James Le Duc | University of Texas, Medical Branch at Galveston (original) (raw)

Papers by James Le Duc

Research paper thumbnail of Personal Protective Equipment for Filovirus Epidemics: A Call for Better Evidence

The Journal of Infectious Diseases, Mar 27, 2015

Personal protective equipment (PPE) is an important part of worker protection during filovirus ou... more Personal protective equipment (PPE) is an important part of worker protection during filovirus outbreaks. The need to protect against a highly virulent fluid-borne pathogen in the tropical environment imposes a heat stress on the wearer that is itself a safety risk. No evidence supports the choice of PPE employed in recent outbreaks, and standard testing procedures employed by the protective garment industry do not well simulate filovirus exposure. Further research is needed to determine the appropriate PPE for filoviruses and the heat stress that it imposes.

Research paper thumbnail of Biocontainment Laboratories: A Critical Component of the US Bioeconomy in Need of Attention

Health security, Feb 1, 2020

Research paper thumbnail of Chronicles of Hantaviruses: Foundations of Epidemiology and Ecology

Research paper thumbnail of Isolation of the Nephropathia Epidemica Agent in Sweden

The Lancet, May 1, 1984

Titration of monoclonal anti-STh by ELISA. STh was purified*" by reverse-phase high-performance l... more Titration of monoclonal anti-STh by ELISA. STh was purified*" by reverse-phase high-performance liquid chromatography and polymerised by glutaraldehyde. Female

Research paper thumbnail of Bioterrorism and Microbial Forensics

CRC Press eBooks, Feb 24, 2023

Research paper thumbnail of A Quarter Century of Emerging Infectious Diseases – Where Have We Been and Where Are We Going?

Acta Medica Academica, Jun 25, 2018

Research paper thumbnail of Genetically Engineered Transmissible Influenza A/H5N1: A Call for Laboratory Safety and Security

Biosecurity and Bioterrorism-biodefense Strategy Practice and Science, Mar 1, 2012

The current discussions surrounding 2 independent studies that succeeded in identifying the genet... more The current discussions surrounding 2 independent studies that succeeded in identifying the genetic changes needed for the influenza A/H5N1 virus to be efficiently transmitted between ferrets, a surrogate for humanto-human transmission, highlight significant challenges and raise fundamental questions about research that both benefits humankind but also has the potential for nefarious applications. Both studies were funded by the National Institute of Allergy and Infectious Diseases, with one conducted at the University of Wisconsin–Madison and the other done at Erasmus Medical Center in Rotterdam, the Netherlands. Some preliminary results were shared with the influenza community previously; however, it was only when the lead investigators of these studies attempted to publish their findings in the scientific literature that serious concern surfaced. The National Science Advisory Board for Biosecurity (NSABB), a formal group established to advise the Department of Health and Human Services and other federal agencies on biosecurity issues, reviewed the studies and recommended that the detailed procedures used in their conduct be excluded from the final publications. It suggested that some process be developed that would allow only those professionals with a bona fide need to know to be granted access to the detailed protocols used. Such a response by peers is virtually unheard of in public health and indeed goes against the openness and transparency upon which scientific progress has traditionally been made. It further raises uncomfortable questions about how such a strategy would be implemented both nationally and internationally, and with whom will the censorship authority be vested to decide what is and is not safe to publish. These discussions are far from over. The importance of laboratory biosafety and biosecurity preparation and training within the many newly constructed biocontainment laboratories around the world has been relegated to fine print in public discussions, which are currently dominated by research and publication oversight issues. It is in these labs where investigators may rightfully expect to build upon these intriguing findings by either replicating the experiments or obtaining the adapted viruses to further relevant investigations of their own design. Both teams conducting the original experiments used biological safety level 3 (BSL-3) facilities enhanced with additional safety precautions to reduce the risk of aerosol transmission. A debate is currently under way as to whether this level of containment is adequate given the approximately 60% mortality rate seen among infected humans since 2003 when the current sustained transmission of H5N1 avian influenza began. A strain of influenza that was efficiently transmitted among humans while causing this level of mortality would result in a global catastrophe unlike anything in recorded history. Given the rapidity with which the novel strain of influenza A/H1N1 virus spread in 2009, it is

Research paper thumbnail of Ecology of California Encephalitis Viruses on the Del Mar Va Peninsula

