the years before the 2014 outbreak (2012: 1.3%, 2013: 0.8%). Few cases were identified in 2020-2021. Children aged 0-1 years accounted for 40%, and 0-4 years for 78%, of the EV-D68 positive patients. Most of the patients with EV-D68 (83%) were hospitalised. Discussion: Also in Norway, EV-D68 has caused outbreaks with significant disease burden, especially among the youngest children. The detection rate varies, with a trend towards biennial outbreaks, except for low numbers in 2018 and during the COVID-19 restrictions (2020-2021). Due to its potential for severe respiratory illness and significant neurological complications, conducting EV-D68 testing is essential both for diagnosing clinically suspected cases, and for monitoring the disease burden.

• Shrestha, Sanjaya; Shrestha, Jasmin; Shrestha, Binob; Strand, Tor Arne; Dudman, Susanne Gjeruldsen & Andreassen, Åshild Kristine [Vis alle 10 forfattere av denne artikkelen] (2024). Enteroviruses, Respiratory Syncytial Virus and Seasonal Coronaviruses in Influenza-like Illness Cases in Nepal. Microbiology Research. 15(4), s. 2247–2260. doi: 10.3390/microbiolres15040150. Fulltekst i vitenarkiv Vis sammendrag

  Acute respiratory infection is one of the leading causes of morbidity and mortality among children in low- and middle-income countries. Due to limited diagnostic capability, many respiratory pathogens causing influenza-like illness go undetected. This study aims to detect enterovirus, respiratory syncytial virus, seasonal coronavirus and respiratory pathogens other than influenza in patients with influenza-like illness. A total of 997 (54.3%) respiratory samples (collected in the years 2016–2018) were randomly selected from 1835 influenza-negative samples. The xTAG Respiratory Viral Panel (RVP) FAST v2 panel was used to detect respiratory pathogens including enterovirus/rhinovirus (EV/RV), respiratory syncytial virus (RSV) and seasonal coronavirus (HKU1, OC43, NL63 and 229E). A total of 78.7% (785/997) were positive for respiratory viruses. Of these viruses, EV/RV was detected in 36.3% (362/997), which is the highest number, followed by RSV in 13.7% (137/997). The seasonal coronaviruses HKU1 and OC43 (1.5%, 15/997), NL63 (1.2%, 12/997) and 229E (1%, 10/997) were also detected. The EV/RV-positive samples were sequenced, of which 16.7% (5/30) were confirmed as EVs and were identified as coxsackievirus (CV) types CVB5, CVB3, CV21 and CVB2. The findings of this study highlight the importance of strengthening influenza-like illness surveillance programs in the region by including other respiratory viruses in their scope besides seasonal human influenza viruses.

• Marvik, Åshild & Dudman, Susanne Gjeruldsen (2024). Clinical Evaluation of the VirClia IgM/IgG Chemiluminescence Tests for the Diagnosis of Tick-Borne Encephalitis in an Endemic Part of Norway. Viruses. 16(9). doi: 10.3390/v16091505. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this study was to evaluate the clinical usefulness of VirClia IgM/IgG single-assay chemiluminescence tests for the diagnosis of tick-borne encephalitis (TBE) in an endemic part of Norway. Patients hospitalized at Vestfold or Telemark Hospitals with suspected infection in the central nervous system (CNS) in the period between May 2021 and December 2023 were included, with 85 TBE cases identified. The VirClia IgM assay was positive in the initial serum sample in 75/85 cases, giving a sensitivity of 88.2% (95% CI, 79.4–94.2). The ReaScan TBE IgM rapid test was positive in 80/85 cases, with an estimated sensitivity of 94.1% (95% CI, 86.8–98.1). Vaccine breakthrough infections were the predominant cause of non-reactive IgM cases. The calculated specificity for the VirClia IgM was 95.8% (95% CI, 92.5–98.0). In conclusion, the sensitivity of the VirClia IgM was non-inferior to the ReaScan TBE IgM rapid test. However, isolated IgM reactive results must be interpreted with caution, since false-reactive results occur

• Dudman, Susanne; Klundby, Ingvild; Øverbø, Joakim; Numanovic, Sanela; Nilsen, Mariann & Lind, Andreas [Vis alle 8 forfattere av denne artikkelen] (2024). Trends in the enterovirus surveillance in Oslo, Norway before and during the COVID-19 pandemic. Frontiers in Virology. 3. doi: 10.3389/fviro.2023.1343781. Fulltekst i vitenarkiv Vis sammendrag

  Background: Enteroviruses have the potential to cause both high morbidity and mortality especially in children. High season in Norway is between August and November, but this seasonality was interrupted by the COVID-19 pandemic. Methods: In this study, we describe the enterovirus surveillance in Norway before and during the COVID-19 pandemic including the years from the start of 2016 until the end of 2022. Screening of enterovirus was performed by both laboratory developed methods and FilmArray® ME Panel. Relevant samples were typed, mostly by VP1 sequencing. Results: Seventy-four percent of all cases occurred in infants under five years of age. A significant reduction in positive cases was observed during the peak years of the COVID-19 pandemic compared to the years before. Pre-pandemic, a wide range of types from all four enterovirus species were detected. During the years with COVID-19 infection control measures, significantly fewer enterovirus types were found along with a substantial reduction in the detection rate. Conclusion: Enterovirus surveillance discovered a large amount of different types mainly affecting infants. The positivity rate was markedly reduced during the pandemic in 2020-2022 and fewer types occurred.

• Shrestha, Jasmin; Shrestha, Sanjaya; Mason, Carl; Sornsakrin, Siriporn; Silapong, Sasikorn & Dhakwa, Jwoti [Vis alle 11 forfattere av denne artikkelen] (2024). Rotavirus strains in children less than 5 years of age: A case control study. Journal of Clinical Virology Plus. 4(2). doi: 10.1016/j.jcvp.2024.100183. Fulltekst i vitenarkiv Vis sammendrag

  Background: Globally, rotavirus A (RV) is a leading cause of acute gastroenteritis (AGE) in young children under 5 years. The main aim of this study was to describe the prevalence of RV in children with and without diarrhea whose age ranged from 3 months to 5 years from two different hospitals of Nepal. We also described the diversity of rotavirus circulating during the pre-vaccination period in Nepal between 2006–2009. Materials and methods: A total of 2400 stool samples collected from children's years with diarrhea (cases, N = 1200) and without diarrhea (controls, N = 1200) were tested for the presence of RV by both enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction (RT-PCR). All samples positive for RT PCR and/or ELISA were further characterized for G and P genotypes by conventional RT-PCR. Results: In total, 500 of the 2398 (20.8 %) samples (424 cases and 76 controls), were positive for RV. The most frequently detected G-types were G12, G1, and G9 and P-types were P[8] and P[6]. The predominant genotypes G12P[6], G12P[8], G1P[8] and G9P[8] were identified in 27.8 %, 24.2 %, 11.8 % and 10.8 % of the samples, respectively. Conclusion: This study observed high prevalence of G12P[6] rotavirus circulating in Nepal before vaccine introduction and they may pose an emerging challenge to current and future vaccine. Therefore, continuous molecular surveillance of circulating genotypes and emerging rotavirus strain should be carried out to better understand the effectiveness of vaccination program.

• Aziz, Asma Binte; Dudman, Susanne; Julin, Cathinka Lønning Halle; Ahmmed, Faisal; Stene-Johansen, Kathrine & Sandbu, Synne [Vis alle 15 forfattere av denne artikkelen] (2024). Receipt of hepatitis E vaccine and fetal loss in rural Bangladesh: further analysis of a double-blind, cluster-randomised, controlled trial. The Lancet Global Health. ISSN 2572-116X. 12(8), s. e1300–e1311. doi: 10.1016/S2214-109X(24)00193-1. Fulltekst i vitenarkiv Vis sammendrag

  Background Vaccination constitutes an attractive control measure for hepatitis E virus (HEV), a major cause of maternal and perinatal mortality globally. Analysis of pregnant participants in an effectiveness trial of the HEV vaccine HEV239 showed possible HEV239-associated fetal losses. We aimed to conduct a detailed analysis of this safety signal. Methods In a double-blind, cluster-randomised trial, 67 villages in Matlab, Bangladesh, were randomly allocated (1:1) to two vaccine groups, in which non-pregnant women aged 16–39 years received either HEV239 (HEV239 group) or Hepa-B (a hepatitis B vaccine; control group). We implemented weekly surveillance for pregnancy detection, and follow-up of pregnancies once every 2 weeks, using physician-confirmed diagnoses to evaluate fetal loss outcomes (miscarriage [spontaneous abortion], stillbirth, and elective termination). Data from a parallel system of reproductive health surveillance in Matlab were used to clarify study diagnoses when necessary. Miscarriage was assessed only among participants whose first positive pregnancy test and vaccination date (for whichever dose was closest to the date of last menstrual period [LMP]) were before 20 weeks’ gestation. We defined the following analysis periods of interest: from 90 days before the LMP until the pregnancy outcome (the proximal period); from the LMP date until the pregnancy outcome (the pregnancy period); from 90 days before the LMP until the LMP date (90 days pre-LMP period); and from enrolment until 90 days before the LMP (the distal period). Both Poisson and Cox regression models were used to assess the associations between receipt of HEV239 and fetal loss outcomes. The trial was registered with ClinicalTrials.gov (NCT02759991). Findings Among the 19 460 non-pregnant participants enrolled in the trial, 5011 were identified as having pregnancies within 2 years following vaccination and met the criteria for analysis (2407 in the HEV239 group and 2604 in the control group). Among participants vaccinated in the proximal period and evaluated for miscarriage, miscarriage occurred in 54 (8·9%) of 607 in the HEV239 group and 32 (4·5%) of 719 in the control group (adjusted relative risk [aRR] 2·0 [95% CI 1·3–3·1], p=0·0009). Similarly, the risk of miscarriages was increased in the HEV239 group versus the control group among participants inadvertently vaccinated during pregnancy (22 [10·5%] miscarriages among 209 participants in the HEV239 group vs 14 [5·3%] of 266 in the control group; aRR 2·1 [95% CI 1·1–4·1], p=0·036) and among those vaccinated within 90 days pre-LMP (32 [8·0%] of 398 vs 18 [4·0%] of 453; 1·9 [1·1–3·2], p=0·013). No increased risk of miscarriage was observed in those who received HEV239 in the distal period (93 [5·6%] of 1647 vs 80 [4·5%] of 1773; 1·3 [0·8–1·9], p=0·295). Stillbirth and elective termination showed no increased risk among women administered HEV239 versus those administered Hepa-B in any of the analysis periods. Interpretation HEV239 given shortly before or during pregnancy was associated with an elevated risk of miscarriage. This association poses a possible safety concern for programmatic use of HEV239 in women of childbearing age.

• Mesinovic, Munib; Wong, Xin Ci; Rajahram, Giri Shan; Citarella, Barbara Wanjiru; Peariasamy, Kalaiarasu M. & Greve, Frank van Someren [Vis alle 1 671 forfattere av denne artikkelen] (2024). At-admission prediction of mortality and pulmonary embolism in an international cohort of hospitalised patients with COVID-19 using statistical and machine learning methods. Scientific Reports. 14(1). doi: 10.1038/s41598-024-63212-7. Fulltekst i vitenarkiv
• Simões, Margarida Pires; Hodcroft, Emma B.; Simmonds, Peter; Albert, Jan; Alidjinou, Enagnon K. & Ambert-Balay, Katia [Vis alle 50 forfattere av denne artikkelen] (2024). Epidemiological and Clinical Insights into the Enterovirus D68 Upsurge in Europe 2021-2022 and Emergence of Novel B3-Derived Lineages, ENPEN Multicentre Study. Journal of Infectious Diseases. ISSN 0022-1899. 230(4), s. e917–e928. doi: 10.1093/infdis/jiae154. Fulltekst i vitenarkiv Vis sammendrag

  Enterovirus D68 (EV-D68) infections are associated with severe respiratory disease and acute flaccid myelitis (AFM). The European Non-Polio Enterovirus Network (ENPEN) aimed to investigate the epidemiological and genetic characteristics of EV-D68 infections and its clinical impact during the fall-winter season of 2021–2022. From 19 European countries, 58 institutes reported 10 481 (6.8%) EV-positive samples of which 1004 (9.6%) were identified as EV-D68 (including 852 respiratory samples). Clinical data were reported for 969 cases; 78.9% of infections were reported in children (0–5 years); and 37.9% of cases were hospitalized. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases including 6 diagnosed with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of 2 novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale European EV-D68 upsurge with severe clinical impact and the emergence of B3-derived lineages.

• Zaman, Khalequ; Halle, Cathinka Lønning; Aziz, Asma Binte; Stene-Johansen, Kathrine; Yunus, Md & Qadri, Firdausi [Vis alle 17 forfattere av denne artikkelen] (2024). Safety and effectiveness of a recombinant hepatitis E vaccine in women of childbearing age in rural Bangladesh: a phase 4, double-blind, cluster-randomised, controlled trial. The Lancet Global Health. ISSN 2572-116X. 12(8), s. e1288–e1299. doi: 10.1016/S2214-109X(24)00192-X. Fulltekst i vitenarkiv Vis sammendrag

  Background Hepatitis E virus (HEV) leads to high mortality in pregnant women in low-income countries. We aimed to evaluate the safety of a HEV vaccine and its effectiveness in preventing hepatitis E during pregnancy. Methods In this phase 4, double-blind, cluster-randomised trial, 67 villages in Matlab, Bangladesh, were randomised 1:1 to receive HEV239 (a recombinant HEV vaccine) or a control vaccine (Hepa-B, a hepatitis B vaccine), using block randomisation with random number tables and blocks of size eight, stratified by cluster population size. Eligible non-pregnant women (aged 16–39 years) were vaccinated intramuscularly on day 0, at 1 month, and at 6 months, and followed up for 2 years after the last immunisation. The primary endpoint was hepatitis E in the pregnant, per-protocol population (those who received all three doses within 2 days of the scheduled dates), while safety was a secondary endpoint, assessed in the intention-to-treat (ITT) population (participants who received at least one dose). Solicited adverse events were recorded for the first 7 days after each dose, and unsolicited events until 2 years after a participant's final dose. Pregnancy-related safety outcomes were assessed in the pregnant ITT population. This study is registered with ClinicalTrials.gov (NCT02759991). Findings Between Oct 2, 2017, and Feb 28, 2019, 19 460 participants were enrolled and received either HEV239 (9478 [48·7%] participants, 33 clusters) or Hepa-B (9982 [51·3%] participants, 34 clusters), of whom 17 937 (92·2%) participants received three doses and 17 613 (90·5%) were vaccinated according to protocol (8524 [48·4%] in the HEV239 group and 9089 [51·6%] in the control group). No pregnant participants were confirmed to have hepatitis E in either treatment group. HEV239 showed a mild safety profile, similar to Hepa-B, with no difference in the proportion of solicited adverse events between groups and no severe solicited events. Pain was the most common local symptom (1215 [12·8%] HEV239 recipients and 1218 [12·2%] Hepa-B recipients) and fever the most common systemic symptom (141 [1·5%] HEV239 recipients and 145 [1·5%] Hepa-B recipients). None of the serious adverse events or deaths were vaccine related. Among pregnant participants, the HEV239 group had a higher risk of miscarriage (136 [5·7%] of 2407 pregnant participants) compared with the control group (102 [3·9%] of 2604; adjusted odds ratio 1·54 [95% CI 1·15–2·08]). Interpretation The effectiveness of HEV239 in pregnant women remains uncertain. HEV239 was safe and well tolerated in non-pregnant women, but findings regarding miscarriage warrant further investigation.

• Battaglini, Denise; White, Nicole M.; Premraj, Lavienraj; Citarella, Barbara Wanjiru; Merson, Laura & Robba, Chiara [Vis alle 601 forfattere av denne artikkelen] (2023). Long-term neurological symptoms after acute COVID-19 illness requiring hospitalization in adult patients: insights from the ISARIC-COVID-19 follow-up study. Journal of Neurology. ISSN 0340-5354. 271(1), s. 79–86. doi: 10.1007/s00415-023-12133-y. Fulltekst i vitenarkiv
• Øverbø, Joakim; Aziz, Asma Binte; Zaman, K.; Clemens, John; Julin, Cathinka Halle & Qadri, Firdausi [Vis alle 16 forfattere av denne artikkelen] (2023). Immunogenicity and safety of a two-dose regimen with hepatitis E virus vaccine in healthy adults in rural Bangladesh: A randomized, double-blind, controlled, phase 2/pilot trial. Vaccine. ISSN 0264-410X. 41(5), s. 1059–1066. doi: 10.1016/j.vaccine.2022.12.064. Fulltekst i vitenarkiv Vis sammendrag

  Background Hepatitis E virus (HEV) is a major cause of acute viral hepatitis worldwide and it contributes to considerable maternal and neonatal mortality and morbidity in many low-income countries like Bangladesh. A three-dose regimen of a vaccine against HEV (HEV 239) has shown promising results in China. The effects and safety of this vaccine in other populations and with different dosing regimens remains uncertain. Objectives Investigate the immune response and safety of a two-dose regimen with the HEV 239 vaccine among healthy adults. Examine the feasibility of conducting a larger HEV 239 vaccine trial in rural Bangladesh. Methods One-hundred healthy men and non-pregnant women 16–39 years old were randomized in a 1:1 ratio to receive two doses of either the study (HEV) or control (Hepatitis B virus, HBV) vaccine (at 0, 1 month). Blood samples were collected at day 0, day 60 and 2 years after vaccination. The primary endpoints were the proportion and severity of adverse events up to 2 months after dose one and the longitudinal shift in anti-HEV IgG levels from day 0 to day 60 and 2 years after vaccination. Results Adverse events to HEV 239 were comparable to the control vaccine, mild in severity and resolved within one to nine days. All participants in the study group seroconverted and achieved high levels of HEV IgG antibodies that remained positive for two years in all but one. A T-cell response was detected one month after HEV 239 vaccination. Conclusion Our results show that two doses of the HEV 239 vaccine produces broad and likely functional immune responses against HEV that remain for at least two years. The safety profile was acceptable and a phase four study of HEV 239 in rural Bangladesh is feasible.

