Thrombotic microangiopathy, addressing the prominent coagulopathy and neuropsychiatric symptoms... microangiopathy and excessive cytokine release.
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Abstract
BACKGROUND Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its associated clinical syndrome COVID-19 are causing overwhelming morbidity and mortality around the globe, disproportionately affecting New York City. A comprehensive, integrative autopsy series that advances the mechanistic discussion surrounding this disease process is still lacking. METHODS Autopsies were performed at the Mount Sinai Hospital on 67 COVID-19 positive patients and data from the clinical records were obtained from the Mount Sinai Data Warehouse. The experimental design included a comprehensive microscopic examination carried out by a team of expert pathologists, along with transmission electron microscopy, immunohistochemistry, RNA in situ hybridization, as well as immunology and serology assays. RESULTS Laboratory results of our COVID-19 cohort show elevated inflammatory markers, abnormal coagulation values, and elevated cytokines IL-6, IL-8 and TNFα. Autopsies revealed large pulmonary emboli in four cases.
We report microthrombi in multiple organ systems including the brain,
as well as conspicuous hemophagocytosis and a secondary hemophagocytic lymphohistiocytosis-like syndrome in many of our patients. We provide electron microscopic, immunofluorescent and immunohistochemical evidence of the presence of the virus and the ACE2 receptor in our samples.
We report microthrombi in multiple organ systems including the brain,
as well as conspicuous hemophagocytosis and a secondary hemophagocytic lymphohistiocytosis-like syndrome in many of our patients. We provide electron microscopic, immunofluorescent and immunohistochemical evidence of the presence of the virus and the ACE2 receptor in our samples.
CONCLUSIONS
We report a comprehensive autopsy series of 67 COVID-19 positive patients revealing that this disease, so far conceptualized as a primarily respiratory viral illness, also causes endothelial dysfunction, a hypercoagulable state, and an imbalance of both the innate and adaptive immune responses. Novel findings reported here include an endothelial phenotype of ACE2 in selected organs, which correlates with clotting abnormalities and thrombotic microangiopathy, addressing the prominent coagulopathy and neuropsychiatric symptoms. Another original observation is that of macrophage activation syndrome, with hemophagocytosis and a hemophagocytic lymphohistiocytosis-like disorder, underlying the microangiopathy and excessive cytokine release. We discuss the involvement of critical regulatory pathways.
__________________________________________________________________________Michael Novakhov - SharedNewsLinks℠ | InBrief |
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Michael Novakhov - SharedNewsLinks  | |||||||
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| Pathophysiology of SARS-CoV-2: targeting of endothelial cells renders a complex disease with thrombotic microangiopathy and aberrant immune response. The Mount Sinai COVID-19 autopsy experience | medRxiv | |||||||
AbstractBACKGROUND Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its associated clinical syndrome COVID-19 are causing overwhelming morbidity and mortality around the globe, disproportionately affecting New York City. A comprehensive, integrative autopsy series that advances the mechanistic discussion surrounding this disease process is still lacking. METHODS Autopsies were performed at the Mount Sinai Hospital on 67 COVID-19 positive patients and data from the clinical records were obtained from the Mount Sinai Data Warehouse. The experimental design included a comprehensive microscopic examination carried out by a team of expert pathologists, along with transmission electron microscopy, immunohistochemistry, RNA in situ hybridization, as well as immunology and serology assays. RESULTS Laboratory results of our COVID-19 cohort show elevated inflammatory markers, abnormal coagulation values, and elevated cytokines IL-6, IL-8 and TNFα. Autopsies revealed large pulmonary emboli in four cases. We report microthrombi in multiple organ systems including the brain, as well as conspicuous hemophagocytosis and a secondary hemophagocytic lymphohistiocytosis-like syndrome in many of our patients. We provide electron microscopic, immunofluorescent and immunohistochemical evidence of the presence of the virus and the ACE2 receptor in our samples. CONCLUSIONS We report a comprehensive autopsy series of 67 COVID-19 positive patients revealing that this disease, so far conceptualized as a primarily respiratory viral illness, also causes endothelial dysfunction, a hypercoagulable state, and an imbalance of both the innate and adaptive immune responses. Novel findings reported here include an endothelial phenotype of ACE2 in selected organs, which correlates with clotting abnormalities and thrombotic microangiopathy, addressing the prominent coagulopathy and neuropsychiatric symptoms. Another original observation is that of macrophage activation syndrome, with hemophagocytosis and a hemophagocytic lymphohistiocytosis-like disorder, underlying the microangiopathy and excessive cytokine release. We discuss the involvement of critical regulatory pathways. | |||||||
| Andes Hantavirus as potential bioweapon - Google Search | |||||||
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| Rodents as Potential Couriers for Bioterrorism Agents | |||||||
eliberate release of pathogens can have a huge impact on society. At the same time, access to a range of pathogens can be relatively easy. Therefore, bioterrorism remains an important area of infectious disease preparedness. Many infectious diseases that have rodents as reservoirs are mentioned among the prime candidates for bioterrorism agents: hemorrhagic fevers, hantavirus, Lassa fever, Rift Valley fever, Q fever, tularemia, brucellosis, and bubonic plague are all rodent-reservoir zoonoses with potentially serious health effects.1 It seems, however, that medical and veterinary scientists have not yet realized the full implication of being able to attack human or livestock populations indirectly through another host-organism and how chronic and insidious the consequences of such an attack would be.1 This lack of awareness among medical professionals could lead to misdiagnosis and failure to recognize the need for rapid intervention in critical situations. Consequently, when discussing effects and damage control during a bioterrorism event, it is important to know not only the pathogen but also its potential reservoirs.
Biological WeaponsApproximately 17 countries in the world, including the former USSR and 5 countries that are implicated as sponsors of international terrorism, have or have had an active biowarfare research program, and several international terrorist organizations are believed to have the financial resources and political contacts needed to gain access to modern bioweapon cultures and production technologies.2,3 Additionally, groups and individuals dissatisfied with a government or society have been known to use or plan to use biological weapons for personal reasons.3Current classification of potential biological weapons is based on agent characteristics, such as the ease of obtaining and dispersing the agent, its virulence, morbidity, mortality, and also the capacity for individual-to-individual transmission. On the web pages of the Centers for Disease Control and Prevention (CDC) and the National Institute of Allergy and Infectious Diseases (NIAID), potential biological weapons are classified, according to the criteria mentioned above, into A, B, and C categories. Category A lists the pathogens that are most feared in the context of bioterrorism events.4 Most attention may need to be focused on combatting infections that have serious medical consequences, but in several cases, the economic damage caused by a pathogen may demand actions even though the medical effects are trivial.1 Bioterrorists may not always be constrained by the need to target or predict their outcome precisely, and extensive epidemics are not a prerequisite for creating great public anxiety.4,5 Simple fear of a disease could be enough to cause economic problems for a region because of, for example, diminished interest in recreational activities and tourism. Consequently, virtually any pathogenic microbe could be used by bioterrorists. Besides human health concerns, the agricultural sector is vulnerable to bioterrorist attacks because domestic animals rarely have an innate resistance to foreign pathogens and are usually not vaccinated against these diseases.4 Even small outbreaks of exotic diseases in livestock could remove a country from the global market for its agricultural products.4 Agricultural bioterrorism is especially insidious as animals themselves may become the primary vectors for transferring agents.4 Furthermore, the majority of category A and B potential biological weapons on the CDC lists are of a zoonotic nature,5 and thus an attack on animal populations could pose a health risk for humans as well. Bioterrorism and WildlifeUnless an area is intensively monitored for pathogens, a deliberate release of infectious agents will probably not be detected at the time of release, but only after people or domestic animals exhibit symptoms of infection. The incubation periods of different kinds of infectious diseases vary, but in many cases, days or even weeks can pass before an outbreak is noticed. This provides the pathogen with the opportunity to spread and infect other organisms that may not have been targeted by the bioattack, such as local wildlife.Wildlife is a natural reservoir for many diseases, and, as seen in the emergence of West Nile virus in the United States, the existence of wildlife reservoirs makes eradication of a disease that has had time to establish itself unrealistic.6 The damage can become extensive when the released agents manage to spread over large geographic areas before they are discovered. Many wildlife species are highly susceptible to high-priority bioterrorism agents,7 and, consequently, pathogens released during a bioattack directed at humans or livestock can either jump to wildlife or persist in the environment and cause zoonotic epidemics for a long time. Furthermore, several diseases with serious medical or economic significance for humans (eg, many viral hemorrhagic fevers) can infect wildlife species without their exhibiting overt clinical signs of infection, which can make the source identification of outbreaks complicated. Control measures of infectious diseases often involve immunization, but in the case of wildlife infections in which humans and domestic animals are not the reservoirs, herd immunity is not achievable, and pathogens cannot be eliminated through immunization.1 Rodents and Infectious DiseasesRodents can function as reservoirs and vectors spreading infectious diseases.8 Many rodent species are highly opportunistic, meaning that they can easily adapt to new conditions and are able to take advantage of temporarily suitable environmental conditions for rapid reproduction. These characteristics have allowed some species, such as the house mouse (Mus musculus) and brown rat (Rattus norvegicus), to spread over most of the Earth's terrestrial areas. Opportunistic qualities may also support a potential dispersal of other accidentally or deliberately introduced rodent species outside their endemic areas in the future. Moreover, the opportunistic species often have peridomestic affinities and often live in close proximity to human settlements, which makes them an important link for transmitting infections among wildlife, humans, and livestock.9The absolute numbers of infectious diseases associated with rodents are not known, mainly because of the lack of complete systematic surveys of rodents for pathogens.9 However, according to Hugh-Jones et al.,10 rodents function as reservoirs for approximately 46% of all globally known zoonoses, and more people are believed to have died in the past thousand years because of rodentborne infections than wars.8 The symptoms of infections that are transmissible by rodents vary from relatively trivial (ie, skin lesions at the site of infection in cases of cowpox) to commonly fatal ones (ie, bubonic plague).1 Transmission of rodentborne infections (Figure 1) may happen directly from rodents to humans (ie, hantaviruses) or via an arthropod vector (ie, fleas in cases of plague, ticks in cases of Lyme disease, and sand flies in cases of leishmaniasis).1 Studies have also shown a direct connection between the abundance of rodents in the wild and the number of rodentborne human infections.11 Rodents as a Dispersal MechanismA deliberate release of infected rodents or the contamination of wild rodents with pathogens would be a relatively easy way to threaten public health. For example, a diseased animal that is left on the ground or in a water source would be easily accessible to wild rodents and could cause a disease outbreak in an unexpected location. Many diseases are environmentally hardy and will be able to persist in organic or inorganic matrices for an extended period4 and could thus potentially infect, for instance, burrowing rats. Subsequent contact of these animals with humans or domestic animals could spread the disease. No incidences of rodent-targeted bioterrorism have been described in modern times. But during World War II, the Japanese army, Unit 731, was reported to have experimented with plague by harvesting plague-infected fleas from infected rodents and dropping them over populated areas in China and Manchuria.12The likelihood of unintentionally infecting wild rodents during a bioattack targeted against humans or livestock is plausible. Most of the diseases caused by category A pathogens exploit rodents as vectors or reservoirs (eg, plague, tularemia, arena viruses, etc). This is also true for many of the diseases caused by category B pathogens (eg, toxoplasmosis, brucellosis, Q fever, etc). It might not be very likely that rodents come across anthrax letters targeted at certain individuals, but aerosolized pathogens that are released into the environment in a less targeted way could infect rodents, especially if the pathogen can survive in the environment for a long period. In cases of bioterrorism directed toward livestock, soil and water contamination by infected excreta from domestic livestock could spread pathogens to the sympatric rodent populations and in this way establish a rodent reservoir of infection.13 Rodents as Disease VectorsHumans often provide rodents with an abundance of supportive resources and favorable microclimatic conditions that allow them to grow in population size, especially in areas where humans have greatly reduced the number of their natural predators.14,15 In Europe, brown rats and house mice are among the most recognized urban rodents. These 2 species have quite different behavioral characteristics; while the house mouse is a highly inquisitive species, rats are cautious and prefer the familiarity of a known environment.14 Rats also show a more dominant nature, suppressing and occasionally preying on house mice.Urban rodent metapopulations usually consist of many small groups that may have little contact with each other except in cases of disturbance.14,16 However, disturbance in the form of road work or building activities is a common event in cities, and it is likely that these human activities enhance the transmission of pathogens between rodent groups. These activities could also increase the opportunities for contact among rodents, humans, and pets. In undisturbed rodent groups, young males typically leave their native groups to disperse into new areas.16 Hence, young males can be expected to be responsible for spreading pathogens between rodent groups. Local overpopulation of rats in cities is most common in areas of failing hygiene, as, for example, near train and bus stations with abundant remains of food and other materials.17 Additionally, unrestricted food supplies