American Journal of Tropical Medicine and Hygiene, 1975

Public reporting burden for the collection of information is estimated to average 1 hour per resp... more Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

Research paper thumbnail of Multinational Outbreak Investigations

Oxford University Press eBooks, Jan 17, 2019

Multinational collaborations on international outbreak investigations and response have a long hi... more Multinational collaborations on international outbreak investigations and response have a long history. Development of the World Health Organization (WHO) in 1948 was closely linked to efforts by the global community to prevent, detect, and respond to outbreaks of international concern. Through the International Health Regulations (IHR) of 2005, a legally binding instrument requiring countries to report certain outbreaks and public health events, WHO outlined a strategy for disease threat response. Efforts by global partners to strengthen cooperation have evolved over the years, including roles and responsibilities of WHO, its Member States, and other partners. Among the challenges faced by Member State and WHO in implementing the IHRs are limited funding to support staffing and operational support as well as sometimes conflicting multijurisdictional decision-making. The response to recent outbreaks provides evidence that much work remains to be done to strengthen IHR mechanisms.

Research paper thumbnail of Network for safe and secure labs

Research paper thumbnail of Serological evidence of Hantaan-related viruses in Hong Kong

Transactions of The Royal Society of Tropical Medicine and Hygiene, 1987

Sera from rats (Rattus norvegicus), domestic animals and man in Hong Kong were studied by immunof... more Sera from rats (Rattus norvegicus), domestic animals and man in Hong Kong were studied by immunofluorescent antibody assay and plaque reduction neutralization tests for evidence of infection by Hantaan-related viruses. Antibody probably arising from infection by Seoul or a Seoul-like virus was detected in rat and human sera (and one pig serum), highlighting the potential public health importance of this group of viruses in Hong Kong, and in the region.

Research paper thumbnail of Clinical and epidemiological aspects of hemorrhagic fever with renal syndrome (HFRS) in Greece

European Journal of Epidemiology, Sep 1, 1987

Research paper thumbnail of Bunyaviruses: Hantavirus and Others

Springer eBooks, 2014

The Bunyaviridae family is the largest family of RNA viruses with more than 350 named isolates. V... more The Bunyaviridae family is the largest family of RNA viruses with more than 350 named isolates. Viruses in the family are divided into five genera (Orthobunyavirus, Phlebovirus, Nairovirus, Hantavirus, and Tospovirus) on the basis of serological, molecular, antigenic, and structural characteristics. The Bunyaviridae are a unique group of viruses whose members are able to infect invertebrates, vertebrates, and plants, and they can be found worldwide. Multiple members are significant pathogens with the ability to cause severe disease in humans, such as encephalitis, hepatitis, or hemorrhagic fever. Most bunyaviruses are spread through sylvatic transmission cycles between susceptible vertebrate hosts and hematophagous arthropods, including ticks, mosquitoes, and phlebotomine flies. Unique are the members of the Hantavirus genus, in that they are not infecting insect vectors but are maintained in nature through persistent infection of rodents. Human and animal pathogenic bunyaviruses can be found in four of the five genera, with tospoviruses being plant pathogens. The large family of bunyaviruses is a pool not only for many emerging and reemerging viruses, such as Rift Valley fever virus, Crimean-Congo hemorrhagic fever virus, and the hantaviruses, but also for recently emerged pathogens, such as the newly identified severe fever with thrombocytopenia syndrome and Heartland, Shuni, and Schmallenberg viruses. This chapter will discuss the most important human pathogens of the Orthobunyavirus, Phlebovirus, Nairovirus, and Hantavirus genera.

Research paper thumbnail of Bunyaviridae

Oxford University Press eBooks, Mar 1, 2020

Viruses of the family Bunyaviridae are the largest family of RNA viruses with more than 350 named... more Viruses of the family Bunyaviridae are the largest family of RNA viruses with more than 350 named isolated. They contain a three-segmented, single-stranded, negative-sense RNA genome. They are divided into five genera, of which four are known to include human pathogens—Orthobunyavirus, Phlebovirus, Hantavirus, and Nairovirus. These viruses are found throughout the world and are transmitted between vertebrate hosts and to humans through the bite of infected arthropod vectors (mosquitoes, ticks, others), or from infectious excreta of rodents and other small mammals, and rarely person to person. Many are transmitted from infected arthropod vector females to the next generation by transovarial transmission, thereby surviving adverse environmental conditions and leading to marked seasonal distribution of disease. There are few vaccines or drugs available to protect against infection. Prevention is by avoidance of exposure to potentially infected arthropod and small mammal vectors.