• Llorente, Ignacio Garcia; Lee, Yunsung; Brynildsrud, Ola Brønstad; Eldholm, Vegard; Magnus, Per Minor & Blomfeldt, Anita [Vis alle 10 forfattere av denne artikkelen] (2023). Tracing the adaptive evolution of SARS-CoV-2 during vaccine roll-out in Norway. Virus Evolution. 10(1). doi: 10.1093/ve/vead081. Fulltekst i vitenarkiv
• Shrestha, Sanjaya; Shrestha, Jasmin; Strand, Tor Arne; Numanovic, Sanela; Andreassen, Åshild Kristine & Dembinski, Jennifer Lynn [Vis alle 8 forfattere av denne artikkelen] (2023). The Molecular Epidemiology of Enterovirus in a Birth Cohort in Nepal. Microbiology Research. ISSN 0944-5013. 14(3), s. 909–917. doi: 10.3390/microbiolres14030063. Fulltekst i vitenarkiv Vis sammendrag

  Acute gastroenteritis (AGE) has a major impact on morbidity and mortality worldwide. The viral aetiology of diarrhoeal diseases may remain unknown due to limited diagnostic facilities. Non-polio enteroviruses (NPEVs) are the third most frequent pathogen detected in stool specimens from AGE cases, yet their potential role in AGE is uncertain. In Nepal, limited data are available on NPEVs, due to both the lack of an adequate surveillance program and the availability of tests. The global polio eradication initiative effort of the WHO has eradicated the incidence of poliomyelitis and acute flaccid paralysis (AFP) from many parts of the world, including Nepal. However, cases of AFP associated with NPEVs have been reported in different countries, including the neighbouring India. This study aims to investigate the diarrhoeal stool samples from a birth cohort until the age of 36 months for NPEVs and the genotype diversity of NPEV in community children with diarrhoea. A total of 280 longitudinal diarrhoeal stool samples that were negative for other enteric pathogens were tested using RT-PCRs. NPEVs was detected in 97 stool specimens (34.6%) and were significantly more frequent in infants up to one year of age. This study identified 17 various NPEV types, with the dominating species being Enterovirus B (EV-B). Ten different types of echoviruses were recorded in this study, with the two rare NPEVs B74 and A120. Based on prevalence, seasonality, and diversity, further studies are warranted to investigate the role of enterovirus in diarrhoeal disease.

• Murphy, Sarah Louise Mikalsen; Halvorsen, Bente; Holter, Jan Cato; Huse, Camilla; Tveita, Anders & Trøseid, Marius [Vis alle 24 forfattere av denne artikkelen] (2023). Circulating markers of extracellular matrix remodelling in severe COVID-19 patients. Journal of Internal Medicine. ISSN 0954-6820. 294(6), s. 784–797. doi: 10.1111/joim.13725. Fulltekst i vitenarkiv Vis sammendrag

  Background Abnormal remodelling of the extracellular matrix (ECM) has generally been linked to pulmonary inflammation and fibrosis and may also play a role in the pathogenesis of severe COVID-19. To further elucidate the role of ECM remodelling and excessive fibrogenesis in severe COVID-19, we examined circulating levels of mediators involved in various aspects of these processes in COVID-19 patients.<p> <p>Methods Serial blood samples were obtained from two cohorts of hospitalised COVID-19 patients (n = 414). Circulating levels of ECM remodelling mediators were quantified by enzyme immunoassays in samples collected during hospitalisation and at 3-month follow-up. Samples were related to disease severity (respiratory failure and/or treatment at the intensive care unit), 60-day total mortality and pulmonary pathology after 3-months. We also evaluated the direct effect of inactivated SARS-CoV-2 on the release of the different ECM mediators in relevant cell lines. <p>Results Several of the measured markers were associated with adverse outcomes, notably osteopontin (OPN), S100 calcium-binding protein A12 and YKL-40 were associated with disease severity and mortality. High levels of ECM mediators during hospitalisation were associated with computed tomography thorax pathology after 3-months. Some markers (i.e. growth differential factor 15, galectin 3 and matrix metalloproteinase 9) were released from various relevant cell lines (i.e. macrophages and lung cell lines) in vitro after exposure to inactivated SARS-CoV-2 suggesting a direct link between these mediators and the causal agent of COVID-19. <p>Conclusion Our findings highlight changes to ECM remodelling and particularly a possible role of OPN, S100A12 and YKL-40 in the pathogenesis of severe COVID-19.

• Debes, Sara Molvig; Haug, Jon Birger; Blasio, Birgitte Freiesleben de; Lindstrøm, Jonas Christoffer; Jonassen, Christine Genevieve Monceyron & Dudman, Susanne Gjeruldsen (2023). Antibiotic Consumption in a Cohort of Hospitalized Adults with Viral Respiratory Tract Infection. Antibiotics. 12(4). doi: 10.3390/antibiotics12040788. Fulltekst i vitenarkiv Vis sammendrag

  Development of antibiotic resistance, a threat to global health, is driven by inappropriate antibiotic usage. Respiratory tract infections (RTIs) are frequently treated empirically with antibiotics, despite the fact that a majority of the infections are caused by viruses. The purpose of this study was to determine the prevalence of antibiotic treatment in hospitalized adults with viral RTIs, and to investigate factors influencing the antibiotic decision-making. We conducted a retrospective observational study of patients ≥ 18 years, hospitalized in 2015–2018 with viral RTIs. Microbiological data were taken from the laboratory information system and information on antibiotic treatment drawn from the hospital records. To investigate decisions for prescribing antibiotic treatment, we evaluated relevant factors such as laboratory and radiological results, in addition to clinical signs. In 951 cases without secondary bacterial RTIs (median age 73 years, 53% female), 720 (76%) were prescribed antibiotic treatment, most frequently beta-lactamase-sensitive penicillins, but cephalosporins were prescribed as first-line in 16% of the cases. The median length of treatment (LOT) in the patients treated with antibiotics was seven days. Patients treated with antibiotics had an average of two days longer hospital stay compared to patients with no such treatment, but no difference in mortality was found. Our study revealed that there is still a role for antimicrobial stewardship to further improve antibiotic use in patients admitted for viral RTIs in a country with relatively low antibiotic consumption.

• Øverbø, Joakim; Aziz, Asma Binte; Zaman, K.; Julin, Cathinka Halle; Qadri, Firdausi & Stene-Johansen, Kathrine [Vis alle 13 forfattere av denne artikkelen] (2022). Stability and Feasibility of Dried Blood Spots for Hepatitis E Virus Serology in a Rural Setting. Viruses. 14:2525, s. 1–11. doi: 10.3390/v14112525. Fulltekst i vitenarkiv Vis sammendrag

  Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In many low-income countries it causes large outbreaks and disproportionally affects pregnant women and their offspring. Surveillance studies to find effective preventive interventions are needed but are hampered by the lack of funding and infrastructure. Dried blood spots (DBS) offer an easier and more robust way to collect, transport, and store blood samples compared to plasma/serum samples, and could ease some of the barriers for such studies. In this study we optimize an HEV IgG ELISA for DBS samples and validate it on 300 paired DBS and plasma samples collected in rural areas of Bangladesh from participants in a HEV vaccine study. We demonstrate that HEV IgG in blood stored as DBS is stable for two months at up to 40 °C, and for five freeze-thaw cycles. The specificity was 97% and the overall sensitivity of the DBS assay was 81%. The sensitivity was higher in samples from vaccinated participants (100%) compared to previously infected participants (59%), reflecting a positive correlation between IgG titer and sensitivity. We found a strong correlation between DBS and plasma samples with an r2 of 0.90, but with a higher degree of difference between individual paired samples. Our study shows that DBS offers a stable alternative to plasma/serum for HEV IgG measurements and can facilitate serological studies, particularly in resource limited areas.

• Barlinn, Regine; Dudman, Susanne Gjeruldsen; Rollag, Halvor; Trogstad, Lill; Lindstrøm, Jonas Christoffer & Magnus, Per Minor (2022). Maternal cytomegalovirus infection and delayed language development in children at 3 years of age-a nested case-control study in a large population-based pregnancy cohort. PLOS ONE. 17(12). doi: 10.1371/journal.pone.0278623. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Maternal cytomegalovirus (CMV) infection in pregnancy may result in vertical transmission of CMV to the child. Long-term effects of congenital CMV infection include visual, cognitive as well as neurological impairment. The aim of this study was to estimate the odds ratios for CMV seropositivity and seroconversion in mothers, with and without delayed language development in 3 year old children, nested within a large cohort. Material and methods The Norwegian Mother, Father and Child Cohort Study (MoBa) is a prospective population-based pregnancy cohort that includes 95 200 mothers and 114 500 children. Blood samples were obtained from mothers during pregnancy weeks 17 or 18 in pregnancy and after birth. We included 300 women from MoBa with children suffering from delayed language development at three years of age, based on validated questionnaires. Within the cohort, 1350 randomly selected women were included as controls to perform a nested case-control study. The cases and controls were tested for CMV IgG antibodies by an enzyme-linked immunosorbent assay. Results Among mothers of cases, 63.2% were CMV-IgG positive in the sample at birth, as compared to 55.9% among controls; OR 1.36, (95% CI; 1.05 to 1.76). Also, among case mothers, 8/118 (6.8%) initially seronegative cases, seroconverted. Among initially seronegative controls, seroconversion occurred in 23/618 (3.7%) mothers. The OR for seroconversion in cases as compared to control mothers was 1.88 (CI; 0.82 to 4.31), thus not statistically significant different. Conclusion This study shows a higher risk of delayed language development at three years of age in children born by mothers seropositive for CMV, compared to children born from seronegative mothers.

• Matthews, Philippa C.; Campbell, Cori; Săndulescu, Oana; Matičič, Mojca; Ruta, Simona Maria & Rivero-Juárez, Antonio [Vis alle 25 forfattere av denne artikkelen] (2022). Acute severe hepatitis outbreak in children: A perfect storm. What do we know, and what questions remain? Frontiers in Pharmacology. 13:1062408, s. 1–20. doi: 10.3389/fphar.2022.1062408. Fulltekst i vitenarkiv Vis sammendrag

  During the first half of 2022, the World Health Organization reported an outbreak of acute severe hepatitis of unknown aetiology (AS-Hep-UA) in children, following initial alerts from the United Kingdom (UK) where a cluster of cases was first observed in previously well children aged &amp;lt;6 years. Sporadic cases were then reported across Europe and worldwide, although in most countries incidence did not increase above the expected baseline. There were no consistent epidemiological links between cases, and microbiological investigations ruled out known infectious causes of hepatitis. In this review, we explore the evidence for the role of viral infection, superimposed on a specific host genetic background, as a trigger for liver pathology. This hypothesis is based on a high prevalence of Human Adenovirus (HAdV) 41F in affected children, together with metagenomic evidence of adeno-associated virus (Adeno-associated viruses)-2, which is a putative trigger for an immune-mediated liver injury. Roles for superantigen-mediated pathology have also been explored, with a focus on the potential contribution of SARS-CoV-2 infection. Affected children also had a high frequency of the MHC allele HLA-DRB1*04:01, supporting an immunological predisposition, and may have been vulnerable to viral coinfections due to disruption in normal patterns of exposure and immunity as a result of population lockdowns during the COVID-19 pandemic. We discuss areas of ongoing uncertainty, and highlight the need for ongoing scrutiny to inform clinical and public health interventions for this outbreak and for others that may evolve in future.

• Granerud, Beathe Kiland; Ueland, Thor; Lind, Andreas; Søraas, Arne Vasli; Fevang, Børre & Steffensen, Anne Katrine [Vis alle 14 forfattere av denne artikkelen] (2022). Omicron Variant Generates a Higher and More Sustained Viral Load in Nasopharynx and Saliva Than the Delta Variant of SARS-CoV-2. Viruses. 14(11). doi: 10.3390/v14112420. Fulltekst i vitenarkiv Vis sammendrag

  The Omicron variant of SARS-CoV-2 spreads more easily than earlier variants, possibly as a result of a higher viral load in the upper respiratory tract and oral cavity. Hence, we investigated whether the Omicron variant generates a higher viral load than that of the Delta variant in saliva and nasopharynx. Both specimens were collected from 52 Omicron and 17 Delta cases at two time points one week apart and analyzed by qRT-PCR. Viral load was measured as 10 log RNA genome copies per 1000 human cells according to the WHO reference standard. We found that Omicron cases carried a higher viral load and had more sustained viral shedding compared to the Delta cases, especially in the nasopharynx.

• Aziz, Asma Binte; Øverbø, Joakim; Dudman, Susanne; Julin, Cathinka Halle; Kwon, Yoon Jeong Gabby & Jahan, Yasmin [Vis alle 8 forfattere av denne artikkelen] (2022). Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh. Viruses. 15:63(1), s. 1–15. doi: 10.3390/v15010063. Fulltekst i vitenarkiv Vis sammendrag

  HEV is the most common cause of acute hepatitis globally. This review summarizes the latest knowledge on the epidemiology, clinical characteristics, testing, and treatment of HEV infection. We also focused on Bangladesh to highlight the distinct challenges and the possible remedies. In low-income settings, the virus is mainly transmitted between people by fecal contamination of drinking water causing large outbreaks, and sporadic cases. The disease is usually mild and self-limiting acute hepatitis. Still, pregnant women and their offspring in low-income countries are at particular risk for severe disease, with up to 20% maternal mortality. Despite the high burden of the disease, HEV remains a relatively neglected virus, with detection hampered by costly tests and a lack of suitable treatments. Molecular PCR diagnostics, together with ELISA antibody tests, remain the preferred methods for diagnosis of HEV; however, rapid bedside diagnostics are available and could offer a practical alternative, especially in low-income countries. One vaccine (HEV 239) is only available in China and Pakistan, as efficacy against the other genotypes remains uncertain. The effectiveness trial conducted in Bangladesh might lead the way in gathering more efficacy data and could, together with improved surveillance and raised awareness, dramatically reduce the global burden of HEV.

• Garcia-Gallo, Esteban; Merson, Laura; Kennon, Kalynn; Kelly, Sadie; Citarella, Barbara Wanjiru & Fryer, Daniel Vidali [Vis alle 1 775 forfattere av denne artikkelen] (2022). ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19. Scientific Data. 9(1). doi: 10.1038/s41597-022-01534-9. Fulltekst i vitenarkiv Vis sammendrag

  The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use.

• Tveita, Anders Aune; Murphy, Sarah Louise Mikalsen; Holter, Jan Cato; Kildal, Anders Benjamin; Michelsen, Annika Elisabet & Lerum, Tøri Vigeland [Vis alle 28 forfattere av denne artikkelen] (2022). High Circulating Levels of the Homeostatic Chemokines CCL19 and CCL21 Predict Mortality and Disease Severity in COVID-19. Journal of Infectious Diseases. ISSN 0022-1899. 226(12), s. 2150–2160. doi: 10.1093/infdis/jiac313. Fulltekst i vitenarkiv Vis sammendrag

  Background Immune dysregulation is a major factor in the development of severe coronavirus disease 2019 (COVID-19). The homeostatic chemokines CCL19 and CCL21 have been implicated as mediators of tissue inflammation, but data on their regulation in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is limited. We thus investigated the levels of these chemokines in COVID-19 patients. Methods Serial blood samples were obtained from patients hospitalized with COVID-19 (n = 414). Circulating CCL19 and CCL21 levels during hospitalization and 3-month follow-up were analyzed. In vitro assays and analysis of RNAseq data from public repositories were performed to further explore possible regulatory mechanisms. Results A consistent increase in circulating levels of CCL19 and CCL21 was observed, with high levels correlating with disease severity measures, including respiratory failure, need for intensive care, and 60-day all-cause mortality. High levels of CCL21 at admission were associated with persisting impairment of pulmonary function at the 3-month follow-up. Conclusions Our findings highlight CCL19 and CCL21 as markers of immune dysregulation in COVID-19. This may reflect aberrant regulation triggered by tissue inflammation, as observed in other chronic inflammatory and autoimmune conditions. Determination of the source and regulation of these chemokines and their effects on lung tissue is warranted to further clarify their role in COVID-19.

• Debes, Sara Molvig; Haug, Jon Birger; Blasio, Birgitte Freiesleben De; Lindstrøm, Jonas Christoffer; Jonassen, Christine M & Dudman, Susanne Gjeruldsen (2022). Clinical Outcome of Viral Respiratory Tract Infections in Hospitalized Adults in Norway: High Degree of Inflammation and Need of Emergency Care for Cases With Respiratory Syncytial Virus. Frontiers in Medicine. 9. doi: 10.3389/fmed.2022.866494. Fulltekst i vitenarkiv Vis sammendrag

  Background: The clinical features and outcomes of viral respiratory tract infections (RTIs) in adults have not been thoroughly studied, especially the respiratory syncytial virus (RSV) disease burden. It has become apparent that outbreaks of RSV in the elderly are associated with increased hospitalization rates. However, little data exists on the severity of such viral RTIs in adults, particularly the need for hospitalization, respiratory support and intensive care. Methods: We conducted a retrospective observational single-center study at Østfold Hospital Trust, Norway, during three winter seasons 2015–2018. Patients ≥18 years with either influenza A, influenza B, RSV A/B, human metapneumovirus, parainfluenza virus 1–4 or adenovirus detected in respiratory specimens were included, if they were hospitalized 14 days prior or following the detection date, with signs of RTI. Hospital records on treatment and outcome were investigated, as well as mortality of all causes up to 30 days from discharge. Results: Of the 1222 infection events that were included, influenza A was the most frequent virus detected (39%), while 179 infection events (14.6%) were due to RSV. Influenza B counted for 24% of the infection events, human metapneumovirus 13%, parainfluenza virus 9% and adenovirus 1%. Patients admitted with RSV more often suffered from COPD and congestive heart failure than patients with influenza A. In addition, RSV patients were overrepresented in the urgent response NEWS score (National Early Warning Score) category ≥5. RSV patients also showed signs of more severe inflammation, with WBC ≥11.1 × 109/L and CRP >100 mg/L, and they were more often treated with antibiotic agents during their hospital stay. However, we found no differences in the need for ICU admission or mortality. Conclusion: Patients with RSV had more often high values for markers of inflammation and elevated NEWS score when compared to patients hospitalized with other common respiratory viruses. Taken into account that they suffered more frequently from comorbidities like COPD, these patients needed hospitalization more urgently. These findings highlight the need for further investigations on RSV disease in adults and the elderly.