in gardens with compost heaps are thought to function as valuable shelters for rats. Just as train and bus stations might be a preferred target for a bioterrorism attack because of the potential for the maximum effect on public health, such areas would also be a prime place for the introduction of pathogens into rodent reservoirs. The structure of rodent communities in rural areas is similar to that in urban ones, but the size of individual territories may be more flexible and may vary with the season and food availability. Furthermore, the structure of rodent communities depends on the local land use and differs, for example, from the areas that are used for livestock farming and cultivation of crops. The mobility of rats depends of the reliability of their food sources. For instance, brown rats can be immobile during food abundance but may roam more than 6 kilometers in other circumstances.18,19 According to Taylor,18 rats that lived near reliable food sources in agricultural areas rarely moved more than 30m from their home sites, but when the food was removed, they expanded their range considerably. Ironically, that means that rodent-proofing a farm after a bioterrorism event would ensure transmission between neighboring farms and probably even to wildlife species. In this case, if the goal is to prevent disease dispersal, it would be wiser to use trapping or rodenticides locally and follow recommendations from an ecological rodent management approach20 rather than rodent-proofing a farm and withdrawing all food sources. Ecological Context of Disease DispersalThe lack of predators and low biodiversity are often ignored ecological parameters that greatly facilitate infectious disease dispersal. Modern cities have a low level of biodiversity, and natural competition and predation mechanisms are altered, allowing abnormal and unbridled growth of certain species. Generally, when a pristine ecosystem is disturbed, specialist species with specific food, nesting, or breeding requirements cannot survive. In the absence of such specialist competitors, opportunistic species with high fecundity will thrive.21 As mentioned above, several opportunistic species also possess characteristics such as high mobility and high population densities that make them ideal hosts and transmitters of zoonotic pathogens.21In recent years, it has become increasingly evident that the loss of biodiversity tends to increase pathogen transmission and disease incidence.9,22 Consequently, the term dilution effect has been admixed into public health forums. The dilution effect hypothesis suggests that high biodiversity reduces the risk of transmission of certain diseases.23 Dilution effect functions only when the pathogen is transmitted horizontally and when the reservoir competence for a certain pathogen varies among potential host species. Increased biodiversity would then increase the likelihood that infected organisms meet more individuals from a nonhost species that would limit pathogen transmission. Indeed, epidemiologic and experimental studies have shown that lower diversity of small mammals increases the prevalence of hantaviruses in their hosts, leading to increased transmission risk to humans.22 Consequently, as a deliberate release of pathogens can be expected to take place in areas of low biodiversity, this condition will considerably facilitate pathogen dispersal. However, in areas where municipalities are regularly performing rodent control, the dynamics of rodent populations and diseases may greatly differ from more degraded urban areas. Additionally, the increasing populations of urban foxes in many European cities may lower the rodent populations but, unfortunately, also add to the dispersal of parasites with complex life cycles, such as Echinococcus multilocularis and other helminths.24-26 The One Health ApproachUnderstanding disease management as a multifactorial issue is critical for preventing disease expansion including in the context of bioterrorism. Behavior and physiology of reservoir organisms (ie, organisms that can amplify a pathogen but are not necessarily a direct link to transmission, often rodents), including humans, wildlife, and domestic animals, and of the disease vectors (ie, organisms that actually transmit the disease, often arthropods but also rodents in some cases) are important factors contributing to infectious disease expansion. Dealing with an outbreak is therefore a task beyond medical and public health specialists alone. It demands the additional understanding of veterinary and environmental factors and knowledge of issues regarding human social behavior and political changes, basic science-related information about pathogen life cycles and evolution, and aspects related to vector/reservoir life history.27 Cooperation between specialists with different expertise is necessary because the factors associated with disease expansion are not independent: For example, modifications in human behavior can change the ecology of wildlife reservoirs and/or disease vectors and in this way affect the transmission patterns of pathogens. It can be expected that, for example, family doctors and veterinarians in countries that are nonendemic for a particular disease will not be aware of its clinical manifestations. This can cause a delay in the diagnosis, leading to higher numbers of fatalities and increased dispersal, including to wildlife. In order to recognize the role of wildlife in the context of bioterrorism, it is important that veterinarians be aware of clinical signs of infection with biothreat agents in wildlife.7 If disease outbreaks occur in nonendemic areas, outside the expected season, or in unexpectedly large numbers, these events could be investigated for the possibility of bioterrorism.4Examples of Rodent Reservoir BioagentsPlagueThe life cycle of plague, Yersinia pestis, involves a complex interaction between rodents and fleas, occasionally involving human infections.28 The most important enzootic and epizootic reservoirs of plague are different kinds of rodents.29 Plague agents are able to survive in the soil for long periods and can be transmitted to burrowing animals for extended periods.30,31 Plague occurs worldwide but primarily in certain locations in Africa and Asia.7The 3 major forms of Y. pestis infection in humans are classic bubonic plague, primary septicemic plague, and pneumonic plague.28 Untreated bubonic plague has a fatality rate of 40% to 60%, whereas the pneumonic and septicemic forms are usually fatal. Human infection can be acquired by flea bites from infected fleas, but also by contact with fluids from infected animals and by respiratory droplets from infected humans or animals.28 Human cases are most commonly associated with die-offs of rodent hosts that lead to fleas leaving the dead animal and seeking new hosts. The mouthparts of rodent fleas are often too weak to penetrate the human skin, but cat fleas can do it with ease.31 Cats are highly sensitive to plague and can be infected both by flea bites and by ingestion of infected rodents. They are also the most likely animals to bring plague into human facilities.7,28 Clinical signs in humans develop 1 to 6 days after becoming infected, providing the pathogen with a time-lag that could be sufficient for both people and animals to move and spread the disease, making control of the disease more difficult.7 Plague is a high-risk potential weapon of bioterrorism. Humans can be easily infected via aerosols, and aerosolized bacteria are easily transmitted between infected humans and animals. This disease has a high attack rate and produces severe clinical disease.28 Moreover, antibiotic-resistant Y. pestis strains are known to exist, and, in aerosolized form, it would be a formidable weapon.32 Plague still occurs naturally in several locations in the world, so it is a relatively easy agent to obtain. It can also be easily disseminated into wild rodent populations in both urban and rural areas. TularemiaAt least 4 subspecies of Francisella tularensis (tularemia) are recognized, 2 of which are human pathogens: Francisella tularensis biovar tularensis and Francisella tularensis biovar palaeartica.7F. tularensis infection has been demonstrated in an impressive number of wildlife species,33 but it is still mainly considered to be a disease of rodents and lagomorphs. Arthropods, such as ticks, biting flies, and mosquitoes, serve as vectors for tularemia and potentially even as long-term reservoirs.33 Tularemia infections occur mainly in the northern hemisphere, most frequently in Scandinavia, Central Europe, North America, Japan, and Russia.15Tularemia is highly infectious and can be transmitted by several epidemiologic routes: through arthropod vectors, direct contact with infected blood and tissues, intact skin and wounds, ocular mucous membranes, inhalation, and ingestion.7,28 The infectious dose depends on the mode of transmission: Only 10 organisms are needed to cause disease by inhalation, whereas 108 organisms are required parenterally.28 Six different forms of tularemia have been classified according to their clinical presentation and route of exposure, although the pneumonic form is the most likely bioterrorism agent because it can be transmitted as an aerosol and has 30% to 60% mortality if untreated.34F. tularensis has been weaponized by the United States and very likely by several other countries.33,34 The highly infectious nature of tularemia makes it possible to use it in the most unsophisticated ways of bioterrorism, as both rodents and humans are able to acquire infections through direct contact with infected rodent carcasses or by consumption of food or water that is contaminated by an infected animal.15 BrucellosisSix species with numerous biotypes of Brucellae have been identified, but only Brucella abortus, B. melitensis, B.suis, and B. canis can cause human disease.28 Brucellosis is a worldwide zoonosis that mainly infects domesticated animals, but different wild mammals, including rodents (especially brown rats and even voles), act as reservoirs.35,36 In livestock, brucellosis is a lifelong infection. The bacteria localize in the reproductive tract and cause spontaneous abortions and sterility.28 Transmission to humans can occur when open wounds are exposed to animal secretions, by infected aerosols, or via consumption of unpasteurized dairy products.In the case of Brucellae, a major threat arises from agroterrorismthat is, the deliberate infection of domestic animals. Brucellosis is an economically important disease in production animals worldwide.35 Countries that are presently free from animal brucellosis could suffer serious economic losses if brucellosis were to be introduced into their livestock.35Brucellae are a highly virulent pathogen in humans and animals and would be an effective biological weapon.35 Only 10-100 aerosolized organisms are needed to cause disease, and the early symptoms of the disease are nonspecific, often leading to delayed diagnosis and ineffective treatment. Although Brucella is sensitive to heat and most disinfectants, it can survive in the environment for up to 2 years, thus constituting a continuous threat to both humans and animals.37 In 1954, B. suis became the first agent to be weaponized by the United States, but several other countries have or are suspected to have weaponized this agent, including the United Kingdom.28,37 Q FeverCoxiella burnetii, which causes Q fever, is a category B bioterrorism agent that is highly infectious in both humans and livestock. C. burnetii spores are extremely resistant to heat and desiccation but also to cold.28C. burnetii is a worldwide zoonosis that infects various mammals (including domestic goats, sheep, and cattle), birds, fish, and arthropods. Urine, feces, and birth material of infected animals are sources for C. burnetii contamination in the environment. Human infections usually occur after inhalation of aerosolized bacteria: A single inhaled organism is enough to produce clinical illness.28 The placentas of infected animals can be heavily contaminated with these bacteria, and during parturition bacteria are released into the environment and may cause infection for up to 150 days.28 The bacterium can survive in the environment for years and may travel long distances in the form of aerosol.19Although cultivation of Coxiella is rather laborious, large amounts of infectious material can be produced.38Coxiella may not cause high mortality, but if released as an aerosol, it could cause acute disabling disease and great economic losses in the agricultural sector. Acute infection of Q fever can be followed by fatal (eg, endocarditis) or debilitating (eg, chronic fatigue syndrome) disorders. Because of nonspecific symptoms, the diagnosis of Q fever might be delayed. Antibiotic treatment is available for the acute form of C. burnetii but not for the chronic complications.38 Brown rats are thought to function as an important factor in the dissemination of endemically circulating Q fever between wild and domestic animals and humans.19 Cats may have a role in these infection routes as well since they prey on the wild reservoirs. Viral Hemorrhagic FeversViral hemorrhagic fevers (VHFs) are caused by a group of viruses that require an animal or insect host reservoir for transmission.39 They are usually geographically restricted to specific regions of the world where they create enzootic infections. Humans generally get infected after exposure to contaminated saliva, urine, or feces of infected animals or by rodent or insect bites.39 VHFs include arenaviruses, such as Lassa fever and South American hemorrhagic fever viruses; bunyaviruses, such as hantaviral infections (HTVs) and Rift Valley fever virus (RVFV); flaviviruses, such as dengue hemorrhagic fever, tickborne encephalitis, and yellow fever viruses; and filoviruses, represented by Ebola and Marburg viruses. For most of these diseases, there are only limited treatment and vaccination options. Some VHFs have been weaponized by researchers in the former Soviet Union, the US, and possibly North Korea.40ArenavirusesArenaviruses are included in the category A pathogen list and as such pose a threat to public health if used as a bioterrorism agent. Traditionally, arenaviruses are divided into the Old and New World arenaviruses. The reservoir hosts of almost all arenaviruses are different kinds of commensal or semicommensal rodents that live close to humans or in cultivated fields.41 In rodents, most of the arenaviruses cause a persistent, asymptomatic infection with chronic viremia and viruria. Lymphocytic choriomeningitis virus (LCMV) is an arenavirus with a worldwide distribution because of its association with the house mouse, Mus musculus. LCMV rarely causes severe infection except in infants and immunocompromised individuals.41,42 In contrast, Old World viruses (ie, Lassa virus and Lujo virus), which are found in Africa, and several New World viruses in South America (eg, Junin, Machupo, Sabia, Guanarito, and Chapere) can cause severe disease and hemorrhagic fever syndrome.43 Rodent-to-human infections of arenaviruses are thought to occur through aerosols and fomites.41 This indicates that these agents could potentially be used as bioweapons if propagated to high titer in cell culture and in aerosols.43Most cases of arenavirus transmission occur in rural, agricultural areas. The lack of rapid diagnostic methods for specific diagnoses of arenaviral hemorrhagic fevers means that diagnoses are usually made late in the illness and in most cases vaccination is not available.43 Because arenaviruses are rarely transmitted from person-to-person and are not carried by arthropods, each arenaviral disease is tightly constrained in the geographic range of its rodent reservoir host.43 This means that a bioterrorism attack could increase the infection prevalence in local rodent fauna in endemic areas only (although a possible spill-over infection in other species cannot be ruled out). When an attack also involves the release of infected rodents, the spread of the disease would depend on the ability of the infected host to establish itself in a nonendemic area. Given the opportunistic