Research paper thumbnail of Technology Advances, High-Risk Research, and a Safe Way Forward

MBio, Oct 26, 2021

The human and economic toll of the coronavirus disease 2019 (COVID-19) pandemic and the unknowns ... more The human and economic toll of the coronavirus disease 2019 (COVID-19) pandemic and the unknowns regarding the origins of the virus, with a backdrop of enormous advances in technologies and human understanding of molecular virology, have raised global concerns about the safety of the legitimate infectious disease research enterprise. We acknowledge the safety and security risks resulting from the broad availability of tools and knowledge, tools and knowledge that can be exploited equally for good or harm. The last 2 decades have shown us that the risks are real. They have also shown us that more traditional top-down regulations alone are not the answer. We encourage government to be thoughtful and nuanced in dealing with this significant challenge and to carefully consider human factors and the important role of organizational-level leadership before simply layering an additional bureaucratic burden on the enterprise without understanding value and cost. KEYWORDS advanced technologies, high-risk research, leadership, nuanced regulation U ncertainties still surround the origins of the coronavirus disease 2019 (COVID-19

Research paper thumbnail of The Power of We

Viruses, Apr 5, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Wild, Laboratory, and Pet Rats-Induced Seoul Hantavirus Disease Worldwide

Recent Progress in Microbiology and Biotechnology Vol. 6, 2021

Rat-borne Seoul hantaviruses are only just being recognized globally as important human pathogens... more Rat-borne Seoul hantaviruses are only just being recognized globally as important human pathogens, even though they have been studied and isolated on 4 different continents (Asia, Europe, the Americas, and Africa) since the early 1980s. Recent reports from Europe and the USA described Seoul hantavirus infection in pet rats and their breeders or owners, suggesting the potential emergence of a "new" public health problem. Wild and laboratory rat-induced Seoul hantavirus infections have, however, been described since the early eighties, due to the omnipresence of the rodent reservoir, the brown rat <em>Rattus norvegicus</em>. Recent studies showed no fundamental differences between pathogenicity and phylogeny of pet rat-Seoul hantaviruses and their formerly described wild or laboratory rat counterparts. The paucity of diagnosed Seoul virus-induced disease in the West is in striking contrast to the thousands of cases recorded since the 1980s in the Far-East, particularly in China. This review of four continents (Asia, Europe, America, and Africa) puts this "emerging infection" in historic perspective, concluding there is an urgent need for greater medical awareness of Seoul virus-induced human pathology in many parts of the world. Given the mostly milder and atypical clinical presentation, sometimes with preserved normal kidney function, the importance of simple urine examination is stressed, since initial, massive but transient proteinuria and microhematuria are rarely lacking. With increasingly sophisticated technology and enhanced clinical awareness, many specific hantaviruses are now recognized; however, SEOV remains the globally most widely distributed hantavirus.

Research paper thumbnail of Functioning of the International Health Regulations during the COVID-19 pandemic

Research paper thumbnail of Bioterrorism and Forensic Microbiology

An Interdisciplinary Perspective, 2014

Research paper thumbnail of Transmission of Ebola Viruses: What We Know and What We Do Not Know

mBio, 2015

Available evidence demonstrates that direct patient contact and contact with infectious body flui... more Available evidence demonstrates that direct patient contact and contact with infectious body fluids are the primary modes for Ebola virus transmission, but this is based on a limited number of studies. Key areas requiring further study include (i) the role of aerosol transmission (either via large droplets or small particles in the vicinity of source patients), (ii) the role of environmental contamination and fomite transmission, (iii) the degree to which minimally or mildly ill persons transmit infection, (iv) how long clinically relevant infectiousness persists, (v) the role that “superspreading events” may play in driving transmission dynamics, (vi) whether strain differences or repeated serial passage in outbreak settings can impact virus transmission, and (vii) what role sylvatic or domestic animals could play in outbreak propagation, particularly during major epidemics such as the 2013–2015 West Africa situation. In this review, we address what we know and what we do not know ...