• Søraas, Arne Vasli; Grødeland, Gunnveig; Granerud, Beathe Kiland; Ueland, Thor; Lind, Andreas & Fevang, Børre [Vis alle 32 forfattere av denne artikkelen] (2022). Breakthrough infections with the omicron and delta variants of SARS-CoV-2 result in similar re-activation of vaccine-induced immunity. Frontiers in Immunology. 13:964525, s. 1–12. doi: 10.3389/fimmu.2022.964525. Fulltekst i vitenarkiv Vis sammendrag

  Background: Results showing that sera from double vaccinated individuals have minimal neutralizing activity against Omicron have been interpreted as indicating the need for a third vaccine dose for protection. However, there is little information about early immune responses to Omicron infection in double vaccinated individuals. Methods: We measured inflammatory mediators, antibodies to the SARS-CoV-2 spike and nucleocapsid proteins, and spike peptide-induced release of interferon gamma in whole blood in 51 double-vaccinated individuals infected with Omicron, in 14 infected with Delta, and in 18 healthy controls. The median time points for the first and second samples were 7 and 14 days after symptom onset, respectively. Findings: Infection with Omicron or Delta led to a rapid and similar increase in antibodies to the receptor-binding domain (RBD) of Omicron protein and spike peptide-induced interferon gamma in whole blood. Both the Omicron- and the Delta-infected patients had a mild and transient increase in inflammatory parameters. Interpretation: The results suggest that two vaccine doses are sufficient to mount a rapid and potent immune response upon infection in healthy individuals of with the Omicron variant.

• Bouziotis, Jason; Arvanitakis, Marianna; Preiser, Jean-Charles; Abbas, Ali; Abdukahil, Sheryl Ann & Abdulkadir, Nurul Najmee [Vis alle 50 forfattere av denne artikkelen] (2022). Association of body mass index with COVID-19 related in-hospital death. Clinical Nutrition. ISSN 0261-5614. 41(12), s. 2924–2926. doi: 10.1016/j.clnu.2022.01.017. Fulltekst i vitenarkiv Vis sammendrag

  Background: Patients with extreme body mass indices (BMI) could have an increased risk of death while hospitalized for COVID-19.<p> <p>Methods: The database of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) was used to assess the time to in-hospital death with competing-risks regression by sex and between the categories of BMI. <p>Results: Data from 12,137 patients (age 60.0 ± 16.2 years, 59% males, BMI 29.4 ± 6.9 kg/m² ) of 48 countries were available. By univariate analysis, underweight patients had a higher risk of mortality than the other patients (sub-hazard ratio (SHR) 1.75 [1.44e2.14]). Mortality was lower in normal (SHR 0.69 [0.58e0.85]), overweight (SHR 0.53 [0.43e0.65]) and obese (SHR 0.55 [0.44e0.67]) than in underweight patients. Multivariable analysis (adjusted for age, chronic pulmonary disease, malignant neoplasia, type 2 diabetes) confirmed that in-hospital mortality of underweight patients was higher than overweight patients (females: SHR 0.63 [0.45e0.88] and males: 0.69 [0.51e0.94]). <p>Conclusion: Even though these findings do not imply changes in the medical care of hospitalized patients, they support the use of BMI category for the stratification of patients enrolled in interventional studies where mortality is recorded as an outcome.

• Degenhardt, Frauke; Ellinghaus, David; Juzenas, Simonas; Lerga-Jaso, Jon; Wendorff, Mareike & Maya-Miles, Douglas [Vis alle 51 forfattere av denne artikkelen] (2022). Detailed stratified GWAS analysis for severe COVID-19 in four European populations. Human Molecular Genetics. ISSN 0964-6906. 31(23), s. 3945–3966. doi: 10.1093/hmg/ddac158. Fulltekst i vitenarkiv Vis sammendrag

  Given the highly variable clinical phenotype of Coronavirus disease 2019 (COVID-19), a deeper analysis of the host genetic contribution to severe COVID-19 is important to improve our understanding of underlying disease mechanisms. Here, we describe an extended genome-wide association meta-analysis of a well-characterized cohort of 3255 COVID-19 patients with respiratory failure and 12 488 population controls from Italy, Spain, Norway and Germany/Austria, including stratified analyses based on age, sex and disease severity, as well as targeted analyses of chromosome Y haplotypes, the human leukocyte antigen region and the SARS-CoV-2 peptidome. By inversion imputation, we traced a reported association at 17q21.31 to a ∼0.9-Mb inversion polymorphism that creates two highly differentiated haplotypes and characterized the potential effects of the inversion in detail. Our data, together with the 5th release of summary statistics from the COVID-19 Host Genetics Initiative including non-Caucasian individuals, also identified a new locus at 19q13.33, including NAPSA, a gene which is expressed primarily in alveolar cells responsible for gas exchange in the lung.

• Cho, Sung-Min; White, Nicole; Premraj, Lavienraj; Battaglini, Denise; Fanning, Jonathon & Suen, Jacky [Vis alle 50 forfattere av denne artikkelen] (2022). Neurological manifestations of COVID-19 in adults and children. Brain. ISSN 0006-8950. doi: 10.1093/brain/awac332. Fulltekst i vitenarkiv
• Baruch, Joaquin; Rojek, Amanda; Kartsonaki, Christiana; Vijayaraghavan, Bharath Kumar Tirupakuzhi; Gonçalves, Bronner P. & Pritchard, Mark G. [Vis alle 50 forfattere av denne artikkelen] (2022). Symptom-based case definitions for COVID-19: Time and geographical variations for detection at hospital admission among 260,000 patients. Influenza and Other Respiratory Viruses. ISSN 1750-2640. 16(6), s. 1040–1050. doi: 10.1111/irv.13039. Fulltekst i vitenarkiv
• Gonçalves, Bronner P.; Hall, Matthew; Jassat, Waasila; Balan, Valeria; Murthy, Srinivas & Kartsonaki, Christiana [Vis alle 50 forfattere av denne artikkelen] (2022). An international observational study to assess the impact of the Omicron variant emergence on the clinical epidemiology of COVID-19 in hospitalised patients. eLIFE. 11. doi: 10.7554/eLife.80556. Fulltekst i vitenarkiv
• Reyes, Luis Felipe; Murthy, Srinivas; Garcia-Gallo, Esteban; Merson, Laura; Ibáñez-Prada, Elsa D. & Rello, Jordi [Vis alle 51 forfattere av denne artikkelen] (2022). Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study. Critical Care. ISSN 1364-8535. 26(1). doi: 10.1186/s13054-022-04155-1. Fulltekst i vitenarkiv
• Wainstein, Marina; MacDonald, Samual; Fryer, Daniel; Young, Kyle; Balan, Valeria & Begum, Husna [Vis alle 50 forfattere av denne artikkelen] (2022). Use of an extended KDIGO definition to diagnose acute kidney injury in patients with COVID-19: A multinational study using the ISARIC–WHO clinical characterisation protocol. PLoS Medicine. ISSN 1549-1277. 19(4). doi: 10.1371/journal.pmed.1003969. Fulltekst i vitenarkiv
• Hammer, Quirin; Dunst, Josefine; Christ, Wanda; Picarazzi, Francesca; Wendorff, Mareike & Momayyezi, Pouria [Vis alle 51 forfattere av denne artikkelen] (2022). SARS-CoV-2 Nsp13 encodes for an HLA-E-stabilizing peptide that abrogates inhibition of NKG2A-expressing NK cells. Cell reports. 38(10). doi: 10.1016/j.celrep.2022.110503. Fulltekst i vitenarkiv Vis sammendrag

  Natural killer (NK) cells are innate immune cells that contribute to host defense against virus infections. NK cells respond to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and are activated in patients with acute coronavirus disease 2019 (COVID-19). However, by which mechanisms NK cells detect SARS-CoV-2-infected cells remains largely unknown. Here, we show that the Non-structural protein 13 of SARS-CoV-2 encodes for a peptide that is presented by human leukocyte antigen E (HLA-E). In contrast with self-peptides, the viral peptide prevents binding of HLA-E to the inhibitory receptor NKG2A, thereby rendering target cells susceptible to NK cell attack. In line with these observations, NKG2A-expressing NK cells are particularly activated in patients with COVID-19 and proficiently limit SARS-CoV-2 replication in infected lung epithelial cells in vitro. Thus, these data suggest that a viral peptide presented by HLA-E abrogates inhibition of NKG2A+ NK cells, resulting in missing self-recognition.

• Knudsen, Per Kristian; Lind, Andreas; Klundby, Ingvild & Dudman, Susanne Gjeruldsen (2022). The incidence of infectious diseases and viruses other than SARS-CoV-2 amongst hospitalised children in Oslo, Norway during the Covid-19 pandemic 2020–2021. Journal of Clinical Virology Plus. 2:100060(1), s. 1–5. doi: 10.1016/j.jcvp.2021.100060. Fulltekst i vitenarkiv Vis sammendrag

  Background Measures to reduce spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the Covid-19 pandemic 2020–2021 may impact other microbiological agents. We aimed to investigate the incidence of infectious diseases and the incidence of viruses other than SARS-CoV-2 amongst children at The Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Norway during 2020–2021 compared to previous years. Methods Data from April 1st 2020 – March 31st 2021 were compared to data from corresponding 12-months periods 2017–2020. ICD-10 infectious disease diagnoses were collected from the Hospital Diagnosis and Procedure Registry and results of virus PCR analyses of different specimens (mainly nasopharyngeal (NF) and faecal samples) were collected from the Laboratory System at the Department of Microbiology. Results The number of hospital contacts with acute bronchiolitis, viral pneumonia, gastroenteritis and viral central nervous system infections were reduced by 90% (p<0.0001), 89% (p<0.0001), 74% (p<0.0001) and 78% (p<0.01), respectively. Respiratory syncytial virus (RSV), influenza virus A and B and Human metapneumovirus (HMPV) were almost completely absent during the pandemic period. The proportions of rhinovirus positive NF samples were 31.7% vs. 34.9% (p<0.05), but not significantly different for adenovirus. The proportions of positive faecal samples were 1% vs. 10% for adenovirus (p<0.00001) and 3.3% vs. 12% for norovirus (p<0.00001), but not significantly different for rotavirus. The proportions of enterovirus positive samples were 3.5% vs. 21.6% (p<0.00001). Conclusion The incidence of several paediatric infectious diseases mainly of viral aetiology declined significantly during the Covid-19 pandemic. Some common respiratory viruses were almost completely absent.

• Niemi, Mari E.K.; Karjalainen, Juha; Liao, Rachel G.; Neale, Benjamin M.; Daly, Mark & Ganna, Andrea [Vis alle 84 forfattere av denne artikkelen] (2021). Mapping the human genetic architecture of COVID-19. Nature. ISSN 0028-0836. 600(7889), s. 472–477. doi: 10.1038/s41586-021-03767-x. Fulltekst i vitenarkiv Vis sammendrag

  The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.

• Eliassen, Knut Eirik Ringheim; Ocias, Lukas; Krogfelt, Karen; Wilhelmsson, Peter; Dudman, Susanne & Andreassen, Åshild Kristine [Vis alle 8 forfattere av denne artikkelen] (2021). Tick-transmitted co-infections among erythema migrans patients in a general practice setting in Norway: a clinical and laboratory follow-up study. BMC Infectious Diseases. 21. doi: 10.1186/s12879-021-06755-8. Fulltekst i vitenarkiv Vis sammendrag

  Background Erythema migrans (EM) is the most common manifestation of Lyme borreliosis. Here, we examined EM patients in Norwegian general practice to find the proportion exposed to tick-transmitted microorganisms other than Borrelia, and the impact of co-infection on the clinical manifestations and disease duration. Methods Skin biopsies from 139/188 EM patients were analyzed using PCR for Neoehrlichia mikurensis, Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Follow-up sera from 135/188 patients were analyzed for spotted fever group (SFG) Rickettsia, A. phagocytophilum and Babesia microti antibodies, and tested with PCR if positive. Day 0 sera from patients with fever (8/188) or EM duration of ≥ 21 days (69/188) were analyzed, using PCR, for A. phagocytophilum, Rickettsia spp., Babesia spp. and N. mikurensis. Day 14 sera were tested for TBEV IgG. Results We detected no microorganisms in the skin biopsies nor in the sera of patients with fever or prolonged EM duration. Serological signs of exposure against SFG Rickettsia and A. phagocytophilum were detected in 11/135 and 8/135, respectively. Three patients exhibited both SFG Rickettsia and A. phagocytophilum antibodies, albeit negative PCR. No antibodies were detected against B. microti. 2/187 had TBEV antibodies without prior immunization. There was no significant increase in clinical symptoms or disease duration in patients with possible co-infection. Conclusions Co-infection with N. mikurensis, A. phagocytophilum, SFG Rickettsia, Babesia spp. and TBEV is uncommon in Norwegian EM patients. Despite detecting antibodies against SFG Rickettsia and A. phagocytophilum in some patients, no clinical implications could be demonstrated.

• Abbas, Ali; Abdukahil, Sheryll Ann; Abdulkadir, Nurul Najmee; Holter, Jan Cato; Müller, Fredrik & Dudman, Susanne [Vis alle 7 forfattere av denne artikkelen] (2021). The value of open-source clinical science in pandemic response: lessons from ISARIC. The Lancet Infectious Diseases. ISSN 1473-3099. doi: 10.1016/S1473-3099(21)00565-X. Fulltekst i vitenarkiv
• Abdukahil, Sheryl Ann; Abe, Ryuzo; Abel, Laurent; Absil, Lara; Acker, Andrew & Adachi, Shingo [Vis alle 50 forfattere av denne artikkelen] (2021). COVID‐19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study. Infection. ISSN 0300-8126. 49, s. 889–905. doi: 10.1007/s15010-021-01599-5. Fulltekst i vitenarkiv Vis sammendrag

  Background The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men.

• Abdukahil, Sheryl Ann; Abe, Ryuzo; Abel, Laurent; Absil, Lara; Acharya, Subhash & Acker, Andrew [Vis alle 50 forfattere av denne artikkelen] (2021). Ten months of temporal variation in the clinical journey of hospitalised patients with COVID-19: An observational cohort. eLIFE. 10:e70970, s. 1–30. doi: 10.7554/eLife.70970. Fulltekst i vitenarkiv Vis sammendrag

  Background: There is potentially considerable variation in the nature and duration of the care provided to hospitalised patients during an infectious disease epidemic or pandemic. Improvements in care and clinician confidence may shorten the time spent as an inpatient, or the need for admission to an intensive care unit (ICU) or high dependency unit (HDU). On the other hand, limited resources at times of high demand may lead to rationing. Nevertheless, these variables may be used as static proxies for disease severity, as outcome measures for trials, and to inform planning and logistics. Methods: We investigate these time trends in an extremely large international cohort of 142,540 patients hospitalised with COVID-19. Investigated are: time from symptom onset to hospital admission, probability of ICU/HDU admission, time from hospital admission to ICU/HDU admission, hospital case fatality ratio (hCFR) and total length of hospital stay. Results: Time from onset to admission showed a rapid decline during the first months of the pandemic followed by peaks during August/September and December 2020. ICU/HDU admission was more frequent from June to August. The hCFR was lowest from June to August. Raw numbers for overall hospital stay showed little variation, but there is clear decline in time to discharge for ICU/HDU survivors. Conclusions: Our results establish that variables of these kinds have limitations when used as outcome measures in a rapidly evolving situation. Funding: This work was supported by the UK Foreign, Commonwealth and Development Office and Wellcome [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

• Reyes, Luis Felipe; Murthy, Srinivas; Garcia-Gallo, Esteban; Irvine, Mike; Merson, Laura & Martin-Loeches, Ignacio [Vis alle 50 forfattere av denne artikkelen] (2021). Clinical characteristics, risk factors and outcomes in patients with severe COVID-19 registered in the ISARIC WHO clinical characterisation protocol: a prospective, multinational, multicentre, observational study. European Respiratory Journal Open Research (ERJ Open Research). 8(1). doi: 10.1183/23120541.00552-2021. Fulltekst i vitenarkiv Vis sammendrag

  Due to the large number of patients with severe coronavirus disease 2019 (COVID-19), many were treated outside the traditional walls of the intensive care unit (ICU), and in many cases, by personnel who were not trained in critical care. The clinical characteristics and the relative impact of caring for severe COVID-19 patients outside the ICU is unknown. This was a multinational, multicentre, prospective cohort study embedded in the International Severe Acute Respiratory and Emerging Infection Consortium World Health Organization COVID-19 platform. Severe COVID-19 patients were identified as those admitted to an ICU and/or those treated with one of the following treatments: invasive or noninvasive mechanical ventilation, high-flow nasal cannula, inotropes or vasopressors. A logistic generalised additive model was used to compare clinical outcomes among patients admitted or not to the ICU. A total of 40 440 patients from 43 countries and six continents were included in this analysis. Severe COVID-19 patients were frequently male (62.9%), older adults (median (interquartile range (IQR), 67 (55–78) years), and with at least one comorbidity (63.2%). The overall median (IQR) length of hospital stay was 10 (5–19) days and was longer in patients admitted to an ICU than in those who were cared for outside the ICU (12 (6–23) days versus 8 (4–15) days, p<0.0001). The 28-day fatality ratio was lower in ICU-admitted patients (30.7% (5797 out of 18 831) versus 39.0% (7532 out of 19 295), p<0.0001). Patients admitted to an ICU had a significantly lower probability of death than those who were not (adjusted OR 0.70, 95% CI 0.65–0.75; p<0.0001). Patients with severe COVID-19 admitted to an ICU had significantly lower 28-day fatality ratio than those cared for outside an ICU.