nature of many rodent species, it may be a possibility in some cases. Hantaviral InfectionsHTVs are transmitted to people via aerosols of infectious excreta (urine, feces, saliva) from chronically infected small wild rodents.44 HTVs are often classified as either hantaviral fever with renal syndrome (HRS) in the Old World or hantaviral pulmonary syndrome (HPS) in the New World, but this dichotomy is not clear in all cases.45 All HTVs are parasitic in small rodents, such as mice, rats, and voles, causing a relatively asymptomatic lifelong infection. HTVs are often species specific, sometimes infecting only a single rodent species.39HPSs cause severe, sometimes fatal, respiratory disease and are mainly associated with wild rodent species of the subfamily Sigmodontinae.46 In the US and Canada, the Sin Nombre virus (also found in other parts of the Americas) is responsible for the majority of cases of HPS. The host of the Sin Nombre virus is the deer mouse (Peromyscus maniculatus), found throughout the western and central US and Canada but also southward in the Americas. In South America a myriad of different HTVs can be found: Andes virus has been reported in Argentina, Chile, and Uruguay; Laguna Negra virus in Paraguay and Bolivia; Rio Mamoré virus in Bolivia; Caño Delgadito virus in Venezuela; and Araraquara and Juquitiba viruses in Brazil.47 The most severe form of HRS is caused by Hantaanvirus (ie, carried by wild urban rats Rattus norvegicus and Rattus rattus and Apodemus mice) and Dobrava-Belgrade virus (associated with Apodemus mice) that occur in Asia and Eastern Europe. A moderate form, the Seoul virus (carried by various species of rats), occurs only in Asia. The majority of mild hantavirus infections in Europe are caused by Puumala virus (primarily associated with the bank vole, Clethrionomys glareolus).44 Mortality after exposure to the severe forms is approximately 5% to 15% and to the milder form, 1% to 2%. Because HTVs exist worldwide and are mainly transmitted by aerosols, there is concern about their potential use as biological weapons, even if they are only listed as category C agents on the CDC's list of bioagents. Their potential threat is increased by the fact that immunity in populations is generally very low, many strains without cross-protection exist, and no vaccines are available.39 Furthermore, diagnosis can be difficult when the disease occurs outside its typical range, as initial clinical symptoms are nonspecific.39 Still, HTVs are notoriously difficult to isolate and produce, even with the means available in the most advanced laboratories, and they usually do not transmit from person-to-person.44 The relative rodent host-specificity of the most virulent HTVs means that introduction of the disease to local wild rodents is possible only in endemic areas (although spill-over effects to local species outside of the endemic areas have not yet been investigated and must be considered a possibility). Introduced into rural or urban rodent fauna, HTVs have the potential to cause long-term medical episodes and to spread fear. FilovirusesFiloviruses, Marburg and Ebola, are highly virulent pathogens that have a high mortality rate. If terrorists were to cause even a small outbreak of Marburg or Ebola, the public perception of the threat alone could cause major social and economic disruption.48 However, the life cycle of these viruses and the potential capacity of rodents as vectors or reservoirs for Ebola and Marburg is still largely unknown. Fruit bats are commonly suggested as the main reservoirs for these diseases,49 but Morvan et al.50 detected Ebola virus glycoprotein and polymerase gene sequences in rodents and shrews and suggested that common small terrestrial mammals living in peripheral forest areas could be reservoirs for Ebola. Even though these results have been debated,49 the possibility that rodents would function as vectors or reservoirs for these viruses in the event of bioterrorism cannot be ruled out. Furthermore, since more than a week would elapse before the first symptoms of illness appear, and since Filoviruses survive at room temperature in liquid or dried material for a number of days, the release of these viruses in an urban area48 could result in their transmission (eg, to rodents) before the disease is discovered.Rift Valley Fever VirusRVFV is a zoonotic arthropodborne pathogen native to Africa that increasingly causes severe morbidity and mortality in humans and livestock.51 The lack of prophylactic and therapeutic methods, the potential for human-to-human transmission, and the significant threat to livestock associated with RVFV make this pathogen a serious bioterrorism threat.52 RVFV is transmitted through a broad range of mosquito genera and by other vectors including sand flies.51 This broad range of competent mosquito vectors, some with a worldwide distribution, makes the prospect of transmission and spread to native wildlife following a bioterrorism event possible. Rodents, among them brown rats, have shown RVFV antibodies in endemic areas and have been suggested to serve as potential intermediate amplifying hosts during periods of livestock immunity following an epizootic. In this way, rodents would play a crucial role in the maintenance of the virus's natural cycle.53 Human RVFV infections are usually preceded by transmission from wild to domestic animal hosts. RVFV has a devastating effect on livestock: For example, in sheep, mortality in lambs under 2 weeks of age approaches 100%, in older animals 30%, and abortions approach 100%. Cattle also show high abortion rates (up to 100%), with adult mortality at approximately 10%.51Contagious Animal DiseasesEven if they do not affect human health, an outbreak of contagious animal diseases can have serious economic consequences for livestock. Consequently, enzootic livestock diseases represent a potentially serious threat against national agricultures as well as many wildlife species.2 Several formerly devastating diseases that have been eradicated from livestock populations in the western world over the past century are still common and readily accessible elsewhere.2 For some diseases, samples or cultures obtained from infected animals are all that would be required to initiate a serious outbreak. Foot-and-mouth disease, malignant catarrhal fever, Newcastle disease, and Rift Valley fever are examples of diseases that can pose major threats to livestock and wildlife and that have been cultivated and possibly weaponized according to Office International des Epizooties.2 Furthermore, these diseases have been shown to infect or be transported by rodents. Other diseases that can infect rodents and could cause economic losses in agricultural settlements are classical swine fever, porcine parovirus, clinical encephalomyocarditis fever virus, and neosporosis.15Will Human Infections Be Detected in Time?The degree and spread of human infections after a bioattack depends on local circumstances. In well-developed areas with good medical resources, the disease dispersal is likely to be noticed and stopped earlier than in poor and degraded areas. If an urban bioattack should result in roaming infected rodents, the most likely humans to first encounter the pathogens are people in degraded urban areas with poor hygiene and especially homeless people. Because of their isolation from the community, these groups can see the disease developing to full lethal proportions before it is discovered. If an affected person is alive when transported to the hospital, the hospital has a chance of performing diagnostics, and it is likely that the pathogen will be identified. But this depends on the standards and experience of the hospital staff, and in cases of bioattacks the previous experience and consequently the capacity to expect a disease may be lacking even if the hospital has high standards. When a person who died due to an unknown, uncommon disease is presented for autopsy, the chances are small that the pathologist will recognize it immediately, and there is a risk that no extra precaution will be taken initially, thus providing the pathogen with the potential to spread to those in the autopsy room. As is the case with tuberculosis transmission in autopsy rooms,54 other pathogens can be aerosolized during an autopsy and spread to workers. If the body is still fresh at the autopsy, an infectious disease may be recognized, but if a body is already decomposing, there is no chance that a forensic pathologist will recognize an infection because the decomposition will hide every possible sign. In this scenario, the chances of transmitting the pathogen to, for instance, a pathologist or members from the police team, in addition to the wildlife that may have been previously rooting around the body, are significant. Additionally, no alarm will reach the public until days later when more infections have been discovered.Prevention, Communication, and EducationIt is obvious that the best way to, at least partly, avoid the dispersal of rodentborne diseases after a bioattack is to control the number of (commensal) rodents before the possible incidence. The efficacy of proactive rodent control programs is evident from several reports, but today complaint-based reactive pest control seems to be the most popular strategy for rodent management among policymakers, as these control actions are easy to document and demonstrate to those with a rodent problem.55 Unfortunately, data from the UK show that if no proactive control is undertaken, it is unlikely that more than about 30% of infestations would be eliminated by a reactive complaints-based strategy. An alternative proactive rodent control strategy enables resources to be targeted where the risk is greatest and is more likely to achieve effective control.55 One of the best examples of this strategy is the long-term urban rodent control program undertaken in Budapest, Hungary, where a strategy applied and monitored over 30 years has not only involved effective control methods but also an analysis of the behavior and habitat use of urban rats.55 Furthermore, several ecological management approaches to control city rats, involving changing the location of food sources in buildings so that the environment is less predictable to rats and breaking links between populations in resource-rich patches have been demonstrated to be efficient in the long term.20 However, resources for proactive work are in many places in the world being withdrawn in favor of less effective and poorly targeted reactive strategies.55When a bioattack happens, in an emergency, there is no time to develop an elaborate strategy for public health communication. If the situation has not been analyzed properly, officials will most likely improvise, and the risk of spreading incorrect information is great.31 Methods of communication that function without inducing panic among the general public must therefore be developed in advance. Local pest management and control agencies are valuable partners for officials in case of a rodentborne disease outbreak, since they most likely have the data about current rodent activity, and they are specialists in pest elimination methods. Consequently, they need to be involved in the lines of communication both with officials and the general public. After a bioattack involving rodentborne pathogens, rats and mice, both dead and live, should be considered potentially infectious.31 People should be advised not to touch dead animals and to make their homes, shelters, and cabins rodent-proof. Homes should also be kept clean, and food and garbage should be covered in rodent-proof containers.7 However, as discussed above, rodent-proofing and cutting off the food flow of rodents in a facility that already contains infected rodents would just result in spreading the pathogens to other households as the rodents will try to find new food sources. Local trapping is recommended, but it is difficult to perform efficient trapping over large rural areas. Rodenticides may be a more efficient solution, but not many rodenticides are allowed in outdoor environments, as the side effects of them on nontarget species may be devastating and cause liver toxicity and increased parasite and pathogen burden.56-58 Furthermore, many rodent species have been shown to become resistant to the most commonly used rodenticides.59 Consequently, developing an efficient and nature-friendly way to implement rodent control would be of high importance. A failure to involve the public as a key partner in a public health crisis could hamper effective epidemic management.60 Simple, clear language should be used for public instructions, making it easier for all groups of society to follow them. As described above, when a pathogen has been introduced among wildlife species, the eradication of it will be difficult, and recurring disease outbreaks can be expected in the future. Consequently, the recommendations for handling the situation must be made with a long-term perspective. Tailored messages are needed for people with jobs that create special exposures. Special education may be provided for, for example, hunters and outdoor recreationists. Restricting activities in areas that are likely to harbor infected animals can also be an important preventive strategy.7 People who are frequently outdoors should also make sure they wear tick-, flea-, and mosquito-proof clothes and wash their hands with clean water after contact with soil. Domestic pets should be treated for ectoparasites, as they often can bring disease home.7 Active surveillance of wild animal populations both before and after a bioterrorism attack is necessary for identifying common baseline values for occurrence of certain diseases and sources of infection in the environment. Better approaches for intervention are needed to be able to prevent the spread of an introduced biological warfare agent into a wild animal population.6 We also need additional research about relative susceptibilities and exposure pathways for animal species living near human populations. An ability to rapidly detect introduced diseases and react quickly to hazards is essential for successful and cost-effective disease control. Diagnostic methods that facilitate early detection (eg, analyses that can detect hundreds of pathogens in a single sample, multiplex assays) can help in the process. AcknowledgmentsWriting of this publication has been supported by the framework of the EU project AniBio Threat (Grant Agreement: Home/2009/ISEC/AG/191) with financial support from the Prevention of and Fight against Crime Programme of the European Union, European CommissionDirectorate General Home Affairs. This publication reflects the views only of the authors, and the European Commission cannot be held responsible for any use that may be made of the information contained therein. | |||||||
| 4:07 PM 5/28/2020 - This is a fantasy: "lack of the restaurant leftovers". The real reason is that #RATS ARE INFECTED WITH #HANTERVIRUS & POSSIBLY #CORONAVIRUS & TRANSMIT THESE #INFECTIONS TO HUMANS, JUST LIKE THEY DID FOR ALL HUMAN HISTORY. Do not fantasize, address the issue! | |||||||
 https://covid-19-review.blogspot.com/2020/05/407-pm-5282020-this-is-fantasy-lack-of.html Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other https://images.app.goo.gl/Qr3tsTKSofoRv6Uf9 This is #Pigs and #Rats #eat Pigs and Rats #world https://images.app.goo.gl/Mp1yyTBxsBrtuv2y8 _________________________________________________________________________ - _______________________________________________________________________  Mike Nova's Shared NewsLinks Review In 250 Brief Posts -
» mikenov on Twitter: Deliberate release of pathogens can have a huge impact on society. At the same time, access to a range of pathogens can be relatively easy. Therefore, bioterrorism remains an important area of infectious disease preparedness. liebertpu
28/05/20 14:27 from TWEETS BY MIKENOV from mikenova (1 sites) Deliberate release of pathogens can have a huge impact on society. At the same time, access to a range of pathogens can be relatively easy. Therefore, bioterrorism remains an important area of infectious disease preparedness. liebertpub....