Research paper thumbnail of Personal Protective Equipment for Filovirus Epidemics: A Call for Better Evidence

The Journal of Infectious Diseases, Mar 27, 2015

Personal protective equipment (PPE) is an important part of worker protection during filovirus ou... more Personal protective equipment (PPE) is an important part of worker protection during filovirus outbreaks. The need to protect against a highly virulent fluid-borne pathogen in the tropical environment imposes a heat stress on the wearer that is itself a safety risk. No evidence supports the choice of PPE employed in recent outbreaks, and standard testing procedures employed by the protective garment industry do not well simulate filovirus exposure. Further research is needed to determine the appropriate PPE for filoviruses and the heat stress that it imposes.

Research paper thumbnail of Biocontainment Laboratories: A Critical Component of the US Bioeconomy in Need of Attention

Health security, Feb 1, 2020

Research paper thumbnail of Chronicles of Hantaviruses: Foundations of Epidemiology and Ecology

Research paper thumbnail of Isolation of the Nephropathia Epidemica Agent in Sweden

The Lancet, May 1, 1984

Titration of monoclonal anti-STh by ELISA. STh was purified*" by reverse-phase high-performance l... more Titration of monoclonal anti-STh by ELISA. STh was purified*" by reverse-phase high-performance liquid chromatography and polymerised by glutaraldehyde. Female

Research paper thumbnail of Bioterrorism and Microbial Forensics

CRC Press eBooks, Feb 24, 2023

Research paper thumbnail of A Quarter Century of Emerging Infectious Diseases – Where Have We Been and Where Are We Going?

Acta Medica Academica, Jun 25, 2018

Research paper thumbnail of Genetically Engineered Transmissible Influenza A/H5N1: A Call for Laboratory Safety and Security

Biosecurity and Bioterrorism-biodefense Strategy Practice and Science, Mar 1, 2012

The current discussions surrounding 2 independent studies that succeeded in identifying the genet... more The current discussions surrounding 2 independent studies that succeeded in identifying the genetic changes needed for the influenza A/H5N1 virus to be efficiently transmitted between ferrets, a surrogate for humanto-human transmission, highlight significant challenges and raise fundamental questions about research that both benefits humankind but also has the potential for nefarious applications. Both studies were funded by the National Institute of Allergy and Infectious Diseases, with one conducted at the University of Wisconsin–Madison and the other done at Erasmus Medical Center in Rotterdam, the Netherlands. Some preliminary results were shared with the influenza community previously; however, it was only when the lead investigators of these studies attempted to publish their findings in the scientific literature that serious concern surfaced. The National Science Advisory Board for Biosecurity (NSABB), a formal group established to advise the Department of Health and Human Services and other federal agencies on biosecurity issues, reviewed the studies and recommended that the detailed procedures used in their conduct be excluded from the final publications. It suggested that some process be developed that would allow only those professionals with a bona fide need to know to be granted access to the detailed protocols used. Such a response by peers is virtually unheard of in public health and indeed goes against the openness and transparency upon which scientific progress has traditionally been made. It further raises uncomfortable questions about how such a strategy would be implemented both nationally and internationally, and with whom will the censorship authority be vested to decide what is and is not safe to publish. These discussions are far from over. The importance of laboratory biosafety and biosecurity preparation and training within the many newly constructed biocontainment laboratories around the world has been relegated to fine print in public discussions, which are currently dominated by research and publication oversight issues. It is in these labs where investigators may rightfully expect to build upon these intriguing findings by either replicating the experiments or obtaining the adapted viruses to further relevant investigations of their own design. Both teams conducting the original experiments used biological safety level 3 (BSL-3) facilities enhanced with additional safety precautions to reduce the risk of aerosol transmission. A debate is currently under way as to whether this level of containment is adequate given the approximately 60% mortality rate seen among infected humans since 2003 when the current sustained transmission of H5N1 avian influenza began. A strain of influenza that was efficiently transmitted among humans while causing this level of mortality would result in a global catastrophe unlike anything in recorded history. Given the rapidity with which the novel strain of influenza A/H1N1 virus spread in 2009, it is

Research paper thumbnail of Ecology of California Encephalitis Viruses on the Del Mar Va Peninsula