• Ueland, Thor; Dyrhol-Riise, Anne Ma; Woll, Bjørn Martin; Holten, Aleksander Rygh; Pettersen, Frank O. & Lind, Andreas [Vis alle 10 forfattere av denne artikkelen] (2021). Increased inflammatory markers reflecting fibrogenesis are independently associated with cardiac involvement in hospitalized COVID-19 patients. Journal of Infection. ISSN 0163-4453. 82(5), s. 186–230. doi: 10.1016/j.jinf.2021.01.017. Fulltekst i vitenarkiv
• Debes, Sara Molvig; Haug, Jon Birger; Blasio, Birgitte Freiesleben De; Jonassen, Christine M & Dudman, Susanne Gjeruldsen (2021). Etiology of viral respiratory tract infections in hospitalized adults, and evidence of the high frequency of prehospitalization antibiotic treatment in Norway. Health Science Reports. 4(4). doi: 10.1002/hsr2.403. Fulltekst i vitenarkiv
• Helfferich, J; Roodbol, Joyce; Wit, Marie-Claire de; Brouwer, Oebele F; Jacobs, Bart C. & Aberle, Stephan W. [Vis alle 50 forfattere av denne artikkelen] (2021). Acute flaccid myelitis and Guillain-Barré syndrome in children: A comparative study with evaluation of diagnostic criteria. European Journal of Neurology. ISSN 1351-5101. 29(2), s. 593–604. doi: 10.1111/ene.15170. Fulltekst i vitenarkiv Vis sammendrag

  Background and purpose Differentiation between acute flaccid myelitis (AFM) and Guillain–Barré syndrome (GBS) can be difficult, particularly in children. Our objective was to improve the diagnostic accuracy by giving recommendations based on a comparison of clinical features and diagnostic criteria in children with AFM or GBS. Methods A cohort of 26 children with AFM associated with enterovirus D68 was compared to a cohort of 156 children with GBS. The specificity of the Brighton criteria, used for GBS diagnosis, was evaluated in the AFM cohort and the specificity of the Centers for Disease Control and Prevention (CDC) AFM diagnostic criteria in the GBS cohort. Results Children with AFM compared to those with GBS had a shorter interval between onset of weakness and nadir (3 vs. 8 days, p < 0.001), more often had asymmetric limb weakness (58% vs. 0%, p < 0.001), and less frequently had sensory deficits (0% vs. 40%, p < 0.001). In AFM, cerebrospinal fluid leukocyte counts were higher, whereas protein concentrations were lower. Spinal cord lesions on magnetic resonance imaging were only found in AFM patients. No GBS case fulfilled CDC criteria for definite AFM. Of the AFM cases, 8% fulfilled the Brighton criteria for GBS, when omitting the criterion of excluding an alternate diagnosis. Conclusions Despite the overlap in clinical presentation, we found distinctive early clinical and diagnostic characteristics for differentiating AFM from GBS in children. Diagnostic criteria for AFM and GBS usually perform well, but some AFM cases may fulfill clinical diagnostic criteria for GBS. This underlines the need to perform diagnostic tests early to exclude AFM in children suspected of atypical GBS.

• Gibory, Moustafa; Bruun, Tone; Flem, Elmira; Dembinski, Jennifer Lynn; Haltbakk, Ildri & Størdal, Ketil [Vis alle 11 forfattere av denne artikkelen] (2021). Genetic diversity of rotavirus strains circulating in Norway before and after the introduction of rotavirus vaccination in children. Journal of Medical Virology. ISSN 0146-6615. 00, s. 1–8. doi: 10.1002/jmv.27484. Fulltekst i vitenarkiv Vis sammendrag

  Globally, rotavirus (RV) is the leading cause of acute gastroenteritis (AGE) in young children under 5 years of age. Implementation of RV vaccination is expected to result in fewer cases of RV in the target population, but it is unknown if this also results in vaccine-induced virus strain replacement. Rotarix, a monovalent vaccine based on G1P[8] RV, was introduced in Norway in the children's immunization program in September 2014. The main aim of this study was to describe the diversity of RV circulating pre and post introduction of the RV vaccine in Norway and investigate changes in genotype distribution during the first 4 years after implementation. A total of 1108 samples were collected from children under 5 years enrolled with AGE from five large hospitals in Norway and were analyzed for RV by enzyme immunoassay (EIA). All positive results were genotyped by multiplex semi-nested reverse transcription PCR for identification of G and P types. In total, 487 of the 1108 (44%) samples, collected from the enrolled children, were positive for RV by EIA method which were further genotyped. G1P[8] was found to be the most common type of RV pre and post RV vaccine implementation followed by G9P[8]. There were neither geographical nor temporal differences in genotype dominance. Also, no apparent changes were shown in the genotype distribution in the postvaccine era for years from 2015 to 2018. In 21.4% of the cases, vaccine strains were detected. Continuous RV genotype surveillance is vital for assessing the effectiveness of a vaccine program and monitoring for any emergence of vaccine-escape strains. Genotyping is also necessary to detect vaccine strains to avoid reporting false-positive cases of active RV infection in newly vaccinated cases.

• Shrestha, Jasmin; Shrestha, Sanjaya; Strand, Tor Arne; Dudman, Susanne Gjeruldsen; Dembinski, Jennifer Lynn & Vikse, Rose [Vis alle 7 forfattere av denne artikkelen] (2021). Diversity of rotavirus strains in children; Results from a community-based study in Nepal. Frontiers in Medicine. 8:712326, s. 1–9. doi: 10.3389/fmed.2021.712326. Fulltekst i vitenarkiv Vis sammendrag

  Objective: The objectives of this study were to describe the incidence and genetic diversity of Rotavirus (RV) infection among children up to 3 years of age in a community in Nepal. Methods: We investigated community-acquired cases of asymptomatic and symptomatic RV infections in children from birth to 36 months of age in a community-based birth cohort in Bhaktapur, Nepal. Monthly surveillance and diarrheal stool samples were collected from 240 children enrolled at birth, of which 238 completed the 3 years of follow-up. Samples were screened for rotavirus by Enzyme Immuno Assay (EIA). All RV screened positives were further genotyped by reverse transcription-polymerase chain reaction for the capsid genes VP7 and VP4. Results: In total, 5,224 stool samples were collected from 238 children, followed from birth to 36 months of age. Diarrhea occurred in 92.4% (230/238) of all children in the cohort. During the 3 years study period, RV was more frequently seen in children with symptoms (7.6%) than in non-symptomatic children (0.8%). The highest RV detection rate was found in younger children between 3 and 21 months of age. Although rotavirus is known as winter diarrhea, it was detected throughout the year except in August. The highest positivity rate was observed in the months between December and March, with a peak in January. Four common G types were seen: G2 (30%), G1 (29%), G12 (19%), and G9 (16%). The most predominant genotypes seen were G2P[4] (30%), followed by G1P[8] (27.0%), G12P[6] (14.0%), G9P[8] (10%), and remaining were mixed, partial, and untyped. Conclusion: Our study confirms that rotavirus is a common cause of gastroenteritis in young children in the community. The prevalence and pathogenicity of rotavirus infection differed by age. There was substantial variability in circulating strains in the community samples compared to samples collected from hospitals. This shows the importance of including community-based surveillance systems to monitor the diversity of circulating rotavirus strains in Nepal.

• Shrestha, Sanjaya Kumar; Shrestha, Jasmin; Andreassen, Åshild Kristine; Strand, Tor A; Dudman, Susanne Gjeruldsen & Dembinski, Jennifer Lynn (2021). Genetic diversity of astrovirus in children from a birth cohort in Nepal. Frontiers in Microbiology. 11, s. 1–9. doi: 10.3389/fmicb.2020.588707. Fulltekst i vitenarkiv Vis sammendrag

  Objective: This study describes the types of Human astroviruses detected in stool samples collected from a birth cohort of children in Nepal. Methods: Using a commercial kit (ProSpecT), a total of 5,224 diarrheal and non-diarrheal stool samples were screened for Human astrovirus by ELISA. RT-PCR was performed on ELISA positive samples (2.8%) for further confirmation. The primary RT-PCR assay used targets the ORF2 region and detects human astrovirus type 1–8. Samples that were negative in this assay were further analyzed using primers that target the ORF1b region of human astrovirus which detect both classical type (HAstV 1–8) and novel types (MLB1–5, VA 1–5). PCR positive samples were analyzed by Sanger sequencing to determine the genotype. Results: A total of 148 available ELISA positive stool samples were analyzed by RT-PCR and further genotyped. RT-PCR analysis of these samples using the ORF2 and ORF1b assay revealed that 124 (84%) were positive for classical human types (HAstV 1–8). Seven different classical HAstV genotypes based on ORF2 and ORF1a were identified (HAstV 1- HAstV 8) with the greatest prevalence of HAstV 5 genotype (42.2%), followed by HAstV 1 (34.7%), HAstV 2 and HAstV 8 (7.4%), HAstV 4 (4.1%), HAstV 3 (3.3%), and HAstV 6 (0.8%). Non-classical types were not detected in our study. Conclusion: A high diversity of circulating Astrovirus strains were detected in young children, both with and without symptoms of gastroenteritis. HAstV 5 and HAstV 1 were the most common genotypes in young children in Nepal.

• Barratt-Due, Andreas; Olsen, Inge Christoffer; Nezvalova-Henriksen, Katerina; Kåsine, Trine; Lund-Johansen, Fridtjof & Hoel, Hedda Benedicte [Vis alle 43 forfattere av denne artikkelen] (2021). Evaluation of the Effects of Remdesivir and Hydroxychloroquine on Viral Clearance in COVID-19 : A Randomized Trial. Annals of Internal Medicine. ISSN 0003-4819. 174(9), s. 1261–1269. doi: 10.7326/M21-0653. Fulltekst i vitenarkiv Vis sammendrag

  Background: New treatment modalities are urgently needed for patients with COVID-19. The World Health Organization (WHO) Solidarity trial showed no effect of remdesivir or hydroxychloroquine (HCQ) on mortality, but the antiviral effects of these drugs are not known. Objective: To evaluate the effects of remdesivir and HCQ on all-cause, in-hospital mortality; the degree of respiratory failure and inflammation; and viral clearance in the oropharynx. Design: NOR-Solidarity is an independent, add-on, randomized controlled trial to the WHO Solidarity trial that included biobanking and 3 months of clinical follow-up (ClinicalTrials.gov: NCT04321616). Setting: 23 hospitals in Norway. Patients: Eligible patients were adults hospitalized with confirmed SARS-CoV-2 infection. Intervention: Between 28 March and 4 October 2020, a total of 185 patients were randomly assigned and 181 were included in the full analysis set. Patients received remdesivir (n = 42), HCQ (n = 52), or standard of care (SoC) (n = 87). Measurements: In addition to the primary end point of WHO Solidarity, study-specific outcomes were viral clearance in oropharyngeal specimens, the degree of respiratory failure, and inflammatory variables. Results: No significant differences were seen between treatment groups in mortality during hospitalization. There was a marked decrease in SARS-CoV-2 load in the oropharynx during the first week overall, with similar decreases and 10-day viral loads among the remdesivir, HCQ, and SoC groups. Remdesivir and HCQ did not affect the degree of respiratory failure or inflammatory variables in plasma or serum. The lack of antiviral effect was not associated with symptom duration, level of viral load, degree of inflammation, or presence of antibodies against SARS-CoV-2 at hospital admittance. Limitation: The trial had no placebo group. Conclusion: Neither remdesivir nor HCQ affected viral clearance in hospitalized patients with COVID-19.

• Benschop, Kimberley; Broberg, Eeva; Hodcroft, E; Schmitz, D; Albert, Jan & Baicus, A [Vis alle 69 forfattere av denne artikkelen] (2021). Molecular Epidemiology and Evolutionary Trajectory of Emerging Echovirus 30, Europe. Emerging Infectious Diseases. ISSN 1080-6040. 27(6), s. 1616–1626. doi: 10.3201/eid2706.203096. Fulltekst i vitenarkiv Vis sammendrag

  In 2018, an upsurge in echovirus 30 (E30) infections was reported in Europe. We conducted a large-scale epidemiologic and evolutionary study of 1,329 E30 strains collected in 22 countries in Europe during 2016–2018. Most E30 cases affected persons 0–4 years of age (29%) and 25–34 years of age (27%). Sequences were divided into 6 genetic clades (G1–G6). Most (53%) sequences belonged to G1, followed by G6 (23%), G2 (17%), G4 (4%), G3 (0.3%), and G5 (0.2%). Each clade encompassed unique individual recombinant forms; G1 and G4 displayed >2 unique recombinant forms. Rapid turnover of new clades and recombinant forms occurred over time. Clades G1 and G6 dominated in 2018, suggesting the E30 upsurge was caused by emergence of 2 distinct clades circulating in Europe. Investigation into the mechanisms behind the rapid turnover of E30 is crucial for clarifying the epidemiology and evolution of these enterovirus infections.

• Hoel, Hedda Benedicte; Heggelund, Lars; Reikvam, Dag Henrik; Stiksrud, Birgitte; Ueland, Thor & Michelsen, Annika [Vis alle 15 forfattere av denne artikkelen] (2020). Elevated markers of gut leakage and inflammasome activation in COVID-19 patients with cardiac involvement. Journal of Internal Medicine. ISSN 0954-6820. 289(4). doi: 10.1111/joim.13178. Fulltekst i vitenarkiv Vis sammendrag

  Background A high proportion of COVID‐19 patients have cardiac involvement, even those without known cardiac disease. Downregulation of angiotensin converting enzyme 2 (ACE2), a receptor for SARS‐CoV‐2 and the renin‐angiotensin system, as well as inflammatory mechanisms have been suggested to play a role. ACE2 is abundant in the gut and associated with gut microbiota composition. We hypothesized that gut leakage of microbial products, and subsequent inflammasome activation could contribute to cardiac involvement in COVID‐19 patients. Methods Plasma levels of a gut leakage marker (LPS‐binding protein, LBP), a marker of enterocyte damage (intestinal fatty acid binding protein, IFABP), a gut homing marker (CCL25, ligand for chemokine receptor CCR9) and markers of inflammasome activation (IL‐1β, IL‐18 and their regulatory proteins) were measured at three time points (day 1, 3–5 and 7–10) in 39 hospitalized COVID‐19 patients and related to cardiac involvement. Results Compared to controls, COVID‐19 patients had elevated plasma levels of LBP and CCL25 but not IFABP, suggesting impaired gut barrier function and accentuated gut homing of T cells without excessive enterocyte damage. Levels of LBP were twice as high at baseline in patients with elevated cardiac markers compared with those without and remained elevated during hospitalization. Also, markers of inflammasome activation were moderately elevated in patients with cardiac involvement. LBP was associated with higher NT‐pro‐BNP levels, whereas IL‐18, IL‐18BP and IL‐1Ra were associated with higher troponin levels. Conclusion Patients with cardiac involvement had elevated markers of gut leakage and inflammasome activation, suggestive of a potential gut‐heart axis in COVID‐19.

• Gibory, Moustafa; Dembinski, Jennifer Lynn; Flem, Elmira; Haltbakk, Ildri & Dudman, Susanne Marie Rogne Gjeruldsen (2020). Effect of rotavirus vaccine implementation on the prevalence of co‐infections with enteric viruses in Norway. Journal of Medical Virology. ISSN 0146-6615. 92(12), s. 3151–3156. doi: 10.1002/jmv.26013. Fulltekst i vitenarkiv Vis sammendrag

  Acute gastroenteritis (AGE) is a common illness in both adults and children worldwide and is caused by several microorganisms including viruses, bacteria, and parasites. Rotavirus (RV), which is the main cause of AGE, can occur as a mixed infection with other viruses. The aim of this study is to assess the molecular epidemiology of viral enteric viruses and assess RV coinfections with other enteric viruses and their influence on disease severity before and after RV vaccine introduction in children under 5 years of age. A total of 600 samples collected from children hospitalized for AGE in five large hospitals in Norway, and were analyzed for viral gastroenteritis agents by enzyme immunoassay and quantitative real‐time polymerase chain reaction (qRT‐PCR). Positive results confirmed either by Sanger sequencing or genotyped by multiplex semi‐nested RT‐PCR. In total, 243 of the 300 (81%) samples, collected from the prevaccine cohort, were positive for at least one of the four viruses tested in this study. RV was most frequently identified in 82.6% of the samples. In the postvaccine cohort, 114 of the 300 (38%) samples were positive for at least one of the viruses tested. RV found in 36.5% of the samples. Coinfections found less frequently in the postvaccine cohort. Among circulating enteric viruses in Norway, RV is the most important cause of viral gastrointestinal infection. As expected, there were fewer RV positive and fewer coinfections after RV vaccine implementation. The results provide valuable data that can aid in further evaluation of the vaccine impact.

• Jørgensen, Marthe Jøntvedt; Holter, Jan Cato; Christensen, Erik; Schjalm, Camilla; Tonby, Kristian & Pischke, Soeren [Vis alle 22 forfattere av denne artikkelen] (2020). Increased interleukin-6 and macrophage chemoattractant protein-1 are associated with respiratory failure in COVID-19. Scientific Reports. 10. doi: 10.1038/s41598-020-78710-7. Fulltekst i vitenarkiv Vis sammendrag

  In SARS-CoV-2 infection there is an urgent need to identify patients that will progress to severe COVID-19 and may benefit from targeted treatment. In this study we analyzed plasma cytokines in COVID-19 patients and investigated their association with respiratory failure (RF) and treatment in Intensive Care Unit (ICU). Hospitalized patients (n = 34) with confirmed COVID-19 were recruited into a prospective cohort study. Clinical data and blood samples were collected at inclusion and after 2–5 and 7–10 days. RF was defined as PaO2/FiO2 ratio (P/F) < 40 kPa. Plasma cytokines were analyzed by a Human Cytokine 27-plex assay. COVID-19 patients with RF and/or treated in ICU showed overall increased systemic cytokine levels. Plasma IL-6, IL-8, G-CSF, MCP-1, MIP-1α levels were negatively correlated with P/F, whereas combinations of IL-6, IP-10, IL-1ra and MCP-1 showed the best association with RF in ROC analysis (AUC 0.79–0.80, p < 0.05). During hospitalization the decline was most significant for IP-10 (p < 0.001). Elevated levels of pro-inflammatory cytokines were present in patients with severe COVID-19. IL-6 and MCP-1 were inversely correlated with P/F with the largest AUC in ROC analyses and should be further explored as biomarkers to identify patients at risk for severe RF and as targets for improved treatment strategies.