» mikenov on Twitter: The majority of pathogens that are listed as potential agents of bioterrorism by the Centers for Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases exploit rodents as vectors or reservoirs. li
28/05/20 14:26 from TWEETS BY MIKENOV from mikenova (1 sites) The majority of pathogens that are listed as potential agents of bioterrorism by the Centers for Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases exploit rodents as vectors or reservoirs. liebe...
» mikenov on Twitter: Rodents as Potential Couriers for Bioterrorism Agents | Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science liebertpub.com/doi/full/10.10
28/05/20 14:25 from TWEETS BY MIKENOV from mikenova (1 sites) Rodents as Potential Couriers for Bioterrorism Agents | Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science liebertpub.com/doi/full/10.10 Posted by mikenov on Thursday, May 28th, 2020 6:25pm mikenov on Twitter
» mikenov on Twitter: But the truth is biological warfare or germ warfare has been part of war for millennia.Coronavirus: A Flashback to Biological Warfare of a Bygone Era | Inter Press Service ipsnews.net/2020/02/corona
28/05/20 14:19 from TWEETS BY MIKENOV from mikenova (1 sites) But the truth is biological warfare or germ warfare has been part of war for millennia. Coronavirus: A Flashback to Biological Warfare of a Bygone Era | Inter Press Service ipsnews.net/2020/02/corona Posted by mikenov on Thursday, M...
» mikenov on Twitter: pigs are asymptomatic carriers of Hantavirus - Google Search google.com/search?q=pigs+
28/05/20 13:46 from TWEETS BY MIKENOV from mikenova (1 sites) pigs are asymptomatic carriers of Hantavirus - Google Search google.com/search?q=pigs+ Posted by mikenov on Thursday, May 28th, 2020 5:46pm mikenov on Twitter
» mikenov on Twitter: This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/PcnPVxG8u7PJCC
28/05/20 13:39 from TWEETS BY MIKENOV from mikenova (1 sites) This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/PcnPVxG8u7PJCC Posted by mikenov on Thursday, May 28th, 2020 5:39pm mikenov on Twitter
» mikenov on Twitter: This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/XhEjVLuzmEfUh8
28/05/20 13:38 from TWEETS BY MIKENOV from mikenova (1 sites) This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/XhEjVLuzmEfUh8 Posted by mikenov on Thursday, May 28th, 2020 5:38pm mikenov on Twitter
» mikenov on Twitter: This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/7EjXWEN2yai5VV
28/05/20 13:37 from TWEETS BY MIKENOV from mikenova (1 sites) This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/7EjXWEN2yai5VV Posted by mikenov on Thursday, May 28th, 2020 5:37pm mikenov on Twitter
» mikenov on Twitter: This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/Mp1yyTBxsBrtuv
28/05/20 13:37 from TWEETS BY MIKENOV from mikenova (1 sites) This is #Pigs and #Rats #eat Pigs and Rats #world images.app.goo.gl/Mp1yyTBxsBrtuv Posted by mikenov on Thursday, May 28th, 2020 5:37pm mikenov on Twitter
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/tNtcPsyZbkhQRh
28/05/20 13:35 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/tNtcPsyZbkhQRh Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/Wfp3VFwvYH2zhB
28/05/20 13:34 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/Wfp3VFwvYH2zhB Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/jfCUzdSR22P3yL
28/05/20 13:34 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/jfCUzdSR22P3yL Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/Qr3tsTKSofoRv6
28/05/20 13:33 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/Qr3tsTKSofoRv6 Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/P6R7rqHDo5GtBR
28/05/20 13:32 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/P6R7rqHDo5GtBR Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/FRUcokHx5cYkp4
28/05/20 13:32 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/FRUcokHx5cYkp4 Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/4UQowwcbJXX6Au
28/05/20 13:31 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/4UQowwcbJXX6Au Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/oEuEx9ZdJ4R23v
28/05/20 13:31 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/oEuEx9ZdJ4R23v Posted by mikenov on Thursday, M...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/8X856zuYq36sX4
28/05/20 13:31 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other images.app.goo.gl/8X856zuYq36sX4 Posted by mikenov on Thursday, M...
» mikenov on Twitter: This is Pigs and Rats eat Pigs and Rats world - Google Search google.com/search?q=This+
28/05/20 13:29 from TWEETS BY MIKENOV from mikenova (1 sites) This is Pigs and Rats eat Pigs and Rats world - Google Search google.com/search?q=This+ Posted by mikenov on Thursday, May 28th, 2020 5:29pm mikenov on Twitter
» mikenov on Twitter: Much the same may also be said of the Pig, which will eat garbage, and even ... Rats are in general miscellaneous feeders, and, when pressed by hunger, will ...This is Pigs and Rats eat Pigs and Rats world - Google Search google.com/s
28/05/20 13:28 from TWEETS BY MIKENOV from mikenova (1 sites) Much the same may also be said of the Pig, which will eat garbage, and even ... Rats are in general miscellaneous feeders, and, when pressed by hunger, will ... This is Pigs and Rats eat Pigs and Rats world - Google Search google.com/sea...
» mikenov on Twitter: Feb 9, 2004 - Rodents, if eaten by swine, also can directly transmit diseases. When rodents live around farm buildings, they are a food source that can attract ... google.com/search?q=This+
28/05/20 13:27 from TWEETS BY MIKENOV from mikenova (1 sites) Feb 9, 2004 - Rodents, if eaten by swine, also can directly transmit diseases. When rodents live around farm buildings, they are a food source that can attract ... google.com/search?q=This+ Posted by mikenov on Thursday, May 28th, 2020 ...
» mikenov on Twitter: Aug 28, 2019 - Although commensal rodents often feed on cereal grains, they will eat many kinds of food including garbage, insects, meat, and even manure. google.com/search?q=This+
28/05/20 13:26 from TWEETS BY MIKENOV from mikenova (1 sites) Aug 28, 2019 - Although commensal rodents often feed on cereal grains, they will eat many kinds of food including garbage, insects, meat, and even manure. google.com/search?q=This+ Posted by mikenov on Thursday, May 28th, 2020 5:26pm mi...
» mikenov on Twitter: Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other - Google Search google.com/search?q=Infec
28/05/20 13:25 from TWEETS BY MIKENOV from mikenova (1 sites) Infection cycle: Pigs eat Rats in feeds, Rats eat infected pork and other infected Rats, Man (especially the Chinese) eats both pigs and rats and feeds them to each other - Google Search google.com/search?q=Infec Posted by mikenov on Th...