American Journal of Tropical Medicine and Hygiene, 1975

Public reporting burden for the collection of information is estimated to average 1 hour per resp... more Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

Research paper thumbnail of Multinational Outbreak Investigations

Oxford University Press eBooks, Jan 17, 2019

Multinational collaborations on international outbreak investigations and response have a long hi... more Multinational collaborations on international outbreak investigations and response have a long history. Development of the World Health Organization (WHO) in 1948 was closely linked to efforts by the global community to prevent, detect, and respond to outbreaks of international concern. Through the International Health Regulations (IHR) of 2005, a legally binding instrument requiring countries to report certain outbreaks and public health events, WHO outlined a strategy for disease threat response. Efforts by global partners to strengthen cooperation have evolved over the years, including roles and responsibilities of WHO, its Member States, and other partners. Among the challenges faced by Member State and WHO in implementing the IHRs are limited funding to support staffing and operational support as well as sometimes conflicting multijurisdictional decision-making. The response to recent outbreaks provides evidence that much work remains to be done to strengthen IHR mechanisms.

Research paper thumbnail of Network for safe and secure labs

Research paper thumbnail of Serological evidence of Hantaan-related viruses in Hong Kong

Transactions of The Royal Society of Tropical Medicine and Hygiene, 1987

Sera from rats (Rattus norvegicus), domestic animals and man in Hong Kong were studied by immunof... more Sera from rats (Rattus norvegicus), domestic animals and man in Hong Kong were studied by immunofluorescent antibody assay and plaque reduction neutralization tests for evidence of infection by Hantaan-related viruses. Antibody probably arising from infection by Seoul or a Seoul-like virus was detected in rat and human sera (and one pig serum), highlighting the potential public health importance of this group of viruses in Hong Kong, and in the region.

Research paper thumbnail of Clinical and epidemiological aspects of hemorrhagic fever with renal syndrome (HFRS) in Greece

European Journal of Epidemiology, Sep 1, 1987

Research paper thumbnail of Bunyaviruses: Hantavirus and Others

Springer eBooks, 2014

The Bunyaviridae family is the largest family of RNA viruses with more than 350 named isolates. V... more The Bunyaviridae family is the largest family of RNA viruses with more than 350 named isolates. Viruses in the family are divided into five genera (Orthobunyavirus, Phlebovirus, Nairovirus, Hantavirus, and Tospovirus) on the basis of serological, molecular, antigenic, and structural characteristics. The Bunyaviridae are a unique group of viruses whose members are able to infect invertebrates, vertebrates, and plants, and they can be found worldwide. Multiple members are significant pathogens with the ability to cause severe disease in humans, such as encephalitis, hepatitis, or hemorrhagic fever. Most bunyaviruses are spread through sylvatic transmission cycles between susceptible vertebrate hosts and hematophagous arthropods, including ticks, mosquitoes, and phlebotomine flies. Unique are the members of the Hantavirus genus, in that they are not infecting insect vectors but are maintained in nature through persistent infection of rodents. Human and animal pathogenic bunyaviruses can be found in four of the five genera, with tospoviruses being plant pathogens. The large family of bunyaviruses is a pool not only for many emerging and reemerging viruses, such as Rift Valley fever virus, Crimean-Congo hemorrhagic fever virus, and the hantaviruses, but also for recently emerged pathogens, such as the newly identified severe fever with thrombocytopenia syndrome and Heartland, Shuni, and Schmallenberg viruses. This chapter will discuss the most important human pathogens of the Orthobunyavirus, Phlebovirus, Nairovirus, and Hantavirus genera.

Research paper thumbnail of Bunyaviridae

Oxford University Press eBooks, Mar 1, 2020

Viruses of the family Bunyaviridae are the largest family of RNA viruses with more than 350 named... more Viruses of the family Bunyaviridae are the largest family of RNA viruses with more than 350 named isolated. They contain a three-segmented, single-stranded, negative-sense RNA genome. They are divided into five genera, of which four are known to include human pathogens—Orthobunyavirus, Phlebovirus, Hantavirus, and Nairovirus. These viruses are found throughout the world and are transmitted between vertebrate hosts and to humans through the bite of infected arthropod vectors (mosquitoes, ticks, others), or from infectious excreta of rodents and other small mammals, and rarely person to person. Many are transmitted from infected arthropod vector females to the next generation by transovarial transmission, thereby surviving adverse environmental conditions and leading to marked seasonal distribution of disease. There are few vaccines or drugs available to protect against infection. Prevention is by avoidance of exposure to potentially infected arthropod and small mammal vectors.