• Smura, Teemu; Blomqvist, Soile; Kolehmainen, Pekka; Schuffenecker, Isabelle; Lina, Bruno & Böttcher, Sindy [Vis alle 19 forfattere av denne artikkelen] (2020). Aseptic meningitis outbreak associated with echovirus 4 in Northern Europe in 2013–2014. Journal of Clinical Virology. ISSN 1386-6532. 129. doi: 10.1016/j.jcv.2020.104535. Fulltekst i vitenarkiv
• Ueland, Thor; Heggelund, Lars; Lind, Andreas; Holten, Aleksander Rygh; Tonby, Kristian & Michelsen, Annika [Vis alle 26 forfattere av denne artikkelen] (2020). Elevated plasma sTIM-3 levels in patients with severe COVID-19. Journal of Allergy and Clinical Immunology. ISSN 0091-6749. 147(1), s. 92–98. doi: 10.1016/j.jaci.2020.09.007. Fulltekst i vitenarkiv Vis sammendrag

  Background The pathogenesis of coronavirus disease 2019 (COVID-19) is still incompletely understood, but it seems to involve immune activation and immune dysregulation. Objective We examined the parameters of activation of different leukocyte subsets in COVID-19–infected patients in relation to disease severity. Methods We analyzed plasma levels of myeloperoxidase (a marker of neutrophil activation), soluble (s) CD25 (sCD25) and soluble T-cell immunoglobulin mucin domain-3 (sTIM-3) (markers of T-cell activation and exhaustion), and sCD14 and sCD163 (markers of monocyte/macrophage activation) in 39 COVID-19–infected patients at hospital admission and 2 additional times during the first 10 days in relation to their need for intensive care unit (ICU) treatment. Results Our major findings were as follows: (1) severe clinical outcome (ICU treatment) was associated with high plasma levels of sTIM-3 and myeloperoxidase, suggesting activated and potentially exhausted T cells and activated neutrophils, respectively; (2) in contrast, sCD14 and sCD163 showed no association with need for ICU treatment; and (3) levels of sCD25, sTIM-3, and myeloperoxidase were inversely correlated with degree of respiratory failure, as assessed by the ratio of Pao2 to fraction of inspired oxygen, and were positively correlated with the cardiac marker N-terminal pro-B–type natriuretic peptide. Conclusion Our findings suggest that neutrophil activation and, in particular, activated T cells may play an important role in the pathogenesis of COVID-19 infection, suggesting that T-cell–targeted treatment options and downregulation of neutrophil activation could be of importance in this disorder.

• Zaman, K; Dudman, Susanne Gjeruldsen; Johansen, Kathrine Stene-; Qadri, Firdausi; Yunus, Md & Sandbu, Synne [Vis alle 20 forfattere av denne artikkelen] (2020). HEV study protocol : design of a cluster- randomised, blinded trial to assess the safety, immunogenicity and effectiveness of the hepatitis E vaccine HEV 239 (Hecolin) in women of childbearing age in rural Bangladesh. BMJ Open. 10:e033702, s. 1–8. doi: 10.1136/bmjopen-2019-033702. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis in the developing world and is a public health problem, in particular among pregnant women, where it may lead to severe or fatal complications. A recombinant HEV vaccine, 239 (Hecolin; Xiamen Innovax Biotech, Xiamen, China), is licensed in China, but WHO calls for further studies to evaluate the safety and immunogenicity of this vaccine in vulnerable populations, and to evaluate protection in pregnancy. We are therefore conducting a phase IV trial to assess the effectiveness, safety and immunogenicity of the HEV 239 vaccine when given in women of childbearing age in rural Bangladesh, where HEV infection is endemic. Methods and analysis Enrolment of a target of approximately 20 000 non-pregnant women, aged 16–39 years, started on 2 October 2017 in Matlab, Bangladesh. Sixty-seven villages were randomised by village at a 1:1 ratio to receive either the HEV vaccine or the control vaccine (hepatitis B vaccine). A 3-dose vaccination series at 0, 1 and 6 months is ongoing, and women are followed up for 24 months. The primary outcome is confirmed HEV disease among pregnant women. After vaccination, participants are requested to report information about clinical hepatitis symptoms. Participants who become pregnant are visited at their homes every 2 weeks to collect information about pregnancy outcome and to screen for clinical hepatitis. All suspected hepatitis cases undergo laboratory testing for diagnostic evaluation. The incidence of confirmed HEV disease among pregnant and non-pregnant women will be compared between the HEV vaccinated and control groups, safety and immunogenicity of the vaccine will also be evaluated. Ethics and dissemination The protocol was reviewed and approved by the International Centre for Diarrhoeal Disease Research, Bangladesh Research Review Committee and Ethical Review Committee, and the Directorate General of Drug Administration in Bangladesh, and by the Regional Ethics Committee in Norway. This article is based on the protocol version 2.2 dated 29 June 2017. We will present the results through peer-reviewed publications and at international conferences. Trial registration number The trial is registered at clinicaltrials.gov with the registry name “Effectiveness Trial to Evaluate Protection of Pregnant Women by Hepatitis E Vaccine in Bangladesh” and the identifier NCT02759991.

• Holter, Jan Cato; Pischke, Soeren; Boer, Eline de; Lind, Andreas; Jenum, Synne & Holten, Aleksander Rygh [Vis alle 32 forfattere av denne artikkelen] (2020). Systemic complement activation is associated with respiratory failure in COVID-19 hospitalized patients. Proceedings of the National Academy of Sciences of the United States of America (PNAS). ISSN 0027-8424. 117(40), s. 25018–25025. doi: 10.1073/pnas.2010540117. Fulltekst i vitenarkiv Vis sammendrag

  Respiratory failure in the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is hypothesized to be driven by an overreacting innate immune response, where the complement system is a key player. In this prospective cohort study of 39 hospitalized coronavirus disease COVID-19 patients, we describe systemic complement activation and its association with development of respiratory failure. Clinical data and biological samples were obtained at admission, days 3 to 5, and days 7 to 10. Respiratory failure was defined as PO2/FiO2 ratio of ≤40 kPa. Complement activation products covering the classical/lectin (C4d), alternative (C3bBbP) and common pathway (C3bc, C5a, and sC5b-9), the lectin pathway recognition molecule MBL, and antibody serology were analyzed by enzyme-immunoassays; viral load by PCR. Controls comprised healthy blood donors. Consistently increased systemic complement activation was observed in the majority of COVID-19 patients during hospital stay. At admission, sC5b-9 and C4d were significantly higher in patients with than without respiratory failure (P = 0.008 and P = 0.034). Logistic regression showed increasing odds of respiratory failure with sC5b-9 (odds ratio 31.9, 95% CI 1.4 to 746, P = 0.03) and need for oxygen therapy with C4d (11.7, 1.1 to 130, P = 0.045). Admission sC5b-9 and C4d correlated significantly to ferritin (r = 0.64, P < 0.001; r = 0.69, P < 0.001). C4d, sC5b-9, and C5a correlated with antiviral antibodies, but not with viral load. Systemic complement activation is associated with respiratory failure in COVID-19 patients and provides a rationale for investigating complement inhibitors in future clinical trials.

• Barlinn, Regine; Trogstad, Lill; Rollag, Halvor; Frøen, Jahn Frederik; Magnus, Per & Dudman, Susanne Gjeruldsen (2020). Parvovirus B19 DNAemia in pregnant women in relation to perinatal death: A nested case‐control study within a large population‐based pregnancy cohort. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 99(7), s. 856–864. doi: 10.1111/aogs.13801. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Parvovirus B19 (B19V) is the infectious cause of exanthema infectiosum. In Europe around 40% of pregnant women are susceptible to infection. Having small children at home is the main risk factor for contracting an infection during pregnancy. The association between B19V‐infection and perinatal death is not yet settled. The aims of the study were to estimate the association between maternal parvovirus B19 infection in pregnancy and perinatal death, and to assess the significance of a positive B19V PCR in pregnancy. Material and methods: The study population consists of women included in the Norwegian Mother and Child Cohort Study, a prospective population‐based pregnancy cohort of nearly 100 000 women. Blood samples were obtained during weeks 17‐18 in pregnancy (M1), at birth, and in umbilical cord blood. Within participants in the pregnancy cohort, 138 cases of perinatal death and 1350 controls with live‐born children were included in a nested case‐control study. Samples were analyzed with B19V serology and B19V PCR according to a predefined test algorithm. For cases, medical records and laboratory results from hospitals were combined with the results of B19V serology and PCR. The reported causes of perinatal death were categorized using the classification system: Causes Of Death and Associated Conditions (CODAC). Results: The B19V seroconversion rates were 9.8% for cases and 6.8% for control mothers. The odds ratio for maternal B19V infection in cases compared with controls was 1.28 (95% CI 0.35‐4.70), adjusted for age, parity, body mass index and tobacco use. B19V‐PCR‐positive samples were detected at weeks 17‐18 of gestation in both cases and controls. The proportion of positive samples was similar in cases and controls, 24% and 28.2%, respectively. Mothers with PCR‐positive M1 samples transmitted B19V vertically in 9.1% of cases and in 11.9% of the controls. Of all perinatal deaths, 53% were attributed to placental pathology or unknown causes. Conclusions: B19V PCR positivity was high and similar in both cases and controls. In our study B19V DNAemia was not seen to be associated with fatal outcome of pregnancy. The clinical significance of B19V DNA detection during pregnancy is uncertain. Caution is needed when diagnosing a B19V infection based only on B19V DNAemia.

• Knoester, Marjolein; Helfferich, J; Poelman, Randy; Leer-Buter, Coretta Van; Brouwer, OF & Niesters, Hubert G.M. [Vis alle 72 forfattere av denne artikkelen] (2019). Twenty-nine Cases of Enterovirus-D68-associated Acute Flaccid Myelitis in Europe 2016: A Case Series and Epidemiologic Overview. The Pediatric Infectious Disease Journal. ISSN 0891-3668. 38(1), s. 16–21. doi: 10.1097/INF.0000000000002188. Fulltekst i vitenarkiv Vis sammendrag

  Background: Enterovirus-D68 (EV-D68) is a respiratory virus within the genus Enterovirus and the family of Picornaviridae. Genetically, it is closely related to rhinovirus that replicates in the respiratory tract and causes respiratory disease. Since 2014, EV-D68 has been associated with the neurologic syndrome of acute flaccid myelitis (AFM). Methods: In October 2016, questionnaires were sent out to a European network including 66 virologists and clinicians, to develop an inventory of EV-D68–associated AFM cases in Europe. Clinical and virologic information of case patients was requested. In addition, epidemiologic information on EV testing was collected for the period between March and October 2016. Results: Twenty-nine cases of EV-D68–associated AFM were identified, from 12 different European countries. Five originated from France, 5 from Scotland and 3 each from Sweden, Norway and Spain. Twenty-six were children (median age 3.8 years), 3 were adults. EV-D68 was detected in respiratory materials (n = 27), feces (n = 8) and/or cerebrospinal fluid (n = 2). Common clinical features were asymmetric flaccid limb weakness, cranial nerve deficits and bulbar symptoms. On magnetic resonance imaging, typical findings were hyperintensity of the central cord and/or brainstem; low motor amplitudes with normal conduction velocities were seen on electromyography. Full clinical recovery was rare (n = 3), and 2 patients died. The epidemiologic data from 16 European laboratories showed that of all EV-D68–positive samples, 99% was detected in a respiratory specimen. Conclusions: For 2016, 29 EV-D68–related AFM cases were identified in mostly Western Europe. This is likely an underestimation, because case identification is dependent on awareness among clinicians, adequate viral diagnostics on respiratory samples and the capability of laboratories to type EVs.

• Mirinaviciute, Grazina; Barlinn, Regine Eva Annica; Dudman, Susanne Marie Rogne Gjeruldsen & Flem, Elmira (2019). Immunity to varicella zoster virus among pregnant women in the Norwegian Mother and Child Cohort Study. PLOS ONE. 14(8). doi: 10.1371/journal.pone.0221084. Fulltekst i vitenarkiv Vis sammendrag

  Infection with varicella zoster virus (VZV) in pregnancy may lead to serious outcomes both for the mother and the newborn. Targeted screening and vaccination of non-immune women during reproductive age could prevent varicella infection in pregnancy. Currently, no universal varicella screening of pregnant women is implemented in Norway, but serological testing in pregnancy is recommended in particular situations. We examined seroprevalence of VZV in a national pregnancy cohort in order to help assess a need for VZV screening of women during reproductive age. Methods We determined the susceptibility to VZV and the reliability of self-reported history of VZV infection in the Norwegian obstetric population by using a random sample of 1,184 pregnant women from the Norwegian Mother and Child Cohort study (MoBa). The MoBa study included approximately 95,200 pregnant women in Norway between 1998 and 2009. Blood samples taken at gestational week 17–18 were analysed using a commercial enzyme immunoassay for specific IgG antibodies to Varicella-Zoster virus. Second sample taken at birth was tested if the first sample result was negative or equivocal. Results Of the 1,184 pregnant women, 98.6% (n = 1,167) were seropositive, 0.83% (n = 10) remained seronegative, and four women (0.34%) seroconverted during their pregnancy. No significant associations were found between serological status and women’s age at birth, gestational age, women’s country of birth and year of child’s birth. One woman reported prior history of varicella, whereas 143 (12.1%) women reported a household exposure to childhood diseases with fever and rash, of which 25 reported exposure to varicella, of which all were seropositive. Conclusions The findings support antenatal screening recommendations in Norway advising testing for VZV in pregnant women with unknown immunity to VZV. Further studies are however needed to better identify target groups for screening and vaccination.

• Hayes, Alexander G.; Nguyen, Dung; Andersson, Monique I.; Antón, Andres; Bailly, Jean-Luc & Beard, Stuart [Vis alle 45 forfattere av denne artikkelen] (2019). A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts. Journal of Medical Virology. ISSN 0146-6615. doi: 10.1002/jmv.25659. Fulltekst i vitenarkiv Vis sammendrag

  Polymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in‐house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV‐A71, echovirus 30, coxsackie A virus 21, and EV‐D68), HPeV3, and specificity controls. Reported results from 48 in‐house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In‐house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10−5). EV‐specific PCRs showed low cross‐reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in‐house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point‐of‐care tests.

• Julin, Cathinka Halle; Hjortaas, Kristian; Dembinski, Jennifer Lynn; Sandbu, Synne; Øverbø, Joakim & Stene-Johansen, Kathrine [Vis alle 7 forfattere av denne artikkelen] (2019). Hepatitis E in Pregnant Women and the Potential Use of HEV Vaccine to Prevent Maternal Infection and Mortality. Current Tropical Medicine Reports. 6(4), s. 197–204. doi: 10.1007/s40475-019-00193-y. Fulltekst i vitenarkiv Vis sammendrag

  Purpose of Review Hepatitis E (HEV) is a continuing public health problem in developing countries, causing high mortality in pregnant women. This article reviews the latest knowledge on HEV in pregnancy, the vaccine candidates that have reached clinical trials, and their potential use during pregnancy. Recent Findings New evidence suggests that a genotype-specific tropism to uteroplacental cells contributes to the multifactorial pathology leading to the increased severity of HEV during pregnancy. Data from pregnant women inadvertently vaccinated are limited but show similar rates of adverse events as non-pregnant women, and no evident harm to newborns. Protective anti-HEV IgG antibodies are estimated to last longer after vaccination than natural infection. Accelerated vaccination appears safe and provides protective antibodies similar to a normal dosing regimen. Summary HEV239 is the most extensively studied vaccine and has been shown to be safe and effective, but more data are needed to recommend use of this vaccine on a global basis. Further studies should focus on safety and efficacy in pregnant women, and evaluate a shorter two-dose regime, which is highly warranted in outbreak situations.

• Mollers, Madellef; Barnadas, Celine; Broberg, Eeva; Penttinen, Pasi; Dudman, Susanne Gjeruldsen & Hauge, Siri Helene [Vis alle 8 forfattere av denne artikkelen] (2019). Current practices for respiratory syncytial virus surveillance across the EU/EEA Member States, 2017. Eurosurveillance. ISSN 1025-496X. 24(40). doi: 10.2807/1560-7917.ES.2019.24.40.1900157. Fulltekst i vitenarkiv
• Paulsen, Katrine Mørk; Vikse, Rose; Soleng, Arnulf; Edgar, Kristin Skarsfjord; Dudman, Susanne Gjeruldsen & Wiklund, Berit Sofie [Vis alle 7 forfattere av denne artikkelen] (2019). TBE in Norway. I Dobler, Gerhard; Erber, Wilhelm; Bröker, M. & Schmitt, Heinz-Josef (Red.), The TBE Book. Global Health Press. ISSN 9789811409141. doi: 10.33442/978-981-14-0914-1_12b-24. Fulltekst i vitenarkiv
• Barlinn, Regine; Dudman, Susanne Gjeruldsen; Trogstad, Lill; Gibory, Moustafa; Müller, Fredrik & Magnus, Per [Vis alle 7 forfattere av denne artikkelen] (2018). Maternal and congenital cytomegalovirus infections in a population-based pregnancy cohort study. APMIS - Journal of Pathologiy, Microbiology and Immunology. ISSN 0903-4641. 126(12), s. 899–906. doi: 10.1111/apm.12899. Fulltekst i vitenarkiv
• Milhano, Natacha Alexandra da Fonseca; Borge, Kaja Sverdrup; Bragstad, Karoline & Dudman, Susanne Gjeruldsen (2018). Management strategies of enterovirus D68 outbreaks: current perspectives. Virus Adaptation and Treatment. 10, s. 1–7. doi: 10.2147/VAAT.S140376. Fulltekst i vitenarkiv Vis sammendrag

  Following its discovery in California in 1962, enterovirus D68 (EV-D68) was reported only sporadically around the world. In August 2014, a marked increase of EV-D68 cases in young children with severe respiratory infections was reported in the USA and Canada and later in Europe and Asia. Some of these cases were also found to be associated with acute flaccid paralysis, which exacerbated public health concern, and has since triggered international efforts to strengthen both EV-D68 and acute flaccid paralysis surveillance systems. This review summarizes the current knowledge on EV-D68, offering an overview of EV-D68 epidemiology, clinical presentations, diagnostic methodologies, and treatment strategies, as well as surveillance and outbreak management.