» "Starving, angry and cannibalistic: America's rats are getting desperate amid coronavirus pandemic" - https://www.nbcnews.com/politics/national... I think, the real #reason is that these #rats are #crazy and psychotic, because they are #sick: intentionall
28/05/20 13:16 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story from Covid-19-Review. <a href="https://covid-19-review.blogspot.com/2020/05/starving-angry-and-cannibalistic.html" rel="nofollow">https://covid-19-review.blogspot.com/2020/05/starving-angry-and-cannibalistic.html</a> ________________________________________________________________________________ Starving, angry ... | |||||||
| Coronavirus New York: CDC warns of aggressive rats - ABC7 New York | |||||||
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| "Starving, angry and cannibalistic: America's rats are getting desperate amid coronavirus pandemic" - https://www.nbcnews.com/politics/national... I think, the real #reason is that these #rats are #crazy and psychotic, because they are #sick: intentionally infected with #Hantavirus and #Coronavirus. They have to be tested and indeed eradicated: they might be the real vector of the Disease X - M.N. | |||||||
 https://covid-19-review.blogspot.com/2020/05/starving-angry-and-cannibalistic.html ________________________________________________________________________________ Starving, angry and cannibalistic: America's rats are getting desperate amid coronavirus pandemic
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| 10:14 AM 5/28/2020 - Covid-19 and infected pork: Maybe, the answer is the INFECTED PORK: Hantavirus? Coronavirus? Co-infection? Other? Are the infected rats and pigs the silent asymptomatic carriers and the super-spreaders of Covid-19? | |||||||
 Covid-19 and infected pork: Maybe, the answer is the INFECTED PORK: Hantavirus? Coronavirus? Co-infection? Other? Are the infected rats and pigs the silent asymptomatic carriers and the super-spreaders of Covid-19? ________________________________________________________________ https://covid-19-review.blogspot.com/2020/05/1014-am-5282020-covid-19-and-infected.html _________________________________________________________________ M.N.: Maybe, the answer is the INFECTED PORK: Hantavirus? Coronavirus? Co-infection? Other?https://ctajournal.biomedcentral.com/articles/10.1186/s13601-020-00323-0 Covid-19 and infected pork - Google Search https://www.google.com/search?q=Covid-19+and+infected+pork&rlz=1C1CHBF_enUS733US733&oq=Covid-19+and+infected+pork&aqs=chrome..69i57.21141j0j7&sourceid=chrome&ie=UTF-8 Are the infected rats and pigs the silent asymptomatic carriers and the super-spreaders of Covid-19? - Google Search https://www.google.com/search?newwindow=1&rlz=1C1CHBF_enUS733US733&sxsrf=ALeKk01lBibFV_dBk038Bc2FfpLM0MZ7Bw%3A1590673060617&ei=pL7PXouLJYPL_QaM8KnACQ&q=Are+the+infected+rats+and+pigs+the+silent+asymptomatic+carriers+and+the+super-spreaders+of+Covid-19%3F&oq=Are+the+infected+rats+and+pigs+the+silent+asymptomatic+carriers+and+the+super-spreaders+of+Covid-19%3F&gs_lcp=CgZwc3ktYWIQDDoECAAQR1C4vQJY1e8CYM2AA2gAcAF4AIABZYgBowGSAQMxLjGYAQCgAQGqAQdnd3Mtd2l6&sclient=psy-ab&ved=0ahUKEwiL7ez11tbpAhWDZd8KHQx4CpgQ4dUDCAw _______________________________________________________________
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| Is diet partly responsible for differences in COVID-19 death rates between and within countries? | Clinical and Translational Allergy | |||||||
ARIA group: Amir Hamzah Abdul Latiff, Baharudin Abdullah, Werner Aberer, Nancy Abusada, Ian Adcock, Alejandro Afani, Ioana Agache, Xenofon Aggelidis, Jenifer Agustin, Cezmi Akdis, Mübeccel Akdis, Mona Al-Ahmad, Abou Al-Zahab Bassam, Oscar Aldrey-Palacios, Emilio Alvarez Cuesta, Ashraf Alzaabi, Salma Amad, Gene Ambrocio, Isabella Annesi-Maesano, Ignacio Ansotegui, Josep Anto, Hasan Arshad, Maria Cristina Artesani, Estrella Asayag, Francesca Avolio, Khuzama Azhari, Ilaria Baiardini, Nissera Bajrović, Petros Bakakos, Sergio Bakeyala Mongono, Christine Balotro-Torres, Sergio Barba, Cristina Barbara, Elsa Barbosa, Bruno Barreto, Joan Bartra, Eric D. 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Fokkens, Jean-François Fontaine, Francesco Forastiere, Jose Miguel Fuentes Pèrez, Emily GaerlanResureccion, Mina Gaga, José Luis Gálvez Romero, Amiran Gamkrelidze, Alexis Garcia, Cecilia Yvonne García Cobas, María de la Luz Hortensia García Cruz, Jacques Gayraud, Bilun Gemicioglu, Sonya Genova, José Gereda, Roy Gerth van Wijk, Maximiliano Gomez, Sandra González Diaz, Maia Gotua, Christos Grigoreas, Ineta Grisle, Marta Guidacci, Nick Guldemond, Zdenek Gutter, Antonieta Guzmán, Tari Haahtela, Ramsa Halloum, Eckard Hamelmann, Suleiman Hammadi, Richard Harvey, Joachim Heinrich, Adnan Hejjaoui, Birthe Hellquist-Dahl, Luiana Hernández Velázquez, Mark Hew, Elham Hossny, Peter Howarth, Martin Hrubiško, Yunuen Rocío Huerta Villalobos, Marc Humbert, Michael Hyland, Guido Iaccarino, Moustafa Ibrahim, Maddalena Illario, Natalia Ilyina, Carla Irani, Zhanat Ispayeva, Juan Carlos Ivancevich, Edgardo Jares, Deborah Jarvis, Ewa Jassem, Klemen Jenko, Rubén Darío Jiméneracruz Uscanga, Sebastian Johnston, Guy Joos, Maja Jošt, Kaja Julge, Ki-Suck Jung, Jocelyne Just, Marek Jutel, Igor Kaidashev, Omer Kalayci, Fuat Kalyoncu, Jeni Kapsali, Przemyslaw Kardas, Jussi Karjalainen, Carmela A. Kasala, Michael Katotomichelakis, Bennoor Kazi, Thomas Keil, Paul Keith, Musa Khaitov, Nikolai Khaltaev, You-Young Kim, Jorg Kleine-Tebbe, Ludger Klimek, Bernard Koffi NGoran, Evangelia Kompoti, Peter Kopač, Gerard Koppelman, Anja Koren Jeverica, Mitja Košnik, Kosta V. Kostov, Marek L. Kowalski, Tanya Kralimarkova, Karmen Kramer Vrščaj, Helga Kraxner, Samo Kreft, Vicky Kritikos, Dmitry Kudlay, Inger Kull, Piotr Kuna, Maciej Kupczyk, Violeta Kvedariene, Marialena Kyriakakou, Nika Lalek, Stephen Lane, Désiree Larenas-Linnemann, Amir Latiff, Susanne Lau, Daniel Laune, Jorge Lavrut, Lan Le, Marcus Lessa, Michael Levin, Jing Li, Philip Lieberman, Giuseppe Liotta, Brian Lipworth, Xuandao Liu, Rommel Lobo, Karin C. Lodrup Carlsen, Carlo Lombardi, Renaud Louis, Stelios Loukidis, Olga Lourenço, Jorge A. Luna Pech, Bojan Madjar, Antoine Magnan, Bassam Mahboub, Alpana Mair, Yassin Mais, Anke-Hilse Maitland van der Zee, Mika Makela, Michael Makris, Hans-Jorgen Malling, Mariana Mandajieva, Patrick Manning, Manolis Manousakis, Pavlos Maragoudakis, Gailen Marshall, Pedro Martins, Mohammad Reza Masjedi, Jorge F. Máspero, Juan José Matta Campos, Marcus Maurer, Sandra Mavale-Manuel, Cem Meço, Erik Melén, Elisabete Melo-Gomes, Eli O. Meltzer, Enrica Menditto, Andrew Menzies-Gow, Hans Merk, Jean-Pierre Michel, Neven Miculinic, Luís Midão, Florin Mihaltan, Kuitunen Mikael, Nikolaos Mikos, Branislava Milenkovic, Dimitrios Mitsias, Bassem Moalla, Giuliana Moda, María Dolores Mogica Martínez, Yousser Mohammad, Mostafa Moin, Mathieu Molimard, Isabelle Momas, Alessandro Monaco, Steve Montefort, Dory Mora, Mario Morais-Almeida, Ralph Mösges, Badr Eldin Mostafa, Joaquim Mullol, Lars Münter, Antonella Muraro, Ruth Murray, Tihomir Mustakov, Robert Naclerio, Rachel Nadif, Alla Nakonechna, Leyla Namazova-Baranova, Gretchen Navarro-Locsin, Hugo Neffen, Kristof Nekam, Angelos Neou, Laurent Nicod, Verena Niederberger-Leppin, Marek Niedoszytko, Antonio Nieto, Ettore Novellino, Elizabete Nunes, Dieudonné Nyembue, Robyn OHehir, Cvetanka Odjakova, Ken Ohta, Yoshitaka Okamoto, Kimi Okubo, Brian Oliver, Gabrielle L. Onorato, Maria Pia Orru, Solange Ouédraogo, Kampadilemba Ouoba, Pier Luigi Paggiaro, Aris Pagkalos, S. P. Palaniappan, Isabella Pali-Schöll, Susanna Palkonen, Stephen Palmer, Carmen Panaitescu Bunu, Petr Panzner, Nikos G. Papadopoulos, Vasilis Papanikolaou, Alberto Papi, Bojidar Paralchev, Giannis Paraskevopoulos, Hae Sim Park, Giovanni Passalacqua, Vincenzo Patella, Ian Pavord, Ruby Pawankar, Soren Pedersen, Susete Peleve, Ana Pereira, Tamara Pérez, Oliver Pfaar, Nhân Pham-Thi, Bernard Pigearias, Isabelle Pin, Konstantina Piskou, Constantinos Pitsios, Kostas Pitsios, Davor Plavec, Dagmar Poethig, Wolfgang Pohl, Antonija Poplas Susic, Todor A. Popov, Fabienne Portejoie, Paul Potter, Lars Poulsen, Alexandra Prados-Torres, Fotis Prarros, David Price, Emmanuel Prokopakis, Robert Puy, Klaus Rabe, Filip Raciborski, Josephine Ramos, Marysia T. Recto, Shereen M. Reda, Frederico Regateiro, Norbert Reider, Sietze Reitsma, Susana Repka-Ramirez, Janet Rimmer, Daniela Rivero Yeverino, José Angelo Rizzo, Carlos Robalo-Cordeiro, Graham Roberts, Nicolas Roche, Mónica Rodríguez González, Eréndira Rodríguez Zagal, Christine Rolland, Regina Roller-Wirnsberger, Miguel Roman Rodriguez, Antonino Romano, Philippe Rombaux, Joel Romualdez, Jose Rosado-Pinto, Nelson Rosario, Lanny Rosenwasser, Menachem Rottem, Philip Rouadi, Nikoleta Rovina, Irma Rozman Sinur, Mauricio Ruiz, Lucy Tania Ruiz Segura, Dermot Ryan, Hironori Sagara, Daiki Sakai, Daiju Sakurai, Wafaa Saleh, Johanna Salimaki, Husain Salina, Konstantinos Samitas, Boleslaw Samolinski, María Guadalupe Sánchez Coronel, Mario Sanchez-Borges, Jaime Sanchez-Lopez, Codrut Sarafoleanu, Faradiba Sarquis Serpa, Joaquin Sastre-Dominguez, Glenis Scadding, Sophie Scheire, Peter Schmid-Grendelmeier, Juan Francisco Schuhl, Holger Schunemann, Maria Schvalbová, Nicola Scichilone, Cecilia Sepúlveda, Elie Serrano, Aziz Sheikh, Mike Shields, Vasil Shishkov, Nikos Siafakas, Alexander Simeonov, Estelle F. Simons, Juan Carlos Sisul, Brigita Sitkauskiene, Ingelbjorg Skrindo, Tanja Soklič Košak, Dirceu Solé, Talant Sooronbaev, Manuel Soto-Martinez, Milan Sova, François Spertini, Otto Spranger, Sofia Stamataki, Lina Stefanaki, Cristiana Stellato, Rafael Stelmach, Peter Sterk, Timo Strandberg, Petra Stute, Abirami Subramaniam, Charlotte Suppli Ulrik, Michael Sutherland, Silvia Sylvestre, Aikaterini Syrigou, Luis Taborda Barata, Nadejda Takovska, Rachel Tan, Frances Tan, Vincent Tan, Ing Ping Tang, Masami Taniguchi, Line Tannert, Jessica Tattersall, Maria do Ceu Teixeira, Carel Thijs, Mike Thomas, Teresa To, Ana Maria Todo-Bom, Alkis Togias, Peter-Valentin Tomazic, Sanna Toppila-Salmi, Elina Toskala, Massimo Triggiani, Nadja Triller, Katja Triller, Ioanna Tsiligianni, Ruxandra Ulmeanu, Jure Urbancic, Marilyn Urrutia Pereira, Martina Vachova, Felipe Valdés, Rudolf Valenta, Marylin Valentin Rostan, Antonio Valero, Arunas Valiulis, Mina Vallianatou, Erkka Valovirta, Michiel Van Eerd, Eric Van Ganse, Marianne van Hage, Olivier Vandenplas, Tuula Vasankari, Dafina Vassileva, Maria Teresa Ventura, Cécilia Vera-Munoz, Dilyana Vicheva, Pakit Vichyanond, Petra Vidgren, Giovanni Viegi, Claus Vogelmeier, Leena Von Hertzen, Theodoros Vontetsianos, Dimitris Vourdas, Martin Wagenmann, Samantha Walker, Dana Wallace, De Yun Wang, Susan Waserman, Magnus Wickman, Sian Williams, Dennis Williams, Nicola Wilson, Kent Woo, John Wright, Piotr Wroczynski, Paraskevi Xepapadaki, Plamen Yakovliev, Masao Yamaguchi, Kwok Yan, Yoke Yeow Yap, Barbara Yawn, Panayiotis Yiallouros, Arzu Yorgancioglu, Shigemi Yoshihara, Ian Young, Osman B. Yusuf, Asghar Zaidi, Fares Zaitoun, Heather Zar, Mario Zernotti, Luo Zhang, Nanshan Zhong, Mihaela Zidarn, Torsten Zuberbier, Celia Zubrinich.
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| COVID-19 Virus Found in Stool May Be Infectious | |||||||
Scientists in China who performed this test with virus they isolated from the stool of a COVID-19 patient found that it could infect living cells. When they looked at infected cells under an electron microscope, they could see the cells releasing viral particles that were presumably ready to go infect more cells, highlighting the potential for the disease to spread this way.
The researchers also determined there was about 100 times more virus in stool than in samples taken from the patients mouth and nose. The question really becomes how big is this, right? And how much does it matter in the grand scheme of things, says Barun Mathema, PhD, an infectious disease epidemiologist at Columbia University in New York City. Still, Mathema says that in certain settings, the virus in stool could be an important factor in the spread of the disease. There will probably be multiple routes of transmission, he says. Right now, he says, We certainly dont think it is a major route. Currently, virus thats released into the air from coughs and sneezes is thought to be the biggest driver of spread. Contact with contaminated surfaces, called fomite transmission, may also be playing a role. Until more is known, Mathema says its not a bad idea to be careful in shared bathrooms, closing the lid on the toilet before you flush when you can to cut down on the creation of toilet plume aerosols. There is, for sure, a lot of aerosolization going on with flushing. Lids, it turns out, are very important, he says. Finally, the CDC says its critical to wash your hands for at least 20 seconds after going to the bathroom, changing a babys diaper, or helping an older child in the bathroom. | |||||||
| Nature publishes Shanghai COVID-19 study that suggests COVID-19 origins unknown | |||||||
Photo: courtesy of the team
Recent Shanghai-based research targeting local confirmed cases of novel coronavirus (COVID-19) once again proved the attacks on a seafood market in Central China's Hubei Province for originating the virus are nonsense.