Research paper thumbnail of Technology Advances, High-Risk Research, and a Safe Way Forward

MBio, Oct 26, 2021

The human and economic toll of the coronavirus disease 2019 (COVID-19) pandemic and the unknowns ... more The human and economic toll of the coronavirus disease 2019 (COVID-19) pandemic and the unknowns regarding the origins of the virus, with a backdrop of enormous advances in technologies and human understanding of molecular virology, have raised global concerns about the safety of the legitimate infectious disease research enterprise. We acknowledge the safety and security risks resulting from the broad availability of tools and knowledge, tools and knowledge that can be exploited equally for good or harm. The last 2 decades have shown us that the risks are real. They have also shown us that more traditional top-down regulations alone are not the answer. We encourage government to be thoughtful and nuanced in dealing with this significant challenge and to carefully consider human factors and the important role of organizational-level leadership before simply layering an additional bureaucratic burden on the enterprise without understanding value and cost. KEYWORDS advanced technologies, high-risk research, leadership, nuanced regulation U ncertainties still surround the origins of the coronavirus disease 2019 (COVID-19

Research paper thumbnail of The Power of We

Viruses, Apr 5, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Wild, Laboratory, and Pet Rats-Induced Seoul Hantavirus Disease Worldwide

Recent Progress in Microbiology and Biotechnology Vol. 6, 2021

Rat-borne Seoul hantaviruses are only just being recognized globally as important human pathogens... more Rat-borne Seoul hantaviruses are only just being recognized globally as important human pathogens, even though they have been studied and isolated on 4 different continents (Asia, Europe, the Americas, and Africa) since the early 1980s. Recent reports from Europe and the USA described Seoul hantavirus infection in pet rats and their breeders or owners, suggesting the potential emergence of a "new" public health problem. Wild and laboratory rat-induced Seoul hantavirus infections have, however, been described since the early eighties, due to the omnipresence of the rodent reservoir, the brown rat <em>Rattus norvegicus</em>. Recent studies showed no fundamental differences between pathogenicity and phylogeny of pet rat-Seoul hantaviruses and their formerly described wild or laboratory rat counterparts. The paucity of diagnosed Seoul virus-induced disease in the West is in striking contrast to the thousands of cases recorded since the 1980s in the Far-East, particularly in China. This review of four continents (Asia, Europe, America, and Africa) puts this "emerging infection" in historic perspective, concluding there is an urgent need for greater medical awareness of Seoul virus-induced human pathology in many parts of the world. Given the mostly milder and atypical clinical presentation, sometimes with preserved normal kidney function, the importance of simple urine examination is stressed, since initial, massive but transient proteinuria and microhematuria are rarely lacking. With increasingly sophisticated technology and enhanced clinical awareness, many specific hantaviruses are now recognized; however, SEOV remains the globally most widely distributed hantavirus.

Research paper thumbnail of Functioning of the International Health Regulations during the COVID-19 pandemic

Research paper thumbnail of Bioterrorism and Forensic Microbiology

An Interdisciplinary Perspective, 2014

Research paper thumbnail of Transmission of Ebola Viruses: What We Know and What We Do Not Know

mBio, 2015

Available evidence demonstrates that direct patient contact and contact with infectious body flui... more Available evidence demonstrates that direct patient contact and contact with infectious body fluids are the primary modes for Ebola virus transmission, but this is based on a limited number of studies. Key areas requiring further study include (i) the role of aerosol transmission (either via large droplets or small particles in the vicinity of source patients), (ii) the role of environmental contamination and fomite transmission, (iii) the degree to which minimally or mildly ill persons transmit infection, (iv) how long clinically relevant infectiousness persists, (v) the role that “superspreading events” may play in driving transmission dynamics, (vi) whether strain differences or repeated serial passage in outbreak settings can impact virus transmission, and (vii) what role sylvatic or domestic animals could play in outbreak propagation, particularly during major epidemics such as the 2013–2015 West Africa situation. In this review, we address what we know and what we do not know ...