• Broberg, Eeva K.; Simone, Benedetto; Jansa, Josep; Prochazka, Birgit; Wyndham-Thomas, Chloé & Ranst, Marc Van [Vis alle 32 forfattere av denne artikkelen] (2018). Upsurge in echovirus 30 detections in five EU/EEA countries, April to September, 2018. Eurosurveillance. ISSN 1025-496X. 23(44). doi: 10.2807/1560-7917.ES.2018.23.44.1800537. Fulltekst i vitenarkiv
• Bollestad, Marianne; Berg, Åse; Rake, Matias Mathisen; Dudman, Susanne Marie Rogne Gjeruldsen & DORENBERG, DAGNY HAUG (2018). En kvinne i 30-årene med sterk hodepine. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 138(9). doi: 10.4045/tidsskr.17.0444. Fulltekst i vitenarkiv
• Harvala, Heli; Broberg, Eeva; Benschop, Kimberley; Berginc, Natasa; Ladhani, Shamez & Susi, Petri [Vis alle 66 forfattere av denne artikkelen] (2018). Recommendations for enterovirus diagnostics and characterisation within and beyond Europe. Journal of Clinical Virology. ISSN 1386-6532. 101, s. 11–17. doi: 10.1016/j.jcv.2018.01.008. Fulltekst i vitenarkiv
• Siira, Lotta Linnea; Nøkleby, Hanne Magdalene; BARLINN, REGINE; Riise, Øystein Rolandsen; Aaberge, Ingeborg Sundsvalen & Dudman, Susanne Gjeruldsen (2018). Response to third rubella vaccine dose. Human Vaccines & Immunotherapeutics. ISSN 2164-5515. 14(10), s. 2472–2477. doi: 10.1080/21645515.2018.1475814. Fulltekst i vitenarkiv
• Paulsen, Katrine Mørk; Vikse, Rose; Soleng, Arnulf; Edgar, Kristin Skarsfjord; Dudman, Susanne Gjeruldsen & Wiklund, Berit Sofie [Vis alle 7 forfattere av denne artikkelen] (2017). TBE in Norway. I Dobler, Gerhard; Erber, Wilhelm; Chitimia-Dobler, Lidia & Schmitt, Heinz-Josef (Red.), The TBE Book. Global Health Press. Fulltekst i vitenarkiv
• Barlinn, Regine; Rollag, Halvor; Trogstad, Lill; Vainio, Kirsti; Basset, Coraline & Magnus, Per [Vis alle 7 forfattere av denne artikkelen] (2017). High incidence of maternal parvovirus B19 infection in a large unselected population-based pregnancy cohort in Norway. Journal of Clinical Virology. ISSN 1386-6532. 94, s. 57–62. doi: 10.1016/j.jcv.2017.07.010. Fulltekst i vitenarkiv
• Mögling, Ramona; Zeller, Hervé; Revez, Joana; Koopmans, Marion; Reusken, Chantal & Dudman, Susanne Gjeruldsen (2017). Status, quality and specific needs of Zika virus (ZIKV) diagnostic capacity and capability in National Reference Laboratories for arboviruses in 30 EU/EEA countries, MAY 2016. Eurosurveillance. ISSN 1025-496X. 22(36). doi: 10.2807/1560-7917.ES.2017.22.36.30609. Fulltekst i vitenarkiv
• Gibory, Moustafa; Haltbakk, Ildri; Flem, Elmira; Vainio, Kirsti; Salamanca, Beatriz Valcarcel & Størdal, Ketil [Vis alle 10 forfattere av denne artikkelen] (2017). Rotavirus detection in bulk stool and rectal swab specimens in children with acute gastroenteritis in Norway. Journal of Clinical Virology. ISSN 1386-6532. 97, s. 50–53. doi: 10.1016/j.jcv.2017.10.017. Fulltekst i vitenarkiv Vis sammendrag

  Background Bulk stool specimens are traditionally used for rotavirus detection but may be challenging to obtain from young children. Immediate and easy sampling may however be required in different situations, such as outbreak investigation. Objectives We assessed the diagnostic performance of rectal swabs compared to bulk stools for the detection of rotavirus by Enzyme Immunoassay (EIA) and multiplex semi-nested reverse transcription PCR (semi-nested RT-PCR) in children recruited through active hospital-based surveillance of acute gastroenteritis in Norway. Study design We obtained 265 paired bulk stool and rectal swab specimens from children under 5 years of age hospitalized with acute gastroenteritis (AGE). Both types of specimens were analyzed for rotavirus by EIA and semi-nested RT-PCR. In addition, VP6-spesific real-time PCR was used to evaluate the detection performance in the two specimen types. Results Concordant results were obtained in 257 (97%) paired specimens by EIA and in 248 (94%) pairs by semi-nested RT-PCR. Results of VP6-specific real-time PCR obtained from 100 pairs of specimens showed concordance in 91% of the pairs. Sensitivity and specificity for rectal swab specimens were 95% and 100% by EIA; 95% and 92% by semi-nested RT-PCR, respectively. Conclusion Both EIA and semi-nested RT-PCR showed a high accuracy, and rectal swab specimens are appropriate for rotavirus diagnosis and may be used as an alternate specimen type when collection of bulk stool is not feasible.

• Lange, Heidi; Øverbø, Joakim; Borgen, Katrine; Dudman, Susanne Gjeruldsen; Hoddevik, Gunnar M & Urdahl, Anne Margrete [Vis alle 8 forfattere av denne artikkelen] (2017). Hepatitis E in Norway: seroprevalence in humans and swine. Epidemiology and Infection. ISSN 0950-2688. 145(1), s. 181–186. doi: 10.1017/S0950268816002144. Fulltekst i vitenarkiv
• Milhano, Natacha Alexandra da Fonseca; Korslund, Lars; Evander, Magnus; Ahlm, Clas; Vainio, Kirsti & Dudman, Susanne Gjeruldsen [Vis alle 7 forfattere av denne artikkelen] (2017). Circulation and diagnostics of Puumala virus in Norway: nephropatia epidemica incidence and rodent population dynamics. APMIS - Journal of Pathologiy, Microbiology and Immunology. ISSN 0903-4641. 125(8), s. 732–742. doi: 10.1111/apm.12712. Fulltekst i vitenarkiv
• Rosenstierne, Maiken Worsøe; Karlberg, Helen; Bragstad, Karoline; Lindegren, Gunnel; Stoltz, Malin Lundahl & Salata, Cristiano [Vis alle 10 forfattere av denne artikkelen] (2016). Rapid bedside inactivation of Ebola virus for safe nucleic acid tests. Journal of Clinical Microbiology. ISSN 0095-1137. 54(10), s. 2521–2529. doi: 10.1128/JCM.00346-16. Fulltekst i vitenarkiv
• Voltersvik, Pål; Aqrawi, Lara Adnan; Dudman, Susanne Gjeruldsen; Hungnes, Olav; Bostad, Leif & Brokstad, Karl Albert [Vis alle 7 forfattere av denne artikkelen] (2016). Pulmonary changes in Norwegian fatal cases of pandemic influenza H1N1 (2009) infection: a morphologic and molecular genetic study. Influenza and Other Respiratory Viruses. ISSN 1750-2640. 10(6), s. 525–531. doi: 10.1111/irv.12410. Fulltekst i vitenarkiv Vis sammendrag

  Background: During the pandemic outbreak of the 2009 swine influenza (A(H1N1) pdm09), 32 fatal cases occurred in Norway and 19 of these were included in this study. Objectives: We characterised pulmonary changes in these fatal Norwegian cases. Patients and Methods: Upon hospitalisation, detailed clinical information and specimens from the upper and lower respiratory pathways were collected. At post-mortem, lung tissue was collected, formalin-fixed and paraffin-embedded. Immunohistochemical and light microscopic examination was performed to visualise the local expression of the A(H1N1) pdm09 virus. Reverse transcription-polymerase chain reaction (RT-PCR) and pyrosequencing of the non-fixed specimens allowed the identification of mutations in the influenza virus surface glycoprotein (haemagglutinin gene) particularly at position 222. Results and Conclusions: The overall course of illness lasted from 2 to 40 days (median 9 days). Diffused alveolar damage (DAD) was evident in 11 cases, 4 of which had no apparent underlying illness. Obesity was prominent in 12 cases, where three individuals were classified as otherwise healthy. The HA D222G mutation was detected in six cases, 3 of which had no underlying illness. Immunohistochemistry showed the A(H1N1)pdm09 virus to be prominent at the site of inflammation both in close proximity to and inside alveolar structures in the lung tissue. In addition to a possible role for the HA D222G mutation, our findings indicate that host factors and underlying conditions in the infected individuals are fundamental for disease outcome in many cases. This study increases our understanding of determinants for the clinical outcome of pandemic influenza, which could guide future treatment.

• Poelman, Randy; Schuffenecker, Isabelle; Leer-Buter, Coretta Van; Josset, Laurence; Niesters, Hubert G.M. & Lina, Bruno [Vis alle 11 forfattere av denne artikkelen] (2015). European surveillance for enterovirus D68 during the emerging North-American outbreak in 2014. Journal of Clinical Virology. ISSN 1386-6532. 71, s. 1–9. doi: 10.1016/j.jcv.2015.07.296. Fulltekst i vitenarkiv
• Findal, Gry; Barlinn, Regine; Sandven, Irene; Stray-Pedersen, Babill; Nordbø, Svein Arne & Samdal, Helvi Holm [Vis alle 9 forfattere av denne artikkelen] (2015). Toxoplasma prevalence among pregnant women in Norway: A cross-sectional study. APMIS - Journal of Pathologiy, Microbiology and Immunology. ISSN 0903-4641. 123(4), s. 321–325. doi: 10.1111/apm.12354. Fulltekst i vitenarkiv
• Cuber, Piotr; Andreassen, Åshild Kristine; Vainio, Kirsti; Asman, Marek; Dudman, Susanne Gjeruldsen & Szilman, Piotr [Vis alle 11 forfattere av denne artikkelen] (2015). Risk of exposure to ticks (Ixodidae) and the prevalence of tick-borne encephalitis virus (TBEV) in ticks in Southern Poland. Ticks and Tick-borne Diseases. ISSN 1877-959X. 6(3), s. 356–363. doi: 10.1016/j.ttbdis.2015.02.010. Fulltekst i vitenarkiv
• Paulsen, Katrine Mørk; Pedersen, Benedikte Nevjen; Soleng, Arnulf; B, Okbaldet Yohanns; Pettersson, John & Dudman, Susanne Gjeruldsen [Vis alle 10 forfattere av denne artikkelen] (2015). Prevalence of tick-borne encephalitis virus in Ixodes ricinus ticks from three islands in north-western Norway. APMIS - Journal of Pathologiy, Microbiology and Immunology. ISSN 0903-4641. 123(9), s. 759–764. doi: 10.1111/apm.12412. Fulltekst i vitenarkiv
• Bragstad, Karoline; Jakobsen, Kirsti; Rojahn, Astrid; Skram, Marius Kurås; Vainio, Kirsti & Holberg-Petersen, Mona [Vis alle 9 forfattere av denne artikkelen] (2015). High frequency of enterovirus D68 in children hospitalised with respiratory illness in Norway, autumn 2014. Influenza and Other Respiratory Viruses. ISSN 1750-2640. 9(2), s. 59–63. doi: 10.1111/irv.12300. Fulltekst i vitenarkiv
• Pfeiffer, Helle Cecilie; Bragstad, Karoline; Skram, Marius Kurås; Dahl, Hilde Margrete; Knudsen, Per Kristian & Chawla, Maninder Singh [Vis alle 11 forfattere av denne artikkelen] (2015). Two cases of acute severe flaccid myelitis associated with enterovirus D68 infection in children, Norway, autumn 2014. Eurosurveillance. ISSN 1025-496X. 20(10). doi: 10.2807/1560-7917.ES2015.20.10.21062. Fulltekst i vitenarkiv
• Larsen, Astrid Lervik; Kanestrøm, Anita; Bjørland, Marthe; Andreassen, Åshild Kristine; Soleng, Arnulf & Vene, Sirkka [Vis alle 7 forfattere av denne artikkelen] (2014). Detection of specific IgG antibodies in blood donors and tick-borne encephalitis virus in ticks within a non-endemic area in southeast Norway. Scandinavian Journal of Infectious Diseases. ISSN 0036-5548. 46(3), s. 181–184. doi: 10.3109/00365548.2013.865140. Fulltekst i vitenarkiv
• Hjetland, Reidar; Henningsson, Anna J.; Vainio, Kirsti; Dudman, Susanne Gjeruldsen; Grude, Nils & Ulvestad, Elling (2014). Seroprevalence of antibodies to tick-borne encephalitis virus and Anaplasma phagocytophilum in healthy adults from western Norway. Scandinavian Journal of Infectious Diseases. ISSN 0036-5548. 47(1), s. 52–56. doi: 10.3109/00365548.2014.959044. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this study was to assess the seroprevalence of antibodies to tick-borne encephalitis virus (TBEV) and Anaplasma phagocytophilum in a healthy adult population from Sogn and Fjordane county in western Norway. Sera from 1, 213 blood donors were analysed for IgG-antibodies to TBEV, and a random subgroup of 301 donors for IgG to A. phagocytophilum. In the TBEV ELISA, five (0.4%) sera were positive. These were all interpreted as “false” positives, as four had received vaccines against flaviviruses, and the remaining was negative for neutralizing antibodies to TBEV. Antibodies to A. phagocytophilum were detected by indirect immunofluorescence in 49 (16.2%) subjects (titer range 80-1280). The results indicate that TBE currently is not endemic in this part of western Norway. However, there is serological evidence of the existence of human granulocytic anaplasmosis in the population.

• Fernandez-Garcia, M; Negredo, *; Papa, *; Donoso-Mantke, *; Niedrig, * & Zeller, * [Vis alle 38 forfattere av denne artikkelen] (2014). European survey on laboratory preparedness, response and diagnostic capacity for crimean-congo haemorrhagic fever, 2012. Eurosurveillance. ISSN 1025-496X. 19(26). Fulltekst i vitenarkiv
• BARLINN, REGINE; Vainio, M Kirsti; Samdal, Helvi Holm; Nordbø, Svein Arne; Nøkleby, Hanne & Dudman, Susanne Gjeruldsen (2014). Susceptibility to cytomegalovirus, parvovirus B19 and age-dependent differences in levels of rubella antibodies among pregnant women. Journal of Medical Virology. ISSN 0146-6615. 86(5), s. 820–826. doi: 10.1002/jmv.23757. Fulltekst i vitenarkiv
• Florek, Nicholas W.; Weinfurter, Jason T.; Jegaskanda, Sinthujan; Brewoo, Joseph N.; Powell, Tim D. & Young, Ginger R. [Vis alle 16 forfattere av denne artikkelen] (2014). Modified vaccinia virus ankara encoding influenza virus hemagglutinin induces heterosubtypic immunity in macaques. Journal of Virology. ISSN 0022-538X. 88(22), s. 13418–13428. doi: 10.1128/JVI.01219-14. Fulltekst i vitenarkiv
• Pereyaslov, D; Rosin, P; Palm, D; Zeller, H; Gross, D & Brown, CS [Vis alle 85 forfattere av denne artikkelen] (2014). Laboratory capability and surveillance testing for middle east respiratory syndrome coronavirus infection in the who european region, June 2013. Eurosurveillance. ISSN 1025-496X. 19(40). Fulltekst i vitenarkiv
• Rykkvin, Rikard; Kilander, Anette; Dudman, Susanne Gjeruldsen & Hungnes, Olav (2013). Within-patient emergence of the influenza A(H1N1) pdm09 HA1 222G variant and clear association with severe disease, Norway. Eurosurveillance. ISSN 1025-496X. 18(3), s. 3–13. Fulltekst i vitenarkiv
• Ytrehus, Bjørnar; Vainio, M Kirsti; Dudman, Susanne Gjeruldsen; Gilray, Janice & Willoughby, Kim (2013). Tick-borne encephalitis virus and louping-ill virus may co-circulate in Southern Norway. Vector Borne and Zoonotic Diseases. ISSN 1530-3667. 13(10), s. 762–768. doi: 10.1089/vbz.2012.1023. Fulltekst i vitenarkiv
• Simonsen, Gunnar Skov; Steinbakk, Martin; Elstrøm, Petter; Larssen, Kjersti Wik; Gran, Frode Width & VESTRHEIM, DIDRIK FRIMANN [Vis alle 11 forfattere av denne artikkelen] (2013). Human Clinical Isolates. I Simonsen, Gunnar Skov & Urdahl, Anne Margrete (Red.), NORM/NORM-VET 2012; Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway. Universitet i Nord-Norge, Veterinærinstituttet og Folkehelseinstituttet. s. 57–85. Fulltekst i vitenarkiv
• Steen, Tore Wælgaard; Arnesen, Trude M; Dudman, Susanne Gjeruldsen; Rojahn, Astrid & Rønning, Karin (2012). Meslingutbrudd ved økt reisevirksomhet og lav vaksinedekning. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 132(8), s. 937–939. doi: 10.4045/tidsskr.11.1269. Fulltekst i vitenarkiv
• Watanabe, Tokiko; Imai, Masaki; Watanabe, Shinji; Shinya, Kyoko; Hatta, Masato & Li, Chengjun [Vis alle 23 forfattere av denne artikkelen] (2012). Characterization In Vitro and In Vivo of Pandemic (H1N1) 2009 Influenza Viruses Isolated from Patients. Journal of Virology. ISSN 0022-538X. 86(17), s. 9361–9368. doi: 10.1128/JVI.01214-12. Fulltekst i vitenarkiv
• Andreassen, Åshild Kristine; Jore, Solveig; Cuber, Piotr; Dudman, Susanne Gjeruldsen; Tengs, Torstein & Isaksen, Ketil [Vis alle 11 forfattere av denne artikkelen] (2012). Prevalence of tick borne encephalitis virus in tick nymphs in relation to climatic factors on the southern coast of Norway. Parasites & Vectors. 5. doi: 10.1186/1756-3305-5-177. Fulltekst i vitenarkiv Vis sammendrag

  Background: Tick-borne encephalitis (TBE) is among the most important vector borne diseases of humans in Europe and is currently identified as a major health problem in many countries. TBE endemic zones have expanded over the past two decades, as well as the number of reported cases within endemic areas. Multiple factors are ascribed for the increased incidence of TBE, including climatic change. The number of TBE cases has also increased in Norway over the past decade, and the human cases cluster along the southern coast of Norway. In Norway the distribution and prevalence of TBE virus (TBEV) in tick populations is largely unknown. The objectives of this study were to estimate the TBEV prevalence in Ixodes ricinus from seven locations and to assess the relationship between the TBEV prevalence and site-specific climatic variables. Methods: A total of 5630 questing nymphs were collected and analyzed in pools of ten. All pools were screened with an in-house real-time RT-PCR, and the positive pools were pyrosequenced. Two methods, minimum infection rate (MIR) and a frequentist method (EPP) for pooled prevalence estimations were calculated and compared. Climatic data were descriptively compared to the corresponding EPP of each location in order to explain variations in TBEV prevalence. Results: The seven foci of TBEV had an estimated overall prevalence (EPP) in pools of nymphs combined, of 0.53% with 95% CI (0.35–0.75), with point prevalence ranging between 0.11%–1.22%. The sites with the highest point prevalences were within the municipalities which had the highest numbers of registered TBE cases. The results indicate that the location with highest point prevalence had the highest relative mean humidity and lowest mean saturation deficit and vice versa for the lowest EPP. Conclusion: Our study confirms the existence of TBEV endemic foci in Norway. These results are of importance to increase the awareness of TBEV infections in Norway and could be used for public information and recommendations of TBE vaccination. EPP is the method of choice for pooled prevalence calculations, since it provides estimated prevalences with confidence intervals. Our findings emphasise the possible importance of microclimatic conditions regarding the TBEV prevalence in ticks.