The results of the study, being published on the website of top academic journal Nature on May 20, implied the Huanan Seafood Market in Hubei's capital Wuhan may not be the birthplace of COVID-19, although the virus outbreak emerged in Wuhan had a strong link to contacts with the market.
Based on the analysis of 112 quality samples from 326 confirmed cases reported in Shanghai between January 20 and February 25, researchers found two major lineages (clade I and clade II) with differential exposure history during the early phase of the outbreak in Wuhan.
A Phylogenetic analysis of the samples saw that, six cases with clear contact history to the Huanan market were all clustered into clade I, while three cases diagnosed at the same period without the contact history were all clustered into clade II, an anonymous member of the research team told the Global Times.
The sequences of the Shanghai cohort were found throughout the two major clades and their subclades, suggesting multiple origins of transmission into Shanghai, said the Nature article titled
Viral and host factors related to the clinical outcome of COVID-19
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There has been no direct evidence that the cross-species COVID-19 transmission originally occurred in the Huanan market, although it was a probable place for human-to-human transmission of the virus because of its relatively high crowd density, said the researcher.
"The origin of the virus remains unknown based on current published data," she told the Global Times. "It still needs scientists' continuous effort in determining the intermediate host of coronavirus, and carrying out comprehensive and detailed virus-tracing studies."
This finding echoes WHO and several COVID-19 studies of global research teams that have suggested COVID-19 origins unknown.
"...be so critical of China (for the virus) is not only unfair, but plainly incorrect and factually untrue," Richard Horton, the editor-in-chief of the British-based medical journal The Lancet, told media on May 1.
The study also found that the determinants of COVID-19 disease severity, which "seemed to stem mostly from host factors such as age, lymphocytopenia, and its associated cytokine storm," read the Nature article, adding that they are the key warning factors for some cases deteriorating to severe ones.
Even though 90 percent of the cases the Shanghai team researched were patients with mild symptoms, there were a few cases that could deteriorate to serious pneumonia and even deadly respiratory failure, the researcher introduced.
"To reduce the incidence of severe cases, medical workers can assess the patients' situations based on these factors and make targeted treatment plans," she said.
Some targeted treatments for severe patients, including treatment of underlying disease, active anti-inflammatory therapy, convalescent plasma immunotherapy and tocilizumab on cytokine storm, have been proved effective in clinical practice, she added.
The team consisted of members from Shanghai's scientific research and medical institutions including Shanghai Public Health Clinical Center, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Institute of Hematology.
Its study provides Chinese experiences in the fight against the virus to the world, the team said.
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| 12:41 PM 5/27/2020 - Covid-19 is the Disease-X-19, one or several diseases or infections, with uncertain causes and mechanisms. It might be the new Bioweapon of the new Pandemic-Biowarfare, the clever and sophisticated Intelligence Operation, possibly by German New Abwehr - M.N. | |||||||
 https://covid-19-review.blogspot.com/2020/05/covid-19-is-disease-x-19-one-or-several.html ___________________________________________________________________ Covid-19 is the Disease-X-19, one or several diseases or infections, with uncertain causes and mechanisms. It might be the new Bioweapon of the new Pandemic-Biowarfare, the clever and sophisticated Intelligence Operation, possibly by German New Abwehr - Google Search - M.N. | 12:41 PM 5/27/2020 _______________________________________________________________________
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| Inflamed brains, toe rashes, strokes: Why COVID-19's weirdest symptoms are only emerging now | National Geographic | |||||||
A coronavirus patient is transferred from a hospital that was full to capacity to another hospital by members of the medical staff of Klinicare in Brussels, Wednesday, April 1, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death.
Photograph by Francisco Seco, AP Photo
An infection can inflict serious damage inside your body in many different ways, and COVID-19 seems to use just about all of them. The coronavirus primarily attacks the lungs, which can cause pneumonia or even respiratory failure, and in one of every five patients, it also leads to multiple organ failure.
Yet, as the pandemic continues to ravage the world, case reports have emerged of more unusual damage ranging from hundreds of tiny blood clots to strokes in young people, and even mysterious inflammatory responses, such as full-body rashes in children and the red lesions that have come to be known unofficially as COVID toe. Although these conditions seem strange and scary, they have been seen in viral medicine even before the advent of COVID-19, and, to some degree, they are to be expected. Every human body is unique, so a disease that strikes millions of people will yield some oddities. What exactly is going on in these cases, and how common are they? Heres what we knowand what the scientific community still needs to find out to treat these unusual cases. COVID-19 and the body: The basicsCOVID-19 starts as a respiratory disease. The virus invades cells in the nose, throat, and lungs and starts to replicate, causing flu-like symptoms that can progress to pneumonia and even punch holes in your lungs, leaving permanent scars. For many patients, thats the worst of it.But for others, the immune system inexplicably goes haywire and their bodies release proteins called cytokinesalarm beacons that help recruit immune cells to the site of an infection. If too many cytokines leak into the bloodstream and fill the body, immune cells start killing anything they encounter. This response, called a cytokine storm, creates massive inflammation that weakens the blood vessels, causing fluid to seep into the lungs air sacs, triggering respiratory failure. A cytokine storm can damage the liver or kidneys and result in multi-organ failure. Possible heart infectionsBeyond the lungs, the new coronavirus seems to wreak havoc in the heart, with one in five COVID-19 patients experiencing some cardiac injury, according to a recent study in China.The heart pumps blood throughout the body, supplying the organs with oxygen from the lungs. Respiratory viruses such as coronaviruses and influenza can interfere with that balance of supply and demand. If a virus attacks the lungs, they become less efficient at supplying oxygen to the bloodstream. An infection can also inflame the arteries, causing them to narrow and supply less blood to the organs, including the heart. The heart then responds by working harder to compensate, which can lead to cardiovascular distress. One unusual and as-yet unexplained symptomeven among young and otherwise healthy peopleis myocarditis, a relatively rare condition in which inflammation weakens the heart muscle.
New reports have raised the possibility that the coronavirus may embed itself directly in the heart. Viruses enter cells by looking for their favorite doorwaysproteins called receptors. In the case of the coronavirus, scientists have noted that the heart possesses the same protein gateway of choice, called ACE-2, that SARS-CoV-2 uses to attack the lungs.
No one convincingly has shown with a biopsy that theres actually viral particles inside the heart muscle cells, says Robert Bonow, a professor of cardiology at the Northwestern University Feinberg School of Medicine and past president of the American Heart Association. He notes that these signs of myocarditis could also be brought on by a cytokine storm thats inflaming the rest of the body. However, viruses such as chickenpox and HIV have been known to directly infect heart muscle, and research suggests that the coronavirus can invade the blood vessel lining. This growing evidence of the significant role the heart is playing has raised the question of whether COVID-19 should also be classified as a cardiovascular disease. Its led to lots of questions about how we treat patients these days, Bonow says. When a 75-year-old man comes in with chest pain, is it a heart attack or COVID? Mysterious blood clottingFor many patients, COVID-19 is causing a lot of clotting and in an unusual number of ways.More than 160 years ago, a German physician named Rudolf Virchow detailed three reasons abnormal blood clots can occur. First, if the inner lining of blood vessels becomes injured, perhaps due to an infection, it can release proteins that promote clotting. Second, clots can form if the blood flow becomes stagnant, which sometimes happens when people in hospital beds are immobile for too long. Finally, vessels can develop a tendency to become cluttered with platelets or other circulating proteins that repair woundswhich typically happens with inherited diseases but can also be triggered by systemic inflammation. I think we have evidence that all three of those are playing a role in COVID, says Adam Cuker, an associate professor of medicine at the Hospital of the University of Pennsylvania who specialises in clotting disorders. Cytokine storms can also exacerbate inflammatory conditions that clog arteries, such as the fatty plaques behind atherosclerosishence why pre-existing cardiovascular disease correlates with severe COVID-19. Doctors are puzzled by the extent of blood clotting caused by COVID-19. In late April, the Washington Post reported that clotting is manifesting itself in some pretty abnormal waysincluding hundreds of microclots that form in the bloodstream, collect in lungs, and clog dialysis machines used to treat kidney disorders.
At the Hospital of the University of Pennsylvania, the intensive care unit is seeing up to three times as many clots in patients with COVID-19 than theyre used to seeing in ICU patients without the disease, Cuker says. So far, trying to address the problem has involved increasing the dose of blood thinners given to patients with COVID-19, even as clinical trials are examining whether these medications actually reduce the risk of coronavirus-induced clots.
Its not clear why COVID-19s clots are so tiny and are filling organs by the hundreds, Cuker says, but it might be due to a part of the immune system called the complement pathway, which involves normally inactive proteins that circulate in the blood. In other disorders, inappropriate activation of this pathway can manifest as tiny clots. Cuker, who is helping to develop guidelines on how to treat COVID-related clotting for the American Society of Hematology, says scientists are taking a broad view in their search for the answers. All of these systems may be playing a role, and we need to understand that. Unexpected strokesThis uptick in clotting may explain why young COVID-19 patients without any cardiac risk factors are suffering from strokes, which typically afflict the brains of the elderly. Although its surprising to see strokes in young people, strokes should perhaps be expected given that the connection was also observed during the 2002-2003 outbreak of SARS, a related coronavirus.Almost all the [neurological] things were seeing now with COVID-19 are things you might have predicted would have happened, says Kenneth Tyler, chairman of the department of neurology at the University of Colorado School of Medicine and a fellow of the American Academy of Neurology.
Most of the strokes reported with COVID-19 have been ischemic, meaning a clot plugs one of the vessels supplying blood to the brain. Ischemic strokes are already common in general, due to their tight correlation with cardiovascular conditions like atherosclerosis. If an ischemic stroke blocks the supply of oxygenated blood for too long, it can impair the area of the brain that lies downstream. Thats why the manifestations caused by the coronavirus can seem randomsuch as trouble speaking or seeing or walking. Some COVID-19 cases have also involved haemorrhagic stroke, which occurs when a weakened blood vessel ruptures and bleeds into the brain, compressing the surrounding brain tissue.
Cuker says its not known how common strokes and clotting might be among COVID-19 patients because most of the observations have been confined to the ICU. That means the record is missing patients who were discharged from the hospital and later developed a COVID-related clot, or people whose infections had mild or no symptoms before the clot. Is this just a small number of cases getting a lot of attention, or is this actually a more common problem that rises to the level of a public health issue? Cuker asks. Brain inflamedReports have also linked COVID-19 to patients suffering from encephalitis, or inflammation of the brain, as well as a much rarer syndrome called GuillainBarré, in which the bodys immune system attacks the nerves. In milder cases, encephalitis can cause flu-like symptoms; in more severe cases, it might bring seizures, paralysis, and confusion.COVID-19 isnt a trailblazer in this regard, as many different virusesherpes, tick-borne viruses, rabies, and the original SARScan cause encephalitis. When one of these viruses invades the nervous system, it can injure and inflame the brain either by directly killing cells or by inviting the immune system to do the job, akin to a cytokine storm. In the case of COVID-19, Tyler says the cause is not known. With GuillainBarré, the immune system attacks the network of nerves and ganglia that run throughout your body. This disorder tends to show up weeks after a germ has cleared the body and can cause weakness and tingling in your extremities that can eventually lead to paralysis. Although this disorder has only been observed in a handful of COVID-19 case reports, Tyler thinks its connection is more than just coincidence. Scientists dont really know the exact mechanisms of GuillainBarré, but it appears to be associated with whats known as the bodys acquired immune system, which responds to a pathogen by developing specific antibodies to fight it. These antibodies take weeks to develop and are normally protectivebut they are thought to occasionally go haywire as well, attacking the nerves and their coating. Skin deep?One of the most recently discoveredand most inexplicablesigns of COVID-19 is a broad range of inflammatory symptoms that it seems to be provoking in the skin, including rashes, the painful red lesions that have come to be known as COVID toe, and the collection of symptoms in children thats been labeled a Kawasaki-like syndrome.Its like reading a dermatology textbook, because it really spans the full gamut, says Kanade Shinkai, a professor of dermatology at the University of California, San Francisco. A virus can cause a rash in two ways. It can spread across the body and deposit itself directly in the skin, which is how chickenpox works. Alternatively, a virus can activate the immune system, producing rashes in nonspecific patterns all over the skin both as part of its normal response to infection or as an overreaction associated with a cytokine storm. Shinkai says viral rashes typically occur in less than 2 percent of patients with other common viruses. However, with COVID-19, rashes take on so many different patterns that its hard to tell if any of them are unique to SARS-CoV-2 in the same way that itchy red bumps and blisters are a telltale sign of chickenpox. The situation is so mystifying that some experts wonder if the rashes seen in COVID-19 patients are just a coincidence.
This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).
Photograph by Illustration by Alissa Eckert, MS; Dan Higgins, MAMS/CDC
Some people have even argued that what were seeing is rashes during the time of COVID-19, but not necessarily rashes associated with COVID-19, Shinkai says. Thats a big mystery and a big scientific question that still needs to be answered.
Thats also the case with COVID toes. Dermatologists are seeing a rise in patients complaining of painful red or purple lesions on their toes and fingers, which might be caused by microclots or inflammation in the blood vessels in those places. But while some patients with COVID toe have tested positive for the virus, this symptom is also present in people who test negative for both the virus itself and the antibodies generated in response, Shinkai says. To better understand these skin manifestations, Shinkai says, we need more studies that describe them comprehensively. Although one Italian study identified rashes in 20 percent of patients, another study out of Wuhan found them in only 0.2 percent of patients. Shinkai wants to know whether that disparity reveals a difference in patients or in the researchers attention to the details. Similarly, scientists are baffled by the diseases in children that have been grouped together as a Kawasaki-like syndrome. Kawasaki disease is a rare condition that causes inflammation in blood vessels throughout the body, particularly in Japanese children. While the cause remains unknown, its symptoms include full-body rashes, swelling, bloodshot eyes, abdominal pain, and diarrohea. Though Kawasaki disease normally resolves on its own without long-term consequences, it can cause severe heart complications. Recently, a spate of reports has identified children diagnosed with COVID-19 who share some or all of the symptoms of Kawasaki disease. Michael Agus, chief of medical critical care at Boston Childrens Hospital, says physicians are only just beginning to describe the connection.
So far, COVID-19 doctors have spotted two forms of Kawasaki-like disease. One centres on viral sepsisa severe inflammatory response to an infection that causes depressed heart function and low blood pressure. The other variety emerges in the weeks after COVID-19 infection or exposure, with some of the more classic Kawasaki symptoms listed above, including changes in the shape of the hearts arteries.
Although this condition sounds scary, Agus says its very rare. It has been observed only in clusters of children in Europe and North America, and its hard to tell whether all the cases are even linked to COVID-19, given that some Kawasaki-like children test negative for the virus and have no signs of antibodies from past infection. Agus says finding the answers will depend on more comprehensive patient descriptions, but also on better access to testing and clinical trials. In the meantime, researchers say, we should stay focused on maintaining the now standard practices to protect ourselves from COVID-19, including wearing masks outside, meticulous handwashing, and careful social distancing. Thats going to be the answer, Agus says, whether this turns into one syndrome or four syndromes. | |||||||
| More than 'covid toes': Numerous reports of skin rashes tied to COVID-19 | Live Science | |||||||
The skin rashes that may be tied to COVID-19 take many forms, from tiny red dots to larger, flat lesions, doctors say.
(Image: © Shutterstock)
The rashes can take many forms some appear as tiny red spots, while others appear as larger flat or raised lesions. Some have a hive-like appearance, while others look like frostbitten toes. | |||||||
| 9:08 AM 5/26/2020 - Covid-19 and Hantaviruses: "The symptoms of the Hantavirus are almost similar to that of Coronavirus, it is essentially transmitted from rodents to humans" | Potential Uses of the Hantavirus as a Biological Weapon | Security Studies Online | |||||||
https://covid-19-review.blogspot.com/2020/05/908-am-5262020-symptoms-of-hantavirus.html
 Potential Uses of the Hantavirus as a Biological Weapon | Security Studies Online https://securitystudiesonline.wordpress.com/2011/08/11/potential-uses-of-the-hantavirus-as-a-biological-weapon/ ______________________________________________________________________
Covid-19 and Hantaviruses
Is "Covid-19" in fact the weaponized Hantavirus infection, with "Sars-Cov-2" as the concomitant, facilitating and "the cover" infection, to make the correct diagnosis more difficult? There are important points that support this point of view: e.g.: very similar symptoms and the modes of transmission. The infected pigs and the pork products, especially those imported from China illegally, where Hantavirus is endemic, can serve as the intermediary sources of infection. I think, that all these and the associated issues, in essence and in brief the weaponization and the mass distribution of the Hantavirus in conjunction with the Covid-19 Pandemic should be looked into carefully. The modern methods of Gene Editing, as it was addressed in the previous posts, make it possible to modify any virus in the lab easily. The question is, if the Sars-Cov-2 was assigned the specific pathogenic features and the modes of transmission of the Hantaviruses, turning them into the combined bioweapon, specifically designed to produce the Pandemics. The specialists should work on these issues. Michael Novakhov | 9:08 AM 5/26/2020 ____________________________________ The symptoms of the hantavirus are almost similar to that of coronavirus, it is essentially transmitted from rodents to humans https://zeenews.india.com/india/coronavirus-vs-hantavirus-symptoms-precautions-and-cure-2271516.html
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| 9:53 AM 5/26/2020 - Mike Nova's Shared NewsLinks Review: Potential Uses of the Hantavirus as a Biological Weapon | Security Studies Online | Studies have shown that this virus can be shed in the feces, which means that shared bathrooms can be a source of infection. | |||||||
 Studies have shown that this virus can be shed in the feces, which means that shared bathrooms can be a source of infection. https://time.com/5837591/unusual-symptoms-of-coronavirus/ _______________________________________________________________________ https://covid-19-review.blogspot.com/2020/05/953-am-5262020-mike-novas-shared.html
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_______________________________________________________________________ Mike Nova's Shared NewsLinks Review In 250 Brief Posts -
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26/05/20 08:52 from TWEETS BY MIKENOV from mikenova (1 sites) hantavirus biological weapon - Google Search google.com/search?q=hanta Posted by mikenov on Tuesday, May 26th, 2020 12:52pm mikenov on Twitter
» mikenov on Twitter: Hantavirus is endemic in China - Google Search google.com/search?q=Hanta
26/05/20 08:47 from TWEETS BY MIKENOV from mikenova (1 sites) Hantavirus is endemic in China - Google Search google.com/search?q=Hanta Posted by mikenov on Tuesday, May 26th, 2020 12:47pm mikenov on Twitter
» mikenov on Twitter: Jan 27, 2020 - Yet another batch of ASF-infected sausages, coming from China, have ... that infected products are discovered on the Russian-Chinese border. ... Illegal Chinese pork reaching Italy ... Brazil's pork exports increase with
26/05/20 08:33 from TWEETS BY MIKENOV from mikenova (1 sites) Jan 27, 2020 - Yet another batch of ASF-infected sausages, coming from China, have ... that infected products are discovered on the Russian-Chinese border. ... Illegal Chinese pork reaching Italy ... Brazil's pork exports increase with 2...
» mikenov on Twitter: illegal exports of pork products from china to italy - Google Search google.com/search?q=illeg
26/05/20 08:32 from TWEETS BY MIKENOV from mikenova (1 sites) illegal exports of pork products from china to italy - Google Search google.com/search?q=illeg Posted by mikenov on Tuesday, May 26th, 2020 12:32pm mikenov on Twitter
» mikenov on Twitter: illegal exports of pork products from china to europe - Google Search google.com/search?newwind
26/05/20 08:30 from TWEETS BY MIKENOV from mikenova (1 sites) illegal exports of pork products from china to europe - Google Search google.com/search?newwind Posted by mikenov on Tuesday, May 26th, 2020 12:30pm mikenov on Twitter
» mikenov on Twitter: Sep 24, 2018 - Pigs were reported to be infected with hantaviruses in. China. They were also susceptible to experimental infection. The identity of the virus ...Hantavirus in pigs - Google Search google.com/search?q=Hanta
26/05/20 08:30 from TWEETS BY MIKENOV from mikenova (1 sites) Sep 24, 2018 - Pigs were reported to be infected with hantaviruses in. China. They were also susceptible to experimental infection. The identity of the virus ... Hantavirus in pigs - Google Search google.com/search?q=Hanta Posted by mik...
» mikenov on Twitter: Hantavirus infections: Friedrich-Loeffler-Institut fli.de/en/news/animal
26/05/20 08:24 from TWEETS BY MIKENOV from mikenova (1 sites) Hantavirus infections: Friedrich-Loeffler-Institut fli.de/en/news/animal Posted by mikenov on Tuesday, May 26th, 2020 12:24pm mikenov on Twitter
» mikenov on Twitter: rodent infestations at pig farms - Google Search google.com/search?q=roden
26/05/20 08:24 from TWEETS BY MIKENOV from mikenova (1 sites) rodent infestations at pig farms - Google Search google.com/search?q=roden Posted by mikenov on Tuesday, May 26th, 2020 12:24pm mikenov on Twitter | |||||||
| Are the tests for the Viral Hemorrhagic Fevers performed in the hospitals for the differential diagnosis when Covid-19 is suspected? | |||||||
#CDC #NIH #NIAID Are the tests for the Viral Hemorrhagic Fevers performed in the hospitals for the differential diagnosis when Covid-19 is suspected? - Google Search
M.N.: I GUESS, THE ANSWER IS NO!!! WHO WILL GIVE THE DEFINITIVE ANSWER, AND WHEN?! https://www.google.com/search?q=Are+the+tests+for+the+Viral+Hemorrhagic+fevers+performed+in+hospitals+for+differential+diagnosis+when+Covid-19+is+suspected%3F&rlz=1C1CHBF_enUS733US733&oq=Are+the+tests+for+the+Viral+Hemorrhagic+fevers+performed+in+hospitals+for+differential+diagnosis+when+Covid-19+is+suspected%3F&aqs=chrome..69i57.83545j0j7&sourceid=chrome&ie=UTF-8
M.N.: A REMARKABLE LACK OF INFORMATION ON THIS SUBJECT! -
covid-19 sars-cov-2 differential diagnosis with viral hemorrhagic fevers - Google Search https://www.google.com/search?q=covid-19+sars-cov-2+differential+diagnosis+with+viral+hemorrhagic+fevers&newwindow=1&rlz=1C1CHBF_enUS733US733&sxsrf=ALeKk039tOmALZioNPFYOvur361wYz9K0g%3A1590434752754&source=lnms&sa=X&ved=0ahUKEwixm-eT38_pAhVxg-AKHXX2DJcQ_AUIDSgA&biw=1536&bih=722&dpr=1.25
Among the first 126 patients evaluated at the reference Laboratory at INMI, only three were confirmed to be infected with SARS-CoV-2 and none of those three was co-infected with other pathogens (Table). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055037/
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| 5:55 PM 5/25/2020 - Mike Nova's Shared NewsLinks Review: May 15, 2020 - Hemorrhagic fever with renal syndrome (HFRS) is endemic in ... Chinese Center for Disease Control and Prevention, Beijing, China; 2. Institute ...hemorrhagic fever china - Google Search | |||||||
https://covid-19-review.blogspot.com/2020/05/555-pm-5252020-mike-novas-shared.html _____________________________________________________________________ Mike Nova's Shared NewsLinks Review In 250 Brief Posts -
» mikenov on Twitter: Rats as Food in China - People in some parts of China are fond of eating rats. ... The rats that Chinese eat are not regarded as dirty ...Chinese eat rats - Google Search google.com/search?q=Chine
25/05/20 17:01 from TWEETS BY MIKENOV from mikenova (1 sites) Rats as Food in China - People in some parts of China are fond of eating rats. ... The rats that Chinese eat are not regarded as dirty ... Chinese eat rats - Google Search google.com/search?q=Chine Posted by mikenov on Monday, May 25th,...