• Vainio, M Kirsti; Steen, T W; Arnesen, T M; Rønning, Karin; Ånestad, Gabriel & Dudman, Susanne Gjeruldsen (2012). Measles virus genotyping an important tool in measles outbreak investigation in Norway, 2011. Eurosurveillance. ISSN 1025-496X. 17(50). Fulltekst i vitenarkiv
• Waalen, Kristian; Kilander, Anette; Dudman, Susanne Gjeruldsen; Ramos-Ocao, Remilyn Vicenta R. & Hungnes, Olav (2012). Age-dependent prevalence of antibodies cross-reactive to the influenza A(H3N2) variant virus in sera collected in Norway in 2011. Eurosurveillance. ISSN 1025-496X. 17(19). Fulltekst i vitenarkiv
• Heyman, P; Ceianu, CS; Christova, I; Tordo, N; Beersma, M & Alves, MJ [Vis alle 28 forfattere av denne artikkelen] (2011). A five-year perspective on the situation of haemorrhagic fever with renal syndrome and status of the hantavirus reservoirs in Europe, 2005-2010. Eurosurveillance. ISSN 1025-496X. 16(36). Fulltekst i vitenarkiv
• Heyman, P; Ceianu, CS; Christova, I; Tordo, N; Beersma, M & Joao, Maria [Vis alle 27 forfattere av denne artikkelen] (2011). A five-year perspective on the situation of haemorrhagic fever with renal syndrome and status of the hantavirus reservoirs in Europe, 2005-2010. Eurosurveillance. ISSN 1025-496X. 16(36). doi: 10.2807/ese.16.36.19961-en. Fulltekst i vitenarkiv
• Yri, Olav Erich; Torfoss, Dag; Hungnes, Olav; Tierens, Anne; Waalen, Kristian & Nordøy, Tone [Vis alle 13 forfattere av denne artikkelen] (2011). Rituximab blocks protective serologic response to influenza A (H1N1) 2009 vaccination in lymphoma patients during or within 6 months after treatment. Blood. ISSN 0006-4971. 118(26), s. 6769–6771. doi: 10.1182/blood-2011-08-372649. Fulltekst i vitenarkiv Vis sammendrag

  Cancer patients are often encouraged to receive seasonal influenza vaccination. The monoclonal antibody rituximab is widely used in treatment of non-Hodgkin lymphoma. This results in a prolonged depletion of normal B cells, which might impair humoral responses. The aim of the present study was to investigate whether lymphoma patients undergoing rituximab-containing treatment regimens or having received such regimens within the past 6 months were able to mount protective antibody responses to the influenza A(H1N1) 2009 virus vaccine Pandemrix during the 2009 “swine flu” pandemic. Contrary to the control group, where 82% responded adequately to the vaccine, none of the 67 patients achieved protective antibody titers, suggesting that lymphoma patients receiving rituximab-containing regimens might not benefit from this vaccine. It is important that doctors who care for such patients are aware that they may fail to respond not only to the influenza vaccine, but also to other common vaccines.

• Watanabe, Tokiko; Shinya, Kyoko; Watanabe, Shinji; Imai, Masaki; Hatta, Masato & Li, Chengjun [Vis alle 38 forfattere av denne artikkelen] (2011). Avian-type receptor-binding ability can increase influenza virus pathogenicity in Macaques. Journal of Virology. ISSN 0022-538X. 85(24), s. 13195–13203. doi: 10.1128/JVI.00859-11. Fulltekst i vitenarkiv
• Vainio, M Kirsti; Rønning, Karin; Steen, TW; Arnesen, TM; Ånestad, Gabriel & Dudman, Susanne Gjeruldsen (2011). Ongoing outbreak of measles in Oslo, Norway, January-February 2011. Eurosurveillance. ISSN 1025-496X. 16(8), s. 9–11. Fulltekst i vitenarkiv
• Vainio, M Kirsti; Noraas, Sølvi; Holmberg, Marte; Fremstad, Hege Reinertsen; Wahlstrøm, H & Ånestad, Gabriel [Vis alle 7 forfattere av denne artikkelen] (2010). Fatal and mild primary dengue virus infections imported to Norway from Africa and south-east Asia, 2008-2010. Eurosurveillance. ISSN 1025-496X. 15(38). Fulltekst i vitenarkiv
• Kilander, Anette; Rykkvin, Rikard; Dudman, Susanne Gjeruldsen & Hungnes, Olav (2010). Observed association between the HA1 mutation D222G in the 2009 pandemic influenza A(H1N1) virus and severe clinical outcome, Norway 2009-2010. Eurosurveillance. ISSN 1025-496X. 15(9), s. 6–8. Fulltekst i vitenarkiv
• Waalen, Kristian; Kilander, Anette; Dudman, Susanne Gjeruldsen; Krogh, Grethe Hermansen; Aune, Torstein & Hungnes, Olav (2010). High prevalence of antibodies to the 2009 pandemic influenza A(H1N1) virus in the Norwegian population following a major epidemic and a large vaccination campaign in autumn 2009. Eurosurveillance. ISSN 1025-496X. 15(31). Fulltekst i vitenarkiv
• Hauge, Siri Helene; Dudman, Susanne Gjeruldsen; Borgen, Katrine; Hungnes, Olav; Brantsæter, Arne Broch & Iversen, Bjørn Gunnar [Vis alle 7 forfattere av denne artikkelen] (2009). Sykdom forårsaket av nytt A(H1N1)-influensavirus. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 129(17), s. 1736–1739. doi: 10.4045/tidsskr.09.0748. Fulltekst i vitenarkiv
• Hauge, Siri Helene; Dudman, Susanne Gjeruldsen; Borgen, Katrine; Lackenby, Angie & Hungnes, Olav (2009). Oseltamivir-resistant influenza viruses A (H1N1), Norway, 2007-08. Emerging Infectious Diseases. ISSN 1080-6040. 15(2), s. 155–162. doi: 10.3201/eid1502.081031. Fulltekst i vitenarkiv
• Ciancio, BC; Meerhoff, TJ; Kramarz, P; Bonmarin, I; Borgen, Katrine & Boucher, CA [Vis alle 20 forfattere av denne artikkelen] (2009). Oseltamivir-resistant influenza A(H1N1) viruses detected in Europe during season 2007-8 had epidemiologic and clinical characteristics similar to co-circulating susceptible A(H1N1) viruses. Eurosurveillance. ISSN 1025-496X. 14(46), s. 13–20. Fulltekst i vitenarkiv
• Hauge, Siri Helene; Blix, Hege Salvesen; Borgen, Katrine; Hungnes, Olav; Dudman, Susanne Gjeruldsen & Aavitsland, Preben (2009). Sales of oseltamivir in Norway prior to the emergence of oseltamivir resistant influenza A(H1N1) viruses in 2007-08. Virology Journal. 6. doi: 10.1186/1743-422X-6-54. Fulltekst i vitenarkiv
• Lackenby, A; Hungnes, Olav; Dudman, Susanne Gjeruldsen; Meijer, A; Paget, WJ & Hay, AJ [Vis alle 7 forfattere av denne artikkelen] (2008). Emergence of resistance to oseltamivir among influenza A(H1N1) viruses in Europe. Eurosurveillance. ISSN 1025-496X. 13(5). Fulltekst i vitenarkiv
• Dudman, Susanne Gjeruldsen; Stene-Johansen, Kathrine & Vik, Inger Sofie Samdal (2008). Resistens ved virusinfeksjoner. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(22), s. 2597–2600. Fulltekst i vitenarkiv
• Hungnes, Olav & Dudman, Susanne Gjeruldsen (2008). Resistens hos influensavirus. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(22), s. 2601–2606. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Aziz, Asma Binte; Dudman, Susanne Gjeruldsen; Zaman, Khalequ & Clemens, John D (2024). Hepatitis E vaccine and fetal loss: the potential pathophysiological basis – Authors' reply. The Lancet Global Health. ISSN 2572-116X. 12(11), s. e1760–e1760. doi: 10.1016/S2214-109X(24)00412-1. Fulltekst i vitenarkiv
• Øverbø, Joakim; Aziz, Asma; Dudman, Susanne Gjeruldsen; Dembinski, Jennifer Lynn; Stene-Johansen, Kathrine & Julin, Cathinka H. [Vis alle 7 forfattere av denne artikkelen] (2023). Promising results from a hepatitis E vaccine study in rural Bangladesh. Fulltekst i vitenarkiv
• Øverbø, Joakim; Aziz, Asma; Zaman, K.; Clemens, John D.; Julin, Cathinka H. & Qadri, Firdausi [Vis alle 16 forfattere av denne artikkelen] (2023). Promising results from a hepatitis E vaccine study in rural Bangladesh. Fulltekst i vitenarkiv
• Aziz, Asma; Julin, Cathinka H.; Dudman, Susanne Gjeruldsen; Øverbø, Joakim; Ali, Mohammad & Stene-Johansen, Kathrine [Vis alle 13 forfattere av denne artikkelen] (2023). Exposure to Hepatitis E vaccine (Hecolin®) and pregnancy outcome: Preliminary results from a Phase IV effectiveness study in rural Bangladesh. Fulltekst i vitenarkiv
• Zaman, K.; Julin, Cathinka H.; Stene-Johansen, Kathrine; Yunus, Md; Qadri, Firdausi & Gurley, Emily S. [Vis alle 17 forfattere av denne artikkelen] (2023). Safety and effectiveness of a recombinant hepatitis E vaccine among women of child bearing age: a large-scale, cluster randomized, double-blind placebo-controlled, phase 4 trial in rural Bangladesh. Fulltekst i vitenarkiv
• Dudman, Susanne Gjeruldsen; Øverbø, Joakim; Aziz, Asma; Julin, Cathinka H.; Stene-Johansen, Kathrine & Qadri, Firdausi [Vis alle 14 forfattere av denne artikkelen] (2023). Immunogenicity after three doses of a recombinant hepatitis E vaccine in female participants in a randomized placebo-controlled trial in rural Bangladesh. Fulltekst i vitenarkiv
• Dudman, Susanne (2022). Prospect for a Hepatitis E vaccine. Fulltekst i vitenarkiv
• Dudman, Susanne Gjeruldsen & Øverbø, Joakim (2022). Hepatitt E - en verdensomspennende epidemi og en lovende vaksine. Fulltekst i vitenarkiv
• Dudman, Susanne Gjeruldsen & Øverbø, Joakim (2021). Gravide kan også vaksineres mot hepatitt E. Fulltekst i vitenarkiv
• Dudman, Susanne (2020). HEV Vaccine Study - trial status and preliminary results. Fulltekst i vitenarkiv
• Ueland, Thor; Holter, Jan Cato; Holten, Aleksander Rygh; Muller, Karl Erik; Lind, A. & Bekken, Gry Klouman [Vis alle 10 forfattere av denne artikkelen] (2020). Distinct and early increase in circulating MMP-9 in COVID-19 patients with respiratory failure: MMP-9 and respiratory failure in COVID-19. Journal of Infection. ISSN 0163-4453. 81(3), s. e41–e43. doi: 10.1016/j.jinf.2020.06.061. Fulltekst i vitenarkiv
• Øverbø, Joakim; Dembinski, Jennifer Lynn; Julin, Cathinka Halle; Stene-Johansen, Kathrine; Qadri, Dr Firdausi & Zaman, K [Vis alle 7 forfattere av denne artikkelen] (2020). Hepatitis E virus antibody detection using dried blood spots. Fulltekst i vitenarkiv
• Aziz, Asma; Dembinski, Jennifer Lynn; Yunus, Md.; Øverbø, Joakim; Dudman, Susanne & Stene-Johansen, Kathrine [Vis alle 12 forfattere av denne artikkelen] (2020). Hepatitis E vaccine safety in healthy adults: Data from a pilot phase of a cluster-randomized effectiveness trial. Fulltekst i vitenarkiv
• Zaman, K & Dudman, Susanne (2020). Designing a cluster-randomized trial to assess the safety, immunogenicity and effectiveness of a Hepatitis E vaccine in women of childbearing age in rural Bangladesh. Fulltekst i vitenarkiv
• Øverbø, Joakim; Dudman, Susanne; Stene-Johansen, Kathrine; Dembinski, Jennifer Lynn; Julin, Cathinka Halle & Sandbu, Synne [Vis alle 8 forfattere av denne artikkelen] (2020). Hepatitis E virus IgG antibody detection using dried blood spots. Fulltekst i vitenarkiv
• Øverbø, Joakim; Dembinski, Jennifer Lynn; Julin, Cathinka Halle; Stene-Johansen, Kathrine & Dudman, Susanne (2019). Hepatitis E virus IgG antibody detection using dried blood spots. Fulltekst i vitenarkiv
• Julin, Cathinka Halle; Dembinski, Jennifer Lynn; Stene-Johansen, Kathrine; Øverbø, Joakim; Qadri, Dr Firdausi & Rahman, Mustafizur [Vis alle 15 forfattere av denne artikkelen] (2017). Feasibility of conducting a Hepatitis E vaccine trial in rural Bangladesh; Results from a pilot study. Fulltekst i vitenarkiv
• Paulsen, Katrine Mørk; Vikse, Rose; Soleng, Arnulf; Edgar, Kristin Skarsfjord; Dudman, Susanne Gjeruldsen & Wiklund, Berit Sofie [Vis alle 7 forfattere av denne artikkelen] (2017). TBE in Norway. I Dobler, Gerhard; Erber, Wilhelm & Schmitt, Heinz-Josef (Red.), TBE - The Book. Global Health Press Pte Ltd. ISSN 9789811119033. Fulltekst i vitenarkiv
• Dembinski, Jennifer Lynn; Rahman, Mustafizur; Julin, Cathinka Halle; Qadri, Dr Firdausi; Øverbø, Joakim & Stene-Johansen, Kathrine [Vis alle 13 forfattere av denne artikkelen] (2017). Laboratory analysis plan for a phase IV effectiveness trial to evaluate the protection of pregnant women with a hepatitis E vaccine in rural Bangladesh and the risk factors for severe hepatitis E infection. Fulltekst i vitenarkiv
• Zaman, K; Dudman, Susanne; Stene-Johansen, Kathrine; Øverbø, Joakim; Dembinski, Jennifer Lynn & Julin, Cathinka Halle [Vis alle 17 forfattere av denne artikkelen] (2017). Designing a cluster-randomized trial to assess the safety, immunogenicity and effectiveness of a Hepatitis E vaccine in women of childbearing age in rural Bangladesh. Fulltekst i vitenarkiv
• Riise, Øystein Rolandsen; Rønning, Karin; Dudman, Susanne Gjeruldsen & Sandbu, Synne (2017). Kan Norge holdes fritt for rubella og meslinger? 137(14/15), s. 1004–1006. doi: 10.4045/tidsskr.17.0047. Fulltekst i vitenarkiv
• Paulsen, Katrine Mørk; Gurung, D; B, Okbaldet Yohanns; Gibory, Moustafa; Pedersen, Benedikte Nevjen & Vainio, Kirsti [Vis alle 20 forfattere av denne artikkelen] (2016). Tick-borne diseases in a one health perspective, host and pathogen interplays The search for TBE virus and related pathogens. Fulltekst i vitenarkiv Vis sammendrag

  TBEV (Tick-borne encephalitis virus) and Borrelia burgdorferi sensu lato are among the most important vector-borne diseases that are emerging. They are the main diseases transmitted by Ixodes ricinus ticks in Europe. I. ricinus is known to transmit other pathogenic microorganisms like- louping ill virus, Anaplasma phagocytophilum, and endosymbionts like-Wolbachia pipientis and Midichloria mitochondrii that may have an influence of the pathogenesis in humans and animals. Factors like climate change, human behavior and migrating animals are involved in the distribution of diseases. The main route of disease transmission is through tick bites, but infection through alimentary system for serious infectious agents like TBEV and wild and production animals as sentinels for transmission. The knowledge of natural foci and prevalence of these infectious microorganisms is important for risk assessment of human disease. Preliminary results from 3240 nymph and 234 adult ticks were collected from six location sites of three counties in Norway. The tick samples were analyzed and minimum infection rate/prevalence was calculated. Body fluids of the host animals are valuable epidemiological parameters for TBEV like cow milk and serum from sheep and cows. This study confirms the existence of TBEV endemic foci compared to earlier study. The prevalence of B. burgdorferi s.l., were analyzed in adult ticks while the prevalence of A. phagocytophilum, W. pipientis, M. mitochondrii were studied in nymph and adults. TBEV were detected in a new location in Hordaland county. The detection of TBEV in milk and serum from cows has never been reported in Norway before.