» mikenov on Twitter: Mar 24, 2020 - A man in China who tested positive for hantavirus died on Monday while traveling to the Chinese province of Shandong for work on a chartered ...Chinese eat rats - Google Search google.com/search?q=Chine
25/05/20 17:00 from TWEETS BY MIKENOV from mikenova (1 sites) Mar 24, 2020 - A man in China who tested positive for hantavirus died on Monday while traveling to the Chinese province of Shandong for work on a chartered ... Chinese eat rats - Google Search google.com/search?q=Chine Posted by mikenov...
» mikenov on Twitter: Cantonese/Nat As the Chinese Year of the Rat approaches, the rodent is ... Even last year many people liked ...Chinese eat rats - Google Search google.com/search?q=Chine
25/05/20 16:59 from TWEETS BY MIKENOV from mikenova (1 sites) Cantonese/Nat As the Chinese Year of the Rat approaches, the rodent is ... Even last year many people liked ... Chinese eat rats - Google Search google.com/search?q=Chine Posted by mikenov on Monday, May 25th, 2020 8:59pm mikenov on Twi...
» mikenov on Twitter: The bamboo rat, the size of a small dog, was traditionally treated as a farm pest until it started gaining ...Chinese eat rats - Google Search google.com/search?q=Chine
25/05/20 16:58 from TWEETS BY MIKENOV from mikenova (1 sites) The bamboo rat, the size of a small dog, was traditionally treated as a farm pest until it started gaining ... Chinese eat rats - Google Search google.com/search?q=Chine Posted by mikenov on Monday, May 25th, 2020 8:58pm mikenov on Twitter
» mikenov on Twitter: Chinese people bred huge wild RATS for their 'nutritious' meat, came up with dozens of ways to cook them ...Chinese eat rats - Google Search google.com/search?q=Chine
25/05/20 16:57 from TWEETS BY MIKENOV from mikenova (1 sites) Chinese people bred huge wild RATS for their 'nutritious' meat, came up with dozens of ways to cook them ... Chinese eat rats - Google Search google.com/search?q=Chine Posted by mikenov on Monday, May 25th, 2020 8:57pm mikenov on Twitter | |||||||
| nosocomial factors in the outbreaks of hemorrhagic fevers - Google Search | |||||||
Search ResultsWeb resultsLessons from nosocomial viral haemorrhagic fever outbreaks ...
<a href="http://academic.oup.com" rel="nofollow">academic.oup.com</a> bmb article Lessons-from-nosoc...
Jan 1, 2005 - Close contact with patients ill with Ebola is the most important risk factor for illness. Other risk factors are infection from contaminated materials such as needles, contact with blood or secretions, preparation of a body for burial or, occasionally, sexual contact.
by SP Fisher-Hoch - 2005 - Cited by 97 - Related articles
Nosocomial Spread of Viral Disease - Clinical Microbiology ...
<a href="http://cmr.asm.org" rel="nofollow">cmr.asm.org</a> content 528.full.pdf
Viral Hemorrhagic Fevers . ... Viruses are important causes of nosocomial infection, but apart from specific ... Factors inffuencing outcome in BMT patients include the type of treat- ... agent of two simultaneous outbreaks of hemorrhagic fever in.
Nosocomial spread of viruses often parallels outbreaks in the community, and the ... Risk factors for severe disease included identification of virus at multiple sites and ... Viral hemorrhagic fevers (VHFs) are a group of severe life-threatening ...
by C Aitken - 2001 - Cited by 160 - Related articles
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| Deutsche Welle: Coronavirus: Experts warn of bioterrorism after pandemic | |||||||
The Council of Europe has warned of a potential increase in the use of biological weapons, like viruses or bacterias, in a post-coronavirus world. Terrorists would not forget "lessons learned" during the pandemic. | |||||||
| Michael Novakhov - SharedNewsLinks: Coronavirus: Experts warn of bioterrorism after pandemic | News | DW | Trump says he's no longer taking hydroxychloroquine | One Doctor Calls The Public Restroom A 'Bio Weapons Factory.' You're In Good Company If You Are Afraid:| Covid-19 and the Viral Infections in Pigs | |||||||
 https://covid-19-review.blogspot.com/2020/05/michael-novakhov-sharednewslinks.html Michael Novakhov - SharedNewsLinks | InBrief | -
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| Coronavirus: Experts warn of bioterrorism after pandemic | News | DW | |||||||
Security experts from the Council of Europe on Monday warned that the global coronavirus outbreak may increase the use of biological weapons by terrorists in the future.
"The COVID-19 pandemic has shown how vulnerable modern society is to viral infections and their reverberations," the council's Committee on Counter-Terrorism said in a statement, reported by the newspapers of Germany's Funke media group. There is no reason to believe that terrorist groups will forget lessons learned from this pandemic, the committee said. "The damage would be quick and potentially global," it added. Read more: Ricin an easy-to-obtain bio-weapon from the internet Greater potential for harm German security agencies have yet to detect any indications that such attacks are in the works, the statement said. However, the deliberate use of disease-causing agents like viruses or bacterias as an act of terrorism "could prove to be extremely effective." Damage to humans and economies could be "significantly higher" than that of a "traditional" terrorist attack. Read more: 'Islamic State' exploiting coronavirus and conflict to rise again European states need coordinated effort The council's security experts called on European states to react with a stronger, coordinated response to this threat. They specifically called for the 47 Council of Europe member states to prepare to fight a biological weapons attack by engaging in training exercises. UN Secretary General Antionio Guterres said in April he sees a growing danger of bioterrorism attacks that aim to create a pandemic similar to that of the coronavirus. The Council of Europe is based in Strasbourg, France. Its aim is to uphold human rights, democracy and the rule of law in Europe.
DW sends out a daily selection of the day's news and features. Sign up here. | |||||||
| Trump says he's no longer taking hydroxychloroquine | |||||||
President Trump said that he is no longer on hydroxychloroquine, the anti-malarial drug he has been taking for several weeks as a treatment to ward off the coronavirus.   | |||||||
| One Doctor Calls The Public Restroom A 'Bio Weapons Factory.' You're In Good Company If You Are Afraid: LAist | |||||||
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By Tovia Smith | NPR While toilet paper has been an issue since the start of the pandemic, now toilets themselves are the concern. As stay-at-home restrictions are lifting, many are feeling a long pent-up urge to go out; what's stopping them is concern about their urge to go while they're out. As in, use the bathroom. Loath to risk the germs in a public restroom, if they can even find one that's open, many are limiting their outings while others are getting creative. Shu Santani, a pediatric cardiologist in Vancouver, never used to think twice before going for his usual two- to three-hour run. Now, everytime he heads out, he becomes kind of obsessed. "It's the anticipation of, 'What if I have to go to the bathroom?' " he said, mocking his usual panic. "Do I have to go to the bathroom? Uh oh, now I'm thinking about going to the bathroom, and now I feel like I have to go to the bathroom." Recently, his worst fears came to be. He really did have to go. His route took him by countless businesses that were closed, before he finally found a car mechanic's shop that was open. But they wouldn't let him in. "The panic grows as the third and fourth options exhaust themselves," he said. He was considering just going outside, then thought better of it. "I can't imagine it would be popular if someone saw me leaving my presumed viral sheddings somewhere in their petunias," he said with a laugh. So he changed his route and finally found a hospital that did let him in. 'DISGUSTINGLY MISERABLE' It was a relief to Santani. But for many people, the prospect of using a public restroom is hardly comforting. Among those who cringe at the idea is Cheryl Bowlan, 69, who is moving from California to Portland, Oregon, and will be driving the 12 hours with her husband. With all the planning and packing, she only recently realized she would have to use the public rest stops along the freeway. It left her just a little panicked. "I woke up early one morning and all of a sudden, ding, it occurred to me. Ick! Nasty!!" she recalled. "There are hundreds of people going through there every day, and I didn't want to do that." Experts say such fears are well founded. "It's miserable. Disgustingly miserable," said Dr. Greg Poland, professor of medicine and infectious diseases at the Mayo Clinic in Rochester, Minnesota. Just the fact that bathrooms tend to be highly trafficked and too cramped for social distancing makes them risky, he said. But on top of that, poor hand washing leaves door knobs, faucets and other surfaces contaminated. And flushing the toilet can create a plume of vaporized germs up to six feet high, he said. While it's not yet proven the coronavirus can spread that way, it is known that other viruses can. "It really is a nightmare," said Poland. With all that going on, he said, "you have a bio weapons factory in [there.]" 'SOCIAL PISS-TANCING' Some businesses are trying to adapt, by installing touch-free doors, faucets and hand dryers, for example. Or they're switching to touch-free paper towel dispensers to avoid the possibility of hand dryers blowing coronavirus through the air another potential, though not yet proven, risk. Businesses are also cleaning and disinfecting more frequently and requiring face masks to enter. Some are even hiring bathroom monitors to control crowds and enforce distancing. Steven Soifer, president of the American Restroom Association, which advocates for clean and safe public bathrooms, said many businesses are also installing dividers between urinals or closing down every other one. "There's a new term out there," he said. "It's called 'social piss-tancing.'" Soifer hopes the heightened awareness brought by COVID-19 will prompt what he sees as a long overdue overhaul of public restrooms. "We're advocating for more revolutionary toilet design with the single stall, fully enclosed water closets with toilet seats covers" that are typical in Europe, he said. "That would address many of the issues." But that would take more money than many businesses would want to invest, and more time than many people can wait, including Cheryl Bowlan. "It suddenly popped into my mind that I'll just do it in the car," she said. Bowlan is one of a growing number of women who have bought a portable urinal called the "Feminal." It's an ergonomically correct canister with a screw cap, designed by urology nurse Linda Asta. Once a niche product for outdoorsy types or bedridden patients, it's now a mass-market, high-demand item. "All of a sudden sales have actually quadrupled in a month and a half," Asta said. PORTABLE POTTIES There are also a slew of other urinals and portable potties for men and women on the market too, as well as feminine funnels, including the Go Girl and the She Wee. Adyn Sonju, a partner at The Tinkle Belle, said her product allows women to "go wherever the men go" and has what she described as a built-in squeegee feature that eliminates the need for toilet paper. "It's freeing to be able to go anywhere and know that you can just go when you need to go," Sonju said. "You just carry it with you like a portable restroom." The Sani-Girl is a disposable option with year-over-year sales that are on track to triple this spring, according to founder Susan Thompson. She thinks the product will not only "change women's lives as they venture back out and start to get their lives back," but may well change bathroom behavior forever, given the public's newly heightened awareness of germs and the "shock" of the pandemic. She adds that some customers even use it in public restrooms so they don't have to sit or touch as many surfaces. The portable products do carry their own risks if you don't hold them in place just right, so most manufacturers recommend practicing at home. You don't want your first try to be on the road, or after a few drinks during a night out. But after a few (hopefully) dry runs at home, they say going on-the-go will be the safer way to go.
Copyright 2020 NPR. To see more, visit <a href="https://www.npr.org" rel="nofollow">https://www.npr.org</a>.
9(MDA1OTI3MjQ5MDEyODUwMTE2MzM1YzNmZA004)) | |||||||
| Michael Novakhov - SharedNewsLinks: 6:44 AM 5/24/2020 - 5:24 PM 5/18/2020 - Covid-19 and the Viral Infections in Pigs | |||||||
 https://covid-19-review.blogspot.com/2020/05/michael-novakhov-sharednewslinks-644-am.html _____________________________________________________________________ Michael Novakhov - SharedNewsLinks | InBrief | - | |||||||
| 6:44 AM 5/24/2020 » Thailand Begins Coronavirus Vaccine Trials on Monkeys 24/05/20 01:12 from Google Alert - coronavirus vaccine | |||||||
 https://covid-19-review.blogspot.com/2020/05/644-am-5242020-thailand-begins.html________________________________________________________________ CoronaVirus News Review In Brief _________________________________________________________________
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