• Neves, Carlos G Das; Paulsen, Katrine Mørk; Gurung, D; Vainio, Kirsti; Dudman, Susanne Gjeruldsen & Heum, Marianne [Vis alle 9 forfattere av denne artikkelen] (2016). TICK-BORNE DISEASES IN A ONE HEALTH PERSPECTIVE, HOSTAND PATHOGEN INTERPLAYS – THE SEARCH FOR TBE VIRUS AND RELATED PATHOGENS IN WILD AND PRODUCTION ANIMALS. Fulltekst i vitenarkiv Vis sammendrag

  TBEV (Tick-borne encephalitis virus) and Borrelia burgdorferi sensu lato are among the most important emerging vector-borne diseases in Europe transmit-ted by the hard tick Ixodes ricinus. I. ricinus is also known to transmit other pathogenic microorganisms like-louping ill virus, Anaplasma phagocytophi-lum, Neoerlichia spp. or Rickettsia spp. which may have an influence of the pathogenesis in humans and animals. Factors like climate change, human be-haviour and migrating animals are involved in the distribution of diseases. The main route of disease transmission is through tick bites, but wild and produc-tion animals are also susceptible to infection and can serve as sentinels/ early warning systems for transmission. 653 serum samples were collected in 15 of the 19 counties in mainland Nor-way from wild reindeer, moose, roe deer and red deer. 3240 nymph and 234 adult ticks were collected from six location sites of three counties in Norway, and 29 milk and serum samples were collected from bovine milk production farms in areas where TBE is known to be present. TBE IgG seroprevalence results from cervids shows that 32 of 653 tested sera had antibodies. The posi-tive TBE IgG sera were found in the counties of Vestfold, Østfold, Aust-Agder, Vest-Agder, Rogaland, Nord-Trøndelag and Nordland. Additional tests to discriminate between TBE and louping ill are currently under way (PCR and neutralization assays). The Estimated Pooled Prevalence (EPP) and the minimum infection rate (MIR) were calculated for nymphs and adults. TBEV were detected in most sites analysed with an overall EPP of 0.26 % in nymphs and 2.62 % in adults. The overall prevalence of DNA analysis of B. burgdorferi s.l. in adult ticks was 6.41%, A. phagocytophilum in nymph was 8% and in adult 19%. Of the total 29 analysed individual cow milk samples, results indicate prevalence of up to 25%, and preliminary PCR results seem to confirm the presence of the viral RNA in individual milk samples. These results seem to indicate that TBEV (and likely other emerging agents) is circulating in wild species and production animals, for which further studies should be conducted to evaluate the importance of these animals in the maintenance and transmission dynamics of TBEV in Norway or elsewhere.

• Jore, Solveig; Andreassen, Åshild Kristine; Moustafa, Gibory; M, Paulsen Katrine; Soleng, Arnulf & Ottesen, Preben [Vis alle 11 forfattere av denne artikkelen] (2014). TBEV along the coast of Southern and Western Norway. Fulltekst i vitenarkiv
• Vainio, Kirsti; Bruun, Tone; Bekkevold, Terese; Rojahn, Astrid; Størvold, Gunnar & Jakobsen, Kirsti [Vis alle 17 forfattere av denne artikkelen] (2014). Aktiv sykehusovervåkning av rotavirus i Norge. Fulltekst i vitenarkiv
• BARLINN, REGINE; Vainio, M Kirsti; Samdal, Helvi Holm; Nordbø, Svein Arne; Nøkleby, Hanne & Dudman, Susanne Gjeruldsen (2013). Age dependent differences in levels of rubella antibodies of pregnant women in Norway. Fulltekst i vitenarkiv
• Waalen, Kristian; Kilander, Anette; Dudman, Susanne Gjeruldsen; Ramos-Ocao, Remilyn Vicenta R. & Hungnes, Olav (2012). Age-dependent seroprevalence to influenza A(H3N2) variant virus in 2011-comparison to immunity to seasonal influenza A(H3N2) circulating in the mid-1990's. Immunology. ISSN 0019-2805. 137, s. 634–634. Fulltekst i vitenarkiv
• Andreassen, Åshild Kristine; Jore, Solveig; Cuber, Piotr; Tengs, Torstein; Dudman, Susanne Gjeruldsen & Ånestad, Gabriel [Vis alle 8 forfattere av denne artikkelen] (2011). Methodological difficulties in detection of Tick-born encephalitis virus, TBEV. Fulltekst i vitenarkiv
• Vik, Inger Sofie Samdal; Dudman, Susanne Gjeruldsen; Hungnes, Olav & Hoddevik, Gunnar M (2011). Feilinformert om influensaserologi. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 131(2), s. 110–111. Fulltekst i vitenarkiv
• Yri, Olav Erich; Torfoss, Dag; Hungnes, Olav; Østenstad, Bjørn; Ekanger, Roald & Wader, Karin Fahl [Vis alle 11 forfattere av denne artikkelen] (2011). LYMPHOMA PATIENTS TREATED WITH RITUXIMAB-CONTAINING REGIMENS DO NOT ACHIEVE PROTECTIVE SEROLOGICAL RESPONSES TO H1N1 INFLUENZA VIRUS AFTER VACCINATION. Annals of Oncology. ISSN 0923-7534. 22, s. 131–131. Fulltekst i vitenarkiv
• Andreassen, Åshild Kristine; Jore, Solveig; Cuber, Piotr; Tengs, Torstein; Dudman, Susanne Gjeruldsen & Ånestad, Gabriel [Vis alle 8 forfattere av denne artikkelen] (2011). Prevalence of Tick-born encephalitis virus (TBEV) in ticks in Southern Norway. Fulltekst i vitenarkiv
• Kilander, Anette; Rykkvin, Rikard; Dudman, Susanne Gjeruldsen & Hungnes, Olav (2010). Author's reply: Association of D222G substitution in haemagglutinin of 2009 pandemic influenza A (H1N1) with severe disease. Eurosurveillance. ISSN 1025-496X. 15(14), s. 17–17. Fulltekst i vitenarkiv
• Dudman, Susanne Gjeruldsen; Aaberge, Ingeborg Sundsvalen & Jacobsen, Eivor Johanne Nordstrand (2022). Diagnostikk av vaksineforebyggbare virus. Strategimøte oktober 2020. Folkehelseinstitutet. ISSN 9788284062648. Fulltekst i vitenarkiv Vis sammendrag

  I regi av «Referansegruppen for ekstern kvalitetssikring i virologi og serologi» ble det den 29.10.2020 holdt strategimøte om «Diagnostikk av vaksineforebyggbare virus». For første gang ble strategimøtet avholdt digitalt. Strategimøte omhandlet vaksinasjon mot virale infeksjoner. Programkomiteen gjorde et utvalg av de vanligste og på andre måter mest relevante agensene. I tillegg ble det holdt innlegg om immunrespons ved vaksinasjon, både generelt og for spesielle grupper som immunsupprimerte og nyfødte. På grunn av sin spesielle relevans ble SARS-CoV-2 omtalt noe bredere, det ble gitt en oppdatering om både agenspåvisning, immunitet og vaksinestatus. Rapporten inneholder sammendrag og anbefalinger slik det kom frem på møtet, samt abstraktene og tabellene.

• Aaberge, Ingeborg Sundsvalen; Aase, Audun; Arnesen, Trude Margrete; Bergsager, Gro; Blystad, Hans Henrik & Bruun, Tone [Vis alle 20 forfattere av denne artikkelen] (2018). Barnevaksinasjonsprogrammet i Norge. Rapport for 2017. Folkehelseinstituttet. Fulltekst i vitenarkiv Vis sammendrag

  Rapporten beskriver det nasjonale barnevaksinasjonsprogrammet i 2017, dekningsstatistikk for de ulike vaksinene, meldte tilfeller av sykdommene vi vaksinerer mot, hvilke vaksiner som ble brukt og meldte bivirkninger av disse. I tillegg gir den informasjon om de ulike overvåkingssystemene vi har for å følge med på effekt og sikkerhet av vaksinene i barnevaksinasjonsprogrammet.

• Aase, Audun; Barlinn, Regine; Bergsager, Gro; Bergsaker, Marianne A Riise; Blystad, Hans Henrik & Bruun, Tone [Vis alle 22 forfattere av denne artikkelen] (2017). Barnevaksinasjonsprogrammet i Norge. Rapport for 2016. Folkehelseinstituttet. Fulltekst i vitenarkiv
• Dudman, Susanne Gjeruldsen; Samdal, Helvi Holm; Dorenberg, Dagny Haug; Christensen, Andreas & Skaare, Dagfinn (2016). Laboratoriediagnostikk ved nye og utbruddsaktuelle virusinfeksjoner. Strategimøte 2015. Folkehelseinstituttet. ISSN 9788280826299. Fulltekst i vitenarkiv Vis sammendrag

  I regi av «Referansegruppe for ekstern kvalitetssikring i virologi og serologi» ble det holdt strategimøte om «Laboratorieberedskap ved nye og utbruddsaktuelle virusinfeksjoner» den 29. oktober 2015 ved Gjestehuset, Lovisenberg, i Oslo. Bakgrunnen for valg av tema var at det den siste tiden har blitt rapportert om flere utbrudd av nye «emerging» og kjente «re-emerging» virus. Det store ebolautbruddet i Vest-Afrika i 2014, samt oppdagelsen av et nytt coronavirus som ga alvorlig luftveisinfeksjon i 2012, viste behovet for beredskap innen dette feltet. Siden det kreves nær kommunikasjon med Folkhälsomyndigheten i Sverige vedrørende diagnostikk av viral blødningsfeber ble foredragsholder fra Stockholm invitert. Intensjonen med programmet var å sette fokus på utbruddsaktuelle virusinfeksjoner men ikke å gi en fullstendig oversikt over feltet. Rapporten inneholder oppsummering og anbefalinger slik det kom fram på møtet, samt sammendrag av foredragene (manuskriptene) som er gjengitt i sin helhet. I tillegg har det etter tillatelse fra foredragsholderne blitt vedlagt bildene fra presentasjonene på møtet.

• Aarseth, Hans Petter; Bergsaker, Marianne A Riise; Dudman, Susanne Gjeruldsen; Heier, Ingvild; Kløvstad, Hilde & Mork, Jon [Vis alle 14 forfattere av denne artikkelen] (2016). Vaksine mot humant papillomavirus (HPV). Rapport fra arbeidsgruppe nedsatt av Nasjonalt folkehelseinstitutt for å vurdere om HPV-vaksine til gutter skal tilbys i program i Norge. Folkehelseinstituttet. ISSN 9788280827050. Fulltekst i vitenarkiv
• Aase, Audun; Barlinn, Regine; Bergsager, Gro; Bergsaker, Marianne A Riise; Blystad, Hans Henrik & Dudman, Susanne Gjeruldsen [Vis alle 19 forfattere av denne artikkelen] (2016). Barnevaksinasjonsprogrammet i Norge. Rapport for 2015. Folkehelseinstituttet. Fulltekst i vitenarkiv
• Ocampo, Joanne Michelle F; Jore, Solveig; Andreassen, Åshild Kristine; Wiklund, Berit Sofie; Dudman, Susanne Gjeruldsen & Ottesen, Preben [Vis alle 12 forfattere av denne artikkelen] (2016). Flått og flåttbårne sykdommer. Lyme borreliose og skogflåttencefalitt i 2015. Folkehelseinstituttet. ISSN 9788280827425. Fulltekst i vitenarkiv
• Kanestrøm, Anita; Litleskare, Irene; Bragstad, Karoline; Dudman, Susanne Gjeruldsen; Bergersen, Bente Magny & Kran, Anne-Marte Bakken [Vis alle 10 forfattere av denne artikkelen] (2016). Usage of Antivirals and the Occurrence of Antiviral Resistance. RAVN in Norway 2015. Folkehelseinstituttet. ISSN 9788280827692. Fulltekst i vitenarkiv
• Andreassen, Åshild Kristine; Kjelland, Vivian; Vainio, Kirsti; Dudman, Susanne Gjeruldsen; Fremstad, Hege Reinertsen & Soleng, Arnulf [Vis alle 10 forfattere av denne artikkelen] (2015). ScandTick: Kartlegging av analysemetoder for diagnostikk av skogflåttencefalitt (TBE) i ØKS regionen. Folkehelseinstituttet. ISSN 9788280826565. Fulltekst i vitenarkiv
• Dudman, Susanne Gjeruldsen; Samdal, Helvi Holm; Barlinn, Regine; Haarr, Elisebet; Christensen, Andreas & Nordbø, Svein Arne [Vis alle 7 forfattere av denne artikkelen] (2015). Laboratoriediagnostikk ved hepatitt B- og C-virusinfeksjoner – nye oppdateringer. Strategimøte 6. november 2014. Program, oppsummering, abstrakter. Folkehelseinstituttet. ISSN 9788280826817. Fulltekst i vitenarkiv
• MacDonald, Emily; Lange, Heidi; Andreassen, Åshild Kristine; Wiklund, Berit Sofie; Dudman, Susanne Gjeruldsen & Ottesen, Preben [Vis alle 11 forfattere av denne artikkelen] (2014). Flått og flåttbårne sykdommer. Årsrapport 2013. Folkehelseinstituttet. Fulltekst i vitenarkiv
• Nøkleby, Hanne; Vik, Inger Sofie Samdal; Aaberge, Ingeborg Sundsvalen; Dudman, Susanne Gjeruldsen & Hoddevik, Gunnar M (2014). Virologisk/serologisk ringtest 2/2013. Resultater og kommentarer. Folkehelseinstituttet. ISSN 9788280826060. Fulltekst i vitenarkiv
• Lange, Heidi; Andreassen, Åshild Kristine; Wiklund, Berit Sofie; Dudman, Susanne Gjeruldsen; Noraas, Sølvi & Ottesen, Preben [Vis alle 14 forfattere av denne artikkelen] (2013). Årsrapport. Flått og flåttbårne sykdommer. Lyme borreliose og skogflåttencefalitt i 2012. Folkehelseinstituttet. ISSN 9788280825612. Fulltekst i vitenarkiv
• Kilander, Anette; Dudman, Susanne Gjeruldsen; Stene-Johansen, Kathrine; Vik, Inger Sofie Samdal; Hungnes, Olav & Waalen, Kristian [Vis alle 9 forfattere av denne artikkelen] (2013). Usage of antivirals and the occurrence of antiviral resistance in Norway 2011-2012. RAVN 2011–12. Folkehelseinstituttet. ISSN 9788280825681. Fulltekst i vitenarkiv
• Nøkleby, Hanne; Vik, Inger Sofie Samdal; Aaberge, Ingeborg Sundsvalen; Dudman, Susanne Gjeruldsen & Hoddevik, Gunnar M (2013). Virologisk/serologisk ringtest 2/2012. Resultater og kommentarer. Nasjonalt folkehelseinstitutt. ISSN 9788280825537. Fulltekst i vitenarkiv
• Njølstad, Gro; Samdal, Helvi Holm; Kanestrøm, Anita; Christensen, Andreas & Dudman, Susanne Gjeruldsen (2012). Laboratoriediagnostikk ved Epstein-Barr-virusinfeksjoner. Strategimøte 1. november 2012. Folkehelseinstituttet. ISSN 9788280825803. Fulltekst i vitenarkiv
• Nøkleby, Hanne; Vik, Inger Sofie Samdal; Aaberge, Ingeborg Sundsvalen; Dudman, Susanne Gjeruldsen & Hoddevik, Gunnar M (2012). Virologisk/serologisk ringtest 2/2011. Resultater og kommentarer. Folkehelseinstituttet. ISSN 9788280825025. Fulltekst i vitenarkiv
• Lange, Heidi; Andreassen, Åshild Kristine; Wiklund, Berit Sofie; Dudman, Susanne Gjeruldsen; Noraas, Sølvi & Ottesen, Preben [Vis alle 13 forfattere av denne artikkelen] (2012). Årsrapport. Flått og flåttbårne sykdommer: Lyme borreliose og skogflåttencefalitt i 2011. Nasjonalt folkehelseinstitutt Oslo. ISSN 9788280825056. Fulltekst i vitenarkiv
• Herrador, Bernardo Guzman; Arnesen, Trude; Bruun, Tone; Dudman, Susanne Gjeruldsen; Elstrøm, Petter & Lange, Heidi [Vis alle 17 forfattere av denne artikkelen] (2012). Smittsomme sykdommer hos utenlandsreisende. Årsrapport 2011. Folkehelseinstituttet. ISSN 9788280825339. Fulltekst i vitenarkiv
• Nøkleby, Hanne; Vik, Inger Sofie Samdal; Aaberge, Ingeborg Sundsvalen; Dudman, Susanne Gjeruldsen & Hoddevik, Gunnar M (2012). Virologisk/serologisk ringtest 1/2012. Resultater og kommentarer. Nasjonalt folkehelseinstitutt. ISSN 9788280825285. Fulltekst i vitenarkiv
• Nøkleby, Hanne; Vik, Inger Sofie Samdal; Aaberge, Ingeborg Sundsvalen; Dudman, Susanne Gjeruldsen & Hoddevik, Gunnar M (2011). Virologisk/serologisk ringtest 1/2011. Resultater og kommentarer. Nasjonalt folkehelseinstitutt. ISSN 9788280824769. Fulltekst i vitenarkiv
• Comelli, Heidi Lange; Andreassen, Åshild Kristine; Dao, PhuongThi Xuan; Dudman, Susanne Gjeruldsen; Noraas, Sølvi & Ottesen, Preben [Vis alle 13 forfattere av denne artikkelen] (2011). Årsrapport : Flått og flåttbårne sykdommer Lyme borreliose og Skogflåttencefalitt i 2010. Nasjonalt folkehelseinstitutt. ISSN 9788280824714. Fulltekst i vitenarkiv
• Åsjö, Birgitta; Vik, Inger Sofie Samdal; Dudman, Susanne Gjeruldsen; Rollag, Halvor; Ormaasen, Vidar & Holberg-Petersen, Mona [Vis alle 8 forfattere av denne artikkelen] (2010). Utredning om nasjonalt overvåkingssystem for virusresistens. Rapport fra arbeidsgruppe. Folkehelseinstituttet. ISSN 9788280823854. Fulltekst i vitenarkiv

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